Thinking About Ob/Gyn

Antonia Roberts and Howard Herrell
  • 4.6 (43)
  • MEDICINE
  • UPDATED BIWEEKLY

A fresh and evidence-based perspective of all things related to obstetrics and gynecology. Follow us on Instagram @thinkingaboutobgyn or visit thinkingaboutobgyn.com for show notes and more. 

  1. DEC 11

    Episode 10.12 The V-Word

    We trace the arc from variolation and Jenner to mRNA, show how vaccines leverage natural immunity, and explain why maternal shots protect both parent and newborn. Data, history, and personal stories make the case that prevention beats cure for OBGYN care. • pertussis surge in Kentucky and preventable infant deaths • child mortality then and now and what changed • variolation to Jenner and the origins of vaccination • how innate and adaptive immunity learn and remember • vaccine types and why today’s antigens are fewer • effectiveness data across polio, measles, rubella, Hib • sanitation myths versus vaccine impact • Wakefield’s fraud and why autism claims fail • three major studies debunking autism myths • essential pregnancy vaccines and timing • RSV options and COVID safety during pregnancy • herd immunity as protection for newborns 0:02 Setting The Stage: Vaccines Under Fire 1:09 Pertussis Surge And Preventable Tragedy 2:20 Child Mortality Then And Now 4:19 What Killed Children In 1850 5:31 Out Of Sight, Out Of Mind 9:51 Origins Of Vaccination: Variolation To Jenner 15:20 Vaccines Use Natural Immunity 20:00 Types Of Modern Vaccines Explained 25:30 Innate And Adaptive Immunity 101 28:40 How Effective Are Vaccines Really 33:40 Polio’s Human Cost And Iron Lungs 39:00 Measles, Rubella, And Pregnancy Risks 44:20 Sanitation Myths Versus Vaccine Impact 47:05 The Wakefield Fraud And Aftermath 52:20 Big Studies Debunk Autism Claims 55:20 Essential Vaccines In Pregnancy 58:00 Takeaways And Next Steps Be sure to check out thinkingaboutobgyn.com for more information and be sure to follow us on Instagram Follow us on Instagram @thinkingaboutobgyn.

    1 hr

  2. NOV 27

    Episode 10.11 Smarter Cancer Screening, Safer Obstetrics

    We share a practical, clinic‑tested system for hereditary cancer screening that standardizes intake and education, then confront how malpractice pressures distort obstetric decision‑making, fetal monitoring, and access to care. Former ACOG president Dr. Richard Waldman offers data, history, and solutions we can use now. • digital workflow that screens every patient annually from age 18  • video education improving informed consent and test completion  • one in four patients meeting hereditary testing criteria  • management changes after testing including MRI, meds, referrals  • addressing cost and genetic discrimination concerns  • OBGYNs as leaders in genetics amid counselor shortages  • malpractice landscape, rising verdicts, and physician burnout  • neonatal encephalopathy criteria grounding courtroom science  • fetal monitoring limits, category II overreaction, cesarean pressure  • VBAC safety tied to selection, readiness, and team systems  • safety culture, simulation, and checklists reducing risk Be sure to check out thinkingaboutobgyn.com for more information and be sure to follow us on Instagram Follow us on Instagram @thinkingaboutobgyn.

    57 min

  3. NOV 13

    Episode 10.10 Habits That Help Doctors Thrive

    Antonia and special guest Kristi Angevine explore how physicians can rethink habits beyond routines to include default thoughts, feelings, and reactions, and how that shift relieves burnout and restores purpose. Practical micro-habits, internal validation, and redefining productivity help us lead better and live better. • habits as automatic thoughts, feelings, reactions • perfectionism, people pleasing, catastrophizing as learned solutions • survival seasons and low‑friction wins • two micro‑habits: emotional check‑ins and box breathing • escaping all‑or‑nothing with iterative learning • redefining productivity around alignment, not to‑do lists • internal validation and making yourself make sense • training culture, criticism, and choosing supportive mentors • identity beyond “doctor first” to include rest and health • coaching options: group community and private work Be sure to check out Thinking about obgyn.com for more information, and be sure to follow us on Instagram 0:01 Setting The Stage: Habits In Medicine 0:32 Introducing Dr. Kristi Angevine 2:05 Redefining What A Habit Really Is 4:20 Perfectionism, People Pleasing, Catastrophizing 7:12 Coping Gone Sideways And Burnout Risk 11:21 Unrealistic Standards And The Inner Critic 15:54 When Work Ethic Becomes Self-Neglect 19:30 Why Simple Routines Aren’t Easy 23:12 Survival Seasons And Low-Hanging Fruit 26:12 Two Five-Minute Habits That Stick 30:45 Escaping All-Or-Nothing Thinking 36:05 Internal Validation As A Mental Habit 41:05 Success Beyond The To-Do List 48:39 Burnout’s Roots And Moral Injury 52:42 Training Culture, Criticism, And Resilience Follow us on Instagram @thinkingaboutobgyn.

    1 hr

  4. OCT 30

    Episode 10:9 Fibroids, Facts, False Beliefs, and More!

    We challenge long-held beliefs about fibroids, highlight new ectopic pregnancy nuances, and dig into real-world dermoid cyst outcomes. We also unpack the evidence and ethics of 39-week induction after IVF and ICSI, balancing small absolute risks with maternal tradeoffs. • Evidence overturning links between fibroids and miscarriage, PROM and abruption • Distinguishing spontaneous versus iatrogenic preterm birth in fibroid pregnancies • Why myomectomy can raise early delivery and cesarean rates in some patients • Ectopic care updates: tube-sparing choices, HCG thresholds, two-dose methotrexate • Experimental adjuncts to methotrexate remain unproven • Dermoid data supporting laparoscopy, irrigation, and specimen bags over open surgery • Surgical decision making during pregnancy and avoiding uterine manipulators • IVF and ICSI timing: late stillbirth risk signals, limits of testing, 39-week logic • Shared decision making when absolute risks are low but values differ Be sure to check out thinkingaboutobgyn.com for more information and be sure to follow us on Instagram 1:33 Fibroids And Miscarriage Myths 5:53 Preterm Birth, PROM, And Hemorrhage 9:31 Myomectomy: Risks, Scars, And Outcomes 13:25 Ectopic Pregnancy: What’s New 18:37 Surgery Versus Methotrexate Nuances 22:05 Experimental Add-Ons To Medical Therapy 27:47 Dermoid Cysts: Real-World Data 32:48 Laparoscopy, Spillage, And Pregnancy 36:06 When Open Surgery Makes Things Worse 40:34 IVF, ICSI, And 39-Week Induction 48:05 Stillbirth Risk: What The Data Shows 55:20 Testing, Timing, And Shared Decisions 1:04:10 Practical Counseling And Tradeoffs Follow us on Instagram @thinkingaboutobgyn.

    1h 7m

  5. OCT 16

    Episode 10.8 Speed in Surgery (+Circs & Autism)

    In this episode, Howard and Maddie White challenge shaky claims linking autism to circumcision and Tylenol, then zero in on speed as the byproduct of essential, evidence-based surgery. We show how essentialism, confidence, and efficiency reduce complications, lower costs, and improve outcomes in the OR. • correlation vs causation in autism narratives and bias in research • why operative time predicts complications across procedures • surgeon volume, variability, and outcome differences • evidence-based cesarean steps that cut time and bleeding • tool and method choices that are safer and faster • confidence as self-efficacy, not arrogance • practical efficiency: setup, flow, visualization, debrief • lean thinking, standardization, and reducing variation Be sure to check out thinkingaboutobgyn.com for more information and be sure to follow us on Instagram 00:00:00 Opening Banter & Autism Claims 00:02:35 Circumcision, Bias, and Correlation vs Causation 00:09:54 Why Speed in Surgery Matters 00:15:35 Surgeon Variability and Outcomes 00:19:35 Evidence-Based Cesarean: Essential Steps 00:27:20 Less Bleeding Through Minimal Dissection 00:31:20 Choosing Methods and Tools that Save Time 00:35:05 Confidence vs Arrogance in the OR 00:40:05 Practical Efficiency: Filming, Flow, and Setup 00:45:05 Visualization, Assisting, and Debriefing 00:50:00 Tools, Tech, and Mastering Basics 00:55:00 Standardization, Lean Thinking, and Takeaways Follow us on Instagram @thinkingaboutobgyn.

    55 min

  6. OCT 2

    10.7 Tylenol and Autism

    We push back on claims that Tylenol or vaccines cause autism and explain how weak methods, conflicts of interest, and cherry-picked data fuel public panic. We also unpack why diagnoses have risen—broad criteria, screening, and access—not because of a new environmental villain. • Summary of claims made at the press event and why they fail • What the cited acetaminophen paper did and didn’t show • Conflicts of interest, pay-to-publish venues, and bias • Why correlation isn’t causation; confounding by indication • Bradford Hill criteria applied to acetaminophen and autism • Sibling-controlled studies as the strongest current evidence • Amish and Cuba myths; diagnosis versus true prevalence • DSM-5 changes driving higher autism diagnoses • State-by-state variation explained by services and funding • Vaccine safety evidence contrasted with myths • Practical counseling: treat fever; use clear, strong evidence Be sure to check out thinking about obgyn.com for more information and be sure to follow us on Instagram 0:00 Setting The Record Straight 2:30 The Press Conference Claims 5:30 Tylenol, Vaccines, And Autism 9:30 The Study Behind The Hype 14:30 Conflicts, Bias, And Bad Methods 19:30 Correlation Isn’t Causation 23:00 Bradford Hill 101 28:30 Amish, Cuba, And Diagnosis Rates 33:30 Screening Tools And Subjectivity 37:30 Sibling Studies: The Strongest Signal 42:00 Why Meta-Analyses Can Mislead 46:00 What The “Navigation Guide” Misses 51:00 Vaccine Myths In Perspective 54:00 Why Autism Diagnoses Rise 59:00 DSM-5 And Access To Services Follow us on Instagram @thinkingaboutobgyn.

    1h 2m

  7. SEP 17

    Episode 10.6 Natural Birth Claims

    Dr. Howard Harrell explores common questions about birth alternatives posed by Anna, a mom-to-be with questions, examining scientific evidence behind claims often found online that challenge evidence-based obstetric practices. The discussion separates facts from philosophy by analyzing actual research data on interventions like epidurals, oxytocin, and birthing positions. • Maternal mortality has decreased 173-fold since 1850, coinciding with the rise of modern obstetrics • The "cascade of interventions" theory isn't supported by scientific evidence • Studies show epidurals don't increase cesarean delivery rates, contrary to popular belief • Oxytocin augmentation, when properly used, can decrease cesarean rates rather than increase them • Upright birthing positions don't show improved outcomes compared to lying on back • Hospital/provider cesarean rates matter more than specific interventions in predicting your risk • For low-risk pregnancies, intermittent rather than continuous fetal monitoring may reduce unnecessary interventions • Best approach combines respecting physiologic birth while using appropriate medical tools when needed Visit thinkingaboutobgyn.com for more information and follow us on Instagram. We'll be back in two weeks. 00:00:02 Introduction to Natural Birth Questions 00:02:09 Historical Maternal Mortality Statistics 00:05:54 Nutrition Myths and Modern Food Safety 00:11:34 Debunking the Cascade of Interventions Theory 00:21:32 Epidurals: Facts vs. Misconceptions 00:35:59 Birth Positions and Perineum Protection 00:44:20 Avoiding Unnecessary Cesareans 00:48:56 Continuous vs. Intermittent Fetal Monitoring 00:56:24 Artificial Rupture of Membranes Discussion Follow us on Instagram @thinkingaboutobgyn.

    59 min

  8. SEP 4

    Episode 10.5 The Dense Breast Dilemma

    Howard and Antonia explore the safety of medications during pregnancy and the controversial reporting requirements for breast density on mammograms, examining how science is being overshadowed by fear-mongering in healthcare decision-making. • Examining the evidence behind avoiding fluconazole (Diflucan) in first trimester, finding that short courses likely pose minimal risk • Discussing the important distinction between possibility and probability when evaluating medication safety in pregnancy • Analyzing the wide variation in cesarean delivery rates across US counties, from 5.4% to over 53% for low-risk patients • Critiquing politically-motivated FDA actions on SSRIs, food dyes, and other health policies not supported by scientific evidence • Explaining why the FDA's requirement to notify women of dense breasts on mammograms may cause more harm than good • Demonstrating how supplemental testing for women with dense breasts leads to false positives and unnecessary procedures • Reviewing the historical development of prenatal diagnosis from early ultrasound to cell-free DNA testing 00:00:33 Evidence for Diflucan in Pregnancy 00:12:12 Cesarean Delivery Rates Across US Counties 00:16:39 FDA's Position on SSRIs and Food Dyes 00:28:46 Managing Dense Breasts in Mammography 00:44:46 History of Prenatal Abnormality Diagnosis Follow us on Instagram @thinkingaboutobgyn.

    58 min
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4.6
out of 5
43 Ratings

About

A fresh and evidence-based perspective of all things related to obstetrics and gynecology. Follow us on Instagram @thinkingaboutobgyn or visit thinkingaboutobgyn.com for show notes and more. 

Information

  • Creator
    Antonia Roberts and Howard Herrell
  • Years Active
    2021 - 2025
  • Episodes
    129
  • Rating
    Clean
  • Copyright
    © 2025 Thinking About Ob/Gyn
  • Show Website
    Thinking About Ob/Gyn

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