Thinking About Ob/Gyn

Antonia Roberts and Howard Herrell
  • 4.6 (44)
  • 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. 1D AGO

    Episode 11.4 Syphilis and lots more!

    We examine why U.S. maternal mortality headlines mislead, showing overdose and violence dominate early postpartum deaths while obstetric causes decline. We then cover strong evidence for opportunistic salpingectomy, debunk a shaky Cochrane-fueled home birth claim, clarify Nexplanon’s five-year approval and bleeding management, confirm no Tylenol-autism link, and walk through modern syphilis testing in pregnancy before closing with pragmatic magnesium use after delivery. • overdose and violence as leading postpartum deaths • pitfalls of cross-country maternal mortality comparisons • fentanyl trends and infant risk • opportunistic salpingectomy reduces ovarian cancer risk • how bad meta-analyses distort home birth safety claims • intent-to-treat and risk matching in birth setting data • Nexplanon five-year efficacy and bleeding treatments • no association between acetaminophen and autism • syphilis screening algorithms and pregnancy timing • magnesium postpartum as seizure prophylaxis, not BP treatment Be sure to check out thinkingaboutobgyn.com for more information and be sure to follow us on Instagram 0:00 Setting The Agenda: What Really Kills Moms 0:33 Redefining Maternal Mortality And Comparisons 2:11 Violence, Overdose, And Postpartum Risk 5:33 State Variability And Media Narratives 8:15 Data On Drugs, Fentanyl, And Infant Harm 11:06 Opportunistic Salpingectomy: New Evidence 14:06 Population Study And Risk Reduction Ranges 16:16 Cochrane Review And Home Birth Claims 20:24 Why Bad Meta-Analyses Mislead 24:15 Real-World Data And Intent-To-Treat For Birth Setting 28:02 Pain, Epidurals, And Cultural Narratives 31:00 Nexplanon Five Years And Bleeding Fixes 35:21 Tylenol And Autism: Meta-Analysis Revisited 38:04 Syphilis Testing In Pregnancy: Why It’s Hard 42:25 Traditional Vs Reverse Algorithms Explained 47:05 Managing Discordant Results And Reinfection 50:11 History, Ethics, And Tuskegee Lessons 54:15 Listener Question: Magnesium Duration Postpartum 59:05 Clinical Judgment Over Dogma And Wrap Follow us on Instagram @thinkingaboutobgyn.

    1h 9m

  2. FEB 4

    Episode 11.3 Preventing Surgical Complications

    We map a prevention-first approach to OBGYN surgical complications—from environmental fixes and technique to early detection, skilled repair, and honest recovery—so fewer patients are harmed and clinicians carry less hidden burden. Practical steps, board-level reasoning, and real cases bring it to life. • applying primordial to quaternary prevention to surgical harm • avoiding unnecessary hysterectomy and favoring safer routes • bladder repair tactics by size and location • ureter injury recognition, stenting, and reimplant options • bowel injury triage, Lembert technique, and resection thresholds • four practical tips to prevent bowel injury • vascular control from aorta to epigastrics and presacral bleeds • preventing neuropathies with smarter positioning and retractors • disclosure with HEAL and supporting clinicians with just culture • key historical insights  0:00 Framing Complications With Prevention 2:55 Primordial To Quaternary: The Model 7:30 Urologic Risks: Bladder First 16:20 Trigone, Stents, And Calling For Help 23:45 Ureter Injury Playbook 33:20 Delayed Ureter Injuries And Management 38:05 Small Bowel: From Serosa To Resection 46:30 Colon Injuries: Repair Or Resect 52:40 Four Tips To Prevent Bowel Injury 58:10 Vascular Injury: Aorta To Epigastrics Be sure to check out thinkingaboutobgyn.com for more information and be sure to follow us on Instagram Follow us on Instagram @thinkingaboutobgyn.

    1h 2m

  3. JAN 22

    Episode 11.2 Rethinking VBAC Risk and a Lot More!

    We unpack new studies that reshape how we counsel on VBAC after short intervals, update what we tell BRCA carriers about estrogen therapy, and explore how self-collected HPV tests can reduce screening gaps. We also question surgical marketing, workforce trends, and the shaky evidence behind aspirin dosing for preeclampsia. • Short interpregnancy interval as a VBAC risk factor, not a contraindication • Absolute uterine rupture rates in spontaneous vs induced labor • Estrogen therapy in BRCA carriers and treated gyn cancers • Cervical screening overuse and underscreening in insured populations • Self-collected HPV testing intervals and access benefits • OB-GYN workforce shortages and rural distribution gaps • Endometriosis surgery indications versus fertility claims • Robotics versus laparoscopy outcomes and training priorities • Aspirin dose trials, lack of placebo arms, and abruption signals • Reading statistics correctly and demanding better editorial standards 0:00 Setting The Agenda: New Studies 0:40 Short Interval Pregnancy And VBAC Risk 3:10 Quantifying Uterine Rupture By Spacing 8:10 Induction, Augmentation, And Rupture Math 9:40 HRT In BRCA Carriers: New Evidence 13:05 Estrogen After Gyn Cancers: Practice Gaps 17:40 Cervical Screening: Overuse And Underscreening 22:30 Self-Collected HPV Testing Guidance 27:00 OB-GYN Shortages And Distribution 33:20 Endometriosis Surgery And Fertility Claims 41:20 Robotics Vs Laparoscopy: Outcomes And Training 47:20 Aspirin Dosing For Preeclampsia: No Signal 55:30 Interpreting Stats And Editorial Standards 59:20 Closing Notes And Next Steps Be sure to check out thinking about obgyn.com for more information, and be sure to follow us on Instagram Follow us on Instagram @thinkingaboutobgyn.

    1 hr

  4. JAN 8

    Episode 11.1 Smarter Hysterectomies, Lower Costs

    Jamie Perry joins this episode as we share ten standout women’s health breakthroughs from 2025 and then get practical about value in endoscopic hysterectomy. The focus is simple: cut waste, save time, protect quality, and expand access through better selection, technique, and team flow. • Key 2025 breakthroughs shaping care and counseling • Why OR time outweighs device price • Preference cards as a lever to reduce waste • Three-arm robotics and smarter instrument choices • Laparoscopic tips: barbed suture, simulation, quadrant workflow, vessel skeletonization • Robotic tips: patient selection, docking discipline, turnover efficiency, data tracking • Same-day discharge and ERAS as non-negotiables • When vaginal route is truly better and why referrals matter Be sure to check out thinkingaboutobgyn.com for more information, and be sure to follow us on Instagram 0:00 Setting The Stage: Why Endoscopy 1:12 Ground Rules And Focus On Value 2:12 Top 10 Women’s Health Breakthroughs Of 2025 15:56 Defining Value In Hysterectomy 18:20 Preference Cards And Instrument Waste 21:28 Three-Arm Robotics And Instrument Costs 24:04 Time As The Biggest Cost Driver 29:56 Same‑Day Discharge And ERAS 33:44 Four Laparoscopic Efficiency Tips 41:28 Four Robotics Efficiency Tips 47:02 When To Choose Vaginal Hysterectomy 54:10 Data Tracking, Referrals, And Culture Change Follow us on Instagram @thinkingaboutobgyn.

    56 min

  5. 12/25/2025

    Episode 10.13 Estrogen, Free Birth, And Misinformation

    We unpack what WHI actually showed about estrogen-only therapy and breast cancer in light of new supporting data, then confront the free birth trend’s preventable harms and the business model behind it. We share clear tools to spot false claims, review new aspirin data on preeclampsia, and outline twelve practical ways to cut waste in gyn surgery. • estrogen-only therapy associated with lower breast cancer diagnosis and mortality • combined estrogen plus progestogen neutralizing estrogen’s protective signal • rare abdominal pregnancy case illustrating basic testing safeguards • free birth movement risks, censorship of bad outcomes, and money incentives • red flags in birth-related posts and the SIFT fact-checking method • four quick filters to vet social content before sharing • nuanced view on aspirin for preeclampsia with mixed trial evidence • twelve surgical sustainability steps that save cost and reduce waste Be sure to check out thinkingaboutobgyn.com for more information and be sure to follow us on Instagram 1:11 Estrogen Therapy And Breast Cancer Risk 6:41 What WHI Actually Showed 11:22 Progesterone, HRT Fads, And Risks 15:35 Wild Case: Abdominal Pregnancy Behind Tumor 20:42 Free Birth Trend And Tragic Outcomes 25:37 How The Misinformation Business Works 30:10 Red Flags In Birth Content Online 35:10 The SIFT Method For Fact-Checking 40:20 Four Tips To Vet Social Posts 46:25 Live Walkthrough: Debunking A Viral Post 52:40 Digital Hygiene And Curating Feeds 56:48 Aspirin For Preeclampsia: Mixed Evidence Follow us on Instagram @thinkingaboutobgyn.

    1h 3m

  6. 12/11/2025

    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

  7. 11/27/2025

    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

  8. 11/13/2025

    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
See All (134)

4.6
out of 5
44 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 - 2026
  • Episodes
    134
  • Rating
    Explicit
  • Copyright
    © 2026 Thinking About Ob/Gyn
  • Show Website
    Thinking About Ob/Gyn

You Might Also Like