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Health & FitnessMedicine

Thinking About Ob/Gyn

Antonia Roberts and Howard Herrell

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. 

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  • 26 episodes
  • fortnightly
  • Avg 1 hr 1 min
  • English

Episodes 26

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  • S11 · E1
    January 8 · 55 min

    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.

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  • S10 · E13
    Dec 25, 2025 · 1 hr 2 min

    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.

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  • S10 · E12
    Dec 11, 2025 · 1 hr

    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.

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  • S10 · E11
    Nov 27, 2025 · 57 min

    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.

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  • S10 · E10
    Nov 13, 2025 · 1 hr

    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 57:05 Coaching Options And Community Follow us on Instagram @thinkingaboutobgyn.

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  • S10 · E9
    Oct 30, 2025 · 1 hr 6 min

    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.

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Showing 21–26 of 26 episodes