Podcasts about acog

Gestational diabetes (GDM) is one of the most common reasons families are advised to plan for an early birth. But what does the evidence actually say about induction for GDM? Does it lower the risk of Cesarean? Prevent big babies? Reduce stillbirth? Or does the timing matter more than the induction itself? In this episode, Dr. Rebecca Dekker and Dr. Morgan Richardson Cayama walk through the updated research on induction for gestational diabetes. You'll learn how outcomes differ before 39 weeks, between 39–40 weeks, and after 41 weeks, and why blood sugar control (diet-controlled versus medication-controlled GDM) can change the conversation entirely. They also review what major professional organizations recommend and discuss the role of extra fetal monitoring in the third trimester. Most importantly, they talk about informed consent, respectful maternity care, and how to navigate conversations if you're feeling pressure to schedule an induction. (00:02:40) Background & research update (00:05:34) What is GDM? Risks & induction rates (00:08:34) Research challenges & study limitations (00:15:36) Timing of birth: 38, 39, 40+ weeks (00:19:26) Big babies & health risks (00:24:27) Professional guidelines (ACOG, NICE, SOGC) (00:27:14) Birth before 41 weeks: common recommendation (00:27:54) Extra fetal monitoring in late pregnancy (00:32:49) Navigating pressure & informed consent View the full list of references here. Resources Read the updated Evidence on: Induction for Gestational Diabetes: ebbirth.com/inducingGDM Get the free respectful care handout: ebbirth.com/369 Grab your Pocket Guide to Labor Induction here. EBB 370 - Updated Evidence on Diagnosing Gestational Diabetes

No episódio de hoje do Check-up Semanal, o Dr. Ronaldo Gismondi, editor-chefe médico do Portal Afya e do Whitebook, comenta os principais destaques recentes em Ginecologia e Obstetrícia, com foco em terapia hormonal na menopausa, decisões no segundo estágio do parto, analgesia para inserção de DIU, impacto dos miomas intramurais na FIV e abordagem diagnóstica do hCG positivo.Leia na íntegra os artigos mencionados hoje:Atualização Cochrane 2025 sobre terapia de reposição hormonal na pós-menopausaParto vaginal operatório X cesárea no período expulsivo: qual a opção mais seguraEficácia e segurança de anestésicos tópicos na inserção de DIUMiomectomia em miomas intramurais antes da FIV: o que dizem as evidências atuais?Novo Consenso Clínico do ACOG sobre avaliação do hCG

The ACOG states that, “Iron deficiency anemia during pregnancy has been associated with an increased risk of low birth weight, preterm delivery, and perinatal mortality and should be treated with iron supplementation in addition to prenatal vitamins. In addition, there may be an association between maternal iron deficiency anemia and postpartum depression, with poor results in mental and psychomotor performance testing in offspring”. Screening for anemia is included in most prenatal lab sets. However, up to 42% of women who enter prenatal care are iron deficient BEFORE anemia is detected. Iron deficiency itself, even without anemia, has also been linked to pregnancy morbidity. The ACOG currently does not have a statement endorsing universal ferritin screening in pregnancy outside of established anemia, but new data is challenging this (Jan 2026, Lancet). Listen in for details. 1. ACOG PB 2332. Wasim T, Bushra N, Nasrin T, Humayun S, Tajammul A, Khawaja KI, Irshad S, Fatima S, Yasin A, Zamora J, Cano-Ibáñez N, Fernandez-Felix BM, Khan KS; Ferritin screening and iron treatment for maternal anaemia and fetal growth restriction prevention (FAIR) Study Group. Intravenous iron for non-anaemic iron deficiency in pregnancy: a multicentre, two-arm, randomised controlled trial. Lancet Haematol. 2026 Jan;13(1):e22-e29. doi: 10.1016/S2352-3026(25)00315-1. PMID: 41482443.3. https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2024.15196

In this episode, we welcome Catrina Bubier, MD, an OB/GYN physician and member of Copic's Board of Directors. Dr. Bubier details her experience with a serious hand injury that temporarily sidelined her from surgical practice. She shares how the injury and subsequent surgeries impacted her ability to work, her relationships with practice partners, and her finances. Dr. Bubier discusses the importance of disability insurance, the emotional challenges of facing a potential end to her career, and the value of planning ahead for unexpected life events. The episode also touches on her advocacy work with ACOG and offers practical advice for physicians on preparing for disability, understanding employment contracts, and building financial resilience.  Feedback or episode ideas email the show at wnlpodcast@copic.comDisclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient's specific condition.

Episode 277-Three-Round Burst of GOFU’s Also Available OnSearchable Podcast Transcript Gun Lawyer — Episode Transcript Page – 1 – of 11 Gun Lawyer — Episode 277 Transcript SUMMARY KEYWORDS GOFUs, New Jersey gun laws, vampire rule, sensitive places, unlawful possession, pretrial detention, federal injunction, carry permit, gun transport, Second Amendment, gun rights, legal advice, gun ownership, gun regulations, gun safety, gun culture. SPEAKERS Speaker 2, Evan Nappen, Teddy Nappen Evan Nappen 00:17 I’m Evan Nappen. Teddy Nappen 00:19 And I’m Teddy Nappen. Evan Nappen 00:21 And welcome to Gun Lawyer. So, you know our show here, one of the things that is very, very famous about our show are GOFUs. And GOFUs, as my listeners know, are Gun Owner Fuck Ups. The idea with GOFUs is these are real cases, actual things that happened. They are expensive lessons that people learn, and that you, the listener, get to learn for free. And of course, we always do the GOFU at the end of the show, whatever this week’s GOFU may be. But suddenly I’ve been pounded with GOFUs, and they’re very important. And I said, you know what? We’re going to do a three round burst here of some really important GOFUs, including what I want to begin with by telling you about this actual case. It illustrates just how insane New Jersey is and what every law-abiding gun owner could, in fact, face. Evan Nappen 01:32 Of course, I’m not using any names, but this is an actual situation that occurred. And some things, looking at the situation that the, and not just necessarily a mistake that the gun owner did, but something that hit me as extremely important for every New Jersey gun owner to make sure they do. There’s a very simple thing that is very important that could be critical between whether or not they hold you in jail or release you. We’re going to get to that from this story so you’ll learn this secret, so that you don’t end up in this GOFU situation. Spending days or weeks incarcerated for nothing, because that’s what the Gulag does, as you know. This is a case that wraps it all up into that. Evan Nappen 02:39 So, here’s this guy who comes into New Jersey, and he’s at a mall. Now, as you may know, the mall is not, in and of itself, a sensitive place, right? Those of us who have familiarized ourself, which hopefully all of you have, with these “sensitive places”. A mall is not, per se, a sensitive place. Now, there can be rules regarding malls where they say, hey, no guns in the mall. We don’t want guns, you know. And any Page – 2 – of 11 private property, whether open to the public or not, can have a prohibition privately saying we don’t want any guns here. In the same way they could say, we don’t want any dogs. We don’t want any bare feet. You know, things like that. The property owner has certain control. But if there is such a sign, if there is such a statement by a property owner, then if you come on to that property and they don’t want you on that property for a reason such as that. They can’t say, hey, we don’t allow minorities on our property. You know, they can’t. You can’t have racial discrimination in a place open to the public. But you can have other restrictions. Evan Nappen 04:07 Now, I happen to personally think that firearms should be viewed as a civil right and in the same category as discrimination, because it is a civil right. But that’s not currently how the law is. So, if a private entity prohibits gun, says no guns, then if you still go on that property and you’re specifically told to leave and don’t, then you’re what’s known as a defiant trespasser. So, what we’re talking about is trespassing, but trespassing is not a sensitive place violation. Sensitive place violations are specific gun law violations that create a certain place that becomes a prohibited area under the law to carry a gun, even if you have a permit to carry. So, this person is in the mall and apparently gets approached by mall security, who has allegedly dogs that can sniff gunpowder. Believe it or not, they’re out there. Apparently, he’s approached and they say, we think you have a gun. Please leave. And he does. No problem. He was asked to leave, and he leaves. Evan Nappen 05:30 After leaving, while in his car, driving, he gets stopped by police. More than even one because, oh, there’s a gun, right? Because, obviously, security called it in, I guess, at some point, and he was stopped. He is stopped for violating, in their minds, the sensitive place prohibition under Section 24 under Chapter 58 of the sensitive places. And what is that? What is that sensitive place that they believe he’s in violation of? Oh, New Jersey’s version of the vampire rule. The vampire rule is that you need permission before you go onto any private property. That is the issue that’s before the United States Supreme Court. The Hawaii, you know, the Woolford case in front of SCOTUS. We’re waiting for a decision. Evan Nappen 06:43 Now, Hawaii had the law just like New Jersey. The only difference is New Jersey’s vampire rule case saying that you can’t go on to private property, whether open to the public or not open to the public, you cannot go on any private property in New Jersey unless you first have permission to carry your gun there. In other words, they needed to have a sign, you know, that says we love guns. You know, basically, guns welcome. You know, guns permitted. Essentially, a sign. Or you got specific permission from the property owner before you enter the property. Hence the vampire rule. You know, as long as you don’t invite the vampire in to your place. That’s where that comes from. Evan Nappen 07:34 Well, New Jersey’s vampire rule, to impose this, you need permission first, before you can go on private property, even private property open to the public, has been found and was found unconstitutional in the Koons versus Platkin case. In Koons. And in that case, as you may recall, Judge Bump found it was unconstitutional and put an injunction on that section, saying it is unenforceable. It’s Page – 3 – of 11 unconstitutional. That any private property that is open to the public, you’re allowed to bring your gun on unless it’s otherwise a sensitive place. So, you know, if you want to go into a 7-11 with your carry gun, you can. It’s open to the public, even though it’s privately owned by 7-11. Now, if you want to go to a private residence, a private place that’s not open to the public, then you do need advanced permission for that. If you go into even your friend’s house, your friend needs to be able to say, yeah, you have permission to have your gun at my house. But not open to the public. Evan Nappen 09:00 So, the mall is open to the public. The mall is not a per se sensitive place. Yet, in this case, the basis for stopping and arresting this man or woman, I won’t even tell you what the sex is, the basis for the arrest is an alleged violation of the sensitive place section for which there is a federal injunction against enforcement. Then because somehow there’s this belief that if you are in violation of sensitive place, you’re also unlawfully carrying even though you have a carry permit, which makes absolutely no sense. There’s no logic to that. He’s charged with unlawful possession of a handgun without a carry permit, even though he has a carry permit. And, of course, with those gun charges, off to the Gulag you go. So, you are arrested, and you are put in jail. Evan Nappen 10:16 Now, the Gulag kicks in, where there’s 48 hours in which the prosecutor gets to decide whether to seek pretrial detention. It is solely within the discretion of the prosecutor. And if the prosecutor decides to seek pretrial detention, you’re going to be held for another five days before there’s a hearing when we can actually argue to get you out. And with the new law that was just signed by Murphy, they can get an additional five days to make sure that the gun is operable, to get an operability report, which is irrelevant to the charges anyway. So, by this arrest, you actually have the opportunity to be incarcerated basically for two weeks, guilty of nothing. Evan Nappen 11:08 What happened? Well, luckily, I got a call very quickly. When this person was in jail, loved ones got a hold of me. And this is on a Saturday, my friends, on a Saturday. Yeah. They do these on Saturday. They just hired me in time that I was able to get onto the court hearing 15 minutes before that first 48 hour time period, for that very first hearing where there’s no argument. The prosecutor either is going to say we’re seeking pretrial detention or not, but at least I could get on. And, lo and behold, I get on, and the prosecutor, big shock, is seeking pretrial detention, which means he’s going to be held or she is going to be held another five days or so, to have that hearing. It may be longer if they’re going to go for the operability nonsense, too. Teddy Nappen 12:11 Doesn’t Bergen County always seek pretrial detention? Evan Nappen 12:16 Well, it’s not just Bergen. And let me say this isn’t necessarily even Bergen, by the way, Teddy. But most counties have a policy of just automatically seeking pretrial detention on most gun cases. So, that’s not a big surprise. But what happens is, in this 48 hour period here, we still have the court appearance. But there’s nothing an attorney officially can do, because the prosecutor is given the sole Page – 4 – of 11 discretion. The prosecutor says, well, it’s gun charges with the Graves Act. Because, of course, the seriousness of the charge is second degree. You’re looking up to 10 years in State Prison. You’ve got a minimum mandatory three and a half years with no chance of parole. So, because of the seriousness of that offense and the Graves Act and it’s guns, we’re going to seek pretrial detention. Evan Nappen 13:13 And the court says, you know, Mr. Nappen, do you have anything that you want to add? And I say, and here’s exactly what I did them. I said, look, I understand how much discretion the prosecutor has here. Normally, we just have to wait until the hearing in order to argue. But I have to say, and I make it clear here. I say, look, my client not only had a permit to carry and why the state can’t access it, you know, they took his wallet and he can’t get to his wallet. And for whatever reason, there’s some glitch in them trying to get it out of the State Police. I don’t know why, but the very basis for his arrest was for a law for which there is an injunction, a federal injunction, that’s been upheld even by the Appeals Court. So, you have law enforcement violating a federal court injunction and charging and utilizing a statute that is enjoined from being enforced. Evan Nappen 14:19 So, in complete violation of that injunction, I make it clear that that is what is going on here with someone who has a permit, who has the lowest scores on the PSA of a one, one, that’s the lowest you can get. The PSAs are your flight risk and danger risk that they calculate into whether you’re to be released. Now they’re looking to hold them for another five to 10 days to even try to get them argued out. And at that point, the court officer actually says, well, counselor, there’s no argument here at this level. You’ll have to argue, you know, at the hearing when it gets scheduled. And I said, look, I’m not arguing anything. I said, do you know what I’m doing? I’m putting the State on notice as to the civil rights violation taking place on my client. At which time, the prosecutor says, look, we haven’t even had a chance to talk, and I said, no, we haven’t. I just got hired and got on here 15 minutes ago. Well, let’s talk. I said, okay. Evan Nappen 15:24 We had a private conference, and when we came back, I’m happy to say that the prosecutor withdrew their motion for pretrial detention. My client got out of jail that day, and now we will fight these charges. I’m extremely confident in how that fight is going to go as well. So, folks, what are the takeaways? Look at the risk you’re running. Look at the utter and complete failure of the Attorney General of New Jersey to inform law enforcement as to the changes in the law by these court actions. Why are the police charging an offense which has been enjoined? Police should know better, but I’ll tell you what else. The Attorney General should be instructing, the way they’ve done so many other times on so many other things, to all law enforcement, explaining how that sensitive place has been enjoined. And how on public property, it is not a sensitive place where you need prior permission under the vampire rule. This hasn’t been done. So, you have what is essentially a false arrest taking place. Evan Nappen 17:06 You have a system designed to incarcerate gun owners. It is outrageous, and you need to know that this what you’re up against. So, what do you need to do to protect yourself? Where’s the GOFU aspect? Well, let me tell you something that would be really important. Here’s what everybody should Page – 5 – of 11 do. Make sure your carry permit, make sure your gun licenses, are also, copies are given to your loved ones. People you can count on. Because if you get incarcerated and your wife or your parents or your brother is calling me and if they can get me copies of your carry permit or gun license that you otherwise can’t access, I can get that to the prosecutor. There doesn’t have to be a dependency for somehow getting it out of the State Police in time. Or finding it in some wallet that’s been confiscated and held in evidence in some other place, in some other room, somewhere else. That can be of great assistance, immediate assistance, in addressing your arrest and avoiding further gulaging of you. So, make sure. The takeaway is to make sure that folks that care about you, that would be the people you would go to if you had a problem, that they can provide and have access to copies of your gun licenses. That would be incredibly important. The other thing is make sure you have an attorney that you can get a hold of right away. An attorney that can come to your aid, argue, to get you out on a Saturday where time is of the essence. Those are the takeaways that are critical from this experience. Evan Nappen 19:08 Let me tell you, the GOFU has taken on a life of its own, and I’m glad about it. I have here a listener who sent a GOFU that they wanted to make our other listeners aware of, and I appreciate that. They asked that I not use a name, but here’s the GOFU letter. It says, I have a GOFU for you. It’s important for people to know to do this, so please share it on your show. This past fall, I planned a trip to Western New York to visit my family. I have a New Jersey PTC, also a PA PTC. I really like to have my gun along on trips with the highway driving. So, I asked a few guys at the shooting range what I should do with the gun when I got to New York state line. They told me to stop at a rest stop before I enter the state, put the unloaded gun in a car safe, and I should be good. That’s what I did. When I reached my destination, I told my family I had brought it, since they like guns, and they absolutely freaked out. They told me, the police would arrest me. It was illegal to bring a gun into a destination in New York. I better bring it in the house and keep it hidden. And hide it really well on the drive back. They really got me worried. So worried, in fact, I couldn’t get to sleep. So, I checked New York gun laws, and sure enough, she was correct. I was scared and felt terrible. I was incriminating my family members. Needless to say, the gun and the safe box and its cable were very hidden on the way back. I was careful not to break any speed limits. You can sum it up this way, but my takeaway is you have to do your own research before you take your gun out of state. Otherwise, you might end up in jail, and I’m very thankful that I didn’t. Evan Nappen 20:50 This is very true. State lines mean something. Now, here’s where the GOFU was. The GOFU was not following Title, 18, 926A thoroughly. That’s the federal preemption that lets you transport interstate. You have to be going from one place where you lawfully can possess and carry to another place. Your end destination has to be a place where you can lawfully possess and carry. Since New York does not recognize New Jersey’s permit or Pennsylvania’s permit, and unless you have a New York non-resident permit, that will not cover you. So, bringing your cased and unloaded gun into New York, now you’re possessing a handgun in New York, and you don’t have the protection of federal preemption. That’s the problem. Page – 6 – of 11 Evan Nappen 21:42 And it is a GOFU. This person is absolutely right. Make sure you know the laws. Make sure you clear it with counsel, so that you do not end up a GOFU. Because if that person had been stopped in New York with that handgun while in New York, they would face dire consequences. So, know the gun laws. Know the state laws. Do your research. Best bet? Well, you can always ask me, that’s one thing you want to do. Get my book, New Jersey Gun Law. I’ll shamelessly plug my book right now, because right in my book is a chapter on how to properly interstate transport, right in there on transportation of guns. What you need to know. Go to EvanNappen.com and get your copy of my book, New Jersey Gun Law. It’s the bible of New Jersey gun law. That’s the kind of stuff you need. That’s the kind of information you must have. That’s what you need to do. You cannot take these things lightly, because the consequences can be dire, and we see it. So, I appreciate this GOFU. I appreciate it being pointed out. These are real people experiencing the horrors of gun laws that are designed to ruin people’s lives and to turn law-abiding citizens into criminals. To oppress our Second Amendment rights. That’s all these laws do. You’ve got to protect yourself, folks. Learn from these tips and learn from these cases so you don’t become the next GOFU. Evan Nappen 23:16 Hey, let me tell you about our friends at WeShoot. WeShoot is an range indoor range in Lakewood, New Jersey. The range where Teddy and I both shoot. We love WeShoot. Great training. Great range facilities. Great pro shop, and a great bunch of folks. This week they’re running some great specials. They have the Chiappa Rhino 60DS, which is a futuristic revolver with its low bore access design. It’s kind of cool. It delivers, you know, reduced recoil because of that and fast follow up shots. They’ve got a Mossberg Gold Reserve Sporting shotgun. It’s an over and under, built for clay and field. It has engraving, premium walnut, and it’s competition ready. It’s a beautiful gun. Check out the Mossberg Gold Reserve Sporting. They also have a Springfield Prodigy Comp gun, comp gun. A modern double-stack 1911-style performer. It has an integrated compensator, and it’s optics ready. It has serious speed for duty or competition. Check out that Springfield. And you can also check out Sarah Sablom. She is on the hunt for a perfect carry gun. You can check out one of these WeShoot girls there. Go to weshootusa.com for their great website with amazing photography. They’re running great deals. They look forward to helping you and making you part of the WeShoot family. Go to weshootusa.com. Evan Nappen 25:05 Let me also mention our friends at The Association of New Jersey Rifle & Pistol Clubs, who just recently, through my friend and colleague, Dan Schmutter, argued in the Coons case at the Appellate level. And we’re looking good. I’m cautiously optimistic. And that’s your Association at work in the courts, fighting the Carry Killer bill. They’re also fighting the assault firearm ban and the large capacity magazine ban. You need to be a member. Go to anjrpc.org. Make sure you belong to your state Association. They are the gun rights defenders for New Jersey. You’ll get a great emails of what’s going on. You’ll get the alerts. You’ll know that you’re part of the solution and helping to fight the gun rights oppressors in New Jersey. Go to anjrpc.org and join today. Teddy, what do you have for us today in Press Checks? Page – 7 – of 11 Teddy Nappen 26:08 Well, as you know, Press Checks are always free, and this is something I want people to understand. We cannot take our foot off the gas when it comes to fighting the good fight for our rights. Because, look, we have had a lot of great victories when it comes to Second Amendment, to the conservative movement, and to getting the word out there, thanks to Alternative tech. But the Left are slowly trying to crawl back their power. What do I mean by that? Well, our friends at Bearing Arms did an article. Cam Edwards says, NBC decided to give a platform to the anti-gun activists. (https://bearingarms.com/camedwards/2026/02/10/nbcs-today-show-gives-anti-2a-activist-platform-for-propaganda-n1231508) Oh, gee, what a shocker! Teddy Nappen 26:59 It was Nicole Hockley out of the Sandy Hook Promise. You know, another one of Bloomberg’s groups who called in to demonetize online influencers in the 2A space. You know, someone like you and I, Dad. You know, people like a Brandon Herrera or Grantham, Mr. Gunzing. You know, any individual who is a pro-gun influencer they want to demonetize. That’s their call to action. I love the framework that she abuses in this. Sandy Hook and the group called Untargeting Kids, a call for platform transparency, putting parents back in charge of firearm safety. You know, whenever I hear the Democrats try to say, we need to stand on parents rights, it’s always comes down to oh, when it comes to firearm safety. But, you know, when it is hardcore pornography being offered to children, oh, that’s fine. Or, you know, a drag queen story hour. Oh, that’s fine. But oh no, when it comes to firearms, we need to give it back to the parents. So, they were trying to, yeah, they were trying to run this experiment, testing YouTube accounts mimicking a nine to 14 year old. Evan Nappen 28:21 Wait. Are you telling me that the Left are hypocrites? Teddy Nappen 28:26 Oh, well, as the saying goes. Evan Nappen 28:28 I don’t know about that. Teddy Nappen 28:30 As the saying goes, they only have double standards, or they would not have any standards at all. Evan Nappen 28:37 Exactly. Teddy Nappen 28:39 That’s how it always is with them. Whenever you see the term parental rights, you can see in the very corner, TM. It’s their version. Not when it comes to gender ideology, not when it comes to abortion, not when it comes to any other thing, but parents rights, TM. That’s their abuse of the language. Did you ever hear the word Democracy, TM. Or Second Amendment, TM. That is their version. Not what we know to be fact and truth. It’s their version. But anyways. So, they ran this experiment, which, you Page – 8 – of 11 know, these experiments can easily be debunked just by the abuse of algorithms. But whatever. We will say, for the sake of argument, we will say this data is true. So, they ran this experiment, and then 14 year old received 1300 firearm-related video recommendations after watching video games and movies that included firearm content. So, you know, a kid watches a bunch of Let’s Plays on Call of Duty, and then all a sudden, he gets a breakdown of an unboxing of a ACOG scope or something stupid. It’s one of those where they’re trying to make this argument, this very weak argument, on saying, oh, these videos are being monetized to target advertising, targeting our children. So, if a kid is interested in firearms, what is the problem with that? Why? He gets bombarded with tons of movies on all forms of graphic violence that goes into that. Then all of a sudden, it comes up with ad on any other influencer regarding firearm breakdown, because that’s the goal. They want you to get engagement. That’s it. And then I love this one. 54% of boys from 10 to 17 report sexually charged firearm content. Now, they do not define what sexually charged firearm content is. Evan Nappen 30:40 What is sexually charged firearm content? What is that? Teddy Nappen 30:43 It’s called we made it up! Because they love to just define terms. Evan Nappen 30:52 They just threw sex with guns, and don’t define it. Teddy Nappen 30:55 Correct. It’s just, and by the way, they don’t list any of the materials that was reviewed by the bots. Evan Nappen 31:02 Wait, it sounds like ammosexuality. Teddy Nappen 31:05 I know. Yeah, it is the hopalosexual all over again. Evan Nappen 31:10 What is that? That’s really interesting. Teddy Nappen 31:12 Yeah, and they don’t list any of the video game content that was reviewed. It doesn’t list any of the movies reviewed or the TV shows. Oh, because they don’t want to show the sexually graphic material that is pushed by the Left. You know, that’s why, you know, ask them. Evan Nappen 31:28 They should list it. They should list all that so that we could carefully review it, Teddy. Teddy Nappen 31:32 Well, unfortunately. Page – 9 – of 11 Evan Nappen 31:34 All these sexual . . . Teddy Nappen 31:37 I know, right? I love, and then she goes on where they’re forming the sense of self-identity that the get, that getting, they’re getting content that is talking about firearms makes you powerful. Firearms makes you sexually attractive. Firearms are the way to solve your conflict. Firearms are used to solve very certain conflicts. You know, when defending yourself against a rapist or a pedophile. You know, in certain situations, it’s a very good solution. It’s not a magic wand, but it solves certain issues. But there’s more. They like to always equate, like, oh, why do you need a gun? Because your penis is small? Like, it’s one of the small ones. Like, it’s that. They always do that. We’re like, what does that have to do with the aspect of your rights to defend yourself? Like that is the goal that they always try to play. And then she goes off on this whole thing of, we need to demonetize this. We need to review this content and look at the algorithms of YouTube transparency on firearms. And there must be. We need to sense. It goes. This long-winded conversation is just, we need to have time to deletion for videos for unsafe handling of firearms. What’s unsafe? Oh, there’s a firearm in the video. It’s just that. It’s just we need it. That censorship is not our goal, though. Yes, it is. Evan Nappen 33:06 I’ll tell you what. Here’s where I’ll take them up on it. Before any movie or TV show where a gun is improperly handled, you know, shows produced by all these major media producers, just have a warning. Just the way they warn about profanity, and they warn about smoking. Put a warning that says “unsafe firearm use is in this movie”. Unsafe firearm use. Do you know how many times we’ll see that? Because the Left media is the largest actual demonstrator of unsafe and unlawful use of firearms. It’s not conservatives. It’s the opposite. And so, let’s see those warnings. That way people suddenly say, wow, look how many times firearms are abused, used improperly and used illegally in the movies? I mean, if you can warn about smoking, you should be able to warn about that. Just put it. Don’t, don’t, don’t suppress it. Don’t try to have prior restraint or ban it, the showing of any of these movies. Just put the warning up front, and let people see just what’s being promoted by Hollyweird. Teddy Nappen 34:33 Well, and also, Hollyweird promotes all the sexual deviancies, where they push it on children. Where you have, you know, children have access to now hardcore pornography all across the internet, thanks to YouTube. Thanks to social media. Like, the level of it’s so disingenuous. Making this argument that we need to protect our children. Except when it comes to the LGBTQAI+ in schools, when it comes to all the other things that they want to sexually groom children. But, oh, firearm content, that’s the issue. When you get down to it, this is what they want. They want the 2019, they want the Biden Administration censorship. Where, right here, out of the House Judiciary Committee where the chairman approves and shows, oh, Google was pressured by the Biden administration to censor Americans. (https://www.pbs.org/newshour/politics/zuckerberg-says-the-white-house-pressured-facebook-to-censor-some-covid-19-content-during-the-pandemic) Page – 10 – of 11 Evan Nappen 35:30 That’s right. This is a really good point. They went after our First Amendment rights, just like the Second Amendment, and we lived through a period of Government censorship attempts that, when you look back, it was, it’s absolutely disgusting, what they pulled and what they were able to accomplish, even in achieving it, Teddy. It’s just insane. You would never think that could happen in America, because originally, the Left was for free speech. The Free Speech Movement was the Left, and now that’s no longer the case. They want the opposite. They don’t want free speech. Oh, hell no. But it used to be part of what true liberals, not today’s progressive, totalitarian liberals want, so-called. No, the classic liberal was absolute free speech, true, and they’ve abandoned that. They’ve abandoned it. Teddy Nappen 36:41 Well, it comes back to the idea of what the Left always does. They have no moral framework. The idea of, oh, what feels good? What is the cultural shift? What is the shifting ideology currently? Where you now have these massive purity tests on the Left, and that’s why they’re in a shooting war against each other as to who controls the party. But to even highlight this fact, Mark Zuckerberg said and admitted to the White House, yeah, I was pressured by the White House to censor people during Covid, over Covid 19 content. Doctors admitting all the false information that was out there. Bring that up. Completely censored off of Facebook, off of YouTube, all these platforms. X. You remember, you remember the Twitter files. Musk is releasing them weekly, showing the insidious combination of Government and censorship on the public square. This is what the Left wants. They are so upset that they have lost their ministry of truth. You remember that push? Evan Nappen 37:51 And they want to, right, and they want to use the same techniques to oppress the Second Amendment. It’s all part of the game plan. Teddy Nappen 38:02 Yeah. Evan Nappen 38:03 Well, Teddy, I appreciate you pointing this out, and I’m sure our listeners do as well. Let me tell you, we had a three round burst for GOFUs, and we only got two of the rounds out. Let me end here with the GOFU number three. And again, we saw this in action. These are actual cases, actual realities. I had a fellow client give me a call and say, hey, they were in court and they didn’t have counsel. Their guns were taken in an allegation of a so-called domestic violence, in which everything got dismissed. But there was an outstanding criminal charge that’s unfounded and going to the court. The so-called victim does not want to proceed. Does not want to proceed. So, what does the prosecutor do? The prosecutor tells this person, look, we’re going to downgrade this to a noise ordinance. Okay? So, it’s no longer in the category of domestic violence. If it stayed in that DV category, it makes you the equivalent of a convicted felon under federal law, and you’re banned from guns. The prosecutor said this way, with it as a noise ordinance, you’re fine. You’ll be perfectly fine. This will not affect your gun rights. Page – 11 – of 11 Evan Nappen 39:52 Now, this is a person who doesn’t have a lawyer. Who’s listening to the prosecutor, who is telling them they can plead this down to an ordinance. When the State’s key witness does not want to proceed and knows that the allegations that were made were not true and knows that it needs to be dropped. So, normally, the thing is, dismiss it straight out, because the complainant, the complaining witness, is not going to be real good for your case here. Okay? We all kind of see that, and it needs to go. But instead, the prosecutor is trying to convince this person to take this ordinance and pay a fine, get an ordinance hit, and saying that it won’t affect their gun rights. Evan Nappen 41:02 Here’s the deal, folks. It does affect your gun rights. You see, when a prosecutor says it doesn’t affect gun rights, that prosecutor is not representing you. They’re representing the State. They’re representing the Government. And if you don’t have counsel to explain to you the actual ramifications and you try to believe this, you know, however well intentioned it may have been, they failed to mention here that, yeah, it’s not a per se disqualifier, meaning, like being a convicted felon or having a conviction for domestic violence, sure, where you’re just out of the box. You’re done. But the reality in New Jersey is that if you plead to even this dopey ordinance for noise, you now have a conviction for an ordinance that started out as a domestic violence charge. Then when you try to apply to get a new pistol purchase permit or renew your carry permit or do a change of address on your Firearm’s ID Card, they go, oh, public health, safety, and welfare. That’s what they’re going to use to deny your application. Public health, safety, and welfare. Based on character, temperament. You know, I call that disqualifier the all-inclusive miscellaneous weasel clause, because that’s where the abuse of discretion comes in. And if you were to fall for this, oh, plead to the ordinance, it won’t affect your gun rights. Wait and see. Because now that comes up on your record and it links to the original charges, those police reports and all. And you ended up taking a plea, which has this appearance that you were guilty of something, and that’s why you pled. It sure as hell can affect your gun rights. So, friends, the takeaway is this. The GOFU is when you’re dealing on any criminal charge, make sure you have counsel that understands the gun laws and don’t try to rely on what a prosecutor may be telling you about how your rights will or won’t be affected. Evan Nappen 43:20 This is Evan Nappen and Teddy Nappen reminding you that gun laws don’t protect honest citizens from criminals. They protect criminals from honest citizens. Speaker 2 43:30 Gun Lawyer is a CounterThink Media production. The music used in this broadcast was managed by Cosmo Music, New York, New York. Reach us by emailing Evan@gun.lawyer. The information and opinions in this broadcast do not constitute legal advice. Consult a licensed attorney in your state. Downloadable PDF TranscriptGun Lawyer S5 E277_Transcript About The HostEvan Nappen, Esq.Known as “America's Gun Lawyer,” Evan Nappen is above all a tireless defender of justice. Author of eight bestselling books and countless articles on firearms, knives, and weapons history and the law, a certified Firearms Instructor, and avid weapons collector and historian with a vast collection that spans almost five decades — it's no wonder he's become the trusted, go-to expert for local, industry and national media outlets. Regularly called on by radio, television and online news media for his commentary and expertise on breaking news Evan has appeared countless shows including Fox News – Judge Jeanine, CNN – Lou Dobbs, Court TV, Real Talk on WOR, It's Your Call with Lyn Doyle, Tom Gresham's Gun Talk, and Cam & Company/NRA News. As a creative arts consultant, he also lends his weapons law and historical expertise to an elite, discerning cadre of movie and television producers and directors, and novelists. He also provides expert testimony and consultations for defense attorneys across America. Email Evan Your Comments and Questions  talkback@gun.lawyer Join Evan's InnerCircleHere's your chance to join an elite group of the Savviest gun and knife owners in America.  Membership is totally FREE and Strictly CONFIDENTIAL.  Just enter your email to start receiving insider news, tips, and other valuable membership benefits.   Email (required) *First Name *Select list(s) to subscribe toInnerCircle Membership Yes, I would like to receive emails from Gun Lawyer Podcast. (You can unsubscribe anytime)Constant Contact Use. Please leave this field blank.var ajaxurl = "https://gun.lawyer/wp-admin/admin-ajax.php";

As BMIs and weights increase across the US population, there have been increased calls for universal screening for existing DM at entrance to prenatal care, if under 20 weeks. Others, including the ACOG, prefer to screen early those with additional risk factors (like prior GDM HX, prior macrosomia, BMI >30, PCOS, first degree relative with diabetes, or age >40). In July 2024, the ACOG released its publication, “Screening for Gestational and Pregestational Diabetes in Pregnancy and Postpartum”. In this guidance, it states, “At this time, there are insufficient data to support the best screening modality for pregestational diabetes in pregnancy, but consideration can be made to use the same diagnostic criteria as for the nonpregnant population (A1c value 6.5 or higher, or fasting plasma glucose value 126 mg/dL or higher, or 2-hour plasma glucose value 200 mg/dL or higher during a 75-g OGTT, or random plasma glucose value 200 mg/dL or higher in patients with classic hyperglycemia symptoms)”. However, a new proposed protocol has been published in AJOG for early screening for DM in pregnancy. This also describes the differences in diagnosis and care for Standard GDM diagnosed at 24-28 weeks, vs a diagnosis of pregestational DM diagnosis made prior to 20-weeks vs “early” GDM also diagnosed under 20 weeks of gestation. Listen in for details. 1. McLaren, Rodney et al.nA Proposed Classification of Diabetes Mellitus in PregnancyAmerican Journal of Obstetrics & Gynecology, Volume 0, Issue 0. Epub Feb 2, 2026; https://www.ajog.org/article/S0002-9378(26)00061-X/fulltext2. ACOG Clinical Practice Update: Screening for Gestational and Pregestational Diabetes in Pregnancy and Postpartum; July 2024; https://journals.lww.com/greenjournal/abstract/2024/07000/acog_clinical_practice_update__screening_for.34.aspx3. Simmons, David et al. “Treatment of Gestational Diabetes Mellitus Diagnosed Early in Pregnancy.” The New England journal of medicine vol. 388,23 (2023): 2132-2144. doi:10.1056/NEJMoa2214956

Learn how ACOG turns advocacy into action, supports clinicians, and creates community. Plus, get tips on how you can get involved. In this episode of BackTable OBGYN, Dr. Sivani Aluru from Endeavor Health in Chicago shares her journey and involvement with ACOG, from her medical school days to her current role as the national JFCAC Chair. --- SYNPOSIS Dr. Aluru describes her experiences on various task forces, including the ACOG 75th Anniversary Task Force, and emphasizes the importance of education, advocacy, and community within the organization. She offers insights into the challenges and benefits of participating in ACOG, provides tips for getting involved, and highlights the ongoing efforts to address critical issues in women's health. The conversation also touches on adapting to the changes brought by the COVID-19 pandemic and the value of staying organized and connected in a demanding field. Find out what ACOG is working on, how it benefits patient care, how it benefits provider education and resources, how it builds community. Get involved! Go to meetings! There are so many roles. If you don't get your role on the first go, try again. Showing up is huge! --- TIMESTAMPS 00:00 - Introduction03:41 - Residency and Early Involvement in ACOG07:29 - Advocacy and Government Affairs18:40 - Balancing Professional and Organizational Work24:28 - Listening to Members' Needs26:36 - Challenges and Value of ACOG Membership29:00 - The Importance of In-Person Meetings34:45 - ACOG's Legislative Advocacy and Future Plans35:48 - Advice for Getting Involved with ACOG40:16 - Conclusion --- RESOURCES ACOG (American College of Obstetricians and Gynecologists)https://www.acog.org/ ACOG CAARE Delegation https://www.acog.org/about/diversity-equity-and-inclusive-excellence/collective-action-strategy/caare-delegation ACOG CREOG (Council on Resident Education in Obstetrics and Gynecology) https://www.acog.org/education-and-events/creog/about

Many studies demonstrate the benefits of yoga during pregnancy, including shorter labor and improved newborn outcomes. The American College of Obstetricians and Gynecologists states that modified yoga is one of the safest exercises for pregnant women. But what exactly does modified yoga mean? ACOG cautions against specific poses and hot yoga. As with any activity, there is nuance in determining which activities are safe. This episode will examine the research on specific poses and on practicing yoga in a heated environment. Plus, the physical changes that can affect your practice, precautions, and tips for modifying yoga during pregnancy. Full article and resources for this episode: https://pregnancypodcast.com/yoga/ Thank you to the brands that power this podcast: The True Belly Serum from 8 Sheep Organics is specially formulated with clinically proven ingredients that penetrate deep into the skin to effectively prevent stretch marks. Like all 8 Sheep products, the True Belly Serum comes with a 100-day Happiness Guarantee. You can try it completely risk-free for 100 days! If you feel the serum has not worked for you, or if you're not 100% happy with your purchase, simply send them an email and they will get you a refund, no questions asked. Save 10% off 8 Sheep Organics at https://pregnancypodcast.com/8sheep/ AG1 is the Daily Health Drink that combines your multivitamin, pre- and probiotics, superfoods, and antioxidants into one simple, green scoop. It's one of the easiest things you can do to support your body every day. When you first subscribe to AG1, you'll get an AG1 Welcome Kit, a bottle of Vitamin D3+K2, AND you'll get to try each new flavor of AG1 and their new sleep supplement, AGZ: https://drinkAG1.com/pregnancypodcast Get More from the Pregnancy Podcast Join thousands of expecting parents who stay up to date with the latest pregnancy news, new episode alerts, exclusive offers, and more: https://pregnancypodcast.com/newsletter Upgrade to Pregnancy Podcast Premium for ad-free episodes, full access to the back catalog, and a free copy of the Your Birth Plan book: https://pregnancypodcast.com/premium Save with discounts and deals available for Pregnancy Podcast listeners: https://pregnancypodcast.com/resources Follow your pregnancy week-by-week with the 40 Weeks podcast. Learn how your baby grows, what's happening in your body, what to expect at prenatal appointments, and get tips for dads and partners: https://pregnancypodcast.com/week Find more evidence-based information on the Pregnancy Podcast website: https://pregnancypodcast.com

Three facts are scientifically undisputed: Serotonin is essential for fetal brain development. SSRIs disrupt the serotonin system. SSRIs freely cross the placenta. So why are pregnant women being told these drugs carry "little or no risk"?In this rare head-to-head debate, Dr. Adam Urato—maternal-fetal medicine specialist and FDA expert panelist—faces off against Dr. Robert Chen, a psychiatry resident willing to do what most of his colleagues won't: step into the arena and defend the establishment position.What unfolds is a striking conversation where both physicians actually agree on more than you'd expect—including that informed consent is failing pregnant women, that the chemical imbalance theory is dead, and that "untreated depression" is a misleading frame designed to sell drugs. The uncomfortable question neither side can fully answer: If SSRIs are correcting depression, why does the research show worse outcomes for women who stay on them?This isn't anti-medication propaganda. It's the conversation your doctor isn't trained to have with you.Listen before you fill that prescription. Visit Center for Integrated Behavioral HealthDr. Roger McFillin / Radically Genuine WebsiteYouTube @RadicallyGenuineDr. Roger McFillin (@DrMcFillin) / XSubstack | Radically Genuine | Dr. Roger McFillinInstagram @radicallygenuineContact Radically GenuineConscious Clinician CollectivePLEASE SUPPORT OUR PARTNERS15% Off Pure Spectrum CBD (Code: RadicallyGenuine)10% off Lovetuner click here

Send us a textThe first days of feeding a newborn can feel like a test you didn't study for: alarms go off every two hours, pumps take over your counter, and every ounce feels like a verdict. We open up about low milk supply, the pull to “keep trying,” and the quiet relief that comes from choosing what actually works for your baby and your life. No shaming, no perfect-parent script—just honest stories and practical paths forward.We dig into the real costs of chasing a plan that doesn't fit: hours spent researching pumps and flanges, returning to shift work with a cooler bag in hand, and the mental math of leaving tables to pump in cramped back offices. There's room here for the science and the context. Breast milk has well-documented benefits, yes, and there are safe, tested alternatives when your body says not today. We talk donor milk banks, how formula has evolved, and why cow's milk shouldn't replace breast milk or formula before age one. Along the way we unpack the long, messy history of feeding trends and remind ourselves that pressure often hides behind the word “support.”The heart of the conversation is a mindset shift: do the best you can with the resources you have right now and let that be perfect. That means asking your pediatrician for alternatives if advice doesn't fit your reality. It means measuring success by a fed baby, a calmer home, and a parent who still feels like a person. You're not required to carry a story about what would have happened 200 years ago. You are allowed to choose the option that keeps your family steady today.If this resonates, follow the show, share it with a friend who needs a kinder take on newborn feeding, and leave a quick review to help more parents find us. Your stories help others breathe easier—what choice brought you peace? Coaching offerKelly Hof: Labor Nurse + Birth CoachBasically, I'm your birth bestie! With me as your coach, you will tell fear to take a hike!Support the showConnect with Kelly at kellyhof.com Join the Bump & Beyond Online Community!https://www.facebook.com/groups/bumpnbeyondGrab The Book of Hormones on Amazon!Medical Disclaimer:This podcast is intended as a safe space for women to share their birth experiences. It is not intended to provide medical advice. Each woman's medical course of action is individual and may not appropriately transfer to another similar situation. Please speak to your medical provider before making any medical decisions. Additionally, it is important to keep in mind that evidence based practice evolves as our knowledge of science improves. To the best of my ability I will attempt to present the most current ACOG and AWHONN recommendations at the time the podcast is recorded, but that may not necessarily reflect the best practices at the time the podcast is heard. Additionally, guests sharing their stories have the right to autonomy in their medical decisions, and may share their choice to go against current practice recommendations. I intend to hold space for people to share their decisions. I will attempt to share the current recommendations so that my audience is informed, but it is up to each individual to choose what is best for them.

Send us a textA healthy baby and a healthy mom can still leave a complicated story behind. We open the door to a birth that didn't follow the plan: an epidural that didn't work, Pitocin contractions that crashed like waves, and a mind trying to keep pace with a body doing the unimaginable. What sounded like chaos turns out to be wisdom—instinctive movement that helped a baby rotate and descend, progress made in spite of pain, and a partner steadying the room when words ran out.Together we examine where control slipped and why that matters. We talk plainly about augmentation, how to assess whether an epidural is effective, and when dialing back Pitocin should be on the table. We explore the emotional fallout of early moments—jealousy when a partner holds the baby first, the sting of being told rather than asked, the reality of stitches and exhaustion. Along the way, we track how hospital culture is changing, from the golden hour of skin-to-skin to more thoughtful language that invites consent and restores agency.This isn't a tidy highlight reel. It's a reframed narrative that honors labor as both physical work and emotional landscape. If your birth story still makes your throat tighten, you're not broken—you're human. Come hear how naming the moment things went sideways can loosen the knot, how instinct deserves credit, and how small shifts in communication can transform the way we remember meeting our children. If this conversation helps you see your own story with kinder eyes, share it with a friend, hit follow, and leave a quick review to help more parents find their footing.Listen to the full episode where Erin Hall shares her birth stories here: https://www.thebirthjourneyspodcast.com/hurricanes-epidurals-and-holding-on-with-erin-hall/ Coaching offerKelly Hof: Labor Nurse + Birth CoachBasically, I'm your birth bestie! With me as your coach, you will tell fear to take a hike!Support the showConnect with Kelly at kellyhof.com Join the Bump & Beyond Online Community!https://www.facebook.com/groups/bumpnbeyondGrab The Book of Hormones on Amazon!Medical Disclaimer:This podcast is intended as a safe space for women to share their birth experiences. It is not intended to provide medical advice. Each woman's medical course of action is individual and may not appropriately transfer to another similar situation. Please speak to your medical provider before making any medical decisions. Additionally, it is important to keep in mind that evidence based practice evolves as our knowledge of science improves. To the best of my ability I will attempt to present the most current ACOG and AWHONN recommendations at the time the podcast is recorded, but that may not necessarily reflect the best practices at the time the podcast is heard. Additionally, guests sharing their stories have the right to autonomy in their medical decisions, and may share their choice to go against current practice recommendations. I intend to hold space for people to share their decisions. I will attempt to share the current recommendations so that my audience is informed, but it is up to each individual to choose what is best for them.

Luis Herrero analiza con Alfonso Egea y Lorena López Lobo las novedades del caso.

Send us a textA hurricane on the horizon, contractions five minutes apart, and a quick detour through a Chick-fil-A drive-thru—Erin's first birth story doesn't read like any class manual. What followed was a long labor, Pitocin without pain relief when an epidural failed, and a body contorting into whatever position brought a sliver of relief. When the anesthesiologist finally got it right and her waters were broken, everything shifted—one push and Kylie arrived. Together we unpack why that experience felt traumatic, how back labor can hint at a sunny-side-up baby, and why instinctive movement often becomes the most powerful tool you have.The second time was a different world. Early March 2020, open triage bays, “flu” precautions that turned out to be COVID, and a race to get an epidural before the cutoff. Her water broke at home, the pressure told the real story, and a few pushes later, Kason was here. We compare what changed—baby position, timing, hospital flow, mindset—and explore the myth that a smooth birth equals success while a hard birth equals failure. Birth plans help, but listening to your body, asking for options, and protecting your headspace matter more.We also go deep on postpartum truths: breastfeeding pressure versus low supply, family history that reframes expectations, and the permission to choose formula or donor milk without shame. Erin talks candidly about body image, the relief of having her partner home during lockdown, and how building Bump and Beyond became a lifeline for parents who need more than advice—they need a village. If you've ever felt out of control, second-guessed every choice, or wondered whether you did enough, this conversation offers clarity, compassion, and practical insight.If this resonated, follow the show, share it with a friend who needs reassurance, and leave a review telling us one belief about birth or postpartum you're ready to let go. Your story can help someone else find theirs. Join the Bump & Beyond Online Community for moms & moms-to-be! Coaching offerKelly Hof: Labor Nurse + Birth CoachBasically, I'm your birth bestie! With me as your coach, you will tell fear to take a hike!Support the showConnect with Kelly at kellyhof.com Join the Bump & Beyond Online Community!https://www.facebook.com/groups/bumpnbeyondGrab The Book of Hormones on Amazon!Medical Disclaimer:This podcast is intended as a safe space for women to share their birth experiences. It is not intended to provide medical advice. Each woman's medical course of action is individual and may not appropriately transfer to another similar situation. Please speak to your medical provider before making any medical decisions. Additionally, it is important to keep in mind that evidence based practice evolves as our knowledge of science improves. To the best of my ability I will attempt to present the most current ACOG and AWHONN recommendations at the time the podcast is recorded, but that may not necessarily reflect the best practices at the time the podcast is heard. Additionally, guests sharing their stories have the right to autonomy in their medical decisions, and may share their choice to go against current practice recommendations. I intend to hold space for people to share their decisions. I will attempt to share the current recommendations so that my audience is informed, but it is up to each individual to choose what is best for them.

HCG is a heterodimeric glycoprotein typically produced by trophoblastic tissue. However, there are occasions where a serum HCG is obtained that remains low level POSITIVE, yet the patient is not pregnant, nor does she have a gynecologic malignancy. Why dose this happen. Not all these instances can be explained by the “PHANTOM” HCG. In this episode, we will review a new Clinical Consensus guideline from the ACOG officially being released in Feb 2026. Like the finding of an aberrant aneuploidy on cell-free DNA testing in pregnancy (NIPT) where the child is found to NOT be affected, where that abnormal result may signal a hidden malignancy, a persistent low level positive HCG that cannot be explained by pregnancy or a gyn cancer may signal a hidden malignancy elsewhere. Listen in for details. 1. ACOG CC #11, February 2026

In January 2026, the ACOG released its Practice Advisory on Screening for fetal Chromosomal Abnormalities. This comes after its Nov 2025 endorsement of the SMFM's Consult Series #74, “Cell-free DNA screening for aneuploidies: Updated guidance”. In this episode we will review the key parts of this PA. Is screening for microdeletions recommended? PLUS, we will focus on cfDNA for sex chromosomal abnormalities. Should screening for sex chromosomal abnormalities (SCAs) be an “opt in” or “opt out” process for patients? What are nest steps after an abnormal SCA screening result? Are commercial tests available for fetal gender recommended? Listen in for details. 1. ACOG PA Jan 2026: https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2026/01/screening-for-fetal-chromosomal-abnormalities?utm_source=higher-logic&utm_medium=email&utm_content=Jan-07&utm_campaign=acog2026-digest2. Society for Maternal-Fetal Medicine Consult Series #74: Cell-free DNA screening for aneuploidies: Updated guidance1 in November 2025.

Send us a textControl doesn't create a meaningful birth experience—clarity does. We dive into the real purpose of a birth plan and show how to turn a rigid checklist into a living compass that anchors your values, guides decisions, and strengthens partnership with your care team. Instead of chasing a “perfect” script, we focus on agency, communication, and the skills that keep you grounded when labor takes an unexpected turn.We trace the history of birth plans from the natural birth movement to modern templates and unpack how the purpose got lost. You'll hear a reality check on pain management—what hospitals actually offer, how relief varies, and why unmedicated goals can morph into pressure. We lay out practical prep for coping: breathwork, positions, movement, mindset, and the environmental choices that help you feel safe. Then we dismantle the myth that staff are responsible for your experience and replace it with a model of partnership in which you lead with your voice while your team supports with expertise.To move from scattered preferences to a cohesive vision, we offer coaching questions that clarify what you want to feel, which choices matter most, what's in your control, and who needs to be aligned—your provider, partner, and doula. This value-first approach reduces confusion, improves decision-making under stress, and lowers the risk of birth trauma by keeping you informed, respected, and engaged. By the end, you'll have a framework to document preferences with purpose and the confidence to adapt without self-blame.If this resonates, share it with a friend who's building a birth plan, subscribe for more coaching-led birth prep, and leave a quick review to tell us which question shifted your mindset. Coaching offerKelly Hof: Labor Nurse + Birth CoachBasically, I'm your birth bestie! With me as your coach, you will tell fear to take a hike!Support the showConnect with Kelly at kellyhof.com Join the Bump & Beyond Online Community!https://www.facebook.com/groups/bumpnbeyondGrab The Book of Hormones on Amazon!Medical Disclaimer:This podcast is intended as a safe space for women to share their birth experiences. It is not intended to provide medical advice. Each woman's medical course of action is individual and may not appropriately transfer to another similar situation. Please speak to your medical provider before making any medical decisions. Additionally, it is important to keep in mind that evidence based practice evolves as our knowledge of science improves. To the best of my ability I will attempt to present the most current ACOG and AWHONN recommendations at the time the podcast is recorded, but that may not necessarily reflect the best practices at the time the podcast is heard. Additionally, guests sharing their stories have the right to autonomy in their medical decisions, and may share their choice to go against current practice recommendations. I intend to hold space for people to share their decisions. I will attempt to share the current recommendations so that my audience is informed, but it is up to each individual to choose what is best for them.

Currently, as of today's date, neither the ACOG nor SMFM currently support routine early induction of labor for suspected fetal macrosomia, instead recommending individualized counseling and reserving elective cesarean for extreme estimated fetal weights. However, a 2025 multicenter, open-label, randomized controlled trial was published in the Lancet comparing induction of labor versus standard care in pregnant women with fetuses suspected to be large for gestational age. The study used a parallel-group design with 1:1 randomization, enrolling women from 106 NHS hospitals across England, Scotland, and Wales. The per-protocol analysis demonstrated a significant reduction (40%) in shoulder dystocia with induction of labor at 38- 38 weeks and 4 days. Is this in conflict with the ACOG current guidance? In this episode, we will review the “Big Baby study” from the Lancet and provide 3 main limitations of this very large study, review the importance of PP vs ITT results, and explain why more data is still needed. Listen in for details. 1. ACOG PB 178; 2017 (reaffirmed 2024)2. Gardosi J, Ewington LJ, Booth K, Bick D, Bouliotis G, Butler E, Deshpande S, Ellson H, Fisher J, Gornall A, Lall R, Mistry H, Naghdi S, Petrou S, Slowther AM, Wood S, Underwood M, Quenby S. Induction of labour versus standard care to prevent shoulder dystocia in fetuses suspected to be large for gestational age in the UK (the Big Baby trial): a multicentre, open-label, randomised controlled trial. Lancet. 2025 May 17;405(10491):1743-1756. doi: 10.1016/S0140-6736(25)00162-X. Epub 2025 May 1. PMID: 40319899.3. Blaauwgeers, Anne N et al. Rethinking induction of labour for LGA fetuses: the Big Baby trial. The Lancet, Volume 406, Issue 10512, 1562

As cannabis becomes more widely available and socially accepted, so does the misconception that it's safe to use during pregnancy and lactation. This course reviews updated guidance from the American College of Obstetricians and Gynecologists (ACOG), highlighting the evidence behind the risks and outlining how pharmacists can address misinformation and counsel patients effectively. You will learn how to support safe, informed decision-making that promotes the health of both parent and child.HOSTRachel Maynard, PharmDGameChangers Podcast Host and Clinical Editor, CEimpactLead Editor, PyrlsGUESTKevin Shea, PharmDPharmacist Vytal Options  Pharmacists, REDEEM YOUR CPE HERE!CPE is available to Health Mart franchise members onlyTo learn more about Health Mart, click here: https://join.healthmart.com/CPE INFORMATION Learning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Identify current ACOG recommendations regarding cannabis use during pregnancy and lactation.2. Describe pharmacist strategies for screening, counseling, and reducing risks associated with cannabis use during the perinatal period.Rachel Maynard and Kevin Shea have no relevant financial relationships to disclose.0.05 CEU/0.5 HrUAN: 0107-0000-25-377-H01-PInitial release date: 12/29/2025Expiration date: 12/29/2026Additional CPE details can be found here.

As cannabis becomes more widely available and socially accepted, so does the misconception that it's safe to use during pregnancy and lactation. This course reviews updated guidance from the American College of Obstetricians and Gynecologists (ACOG), highlighting the evidence behind the risks and outlining how pharmacists can address misinformation and counsel patients effectively. You will learn how to support safe, informed decision-making that promotes the health of both parent and child.HOSTRachel Maynard, PharmDGameChangers Podcast Host and Clinical Editor, CEimpactLead Editor, PyrlsGUESTKevin Shea, PharmDPharmacist Vytal Options PRACTICE RESOURCEPurchase this course to receive the exclusive downloadable practice resource handout to use as a reference guide to the podcast. CPE REDEMPTIONThis course is accredited for continuing pharmacy education! Click the link below that applies to you to take the exam and evaluation:If you are already enrolled in this course, click here to redeem your credit. To purchase this episode and claim your CPE credit, click here. CPE INFORMATIONLearning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Identify current ACOG recommendations regarding cannabis use during pregnancy and lactation.2. Describe pharmacist strategies for screening, counseling, and reducing risks associated with cannabis use during the perinatal period.Rachel Maynard and Kevin Shea have no relevant financial relationships to disclose.0.05 CEU/0.5 HrUAN: 0107-0000-25-377-H01-PInitial release date: 12/29/2025Expiration date: 12/29/2026Additional CPE details can be found here.Follow CEimpact on Social Media:LinkedInInstagram

Podcast Family, in our immediate past episode we tackled the discrepancy that is often found between a clinical diagnosis of intra-amniotic infection/chorioamnionitis and histological chorioamnionitis. From that episode, we received a fantastic question from one of our podcast family members: Can a patient have IAI without fever? That question is really deep and highlights a gap in the current diagnostic scheme/ criteria from the ACOG. Listen in for details!1. ACOG CO 7122. Sukumaran S, Pereira V, Mallur S, Chandraharan E. Cardiotocograph (CTG) Changes and Maternal and Neonatal Outcomes in Chorioamnionitis and/­or Funisitis Confirmed on Histopathology. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2021. C3. Romero R, Chaemsaithong P, Korzeniewski SJ, et al. Clinical Chorioamnionitis at Term III: How Well Do Clinical Criteria Perform in the Identification of Proven Intra-Amniotic Infection? Journal of Perinatal Medicine. 2015.

Send us a textMost moms are scared of labor because no one ever explains what the sensations actually feel like. So today, we're breaking it down — in real, simple, honest terms.In this video, we talk about: ✨ What early labor really feels like ✨ How contractions change as your body opens ✨ Why pelvic pressure feels so intense (and why it's GOOD) ✨ The emotional “crisis moments” that happen right before progress ✨ How to reframe sensations so you feel confident instead of scaredWhen you understand what's happening in your body, labor stops feeling like something to fear — and starts feeling like something you can move with.If you want the notes from this video (including the labor sensation guide + the self-coaching prompts), comment NOTES below and I'll send them to you.

Depo-Provera was approved in 1992 by U.S. regulators. About 1 in 4 sexually active women in the United States have used the shot at some point, according to the U.S. Centers for Disease Control and Prevention (CDC). Meningiomas are common intracranial tumors with a female predominance. In fact, they are the most common primary brain tumor in women, with an incidence of approximately 12.76 per 100,000 in the general female population. The vast majority of these tumors are benign (World Health Organization [WHO] grade 1) while 15% to 20% of these tumors can behave atypically (WHO grade 2) and rarely, in 1% to 2% of cases, these tumors can be malignant (WHO grade 3). We covered the relationship between Depo-Provera, as a contraceptive agent, and brain meningiomas back in March 2024. With the increase in data, the ACOG released a patient centered counseling tool titled, “Counseling Patients on Birth Control Injection and Meningioma”. The most recent update on this story comes from the FDA, which has granted a medication label change to Depo-Provera (Pfizer) warning of this association. Even though association does not prove causation, the association between depo and meningiomas seems strong (with new data from the US). Does this warning extend to other progestins? Listen in for details. 1. https://podcasts.apple.com/us/podcast/dr-chapas-obgyn-clinical-pearls/id1412385746?i=10006508795722. ACOG's “Counseling Patients on Birth Control Injection and Meningioma” 3. https://www.statnews.com/pharmalot/2025/12/17/fda-pfizer-contraception-cancer-preemption-depoprovera/4. Xiao T, Kumar P, Lobbous M, et al. Depot Medroxyprogesterone Acetate and Risk of Meningioma in the US. JAMA Neurology. 2025;82(11):1094-1102. doi:10.1001/jamaneurol.2025.3011.5. de Dios E, Näslund O, Choudhry M, et al.Prevalence and Symptoms of Incidental Meningiomas: A Population-Based Study.Acta Neurochirurgica. 2025;167(1):98. doi:10.1007/s00701-025-06506-7.6. Schaff LR, Mellinghoff IK.Glioblastoma and Other Primary Brain Malignancies in Adults: A Review. JAMA. 2023;329(7):574-587. doi:10.1001/jama.2023.0023.7. BMJ 2024; 384 doi: https://doi.org/10.1136/bmj-2023-078078 (Published 27 March 2024) Cite this as: BMJ 2024;384:e078078

The second stage of labor, characterized by active pushing and the descent of the fetal head, can be a challenging and prolonged phase for both mother and baby. Various interventions have been explored to optimize this stage, and one such technique involves the application of vaginal lubricants. The rationale behind this approach is to reduce friction between the fetal head and the birth canal, potentially leading to smoother and faster delivery. Does this seemingly simple technique work? Does the ACOG mention this in the CPG 8 from January 2024? What does the latest research tell us about its effectiveness in assisting or speeding up the birthing process? Listen in for details.1. Yang Q, Cao X, Hu S, Sun M, Lai H, Hou L, Wang Q, Wu C, Wu Y, Xiao L, Luo X, Tian J, Ge L, Shi L. Lubricant for reducing perineal trauma: A systematic review and meta-analysis of randomized controlled trials. J Obstet Gynaecol Res. 2022 Nov;48(11):2807-2820. doi: 10.1111/jog.15399. Epub 2022 Aug 16. PMID: 36319196.2. ACOG: First and Second Stage Labor Management Clinical Practice Guideline Number 8: January 20243. Aquino CI, Saccone G, Troisi J, Zullo F, Guida M, Berghella V. Use of lubricant gel to shorten the second stage of labor during vaginal delivery. J Matern Fetal Neonatal Med. 2019 Dec;32(24):4166-4173. doi: 10.1080/14767058.2018.1482271. Epub 2018 Jun 27. PMID: 29804505.4. Beckmann MM, Stock OM. Antenatal Perineal Massage for Reducing Perineal Trauma. The Cochrane Database of Systematic Reviews. 2013;(4):CD005123. doi:10.1002/14651858.CD005123.pub3.

Breech presentation can bring up a lot of questions, uncertainty, and fear for expecting families—especially when conversations quickly turn to C-sections as the default option. In this episode of The New Mom Talk Podcast, we take a closer look at the current ACOG (American College of Obstetricians and Gynecologists) guidelines on breech presentation and vaginal delivery, and what they actually mean for parents navigating this situation.Our guest, Dr. Elliot Berlin, is a pregnancy-focused chiropractor, childbirth educator, and host of the Informed Pregnancy Podcast. He is also the creator of Informed Pregnancy Plus, a streaming platform for pregnancy education, and One Way or a Mother, an audio docuseries that explores real birth stories in depth. With decades of experience supporting families through pregnancy and birth, Dr. Berlin brings a balanced, evidence-based perspective to this important topic.In this conversation, we start by breaking down what ACOG stands for and why its guidelines matter when making informed decisions about birth. Dr. Berlin explains how ACOG's stance on vaginal breech birth has evolved over time, including why access to vaginal breech delivery has become more limited despite updated guidance that supports it in specific situations.We discuss the criteria providers may consider when determining whether someone is a good candidate for a vaginal breech birth, such as fetal position, gestational age, provider training, and birth setting. Dr. Berlin also shares insight into how accessible vaginal breech birth is today, why many families struggle to find supportive providers, and how parents can advocate for themselves when discussing options.Finally, we explore the risks and benefits of planned vaginal breech birth versus scheduled C-section, along with practical ways parents can educate themselves and prepare mentally, emotionally, and physically—especially if a breech presentation is discovered later in pregnancy.Whether you're currently facing a breech diagnosis or simply want to be more informed about your options, this episode empowers you with knowledge, context, and tools to have confident, informed conversations with your care team.Connect with Dr. Elliot Berlin:Official Website: https://www.doctorberlin.com/IG: @doctorberlin acog guidelines breech birth, vaginal breech delivery, breech presentation pregnancy, vaginal breech birth risks and benefits, breech birth options, informed pregnancy podcast, dr elliot berlin, breech birth advocacy, pregnancy education, childbirth decision makingwww.NewMomTalk.comBuy Me A CoffeeIG: @NewMomTalk.PodcastYouTube: @NewMomTalkMariela@NewMomTalk.comInterested in being a guest? Shoot us an email!- best parenting podcast- best new mom podcast- best podcasts for new moms- best pregnancy podcast- best podcast for expecting moms- best podcast for moms- best podcast for postpartum- best prenatal podcast- best postnatal podcast- best podcast for postnatal moms- best podcast for pregnancy moms- new mom - expecting mom- first time mom

Send us a textBirth often feels like a test you can fail, even when you and your baby are healthy. We tackle the missing support layer that changes that feeling: prenatal coaching that builds a grounded mindset, clear communication, and a flexible plan you can trust when things get real.We start by naming the gap most parents feel between medical safety and emotional steadiness. I walk through how prenatal coaching complements your OB, midwife, nurses, and doula by focusing on beliefs, boundaries, and language. Together, we surface the quiet stories—like “natural is the only good birth” or “if I plan hard enough, I can control everything”—and gently replace them with thoughts that match your values. You'll hear how to craft a birth vision that guides decisions without boxing you in when clinical realities change.From there, we practice power-sharing with providers so consent becomes a conversation. I share simple, high-impact questions that help you pause, understand risks and benefits, and consider options without escalating conflict. We dig into what reduces emotional birth trauma: asking for explanations when safe, naming your preferences, and learning grounding tools that work in triage or transition. I also clarify what a prenatal coach does and doesn't do—I'm not diagnosing or changing meds; I'm your thinking partner before birth and a steady guide in the debrief after.If you've felt anxious at appointments, stuck between induction and waiting, wondering about epidurals or VBAC, or carrying a hard first birth into a new pregnancy, this conversation offers a way forward. You'll leave with language to advocate, a mindset that lowers shame, and a vision that helps you feel like the leader of your birth story. If you want the detailed notes with questions to ask, common beliefs to revisit, and prompts to start your birth vision, comment “notes” and I'll send them your way. Like what you heard? Subscribe, share with a friend, and leave a review to help others find the show. Coaching offerKelly Hof: Labor Nurse + Birth CoachBasically, I'm your birth bestie! With me as your coach, you will tell fear to take a hike!Support the showConnect with Kelly at kellyhof.com Join the Bump & Beyond Online Community!https://www.facebook.com/groups/bumpnbeyondGrab The Book of Hormones on Amazon!Medical Disclaimer:This podcast is intended as a safe space for women to share their birth experiences. It is not intended to provide medical advice. Each woman's medical course of action is individual and may not appropriately transfer to another similar situation. Please speak to your medical provider before making any medical decisions. Additionally, it is important to keep in mind that evidence based practice evolves as our knowledge of science improves. To the best of my ability I will attempt to present the most current ACOG and AWHONN recommendations at the time the podcast is recorded, but that may not necessarily reflect the best practices at the time the podcast is heard. Additionally, guests sharing their stories have the right to autonomy in their medical decisions, and may share their choice to go against current practice recommendations. I intend to hold space for people to share their decisions. I will attempt to share the current recommendations so that my audience is informed, but it is up to each individual to choose what is best for them.

It's so interesting to see how medical evidence evolves, and changes, over time. The result of course is that clinical practice evolves and changes as well. The story of umbilical cord management at time of delivery highlights this very issue very well. The ACOG first recommended delayed cord clamping (DCC) in 2012, for preterm infants, as data showed marked improvement in neonatal outcomes in that population. In this episode, we will briefly walk through the timeline from 2012 to the latest update on DCC which came from the AAP in October 2025, just one month after the ACOG had their DCC update. This story also exemplifies how professional medical societies don't always have the SAME recommendations, with small tweaks, in their guidance. So, Dr Chapa and I will summarize these key updates…Listen in for details!1. ACOG 2012: DCC for preterm infants only 2. ACOG 2016: ACOG Recommends Delayed Umbilical Cord Clamping for All Healthy Infants, including term: https://mdedge.com/obgynnews/article/121349/obstetrics/acog-supports-delayed-umbilical-cord-clamping-term-infants3. ACOG Dec 2020, CO 814: Delayed Umbilical Cord Clamping After Birth4. ACOG Obstet Gynecol. January 2022; 139(1): 121–137. doi:10.1097/AOG.0000000000004625. Management of Placental Transfusion to Neonates After Delivery5. ACOG (ePUB July ) Sept 2025: ACOG releases a Clinical Practice Update: An Update to Clinical Guidance for Delayed Umbilical Cord Clamping After Birth in Preterm Neonates6. AHA/AAP Oct 2025 Update: Neonatal Resuscitation: 2025 American Heart Association and American Academy of Pediatrics Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Send us a textYour prenatal care should feel calm, respectful, and evidence-based—yet many of us hit a point where advice from a provider doesn't match what we've learned or what our gut is telling us. That moment is disorienting. We break down why it feels so heavy, how to get grounded fast, and the practical steps to find alignment without burning bridges.We start by naming the emotional waves that follow a shaken trust: fear that you're missing something, grief for the relationship you thought you had, and the stress of choices you didn't expect to make late in pregnancy. From there, we anchor to ACOG standards—the baseline for safe, evidence-based care—and highlight five clear red flags: recommendations that don't align with guidance, dismissive responses to questions, a tone shift toward rigidity near your due date, inconsistent information inside a group practice, and that loud, unsettled intuition after appointments.You'll get simple, powerful scripts to slow things down in the room: ask for the medical reasoning, whether the advice is individualized or a policy, and whether there's time to think before deciding. We talk through the “middle space” between staying and switching—how to sit with your feelings, confirm the guideline, and plan one focused follow-up conversation that can restore trust or confirm misalignment. If a switch becomes the right move, we share how parents successfully transition even late in pregnancy, how to transfer records smoothly, and how to reframe the change as moving toward the birth experience you want and deserve.By the end, you'll trust your intuition as data, know how to compare recommendations to ACOG guidance, and feel confident seeking a second opinion or a new provider when needed. If this helped, subscribe, share with a friend who needs it, and leave a review telling us which question you'll bring to your next prenatal visit. Coaching offerKelly Hof: Labor Nurse + Birth CoachBasically, I'm your birth bestie! With me as your coach, you will tell fear to take a hike!Support the showConnect with Kelly at kellyhof.com Join the Bump & Beyond Online Community!https://www.facebook.com/groups/bumpnbeyondGrab The Book of Hormones on Amazon!Medical Disclaimer:This podcast is intended as a safe space for women to share their birth experiences. It is not intended to provide medical advice. Each woman's medical course of action is individual and may not appropriately transfer to another similar situation. Please speak to your medical provider before making any medical decisions. Additionally, it is important to keep in mind that evidence based practice evolves as our knowledge of science improves. To the best of my ability I will attempt to present the most current ACOG and AWHONN recommendations at the time the podcast is recorded, but that may not necessarily reflect the best practices at the time the podcast is heard. Additionally, guests sharing their stories have the right to autonomy in their medical decisions, and may share their choice to go against current practice recommendations. I intend to hold space for people to share their decisions. I will attempt to share the current recommendations so that my audience is informed, but it is up to each individual to choose what is best for them.

Major health organizations, including the CDC and ACOG, recommend universal Hepatitis C Virus (HCV) screening for all pregnant women during each pregnancy and at time of delivery. Ideally, pregnant women should be screened for hepatitis C virus infection at the first prenatal visit of each pregnancy. If the antibody screen result is positive, hepatitis C virus RNA polymerase chain reaction testing is done to confirm the diagnosis. The risk of perinatal transmission of HCV is up to 9%, with at least one-third of transmissions occurring antenatally. While antiviral therapy is recommended for Hepatitis B in pregnancy with a viral load greater than 200,000 international units/mL to decrease the risk of vertical transmission, the same is not the case for Hep C. According to the ACOG CPG #6 from September 2023, there are no standard treatment protocols for Hep C in pregnancy but a new publication from the PINK journal (7 Dec 2025) is calling for a change. That new publication is, “Hepatitis C Treatment During Pregnancy: Time for a Practice Change”. Listen in for details. 1. ACOG CPG #6; Sept 20262. Bhattacharya D, Aronsohn A, Price J, Lo Re V. Hepatitis C Guidance 2023 Update: AASLD-IDSA Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 2023;:ciad319. doi:10.1093/cid/ciad319.3. Chappell CA, Kiser JJ, Brooks KM, et al. Sofosbuvir/¬Velpatasvir Pharmacokinetics, Safety, and Efficacy in Pregnant People With Hepatitis C Virus. Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America. 2025;80(4):744-751. doi:10.1093/cid/ciae595.4. Reau N, Munoz SJ, Schiano T. Liver Disease During Pregnancy. The American Journal of Gastroenterology. 2022;117(10S):44-52. doi:10.14309/ajg.0000000000001960.5. Dutra, Karley et al. Hepatitis C Treatment During Pregnancy: Time for a Practice Change. American Journal of Obstetrics & Gynecology MFM, Volume 0, Issue 0, 1018656. Society for Maternal-Fetal Medicine Consult Series #56: Hepatitis C in Pregnancy-Updated Guidelines: Replaces Consult Number 43, November 2017. Society for Maternal-Fetal Medicine (SMFM). Electronic address: pubs@smfm.org, Dotters-Katz SK, Kuller JA, Hughes BL. American Journal of Obstetrics and Gynecology. 2021;225(3):B8-B18. doi:10.1016/j.ajog.2021.06.008

Send us a textBirth feels different when the room feels safe. We dig into how to choose a doula by focusing on connection, clarity, and calm rather than running a rigid checklist. Instead of quizzing someone for the “right” answers, we map the questions that actually reveal fit: their vibe during intensity, their range across home and hospital births, and how they help you stay informed without pushing an agenda. If your goal is a steadier nervous system and a smoother decision path, this conversation gives you the language to get there.We break down what to ask and why it matters: how they describe their style, the types of births they've supported, their comfort with inductions and c-sections, and how they collaborate with nurses and providers when decisions move quickly. You'll hear how to screen for flexibility and respect for your choices, plus the cues that signal a red flag—like fighting the hospital rather than helping you navigate it. We also cover communication plans, on-call timing, when they typically join you in labor, and how they include partners so your support team works as one.Backups and advocacy round it out. You'll learn how to ask about backup doulas and why a quick intro can ease last-minute stress. Then we define real advocacy in the hospital: making space for your voice, slowing moments for consent, and protecting your presence without speaking over others. By the end, you'll know which few questions to ask, what a good answer sounds like, and how to trust the feeling in your body when the fit is right. If you're planning a hospital birth, exploring unmedicated options, or anywhere in between, this guide helps you choose support that aligns with your values.If this helped you get clear, follow the show, share it with someone planning their birth, and leave a quick review so others can find it. And if you want my notes from this video, comment “notes” below. Coaching offerKelly Hof: Labor Nurse + Birth CoachBasically, I'm your birth bestie! With me as your coach, you will tell fear to take a hike!Support the showConnect with Kelly at kellyhof.com Join the Bump & Beyond Online Community!https://www.facebook.com/groups/bumpnbeyondGrab The Book of Hormones on Amazon!Medical Disclaimer:This podcast is intended as a safe space for women to share their birth experiences. It is not intended to provide medical advice. Each woman's medical course of action is individual and may not appropriately transfer to another similar situation. Please speak to your medical provider before making any medical decisions. Additionally, it is important to keep in mind that evidence based practice evolves as our knowledge of science improves. To the best of my ability I will attempt to present the most current ACOG and AWHONN recommendations at the time the podcast is recorded, but that may not necessarily reflect the best practices at the time the podcast is heard. Additionally, guests sharing their stories have the right to autonomy in their medical decisions, and may share their choice to go against current practice recommendations. I intend to hold space for people to share their decisions. I will attempt to share the current recommendations so that my audience is informed, but it is up to each individual to choose what is best for them.

Send us a textThe holidays ask a lot from anyone, and even more from someone navigating pregnancy or early postpartum. Between loud rooms, strong smells, and a conveyor belt of opinions about your body and your baby, your nervous system can hit overload fast. We dive into why this happens, how to spot it sooner, and the exact words you can use to step away without guilt or drama.You'll hear our favorite “golden ticket” exit lines that protect your peace while sounding perfectly reasonable to family and friends. For pregnancy, phrases like I'm exhausted, I need to lie down for a bit or These smells are overwhelming, I'm going to get some fresh air let you reset before stress spikes. For postpartum, baby-centered lines such as Baby needs to feed somewhere quiet or It's getting too stimulating for the baby create space for both of you to breathe. We also share boundary scripts for classic comments like Are you sure you should eat that? and You look ready to pop, using neutral redirects, the expert card, humor that disarms, and firm shutdowns for repeat offenders.We close with clean, kind ways to leave early—We're heading home, I'm at my limit today, My body's telling me it needs rest—so you can honor your limits without overexplaining. The goal isn't to win debates; it's to protect your energy, reduce overstimulation, and keep your mental health front and center during a season that can quickly become too much. If you're ready to choose calm over chaos and practice self-trust in real time, this one's for you.If this resonated, follow the show, share it with a friend who needs permission to leave early, and leave a quick review telling us which script you'll try first. Your peace matters—let's protect it together. Coaching offerKelly Hof: Labor Nurse + Birth CoachBasically, I'm your birth bestie! With me as your coach, you will tell fear to take a hike!Support the showConnect with Kelly at kellyhof.com Join the Bump & Beyond Online Community!https://www.facebook.com/groups/bumpnbeyondGrab The Book of Hormones on Amazon!Medical Disclaimer:This podcast is intended as a safe space for women to share their birth experiences. It is not intended to provide medical advice. Each woman's medical course of action is individual and may not appropriately transfer to another similar situation. Please speak to your medical provider before making any medical decisions. Additionally, it is important to keep in mind that evidence based practice evolves as our knowledge of science improves. To the best of my ability I will attempt to present the most current ACOG and AWHONN recommendations at the time the podcast is recorded, but that may not necessarily reflect the best practices at the time the podcast is heard. Additionally, guests sharing their stories have the right to autonomy in their medical decisions, and may share their choice to go against current practice recommendations. I intend to hold space for people to share their decisions. I will attempt to share the current recommendations so that my audience is informed, but it is up to each individual to choose what is best for them.

Lisa Bourne walks through the month's most significant life issues—from new developments in late-term abortion access and alarming cases of chemical abortion misuse, to sweeping pro-abortion legislation advancing in Pennsylvania. The episode also covers ACOG's recent comments on self-managed abortion … Continue reading →

Having data is sometimes different than having clinically applicable data. This is exactly the issue with the proposed plan to reduce surgical site infection (SSI) by changing surgical gloves after placental delivery at C-Section. Just 24 hours ago, we received the question from a PGY4 OBGYN resident asking whether the practice of changing surgical gloves at C-Section after placental delivery to reduce SSI was evidence-based. So, in this episode, we will review the data - which is timely since this was recently published on November 13, 2025 in the J Hospital Infection. This study follows a statement on this practice released by FIGO in September 2025. It's an interesting proposal, and there is clearly data in support of this, yet the ACOG and CDC do not recommend this practice as of Nov 2025. Is there a disconnect? Listen in for details. 1. FIGO: https://www.figo.org/news/new-ijgo-review-provides-comprehensive-framework-preventing-post-caesarean-sepsis (International Journal of Gynecology & Obstetrics)2. Stanberry B, Jordan L, Pullyblank A, Hargreaves J. Glove change during caesarean birth: impact on maternity service budgets and capacity. J Hosp Infect. 2025 Nov 13:S0195-6701(25)00354-8. doi: 10.1016/j.jhin.2025.10.033. Epub ahead of print. PMID: 41241232.3. Narice BF, Almeida JR, Farrell T, Madhuvrata P. Impact of Changing Gloves During Cesarean Section on Postoperative Infective Complications: A Systematic Review and Meta-Analysis. Acta Obstetricia Et Gynecologica Scandinavica. 2021;100(9):1581-1594. doi:10.1111/aogs.14161.4. Routine Sterile Glove and Instrument Change at the Time of Abdominal Wound Closure to Prevent Surgical Site Infection (ChEETAh): A Pragmatic, Cluster-Randomised Trial in Seven Low-Income and Middle-Income Countries.NIHR Global Research Health Unit on Global Surgery. Lancet (London, England). 2022;400(10365):1767-1776. doi:10.1016/S0140-6736(22)01884-0.5. Gialdini C, Chamillard M, Diaz V, Pasquale J, Thangaratinam S, Abalos E, Torloni MR, Betran AP. Evidence-based surgical procedures to optimize caesarean outcomes: an overview of systematic reviews. EClinicalMedicine. 2024 May 19;72:102632. doi: 10.1016/j.eclinm.2024.102632. PMID: 38812964; PMCID: PMC11134562.

Send us a textWhen contractions hit and the baby feels low, the last thing any parent needs is a clipboard. We walk through the legal protections that guarantee timely care under EMTALA and translate them into practical steps you can use the moment you arrive at the hospital in labor. From spotting red flags of imminent birth to understanding exactly what “medical screening exam” and “stabilizing care” should look like, we break complex policy into clear, actionable moves that keep you and your baby safe.You'll hear a grounded, real-world analysis of a widely shared ER incident and why it mattered—not for outrage, but as a lesson in what to demand. We share concise scripts your partner can read verbatim to activate the right team fast: how to ask for the labor and delivery charge nurse, how to request an OB rapid response, and what to say if anyone prioritizes paperwork over care. We also cover what to prepare now: a phone note titled “Hospital: My Rights In Labor,” a simple printed card to hand over if you can't speak, and smart questions to ask your provider about emergency workflows and who moves you to labor and delivery.We speak directly to Black mothers and families about the documented risks of delayed care and minimized pain, offering tools to be heard the first time. The goal isn't fear—it's confidence. With a few phrases, a plan, and a clear understanding of your rights, you can turn confusion into momentum and make the hospital work for you when minutes matter.If this helped, subscribe, share with a parent-to-be, and leave a review with the one phrase you're saving to your phone. Your story could help someone get the care they're owed. Coaching offerKelly Hof: Labor Nurse + Birth CoachBasically, I'm your birth bestie! With me as your coach, you will tell fear to take a hike!Support the showConnect with Kelly at kellyhof.com Join the Bump & Beyond Online Community!https://www.facebook.com/groups/bumpnbeyondGrab The Book of Hormones on Amazon!Medical Disclaimer:This podcast is intended as a safe space for women to share their birth experiences. It is not intended to provide medical advice. Each woman's medical course of action is individual and may not appropriately transfer to another similar situation. Please speak to your medical provider before making any medical decisions. Additionally, it is important to keep in mind that evidence based practice evolves as our knowledge of science improves. To the best of my ability I will attempt to present the most current ACOG and AWHONN recommendations at the time the podcast is recorded, but that may not necessarily reflect the best practices at the time the podcast is heard. Additionally, guests sharing their stories have the right to autonomy in their medical decisions, and may share their choice to go against current practice recommendations. I intend to hold space for people to share their decisions. I will attempt to share the current recommendations so that my audience is informed, but it is up to each individual to choose what is best for them.

In this episode, we tackle one of the most common questions in pregnancy of late: Is Tylenol safe? It's the medication nearly every pregnant person reaches for at some point, yet the internet is full of conflicting headlines and confusing studies. We break down what the data actually shows, when Tylenol is appropriate, and how to use it safely. What We Cover • Why Tylenol (acetaminophen) is considered one of the first-lines in pregnancy We explain decades of clinical use, major guideline recommendations, and why it remains the preferred option for fever and pain relief. • What the research actually says about safety We unpack the difference between correlation and causation, discuss recent observational studies, and highlight what ACOG and SMFM currently recommend. • When Tylenol is truly needed Fever above 100.4, migraines, musculoskeletal pain, postpartum use, and how untreated fever or pain can create more risk than the medication itself. • How to use it safely Typical dosing, maximum limits in 24 hours, how to avoid hidden acetaminophen in combination products, and who should be more cautious. • What to avoid We clarify why NSAIDs (like ibuprofen) are not recommended in most stages of pregnancy and why people often confuse these medications. Resources Mentioned • ACOG guidance on pain and fever management during pregnancy • SMFM clinical recommendations • FDA medication safety overview (pregnancy and lactation) Call to Action If you have questions about medication safety in pregnancy or aren't sure what's right for your symptoms, talk with a clinician who understands the nuances of both maternal health and functional medicine. The right guidance can give you confidence and peace of mind.   Got something you want to share or ask? Keep it coming.  We love hearing from you. Email us or send a voice memo, and you might just hear it on the next episode. Don't forget to like, comment, and subscribe—your questions could be featured in our next episode! For additional resources and information, be sure to visit our website at Maternal Resources: https://www.maternalresources.org/. You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement: YouTube: Dive deeper into pregnancy tips and stories atyoutube.com/maternalresources . Instagram: Follow us for daily inspiration and updates at @maternalresources . Facebook: Join our community at facebook.com/IntegrativeOB Tiktok: NatureBack Doc on TikTok Grab Our Book! Check out The NatureBack Method for Birth—your guide to a empowered pregnancy and delivery. Shop now at naturebackbook.myshopify.com .  

Send us a textBirth can be both clinical and deeply human, and few moments capture that better than a planned C-section. I wanted to remove the mystery and the fear, so I walk you step by step through what it actually feels like—from walking into a bright, cold OR to hearing that first cry and settling into recovery with your baby. This is not theory; it's a grounded, nurse-led guide to sensations, timelines, and choices that help you feel safe and in control.I start with the spinal: what the quick pinch feels like, how the warmth spreads, and why numbness without sharp pain lets you stay awake and present. You'll learn how the team preps your abdomen, places the drape, and runs a safety timeout that confirms your identity and plan. Then I get honest about the odd but normal feelings during surgery—deep pressure, tugging, and that famous “doing dishes in my belly” sensation—as the team guides your baby to the incision. I cover cord clamping timing, the brief handoff to the NICU nurse, and options for skin to skin while your surgeon completes the careful, longer closure of the uterus, fascia, and skin.Recovery gets equal attention. I explain the first two hours in the PACU, why shivering and itching can happen, how often your uterus is checked, and how early mobility lowers clot risk and eases gas pain. You'll hear practical tips on feeding, pain management, and what soreness and tightness feel like in the first days. Throughout, I keep the focus on respect, safety, and choice, rooted in real clinical steps and clear language.If you or someone you love is preparing for a C-section, this walkthrough turns the unknown into a map. Listen, share with a partner, and save it for the big day. If you want the deeper dive on anesthesia from Dr. Bella Spate, comment “podcast” below for the link—and don't forget to follow, rate, and leave a review to help others find this birth resource. Coaching offerKelly Hof: Labor Nurse + Birth CoachBasically, I'm your birth bestie! With me as your coach, you will tell fear to take a hike!Support the showConnect with Kelly at kellyhof.com Join the Bump & Beyond Online Community!https://www.facebook.com/groups/bumpnbeyondGrab The Book of Hormones on Amazon!Medical Disclaimer:This podcast is intended as a safe space for women to share their birth experiences. It is not intended to provide medical advice. Each woman's medical course of action is individual and may not appropriately transfer to another similar situation. Please speak to your medical provider before making any medical decisions. Additionally, it is important to keep in mind that evidence based practice evolves as our knowledge of science improves. To the best of my ability I will attempt to present the most current ACOG and AWHONN recommendations at the time the podcast is recorded, but that may not necessarily reflect the best practices at the time the podcast is heard. Additionally, guests sharing their stories have the right to autonomy in their medical decisions, and may share their choice to go against current practice recommendations. I intend to hold space for people to share their decisions. I will attempt to share the current recommendations so that my audience is informed, but it is up to each individual to choose what is best for them.

The ACOG acknowledges that maternal obesity affects labor curves and recommends allowing more time for cervical dilation before diagnosing labor arrest in obese patients. This approach aims to avoid unnecessary interventions, such as premature cesarean delivery, which may occur if standard labor curves are strictly applied to obese women. In this episode, we will review a new study from the AJOG (08 Nov 2025) which describes labor progression and duration according to maternal body mass index, validating the need (possibly) for a BMI -based labor curve. Has there been advocates of a BMI-based labor curve? Listen in for details.1. Edwards, Sara et al. Characterizing Labor Progression and Duration According to Maternal Body Mass Index. American Journal of Obstetrics & Gynecology, Volume 0, Issue 02. Lundborg L, Liu X, Åberg K, et al. Association of Body Mass Index and Maternal Age With First Stage Duration of Labour. Scientific Reports. 2021;11(1):13843. doi:10.1038/s41598-021-93217-5.3. Kominiarek MA, Zhang J, Vanveldhuisen P, et al. Contemporary Labor Patterns: The Impact of Maternal Body Mass Index. American Journal of Obstetrics and Gynecology. 2011;205(3):244.e1-8. doi:10.1016/j.ajog.2011.06.014.4. Norman SM, Tuuli MG, Odibo AO, et al. The Effects of Obesity on the First Stage of Labor.Obstetrics and Gynecology. 2012;120(1):130-5. doi:10.1097/AOG.0b013e318259589c.

 #surrogacy #ivf #surrogate Grace's Instagram: https://www.instagram.com/graces_surro_journey?igsh=MzRlODBiNWFlZA== Kiely's Instagram: https://www.instagram.com/thatsurrogatelife?igsh=NTc4MTIwNjQ2YQ==What happens when the transfers are done, the last delivery is behind you, and the identity you wore with pride suddenly shifts? We sit down with a seasoned pair of voices—Grace, a two‑time carrier, and Kiely, a four‑time carrier—to talk candidly about “retirement” from surrogacy, the choice to step back versus being told no by clinics, and the surprising ways purpose expands after the final journey.The conversation moves from age cutoffs and ACOG guidance on C‑sections to the emotional calculus of ending on your own terms. Grace shares how preparing for her last pregnancy shaped a peaceful exit, while Kiely explains why she wanted the decision to be hers, then channeled that energy into writing, mentoring, and creating Send a Friend, a grassroots program that brings an experienced surrogate to support first‑time postpartum surrogates. Along the way, we reflect on what surrogacy teaches our families: that love builds families in many forms; that children can learn to answer strangers with clarity and pride; and that empathy deepens when you stand next to someone who longs for a child money can't buy.We also get practical. Expect frank talk about changing insurance rules, clinic discretion, compensation norms, and how to research without falling into bias. You'll hear why Facebook groups can be both a lifeline and a minefield, and how to gather perspective that sets realistic expectations for matching, protocols, and postpartum recovery. Most of all, we reframe the label “retired.” You're not done—you're a surrogate emerita, carrying wisdom forward through advocacy, education, and community.If this conversation resonates, follow the show, share it with someone curious about surrogacy, and leave a review with the insight you wish every new surrogate knew. Your voice helps more families—and more surrogates—find their path.My Mom Is Brave- https://a.co/d/bENg23CSend a friend- https://thatsurrogatelife.com/send-a-friend?fbclid=IwRlRTSAN6_4JleHRuA2FlbQIxMABzcnRjBmFwcF9pZAo2NjI4NTY4Mzc5AAEeWkNyXW2MxUwkTjDVHsBzCcmsoautbyibsqDBUbhCpFOcLozud1tg5LweaWw_aem_XCw185aF7SEW5njM85Y4MASend us a texthttps://stopsitsurrogate.com

There are so many factors as to why someone would take the IVF path, and so many factors in the process itself. So today's episode is all about In Vitro Fertilization (IVF)- why people choose it, what the process involves, and how to prepare the body and mind for that process. We'll also debunk common IVF myths, explore what to expect along the way, and shed light on so much more. Joining me today on Yoga|Birth|Babies is Dr. Aimee Eyvazzadeh, a fertility specialist in San Ramon, CA. Dr. Aimee earned her medical degree from UCLA, completed her OB-GYN residency at Harvard, and holds a fellowship in reproductive endocrinology and infertility, as well as a Master's in Public Health from the University of Michigan. A fellow of ACOG, she remains active in fertility research. Dr. Aimee is also the host of the top-rated podcast The Egg Whisperer Show- and a mother of four! I'm thrilled to welcome her to share her expertise on the world of IVF. Get the most out of each episode by checking out the show notes with links, resources and other related podcasts at: prenatalyogacenter.com Don't forget to grab your FREE guide, 5 Simple Solutions to the Most Common Pregnancy Pains HERE  If you love what you've been listening to, please leave a rating and review! Yoga| Birth|Babies (Apple) or on Spotify! To connect with Deb and the PYC Community:  Instagram & Facebook: @prenatalyogacenter Youtube: Prenatal Yoga Center Learn more about your ad choices. Visit megaphone.fm/adchoices

On March 7, 2025, we released an episode summarizing key aspects of a NEJM publication regarding male partner therapy for women with recurrent BV. Although that study had limitations, the results were very surprising. Now, on 10/16/25 (7 months later), the ACOG has a new Clinical Practice Update (CPU) on this very issue. In this episode we will briefly summarize that March 2025 NEJM publication and highlight the TWO updated clinical recommendations from the ACOG regarding male partner therapy for the prevention of BV in women. PLUS, we will briefly discuss why although male partner therapy should be considered, partner EPT is “not recommended” at this time by the ACOG. 1. ACOG CLINICAL PRACTICE UPDATE: Concurrent Sexual Partner Therapy to Prevent Bacterial Vaginosis Recurrence Obstetrics & Gynecology ():10.1097/AOG.0000000000006102, October 16, 2025. | DOI: 10.1097/AOG.00000000000061022. Chapa Clinical Pearls March 2025 Episode: https://open.spotify.com/episode/4sW9tTe9CdYVQsCRBjqQQP3. Vodstrcil LA, Plummer EL, Fairley CK, Hocking JS, Law MG, Petoumenos K, et al. Male-partner treatment to prevent recurrence of bacterial vaginosis. N Engl J Med 2025;392:947–57. doi: 10.1056/NEJMoa2405404STRONG COFFEE PROMO: 20% Off Strong Coffee Company https://strongcoffeecompany.com/discount/CHAPANOSPINOBG

Maternal safety changes when we stop relying on heroics and start building systems. We open the door to the 2025 APSF Stolting Conference series with a fast, practical tour of what truly reduces morbidity and mortality: collaboration across anesthesia, obstetrics, cardiology, and nursing; open‑source AIM bundles; early warning tools; and standards that compress time-to-treatment when minutes matter. Along the way, we confront the three deadly D's—denial, delay, dismissal—and replace them with teamwork, tools, timeliness, and trust.We dig into the history that got us here, from case reports and confidential inquiries to robust maternal mortality review committees and rapid-cycle data that power real change. Then, we zero in on the leading cause of pregnancy-related death—cardiovascular disease—and why risk spikes in the postpartum period. A vivid case of peripartum cardiomyopathy shows how quickly decompensation unfolds and why anesthesia must be in the room early: shaping plans, managing hemodynamics, placing monitors, coordinating with cardiology and OB, and, when needed, activating ECMO. We highlight actionable steps like antenatal anesthesia consults for high‑risk patients, postpartum telemetry monitoring, and pregnancy heart teams that make escalation the rule, not the exception.Progress is real for hemorrhage and hypertension, but disparities remain stark for Black, Hispanic, and Asian Pacific Islander patients. We talk about implicit bias, access, and respectful care, and we share multilingual urgent maternal warning signs so patients and clinicians recognize danger sooner. The ASA's recommendations give a clear roadmap for anesthesiologist leadership—on review committees, quality teams, simulation programs, and implementation of SOAP and ACOG frameworks—so that safety becomes predictable.If this conversation sparks ideas for your unit, we'd love to hear them. Subscribe, share with a colleague who works on labor and delivery, and leave a review telling us the one system change you'll champion this month.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/276-maternal-care-transformed/© 2025, The Anesthesia Patient Safety Foundation

On October 9, 2025, the ACOG released a clinical practice update (CPU) regarding Zouranolone and brexanolone. As postpartum depression is an area of continued research and need for therapeutics, any new clinical practice update on the subject is welcome. So what's new in this update?! Well…the answer will surprise you. Listen in for details on the CPU, and a mini-review of the concerns for Zuranolone. 1. ACOG CPU Oct 9, 2025: Zuranolone and Brexanolone for the Treatment of Postpartum Depression 2. ACOG PA Aug 2023: Zuranolone for the Treatment of Postpartum Depression 3. Clinical Practice Guideline No. 5, Treatment and Management of Mental Health Conditions During Pregnancy and Postpartum (Obstet Gynecol 2023;141:1262–88)STRONG COFFEE PROMO: 20% Off Strong Coffee Company https://strongcoffeecompany.com/discount/CHAPANOSPINOBG

Sometimes you hear something that makes you just stop and say, “What did you say?!”. Yep, in this episode we will give evidence-based answers to three questions that I heard TODAY that made me stop and ask, “What did you say?”. In this episode we will cover: 1. Umbilical cord blood collection from a monochorionic twin gestation, 2. Predictability of the mBPP compared to full BPP, and 3. Breastfeeding during postpartum cannabis use (this last one is not so intuitive as you would think, and there is new ACOG guidance on this which we will review). Listen in for details!1. ACOG PB 229; 20212. ACOG CC #10: Cannabis Use During Pregnancy and Lactation3. Kaufman DA, Lucke AM, Cummings JJ. Postnatal Cord Blood Sampling: Clinical Report.Pediatrics. 2025;155(6):e2025071811. doi:10.1542/peds.2025-071811.4. Simpson L, Khati NJ, Deshmukh SP, et al. ACR Appropriateness Criteria Assessment of Fetal Well-Being. Journal of the American College of Radiology : JACR. 2016;13(12 Pt A):1483-1493. doi:10.1016/j.jacr.2016.08.028.STRONG COFFEE PROMO: 20% Off Strong Coffee Company https://strongcoffeecompany.com/discount/CHAPANOSPINOBG

In July 2023, the ACOG released a Practice Advisory stating, “Based on data on the benefit of adjunct HPV vaccination, ACOG recommends adherence to the current Centers for Disease Control and Prevention (CDC) recommendations for vaccinations of individuals aged 9–26 years, and to consider adjuvant HPV vaccination for immunocompetent previously unvaccinated people aged 27–45 years who are undergoing treatment for CIN 2+”. The possible beneficial effect of peri-treatment HPV vaccination goes back to the early 2010s. But science is always changing, and MEDICINE MOVES FAST. In September 2025, the Lancet's Obstetrics, Gynecology, and Women's Health journal published the VACCIN trial to test that guidance. These authors found that, “Although previous studies, including meta-analyses and observational studies, have shown that adjuvant HPV vaccination reduces the recurrence of cervical dysplasia after surgical treatment, our trial suggests that adjuvant HPV vaccination is not effective in reducing the recurrence of CIN 2–3 lesions, contradicting the conclusions of previous works”. They have also called for a REVISION to prior guidance. This is FASCINATING. Listen in for details. 1. ACOG PA July 2023, “Adjuvant Human Papillomavirus Vaccination for Patients Undergoing Treatment for Cervical Intraepithelial Neoplasia 2+”2. Adjuvant prophylactic human papillomavirus vaccination for prevention of recurrent high-grade cervical intraepithelial neoplasia lesions in women undergoing lesion surgical treatment (VACCIN): a multicentre, phase 4 randomised placebo-controlled trial in the Netherlands: https://www.sciencedirect.com/science/article/pii/S305050382500007X#:~:text=To%20our%20knowledge%2C%20this%20is,the%20conclusions%20of%20previous%20works.STRONG COFFEE PROMO: 20% Off Strong Coffee Company https://strongcoffeecompany.com/discount/CHAPANOSPINOBG

A breakthrough discovery in the 1970s was the determination of alpha-fetoprotein levels in the serum of pregnant women to detect fetuses with neural tube defects. In the case of high AFP values in maternal serum, amniocentesis was performed to determine the levels of AFP and acetylcholinesterase (AChE) in the amniotic fluid to confirm the diagnosis. Currently, the ACOG states that high-quality, second-trimester fetal anatomy ultrasonography is an appropriate screening test for NTDs where routinely performed for fetal anatomic survey at 18 to 22 weeks. If optimal images of the fetal spine, intracranial anatomy, or anterior abdominal wall are not obtained (eg, fetal position or maternal obesity), MSAFP should be performed to improve detection of NTDs (ACOG Practice Bulletin No. 187: Neural Tube Defects. Committee on Practice Bulletins Obstet Gynecol. 2017). Some clinicians (as we do in our practice) order both fetal anatomy ultrasound and msAFP concurrently. What are the implications when the msAFP is elevated with a normal fetal anatomical survey? Where is this msAFP coming from? Listen in for details.1. ACOG Practice Bulletin No. 187: Neural Tube Defects. Committee on Practice Bulletins Obstet Gynecol. 20172. Pregnancy Outcomes Regarding Maternal Serum AFP Value in Second Trimester Screening. Bartkute K, Balsyte D, Wisser J, Kurmanavicius J. Journal of Perinatal Medicine. 2017;45(7):817-820. doi:10.1515/jpm-2016-0101.3. Głowska-Ciemny J, Szmyt K, Kuszerska A, Rzepka R, von Kaisenberg C, Kocyłowski R. Fetal and Placental Causes of Elevated Serum Alpha-Fetoprotein Levels in Pregnant Women. J Clin Med. 2024 Jan 14;13(2):466. doi: 10.3390/jcm13020466. PMID: 38256600; PMCID: PMC10816536.STRONG COFFEE PROMO: 20% Off Strong Coffee Company https://strongcoffeecompany.com/discount/CHAPANOSPINOBG

ACOG, the American College of Obstetricians and Gynecologists, recently published EMS guidelines for treatment of hypertension in pregnancy/pre-eclampsia, eclampsia, and postpartum hemorrhage. Drs. Jenna White and Christopher Zahn join Dr Jarvis to discuss the science behind these recommendations as well as how to implement them into our practice. Citations:1. https://www.acog.org/programs/obstetric-emergencies-in-nonobstetric-settings2. Vuncannon, D. M.; Platner, M. H.; Boulet, S. L. Timely Treatment of Severe Hypertension and Risk of Severe Maternal Morbidity at an Urban Hospital. American Journal of Obstetrics & Gynecology MFM 2023, 5 (2), 100809. https://doi.org/10.1016/j.ajogmf.2022.100809.3. Gupta, M.; Greene, N.; Kilpatrick, S. J. Timely Treatment of Severe Maternal Hypertension and Reduction in Severe Maternal Morbidity. Pregnancy Hypertension 2018, 14, 55–58. https://doi.org/10.1016/j.preghy.2018.07.010.

Maternal perception of decreased fetal movement at term occurs in up to 15% of pregnancies and is a cause for maternal and provider concern. All maternal concerns of decreased fetal movement require an assessment of fetal wellbeing. But what about the patient with recurrent episodes of reduced fetal movements at term? Routine induction of labor is not supported solely for decreased fetal movement in a non-growth-restricted fetus, as increased intervention rates (including induction of labor and early term birth) have not demonstrated improved perinatal outcomes and may increase neonatal morbidity, such as respiratory distress and NICU admission. Some international sources (ISUOG) have recognized the cerebroplacental ratio (CPR) as a possible ultrasound tool to investigate possible early placental insufficiency before fetal growth restriction occurs. Is CPR helpful for decreased fetal movements at term? A new publication from the Lancet's new journal- Obstetrcis, Gynecology, and Women's Health- states that it is. Is the CPR ultrasound assessment recognized by the ACOG or SMFM? Listen in for details. 1. The cerebroplacental ratio: a useful marker but should it be a screening test? (2025): https://obgyn.onlinelibrary.wiley.com/doi/10.1002/uog.29154#:~:text=The%20ISUOG%20guidelines%20recommend%20using,after%2038%20weeks'%20gestation44.2. Turner JM, Flenady V, Ellwood D, Coory M, Kumar S.Evaluation of Pregnancy Outcomes Among Women With Decreased Fetal Movements.JAMA logoJAMA Network Open. 2021;4(4):e215071. doi:10.1001/jamanetworkopen.2021.5071.3. Cerebroplacental ratio-based management versus care as usual in non-small-for-gestational-age fetuses at term with maternal perceived reduced fetal movements (CEPRA): a multicentre, cluster-randomised controlled trial. https://www.sciencedirect.com/science/article/pii/S30505038250000204. Hofmeyr GJ, Novikova N. Management of Reported Decreased Fetal Movements for Improving Pregnancy Outcomes. The Cochrane Database of Systematic Reviews. 2012;(4):CD009148. doi:10.1002/14651858.CD009148.pub2.STRONG COFFEE PROMO: 20% Off Strong Coffee Company https://strongcoffeecompany.com/discount/CHAPANOSPINOBG

ACOG's 2025 consensus finally validates IUD insertion pain. Lisa breaks down what this means for practitioners and how to advocate for evidence-based pain management in cervical procedures. Follow this link to view the full show notes page! This episode is sponsored by Lisa's new book Real Food for Fertility, co-authored with Lily Nichols! Grab your copy here!  Would you prefer to listen to the audiobook version of Real Food for Fertility instead?

In his weekly clinical update, Dr. Griffin with Vincent Racaniello are dismayed about the recent attack on public health the firing of the director of the CDC as well as resignation of 3 others members of the agency's leadership, the continued Legionnaire's outbreak in Harlem, suspension of Ixchiq the Chikungunya virus attenuated infectious vaccine, the first US case of New World screwworm before Dr. Griffin deep dives into recent statistics on the measles epidemic, RSV, influenza and SARS-CoV-2 infections, the Wasterwater Scan dashboard, Johns Hopkins measles tracker, association Guillian-Barré syndrome with RSV vaccination, guidelines for using RSV vaccines, whether or not the NB.1.8.1 should be included in the fall 2025 vaccines, the American College Obstetricians and Gynecologists recommendations for the COVID, RSV and influenza vaccines, FDA approval letters for Pfizer, moderna and Novagax COVID vaccines including label changes for use in those between 5 through 64 years, where to find PEMGARDA, long COVID treatment center, where to go for answers to your long COVID questions, and contacting your federal government representative to stop the assault on science and biomedical research. Subscribe (free): Apple Podcasts, RSS, email Become a patron of TWiV! Links for this episode White House Says New C.D.C. Director Is Fired, but She Refuses to Leave (NY Times) CDC director refuses to leave after White House order (BBC) Legionnaires' Disease: In Harlem(NYC Health) New York City Health Department Provides Update on Community Cluster of Legionnaires' Disease in Central Harlem(NYC Health: Promoting and protecting the City's health) FDA Update on the Safety of Ixchiq (Chikungunya Vaccine, Live) (FDA) Vimkunya (Bavarian Nordiac) U.S. and Panama for the control of the Screwworm pest (COPEG) Rare human case of flesh-eating parasite New World screwworm identified in US(CNN) USDA Announces Sweeping Plans to Protect the United States from New World Screwworm (USDA) HHS details New World screwworm response after human case(CIDRAP) Wastewater for measles (WasterWater Scan) Measles cases and outbreaks (CDC Rubeola) Tracking Measles Cases in the U.S. (Johns Hopkins) Weekly measles and rubella monitoring (Government of Canada) Measles (WHO) Get the FACTS about measles (NY State Department of Health) Measles (CDC Measles (Rubeola)) Measles vaccine (CDC Measles (Rubeola)) Presumptive evidence of measles immunity (CDC) Contraindications and precautions to measles vaccination (CDC) Measles (CDC Measles (Rubeola)) Measles vaccine recommendations from NYP (jpg) Adverse events associated with childhood vaccines: evidence bearing on causality (NLM) Measles Vaccination: Know the Facts(ISDA: Infectious Diseases Society of America) Deaths following vaccination: what does the evidence show (Vaccine) Influenza: Waste water scan for 11 pathogens (WastewaterSCan) US respiratory virus activity (CDC Respiratory Illnesses) Respiratory virus activity levels (CDC Respiratory Illnesses) Weekly surveillance report: clift notes (CDC FluView) Relative effectiveness of high-dose versus standard-dose influenza vaccine against hospitalizations and mortality according to frailty score (JID) FDA-CDC-DOD: 2025-2046 influenza vaccine composition (FDA) RSV: Waste water scan for 11 pathogens (WastewaterSCan) US respiratory virus activity (CDC Respiratory Illnesses) ENFLONSIA: novel drug approvals 2025 (FDA) RSV-Network (CDC Respiratory Syncytial virus Infection) Vaccines for Adults (CDC: Respiratory Syncytial Virus Infection (RSV)) Evaluation of Guillain-Barré Syndrome (GBS) following Respiratory Syncytial Virus (RSV) Vaccination Among Adults 65 Years and Older (FDA) Economic Analysis of Protein Subunit and mRNA RSV Vaccination in Adults aged 50-59 Years (CDC: ACIP) Evidence to Recommendations Framework (EtR): RSV Vaccination in Adults Aged 50–59 years (CDC: National Center for Immunization and Respiratory Diseases) Waste water scan for 11 pathogens (WastewaterSCan) COVID-19 deaths (CDC) Respiratory Illnesses Data Channel (CDC: Respiratory Illnesses) COVID-19 national and regional trends (CDC) COVID-19 variant tracker (CDC) SARS-CoV-2 genomes galore (Nextstrain) Antigenic and Virological Characteristics of SARS-CoV-2 Variant BA.3.2, XFG, and NB.1.8.1 (bioRxiV) Veering from CDC, ACOG recommends maternal vaccination against COVID-19 (CIDRAP) ACOG Releases Updated Maternal Immunization Guidance for COVID-19, Influenza, and RSV (American College of Obstericians and Gynecologists) COVID-19 Vaccination Considerations for Obstetric–Gynecologic Care (American College of Obstericians and Gynecologists) Pfizer and BioNTech's COMIRNATY® Receives U.S. FDA Approval for Adults 65 and Older and Individuals Ages 5 through 64 at Increased Risk for Severe COVID-19 (Pfizer)  COMIRNATY approval letter (FDA) Moderna Receives U.S. FDA Approval for Updated COVID-19 Vaccines Targeting LP.8.1 Variant of SARS-CoV-2 (FEEDS) SPIKEVAX approval letter (FDA) Novavax's Nuvaxovid 2025-2026 Formula COVID-19 Vaccine Approved in the U.S (Novavax) NUVAXOVID approval letter (FDA) Where to get pemgarda (Pemgarda) EUA for the pre-exposure prophylaxis of COVID-19 (INVIYD) Infusion center (Prime Fusions) CDC Quarantine guidelines (CDC) NIH COVID-19 treatment guidelines (NIH) Drug interaction checker (University of Liverpool) Paxlovid (Pfizer) Infectious Disease Society guidelines for treatment and management (ID Society) Molnupiravir safety and efficacy (JMV) Convalescent plasma recommendation for immunocompromised (ID Society) What to do when sick with a respiratory virus (CDC) Managing healthcare staffing shortages (CDC) Steroids,dexamethasone at the right time (OFID) Anticoagulation guidelines (hematology.org) Daniel Griffin's evidence based medical practices for long COVID (OFID) Long COVID hotline (Columbia : Columbia University Irving Medical Center) The answers: Long COVID Reaching out to US house representative Letters read on TWiV 1248 Dr. Griffin's COVID treatment summary (pdf) Timestamps by Jolene Ramsey. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to daniel@microbe.tv Content in this podcast should not be construed as medical advice.

Recently, the American College of Obstetricians and Gynecologists rejected federal funding in response to the current US administration's polices. We talk about what this means.See omnystudio.com/listener for privacy information.

*Content warning: pregnancy and birth trauma, medical trauma and negligence. *Free + Confidential Resources + Safety Tips: somethingwaswrong.com/resources Moms Advocating For MomsS23 survivors Markeda, Kristen and Amanda have created a nonprofit, Moms Advocating for Moms, in hopes to create a future where maternal well-being is prioritized, disparities are addressed, and every mother has the resources and support she needs to thrive: https://www.momsadvocatingformoms.org/take-actionhttps://linktr.ee/momsadvocatingformoms Please sign the survivors petitions below to improve midwifery education and regulation in Texashttps://www.change.org/p/improve-midwifery-education-and-regulation-in-texas?recruiter=1336781649&recruited_by_id=74bf3b50-fd98-11ee-9e3f-a55a14340b5a&utm_source=share_petition&utm_campaign=share_for_starters_page&utm_medium=copylink Malik's Law https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB4553 M.A.M.A. has helped file a Texas bill called Malik's Law, which is intended to implement requirements for midwives in Texas to report birth outcomes in hopes of improving transparency and data collection in the midwifery field in partnership with Senator Claudia Ordaz. Markeda's Instagram:https://www.instagram.com/markedasimone/Moms Advocating for Moms Alliance:https://www.instagram.com/momsadvocatingformomsalliance/Dr. Shannon Clark's websitehttps://www.babiesafter35.com/Dr. Shannon Clark on TikTokhttps://www.tiktok.com/@babies_after_35Dr. Shannon Clark on Instagramhttps://www.instagram.com/babiesafter35/*Sources:American College of Nurse Midwiveshttps://midwife.org/ American College of Obstetricians and Gynecologists (ACOG)https://www.acog.org/ ACOG's Texas Levels of Maternal Care Verification Program: Quality Through Partnershiphttps://www.acog.org/news/news-articles/2018/09/texas-lomc-verification-program-quality-through-partnership A Comprehensive Case Report Emphasizing the Role of Caesarean Section, Antibiotic Prophylaxis, and Post-operative Care in Meconium-Stained Fetal Distress Syndromehttps://pmc.ncbi.nlm.nih.gov/articles/PMC11370710/#:~:text=Meconium%2Dstainedamnioticfluid(MSAF)oftenleadstomore,andneonatalmortality%5B3%5D The Difference Between Health Equity and Equalityhttps://www.hopkinsacg.org/health-equity-equality-and-disparities/ EMTALA – Transfer Policyhttps://hcahealthcare.com/util/forms/ethics/policies/legal/emtala-facility-sample-policies/generic-emtala-transfer-policy-a.pdf How cuts at the National Institutes of Health could impact Americans' healthhttps://www.cbsnews.com/news/nih-layoffs-budget-cuts-medical-research-60-minutes/ Individualized, supportive care key to positive childbirth experience, says WHOhttps://www.who.int/news/item/15-02-2018-individualized-supportive-care-key-to-positive-childbirth-experience-says-who Is a HIPAA Violation Grounds for Termination?https://www.hipaajournal.com/hipaa-violation-grounds-for-termination/#:~:text=AHIPAAviolationcanbe,sanctionspolicyoftheemployer March of Dimeshttps://www.marchofdimes.org/peristats/about-us Maternal Safety Series: Joint Commission Case Review Requirementshttps://www.greeley.com/insights/maternal-safety-series-joint-commission-case-review-requirements Meconiumhttps://my.clevelandclinic.org/health/body/24102-meconium Meconium Aspiration Syndromehttps://my.clevelandclinic.org/health/diseases/24620-meconium-aspiration-syndrome Meconium Aspiration Syndrome, Hypoxic-Ischemic Encephalopathy and Therapeutic Hypothermia-A Recipe for Severe Pulmonary Hypertension?https://pubmed.ncbi.nlm.nih.gov/38929252/#:~:text=Infantsbornthroughmeconium%2Dstained,ofthenewborn(PPHN) Medical Auditing Frequently Asked Questionshttps://www.aapc.com/resources/medical-auditing-frequently-asked-questions?srsltid=AfmBOooNLHrxkJi3hp2CO-3OkVj1heZAqWFVu7B-M8njnrJs8R78BBoM Midwifery continuity of care: A scoping review of where, how, by whom and for whom?https://pmc.ncbi.nlm.nih.gov/articles/PMC10021789/#:~:text=Midwife%2Dledcontinuitymodelsin,plausiblehypothesesrequirefurtherinvestigation National Midwifery Institutehttps://www.nationalmidwiferyinstitute.com/midwifery North American Registry of Midwives (NARM)https://narm.org/ Outcome of subsequent pregnancies in women with complete uterine rupture: A population-based case-control studyhttps://pubmed.ncbi.nlm.nih.gov/35233771/ Physiology, Pregnancyhttps://www.ncbi.nlm.nih.gov/books/NBK559304/ Pregnant women are less and less able to access maternity carehttps://www.nbcnews.com/health/health-news/pregnant-women-cant-find-doctors-growing-maternity-care-deserts-rcna169609 State investigating Dallas birth center and midwives, following multiple complaints from patientshttps://www.wfaa.com/article/news/local/investigates/state-investigating-dallas-birth-center-midwives-following-multiple-complaints-from-patients/287-ea77eb18-c637-44d4-aaa2-fe8fd7a2fcef Texas Department of Licensing and Regulation (TDLR)https://www.tdlr.texas.gov/ Texas Occupations Code, Chapter 203. Midwives https://statutes.capitol.texas.gov/Docs/OC/htm/OC.203.htmTypes of Health Care Quality Measureshttps://www.ahrq.gov/talkingquality/measures/types.html#:~:text=Outcomemeasuresmayseemto,informationabouthealthcarequality The US has the highest rate of maternal deaths among high-income nations. Norway has zerohttps://amp.cnn.com/cnn/2024/06/04/health/maternal-deaths-high-income-nations U.S. maternal deaths doubled during COVID-19 pandemic, among other findings in new studyhttps://www.brown.edu/news/2025-04-28/maternal-mortality#:~:text=Maternalmortalityratesdeclinedagainin2022,dieeachyearintheUnitedStates What is ‘physiological birth'? A scoping review of the perspectives of women and care providershttps://www.sciencedirect.com/science/article/pii/S0266613824000482 World Health Organization, Maternal mortalityhttps://www.who.int/news-room/fact-sheets/detail/maternal-mortality Zucker School of Medicine, Amos Grunebaum, MDhttps://faculty.medicine.hofstra.edu/13732-amos-grunebaum/publications *SWW S23 Theme Song & Artwork: Thank you so much to Emily Wolfe for covering Glad Rag's original song, U Think U for us this season!Hear more from Emily Wolfe:On SpotifyOn Apple Musichttps://www.emilywolfemusic.com/instagram.com/emilywolfemusicGlad Rags: https://www.gladragsmusic.com/ The S23 cover art is by the Amazing Sara StewartFollow Something Was Wrong:Website: somethingwaswrong.com IG: instagram.com/somethingwaswrongpodcastTikTok: tiktok.com/@somethingwaswrongpodcast Follow Tiffany Reese:Website: tiffanyreese.me IG: instagram.com/lookiebooSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.