Podcasts about acog

Today we're diving into a lab order that almost every ob-gyn, midwife, and labor-and-delivery nurse were traditionally trained to do: the routine Postpartum Day 1 Hemoglobin and hematocrit. For decades, checking a patient's H&H after delivery was automatic. Didn't matter if it was a smooth, uncomplicated vaginal birth with minimal blood loss or a complex emergency C-section- come 6:00 AM the next morning, someone was drawing blood. Historically, the logic felt airtight: First, visual estimation of blood loss (the EBL) during delivery is notoriously inaccurate; clinicians often underestimate heavy bleeding by as much as 30 to 50 percent. Second, severe postpartum anemia can be sneaky. A patient might look fine lying in bed, but an undetected crash in hemoglobin can lead to severe fatigue, impaired bonding, delayed recovery, or even delayed postpartum hemorrhage complications. And third, early detection meant early intervention- giving iron or transfusing blood before the patient got discharged home. It was standard, it was defensive, and it felt safe. But here is the million-dollar question: Is a blanket, universal Postpartum H&H actually evidence-based in modern obstetric care? Or are we just poking healthy, asymptomatic patients, driving up healthcare costs, and treating lab numbers instead of the clinical patient? Today we will be looking at what the major guidelines, including ACOG, actually say, and why target-based screening has long replaced universal testing. Let's get into it!1. Ruiz de Viñaspre-Hernández R, Gea-Caballero V, Juárez-Vela R, Iruzubieta-Barragán FJ.The definition, screening, and treatment of postpartum anemia: A systematic review of guidelines. Birth. 2021. 2. Anemia in Pregnancy: ACOG Practice Bulletin, Number 233.Obstetrics and Gynecology. 2021. Committee on Practice Bulletins—Obstetric3. Muñoz M, et al. Patient blood management in obstetrics: management of anaemia and haematinic deficiencies in pregnancy and in the post-partum period: NATA consensus statement. Transfus Med. 2018 Feb;28(1):22-39

In this episode of GynoCurious, host Dr. Amy Novatt sits down with Dr. Mallory Stuparich, a fellowship-trained minimally invasive gynecologic surgeon based in Los Alamitos, California, to take a deep dive into endometriosis — a chronic, estrogen-dependent inflammatory condition affecting roughly 10% of women and girls of reproductive age worldwide. Dr. Stuparich describes endometriosis as a systemic, neuro-immune condition rather than a purely hormonal one, drawing connections to autoimmune disorders, Ehlers-Danlos syndrome, and POTS. The two doctors then walk through what a real diagnostic workup looks like, from the "four Ds and an I" symptom pattern (dysmenorrhea, dyschezia, dysuria, dyspareunia, and infertility) to the value of a specialized pelvic exam and transvaginal mapping ultrasound — dispelling the myth that normal imaging rules out the disease. They also cover emerging blood-based tests, the recently updated ACOG guidelines allowing clinical diagnosis without surgery, and the critical distinction between ablative and excisional surgery. Rounding out the episode, Dr. Stuparich shares lifestyle and dietary strategies — including anti-inflammatory eating patterns and the supplement NAC — that can help manage symptoms alongside medical or surgical treatment. The episode closes with a call for patients to trust their instincts, seek second opinions when something feels wrong, and never suffer in silence. Listeners looking for a specialist can find Dr. Stuparich across social media under her name, and Dr. Novatt reminds her audience that persistent pain always deserves investigation, whatever its cause. Questions of comments? Call 845-307-7446 or email comments@radiofreerhinecliff.org Produced by Jennifer Hammoud and Matty Rosenberg @ Radio Free Rhiniecliff

Coffee feels simple until you watch two people drink the same amount and have totally different outcomes. One of us can sip an afternoon coffee and sleep fine. The other can take a similar dose at noon and stare at the ceiling all night. So we slow it down and make it practical: coffee and caffeine are not the same thing, and the best way to understand your own response is to think in three variables we can actually test, the dose, the clock, and the person.We explain what caffeine is doing in the brain, starting with adenosine and sleep pressure, then why caffeine can make you feel more alert without paying back any sleep debt. If you have ever said “coffee makes me feel normal,” we talk through what that might mean, including the possibility of overnight caffeine withdrawal versus a true stimulant effect. We also get specific about dosing: a “cup” is not a dose, decaf is not zero, and caffeine can come from coffee, tea, soda, energy drinks, supplements, and even some medications. We discuss the FDA's 400 mg per day benchmark as a population-level reference, not a personal target.Then we dig into timing and sleep quality. A key idea is that caffeine may still be in your system after the buzz is gone, and sleep impact is not just about falling asleep, it is also about how the whole night goes and how you function the next day. We talk about metabolism and sensitivity, how tolerance can build, and why symptoms like jitters, anxiety, palpitations, reflux, or disrupted sleep are worth listening to. We also share ACOG's commonly cited pregnancy guidance to stay under about 200 mg per day and why your personal medical context can change the right plan.We close with what coffee research can and cannot tell us, why observational studies are reassuring but not prescriptions, and a simple self-experiment you can run this week: find the approximate caffeine in your usual drink, place it on your sleep clock, and see what you notice. If this helped, subscribe, share it with a friend who “can drink espresso at night,” and leave a review so more people can find the show.Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply.Support the showProduction and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RNArtwork Rebrand and Avatars:Vantage Design Works (Vanessa Jones) Website: https://www.vantagedesignworks.com/Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qrOriginal Artwork Concept: Olivia Pawlowski

The ACOG PB 222 states, “In women with preeclampsia with severe features at less than 34 0/7 weeks of gestation, with stable maternal and fetal condition, expectant management may be considered”. The expectant management of preeclampsia with severe features before 34 0/7 weeks of gestation is based on strict selection criteria of those appropriate candidates and is best accomplished in a setting with resources appropriate for maternal and neonatal care. BOX 4 in that ACOG guidance lists “Conditions Precluding Expectant management”, with one of the conditions being “Uncontrolled severe-range blood pressures (persistent systolic blood pressure 160 mm Hg or more or diastolic blood pressure 110 mm Hg or more not responsive to antihypertensive medication” (i.,e. persistent and refractory to appropriate medication). But what defines “uncontrolled hypertension”? When is preterm delivery indicated based on that feature? In this episode, we will answer this real-world clinical question. So, for a patient who is otherwise stable, asymptomatic, without HELLP syndrome, whose fetus is stable but is under 34 weeks, when can “uncontrolled hypertension” be diagnosed to prompt delivery? Listen in for details as we highlight the 2022 SMFM Special Report on that matter. 1. ACOG PB 2222. SMFM Special report: Preeclampsia: a report and recommendations of the workshop of the Society for Maternal-Fetal Medicine and the Preeclampsia Foundation, Nov 20223. De Backer J, Haugaa KH, Hasselberg NE, et al. 2025 ESC Guidelines for the Management of Cardiovascular Disease and Pregnancy. European Heart Journal. 20254. SOGC Clinical Practice Guideline: Diagnosis, Evaluation, and Management of the Hypertensive Disorders of Pregnancy: Executive Summary; No. 307, May 20145. ISSHP (2018): The hypertensive disorders of pregnancy: ISSHP classification, diagnosis & management recommendations for international practice. Preg Hypertension. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/http://www.isshp.org/wp-content/uploads/2018/06/1-s2.0-S2210778918301260-main.pdf

Send us Fan MailBleeding that feels “off” is easy to downplay until it derails your life or shows up after menopause. We revisit our conversation with women's health nurse practitioner Kelsey Kennedy and layer in what's changed since then, including newer ACOG guidance that supports a more proactive approach to postmenopausal bleeding. The key message is simple: a reassuring pelvic ultrasound alone is not always enough, because high grade endometrial cancer can occur even with a thin lining. Kelsey and Dr. Thacker walk through what abnormal uterine bleeding actually means in real life, from irregular cycles and spotting between periods to heavy flow that soaks pads, clothes, and sheets. Then they sort the most common causes including fibroids, endometrial polyps, adenomyosis, and endometriosis, and we explain why minimally invasive gynecologic surgery (MIGS) teams can be so valuable when surgery is on the table or when prior care has not found the answer. They also highlight an often missed angle: some abnormal bleeding is driven by bleeding disorders like von Willebrand disease, not just gynecologic anatomy or hormones.Support the show

Broadcast from KSQD, Santa Cruz on 9-03-2026: With CDC vaccine guidance politically contested, major medical societies (AAFP, AAP, ACOG, IDSA) issued their own recommendations through the Vaccine Integrity Project. Dr. Dawn recommends flu shots in October for peak Thanksgiving antibodies, high-dose flu vaccine (not adjuvanted) for frail seniors, and COVID/flu/RSV given at the same visit—except delay COVID vaccination four to six months after recent infection. Pregnant women should receive RSV vaccine at 32-36 weeks, and infants under eight months entering their first RSV season need vaccination if the mother wasn't vaccinated. RSV is one-time only for adults 75+, or for high-risk 50-74-year-olds. Measles is the most contagious human disease, transmissible through brief incidental contact (buses, taxis, carnival rides). Beyond acute mortality (one in 5,000 pre-vaccine), survivors face rare but catastrophic subacute sclerosing panencephalitis 10-40 years later—immune-mediated brain destruction comparable to Huntington's. Thirty percent of current outbreak cases are in adults reflecting decades of under-vaccination in certain communities, and pregnant unvaccinated mothers create a dangerous one-year window since the live vaccine cannot be given during pregnancy. Inlicitide (brand name Lipithandra) is the first oral PCSK9 inhibitor for LDL reduction, priced at $315/month versus $600 for the injectable version. Dr. Dawn positions it strictly as a treatment—not preventive—drug for patients who've had a heart attack or equivalent event and cannot achieve target LDL on statins alone, with prior authorization typically successful given documented disease. Updated cancer screening guidance from major societies: cervical cancer screening at 25 for HPV-vaccinated women (earlier if unvaccinated), annual mammograms from 45-54 then biennial, PSA screening starting at 50, and low-dose CT lung cancer screening at 50-80 for heavy smokers. Dr. Dawn pushes back on the 2018 Task Force downplaying of PSA screening, noting MRI-targeted transperineal biopsies have dramatically reduced false-positive complications. She also warns about rising male cancer diagnoses at later stages for stomach, lung, tongue, and throat cancers, and recommends the vinegar test for suspicious oral white spots. Parkinson's disease develops through a decades-long prodromal phase before motor symptoms appear—by tremor onset, at least half the substantia nigra neurons are dead. Four early warning signs: persistent loss of smell (90% of Parkinson's patients experience this up to 20 years before diagnosis; free scratch-and-sniff cards available from The Michael J. Fox Foundation), REM sleep behavior disorder (acting out dreams; 50-70% develop Parkinson's or Lewy body dementia within 5-10 years, 130-fold higher risk if over 50), chronic constipation (possibly linked to gut microbiome production of misfolded alpha-synuclein), and orthostatic hypotension. Available diagnostics include alpha-synuclein seed amplifier assay (CSF), skin biopsy, and DaTscan SPECT imaging (typically covered with "clinical uncertainty" documentation). A caller with insomnia asks about using vinegar to clean his new CPAP machine. Dr. Dawn recommends one part white vinegar to three parts warm water, then rinsing—or unscented Dr. Bronner's castile soap. She emphasizes avoiding bleach, alcohol, ammonia, scented soaps, and moisturizers, since mold prevention is the primary cleaning goal. Columbia University's STAR (Sperm Track and Recovery) AI system, inspired by astronomical star-detection algorithms, hunts vanishingly rare sperm in men with azoospermia by streaming semen through a hair-thin channel imaged 300 times per second. A robotic arm extracts flagged cells within milliseconds. Of 175 patients tested, 30% had recoverable sperm, and the system produced its first baby late last year for a couple with 20 years of infertility.

Send us Fan MailSomewhere between 2019 and now, "wait 12 weeks" turned into a rule. It is not a rule. It never was.I have been in pelvic health for 26 plus years, and right now I am watching that number get handed around in Facebook groups, on social, and quite honestly by a lot of professionals who are leaning really hard on it. I don't know that the foundation exists to do that. So this is a solo episode where I walk you back through how we got here.

We move from a Dolly Parton story to the very real ways policy, training, and clinical guidance shape what patients can access and what clinicians can safely provide. We break down the end of global OB billing, the risks of vaccine schedule “tweaks,” and why surgical convenience can quietly drive worse care. • rural maternity deserts and why reimbursement must cover facility costs • content warnings and protecting our own mental health while learning from high-profile perinatal cases • the shift from global maternity fees to E/M problem-based prenatal visits • work RVUs, delivery billing and why correct coding matters • measles deaths, herd immunity and why splitting MMR increases missed protection • robotic surgery dominance, laparoscopic deskilling and training priorities • ACOG opportunistic salpingectomy guidance for ovarian cancer prevention • practical techniques to complete salpingectomy during vaginal hysterectomy • listener question on urinary retention and pudendal nerve injury myths 0:00 Welcome And A Dolly Parton Story6:07 Perinatal Mental Health And Content Warnings8:20 OB Billing Shifts From Global To E/M15:17 Measles Deaths And The MMR Split20:05 Robotic Dominance And Laparoscopy Deskilling31:41 ACOG Salpingectomy Guidance And Ovarian Cancer40:53 Vaginal Hysterectomy Tube Removal Techniques53:10 Urinary Retention And Pudendal Nerve Myths1:06:22 Final Takeaways And Where To FollowThanks for listening be sure to check out thinkingaboutobyn.com for more information and be sure to follow us on Instagram Follow us on Instagram @thinkingaboutobgyn.

Labor Live is your chance to practice navigating labor before you're actually in it. This interactive birth simulation delivers real-life labor scenarios straight to your phone, letting you make decisions, explore your options, and learn what questions to ask your provider along the way. Labor Live starts September 1. Head to https://joinlaborlive.com/ to save your spot! Low amniotic fluid can be one of those pregnancy diagnoses that sends you straight into a Google rabbit hole. So in this episode, HeHe sits down with board-certified OBGYN Dr. Lawren Honken to break down oligohydramnios, what it actually means, how it's diagnosed, and when low fluid may or may not mean it's time to induce. Dr. Lawren explains how providers measure amniotic fluid, including the difference between the single deepest pocket and AFI, and why one measurement may give us a more useful picture than the other. They also dig into what can contribute to low fluid, from dehydration and placental function to hypertension, preeclampsia, fetal growth restriction, ruptured membranes, and other pregnancy complications. And then we get into the big question: Does low amniotic fluid automatically mean you need an induction? Spoiler: it's more nuanced than that. HeHe and Dr. Lawren talk through hydration and repeat ultrasounds, fetal monitoring, the risks associated with truly low fluid, ACOG guidance for isolated oligohydramnios, and what happens when you're trying to decide whether to continue the pregnancy or move toward delivery. They also have a really important conversation about informed consent, trauma-informed care, provider communication, and why a diagnosis shouldn't automatically mean you're rushed into a decision without understanding your options. Because sometimes the most empowering thing your provider can give you isn't another intervention. It's information, context, and the space to make an informed decision about your own body and baby. If you've been told you have low amniotic fluid, you're being monitored for oligohydramnios, or you're trying to understand when an induction is actually medically indicated, this is one you want in your back pocket. Chapters 00:00 Induction Shockwave 01:12 Pregnancy Diagnosis Minefield 03:42 Meet Dr. Lawren Honken 07:52 What Is Low Amniotic Fluid? 10:55 Hydration, Placenta & Clues 14:34 What Causes Low Fluid? 19:20 Amnioinfusion Explained 22:25 When Does Induction Make Sense? 29:08 Individualized & Trauma-Informed Care 33:31 HeHe Shares a Personal Birth Story 36:41 When Your Water Breaks Without Contractions 39:13 How Accurate Is an Ultrasound? 41:00 The Risks of Low Amniotic Fluid 46:49 Advocating for Your Options 51:27 The Triage Reassurance Algorithm 54:20 Provider Compassion & Burnout 01:00:26 Questions to Ask Your Provider 01:02:03 Where to Follow Dr. Lawren 01:03:17 Final Wrap & Subscribe Guest Bio: Dr. Lawren Honken is a board-certified OB/GYN, Certified Menopause Practitioner, surgeon, mother of four, and creator of Your Friend the OB/GYN. She is passionate about helping women understand their options through evidence-based education so they can make informed decisions that align with their values, goals, and unique circumstances. Her approach emphasizes patient autonomy, shared decision-making, and compassionate, individualized care. Connect with Dr. Honken here: YourFriendTheOBGYN.com SOCIAL MEDIA: Connect with HeHe on Instagram: https://www.instagram.com/tranquilitybyhehe/  Connect with Dr. Honken on IG: https://www.instagram.com/yourfriendtheobgyn/ LINKS MENTIONED: IG account measure the placenta: https://www.instagram.com/measuretheplacenta/ Listen to our episode with Dr. Florescue here: ​​https://www.youtube.com/watch?v=VEex1HJId2o BIRTH EDUCATION: Learn how to stay in control of your birth and reduce the risk of unnecessary interventions in our Avoid a C-Section Webinar. HeHe breaks down the cascade of interventions, explains what's really happening in the hospital, and shares practical strategies to protect your birth plan, advocate for yourself, and navigate labor with confidence. Perfect for anyone who wants a positive, informed hospital birth experience: https://www.thebirthlounge.com/csection Feeling nervous about speaking up in labor? Our Scripts for Advocacy give you the exact words to handle the most common conversations that can make or break your birth experience. From declining unnecessary interventions to asking the right questions about procedures, these scripts empower you to stay in control, speak confidently, and protect your birth plan — even when the pressure is on. Think of it as your personal toolkit for advocating like a pro, so you can focus on your baby, not the stress: https://www.thebirthlounge.com/Scripts-for-Advocacy And if you haven't grabbed it yet… Snag my free Pitocin Guide to understand the risks, benefits, and red flags your provider may not be telling you about, so you can make informed, powerful decisions in labor: https://www.thebirthlounge.com/pitocin Join The Birth Lounge for judgment-free, evidence-based childbirth education from HeHe that shows you exactly how to navigate hospital policies, avoid unnecessary interventions, and have a trauma-free labor experience, all while feeling wildly supported every step of the way: https://www.thebirthlounge.com/ Want prep delivered straight to your phone? Download The Birth Lounge App for bite-sized birth and postpartum tools you can use anytime, anywhere: https://www.thebirthlounge.com/app

As of August 20th, 2026, the ACOG has released an updated Clinical Practice Update on opportunistic salpingectomy. Here's why this matters so much: we now know that the vast majority of high-grade serous epithelial ovarian cancers actually start not in the ovaries, but in the fallopian tubes. By removing those tubes during routine pelvic, obstetric, or even non-gynecologic abdominal surgeries, we aren't just performing standard procedures—we are drastically cutting the lifetime risk of epithelial ovarian cancer by up to 78%. Today, we're breaking down what's inside ACOG's latest guidance, how surgical practices are shifting, and why this simple step is saving lives. Let's dive in!"1. ACOG CPU (Aug 20, 2026): https://www.acog.org/news/news-releases/2026/08/acog-strengthens-recommendations-supporting-salpingectomy-ovarian-cancer-prevention2. ACOG CO 774: Opportunistic Salpingectomy as a Strategy for Epithelial Ovarian Cancer Prevention (2019, reaffirmed 2024)

ACOG recommends the use of oral or vaginal misoprostol, vaginal dinoprostone (either gel or insert), or mechanical methods for cervical ripening. Plus, it states, “Combination methods (pharmacologic and mechanical) are also effective”. The July 2026 ACOG CPG 9 states this regarding vaginal misoprostol compared to vaginal dinoprostone for labor induction: “Vaginal dinoprostone is effective for cervical ripening; however, vaginal misoprostol has higher efficacy and less need for oxytocin augmentation. The Cochrane database systematic review in 2010 that compared vaginal misoprostol with vaginal dinoprostone in 38 trials (7,022 participants) showed a lower rate of failure to achieve vaginal delivery in 24 hours (RR 0.77) and reduced need for oxytocin augmentation with misoprostol (RR 0.68). There were no differences in the rates of cesarean delivery or tachysystole with FHR changes”. Now, as of August 19, 2026, a new meta-analysis from BJOG is examining this comparison (vaginal miso vs vaginal dino) again. Did they find the same thing? Listen in for details. 1. G. Andersson, B. Greenfield, A. Hunt, et al., “ Vaginal Misoprostol Compared to Vaginal Dinoprostone for Induction of Labour: A Systematic Review and Meta-Analysis,” BJOG: An International Journal of Obstetrics & Gynaecology (2026): 1–12, https://doi.org/10.1111/1471-0528.70314.2. ACOG Clinical Practice Guideline No. 9: Cervical Ripening in Pregnancy

A Podcast from Obstetrics & Gynecology highlighting the latest research and practice updates in the field. This episode features interviews with Dr. Ethan A. Litman, author of the article, "A Quality-Improvement Study Evaluating Three Postpartum Prophylactic Oxytocin Rates and Blood Loss After Vaginal Birth," and Dr. Moeun Son, author of the related editorial, "Moving Toward Standardization of Prophylactic Oxytocin Dosing in the Third Stage of Labor." This episode is sponsored by ModMed. Eliminate after-hours charting and get your life back with the AI-Powered Practice and software built exclusively by OBGYNs, for OBGYNs. For more information, visit modmed.com/obgynfirst This session and the information presented is designed as an educational resource to aid clinicians when providing obstetric and gynecologic care and for information purposes only. The use of this information is voluntary, and clinicians should be familiar with and comply with all applicable laws and regulations. This information is not intended to be used as a substitute for your independent judgment, is not medical advice and should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. The information provided reflects the views of the presenters and not necessarily the views of ACOG, and is provided "as is" without any warranty of accuracy, reliability or otherwise, either express or implied. Neither ACOG Foundation, the American College of Obstetricians and Gynecologists, nor its officers, directors, members, employees, and agents, will not be liable for any loss, damage, or claim with respect to any liabilities, including direct, special, indirect, or consequential damages, incurred in connection with this session or the information presented. ACOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person.

A Podcast from Obstetrics & Gynecology highlighting the latest research and practice updates in the field. This episode features an interview with Drs. Andrew Zakhari and Basile Tessier-Cloutier, authors of "The Role of Molecular Characterization in Precision Medicine in Endometriosis." This episode is sponsored by ModMed. Eliminate after-hours charting and get your life back with the AI-Powered Practice and software built exclusively by OBGYNs, for OBGYNs. For more information, visit modmed.com/obgynfirst This session and the information presented is designed as an educational resource to aid clinicians when providing obstetric and gynecologic care and for information purposes only. The use of this information is voluntary, and clinicians should be familiar with and comply with all applicable laws and regulations.  This information is not intended to be used as a substitute for your independent judgment, is not medical advice and should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. The information provided reflects the views of the presenters and not necessarily the views of ACOG, and is provided "as is" without any warranty of accuracy, reliability or otherwise, either express or implied. Neither ACOG Foundation, the American College of Obstetricians and Gynecologists, nor its officers, directors, members, employees, and agents, will not be liable for any loss, damage, or claim with respect to any liabilities, including direct, special, indirect, or consequential damages, incurred in connection with this session or the information presented. ACOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person.

For most of modern obstetric practice, the question "what does the CDC recommend?" and the question "what does ACOG recommend?" had the same answer. In 2026, they no longer do. In this episode, we walk through how the two most influential sources of maternal immunization guidance in the United States came apart, what each one now actually says, and — most importantly — what that means for the pregnant patient sitting in your office, or for the pregnant person reading conflicting headlines and trying to decide what to do. What we cover How we got here. The May 2025 announcement removing COVID-19 vaccination from federal recommendations for healthy children and pregnant women; the replacement of the entire Advisory Committee on Immunization Practices in June 2025; the shift to "shared" or "individual-based" clinical decision-making; and the January 2026 overhaul of the childhood schedule made without the standard ACIP process. ACOG's break from ACIP. In February 2026, ACOG withdrew as a liaison organization to ACIP, citing concerns that the committee's scientific integrity and evidence-based approach had been compromised. The first independent maternal schedule. On June 10, 2026, ACOG released its 2026 Maternal Immunization Schedule — the first time the College has issued a schedule that differs from federal recommendations. It is endorsed by 13 medical societies and health organizations. Where the two schedules actually diverge. ACOG places four vaccines in the "routinely recommended during pregnancy" category: influenza (inactivated or recombinant), COVID-19, Tdap, and RSV. Current federal guidance routinely recommends Tdap and RSV in pregnancy, and treats COVID-19 vaccination as an individual decision-making conversation rather than standard preventive care. The thimerosal question. Federal guidance advises thimerosal-free influenza products; ACOG's position is that thimerosal-containing vaccines are safe in pregnancy. What hasn't changed: the evidence. Pregnancy remains a recognized risk factor for severe COVID-19 illness, ICU admission, and mechanical ventilation. Millions of doses administered in pregnancy have not shown an increased risk of adverse maternal or fetal outcomes. Maternal vaccination transfers antibodies transplacentally to infants under six months, who are too young to be vaccinated themselves. The counseling problem. As of February 2026, roughly 11% of pregnant women had received a COVID-19 vaccine this season — a substantial drop from the prior year. We talk candidly about what happens to uptake when guidance becomes contradictory, and how to have a productive conversation with a patient who has read three different things from three "official" sources. Practical guidance for clinicians. Documentation, timing windows, coadministration, and how to counsel without either dismissing a patient's hesitancy or overstating certainty. Key timing windows in ACOG's 2026 schedule Influenza — inactivated or recombinant product only, any trimester, ideally before the start of flu season. COVID-19 — any trimester, any available product, with emphasis on vaccination at the earliest opportunity. Tdap — every pregnancy regardless of prior Tdap history, preferably early in the 27–36 week window. RSV (Abrysvo) — a single dose between 32 weeks 0 days and 36 weeks 6 days; infant monoclonal antibody is an alternative, including in subsequent pregnancies after a prior Abrysvo dose. The takeaway Federal recommendations changed. The underlying science did not. Where guidance conflicts, the question for clinicians is not which agency has more authority but which recommendation is supported by the evidence — and how to communicate that clearly enough that patients can make an informed decision rather than a confused one. Resources ACOG 2026 Maternal Immunization Schedule — acog.org ACOG Practice Advisory: COVID-19 Vaccination Considerations for Obstetric–Gynecologic Care ACOG: COVID-19 Vaccines and Pregnancy — Conversation Guide for Clinicians CDC: COVID-19 Vaccination for Women Who Are Pregnant or Breastfeeding

Twenty years ago, one study scared a generation of women off hormones — and we're still paying for it. But here's what almost nobody explains: not all hormones are the same, and "bioidentical" doesn't mean what most people think. In this episode, Jessica Christy untangles two questions people constantly blur together: bioidentical vs. synthetic (the molecule), and FDA-approved vs. custom-compounded (the source). They're not the same question — and knowing the difference changes the conversation you have with your provider. She walks through the WHI backstory fairly (what that 2002 study actually used, and why its findings got over-generalized to all hormone therapy), what the clot-risk data really shows by molecule and by route, and where custom-compounded hormones do — and don't — fit, according to ACOG and the Endocrine Society. In this episode: Why "bioidentical" does NOT mean "compounded" — and why many bioidentical hormones are FDA-approved The real story behind the 2002 WHI study and the harm of over-generalizing it Molecule matters: estradiol and micronized progesterone vs. older CEE/MPA Route matters: why oral vs. transdermal changes the risk picture Where custom-compounded hormones, pellets, and saliva testing actually fit The smart questions to ask your provider before starting hormone therapy The goal isn't a miracle — it's the right molecule, the right route, the right dose, monitored over time. If you've been scared off hormones, or told "you're too old," the real answer depends on your molecule, route, dose, and risk factors. Book a Cultured Wellness hormone evaluation to see if — and which — hormone therapy fits you. BOOK NOW This episode is education, not medical advice — always loop in your own provider. Because at Culture Collective, we inspire confidence.

Free Class: How to Avoid an Unnecessarean  HeHe is bringing back an updated version of her most-requested birth class with a fresh update of her best strategies for reducing your risk of an unnecessary C-section, plus how to confidently navigate interventions and decisions in the hospital. Join her live August 19 at 1:30 PM ET at thebirthlounge.com/freecall. In this solo episode of The Birth Lounge Podcast, HeHe breaks down one of the most frustrating labels you can hear in labor: “failure to progress.” Because taking longer than expected does NOT automatically mean your labor is failing. HeHe walks through what ACOG actually considers an active-phase arrest, including the 6 cm threshold, ruptured membranes, and how much time without cervical change is actually needed before calling labor stalled. She also breaks down why the clock can become your biggest enemy in the hospital and how slow labor progress can sometimes turn into an unnecessary C-section simply because everyone gets impatient. You'll learn practical ways to support your body and your baby's positioning, from staying upright and changing positions to resting, eating, drinking, and laboring at home longer when it's safe to do so. HeHe also talks about amniotomy, why breaking your water isn't always the harmless "next step," and why feeling safe and supported can make a HUGE difference in how your labor unfolds. Most importantly, this episode is about knowing when you actually need intervention and when you simply need more time. HeHe shares how to look at your provider's and hospital's C-section rates, ask better questions, and choose a care team that understands that every labor is different. 01:23 Welcome & Free Class Announcement 04:26 What Is Failure to Progress? 07:39 Understanding ACOG Guidelines 09:27 Physical Tips to Avoid Failure to Progress 17:53 Rest & Nourishment During Labor 20:04 The Risks of Amniotomy 26:26 Feeling Safe in Your Birth Environment 28:23 Finding the Right Provider & C-Section Rates 34:46 Final Thoughts & Outro SOCIAL MEDIA: Connect with HeHe on Instagram: https://www.instagram.com/tranquilitybyhehe/    BIRTH EDUCATION: Learn how to stay in control of your birth and reduce the risk of unnecessary interventions in our Avoid a C-Section Webinar. HeHe breaks down the cascade of interventions, explains what's really happening in the hospital, and shares practical strategies to protect your birth plan, advocate for yourself, and navigate labor with confidence. Perfect for anyone who wants a positive, informed hospital birth experience: https://www.thebirthlounge.com/csection Feeling nervous about speaking up in labor? Our Scripts for Advocacy give you the exact words to handle the most common conversations that can make or break your birth experience. From declining unnecessary interventions to asking the right questions about procedures, these scripts empower you to stay in control, speak confidently, and protect your birth plan — even when the pressure is on. Think of it as your personal toolkit for advocating like a pro, so you can focus on your baby, not the stress: https://www.thebirthlounge.com/Scripts-for-Advocacy And if you haven't grabbed it yet… Snag my free Pitocin Guide to understand the risks, benefits, and red flags your provider may not be telling you about, so you can make informed, powerful decisions in labor: https://www.thebirthlounge.com/pitocin Join The Birth Lounge for judgment-free, evidence-based childbirth education from HeHe that shows you exactly how to navigate hospital policies, avoid unnecessary interventions, and have a trauma-free labor experience, all while feeling wildly supported every step of the way: https://www.thebirthlounge.com/ Want prep delivered straight to your phone? Download The Birth Lounge App for bite-sized birth and postpartum tools you can use anytime, anywhere: https://www.thebirthlounge.com/app   LINKS MENTIONED: Find your hospitals c-section rate here: https://ratings.leapfroggroup.org/  

Today, we are taking a deep dive into an intervention that almost every labor and delivery unit in North America has adopted over the last decade: Quantitative Blood Loss, or QBL. ACOG first recommended quantitative blood loss assessment in Committee Opinion Number 794, published in December 2019. This opinion recommended that every birthing facility implement a standardized, quantitative method for measuring cumulative blood loss at all deliveries, replacing visual estimation as the default approach. This built on earlier ACOG efforts, including the 2015 reVITALize initiative, which standardized obstetric data definitions and defined postpartum hemorrhage using cumulative measured blood loss thresholds (≥1,000 mL regardless of delivery route, or blood loss accompanied by signs/symptoms of hypovolemia). We've all weighed sponges, measured calibrated drapes, and run the math. But here's the million-dollar question: Does measuring blood loss accurately, on its own, actually improve outcomes for patients? The answer is YES….and NO at the same time. Listen in for details as we discuss new data (July 2026 in AJOG) on this topic. 1. White A, Burns RN, Pruszynski JE, Ravindra D, Fin KX, Montgomery T, Jestes E, Ambia AM, Anyaehie B, Duryea EL. Establishing Normal Blood Loss Thresholds at the Time of Delivery Based on Quantitative Blood Loss. Am J Obstet Gynecol. 2026 Jul. DOI: 10.1016/j.ajog.2026.07.028. S0002-9378(26)00395-9. YMOB 16849.2. Quantitative Blood Loss in Obstetric Hemorrhage: ACOG COMMITTEE OPINION, Number 794.Obstetrics and Gynecology. 2019. Committee on Obstetric Practice3. Coomarasamy A, Devall AJ, Bell S, et al. Diagnosis and Treatment of Postpartum Haemorrhage: A Race Against Time. Lancet. 2026.

ACOG first recommended antiviral suppressive therapy at 36 weeks of gestation for women with a history of genital herpes in 2007, with the publication of Practice Bulletin No. 82 ("Management of Herpes in Pregnancy," June 2007). This was the first ACOG practice bulletin specifically dedicated to genital herpes management in pregnancy, and it established the 36-week suppressive therapy recommendation based on the RCTs available at that time (including the Watts 2003, Sheffield 2006, and Andrews 2006 trials). The recommendation was subsequently reaffirmed and updated in Practice Bulletin No. 220, published in May 2020, which is the current version. However, these trials had patients who ultimately delivered at/after 38 weeks. In a patient with a history of genital HSV for whom suppression is recommended but who will have a medically indicated delivery at 37 weeks, say for a hypertension disorder of pregnancy, is 36 week initiation of HSV antiviral medication enough time for suppression? There is a gap in high quality data on this. In this episode, we will review the published data and reach a clinical decision as to whether one week suppression is enough, or if initiation earlier is reasonable. 1. ACOG PB 822. ACOG PB 220

In part 2 of this episode of The Phoenix Cast, Violence Prevention Educator Cassandra Carmona-Wayman (she/hers/ella) continues her conversation with reproductive health advocate Cristina Ponce (she/hers) about Abortion Access, Reproductive Coercion, and Survivor Autonomy. Cristina shares her abortion story and shares her lived experiences with these topics. We also unpack how shifting laws, financial barriers, and crisis pregnancy centers impact survivor autonomy and safety. We highlight practical resources like abortion funds, doulas, travel support, and trusted clinic locators. We also break down myths about medication abortion and centering abortion as both healthcare and a crucial safety option for survivors of violence.Content warnings: discussion of abortion (including personal and self-managed abortion stories), reproductive coercion, intimate partner and interpersonal violence, sexual violence (including rape and sexual coercion), pregnancy-related homicide risk, and anti-abortion harassment/misinformation.Additionally:We discuss healthcare clinics and abortion providers near the Denver Metro area. Please be aware of clinics that misrepresent their services and can appear misleading to patients in need of care. Some “crisis pregnancy centers” near campus and in Denver are not medical clinics and may offer misleading or incomplete information about abortion and pregnancy options. When you can, seek licensed providers or clinics that clearly offer full-spectrum reproductive healthcare, and remember you can reach out to the Phoenix Center at Auraria for confidential support and accurate referrals.Sources and Resources mentioned in the episode:American College of Obstetricians and Gynecologists. Committee Opinion No. 554: Reproductive and Sexual Coercion. American College of Obstetricians and Gynecologists, 2013.American College of Obstetricians and Gynecologists. “Reproductive and Sexual Coercion.” ACOG, Feb. 2013,  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/02/reproductive-and-sexual-coercion.Centers for Disease Control and Prevention. “About Violence and Pregnancy.” Centers for Disease Control and Prevention,  https://www.cdc.gov/intimate-partner-violence/about/violence-and-pregnancy.html.Centers for Disease Control and Prevention. “Pregnancy Resulting from Sexual Violence.” Centers for Disease Control and Prevention,  https://www.cdc.gov/sexual-violence/about/pregnancy-resulting-from-sexualviolence.html.Cobalt Abortion Fund. Cobalt Abortion Fund,  https://cobaltaf.org/.Colorado Doula Project. Colorado Doula Project,  https://www.coloradodoulaproject.org/.Foster, Diana Greene. The Turnaway Study: Ten Years, a Thousand Women, and the Consequences of Having—or Being Denied—an Abortion. Scribner, 2020.Grace, Kelsey T., and Julie C. Anderson. “Reproductive Coercion: A Systematic Review.” Journal of Midwifery & Women's Health, vol. 63, no. 4, 2018, pp. 371–84.Guttmacher Institute. U.S. Abortion Patient and Policy Reports. Guttmacher Institute, https://www.guttmacher.org.Miller, Elizabeth, et al. “Pregnancy Coercion, Intimate Partner Violence and Unintended Pregnancy.” Contraception, vol. 81, no. 4, 2010, pp. 316–22.National Abortion Federation. National Abortion Federation,  https://prochoice.org/.National Academies of Sciences, Engineering, and Medicine. The Safety and Quality of Abortion Care in the United States. National Academies Press, 2018.“North Carolina Bill Would Authorize Deadly Force for Women Seeking Abortions.” WCNC Charlotte,  https://www.wcnc.com/article/news/politics/north-carolina-politics/north-carolina-bill-would-authorize-deadly-force-for-women-seeking-abortions/275-353d54a3-9231-4341-ae44-a127546db76f.Raymond, Elizabeth G., and David A. Grimes. “The Comparative Safety of Legal Induced Abortion and Childbirth in the United States.” Obstetrics & Gynecology, vol. 119, no. 2, 2012, pp. 215–19.“Reproductive Coercion.” The National Domestic Violence Hotline,  https://www.thehotline.org/resources/reproductive-coercion/.“Reproductive Coercion: What Is It?” Teen Vogue,  https://www.teenvogue.com/story/what-is-reproductive-coercion.Sexual Assault Awareness Fund. “Bisexual Women Are More Likely to Have Abortions.” Sexual Assault Awareness Fund, https://saafund.org/bisexual-women-are-more-likely-to-have-abortions/.Society of Family Planning. #WeCount Reports on Abortion Access After Dobbs.Society of Family Planning,  https://societyfp.org/.Tarzia, Laura, et al. “Reproductive Coercion and Abuse: A Systematic Review of Qualitative Evidence.” Trauma, Violence, & Abuse,  https://pmc.ncbi.nlm.nih.gov/articles/PMC5819992/.Van Parys, An-Sofie, et al. “Prevalence and Evolution of Intimate Partner Violence before and during Pregnancy: A Cross-Sectional Study.” BMC Pregnancy and Childbirth, vol. 14, 2014, article 294,  https://doi.org/10.1186/1471-2393-14-294.Washington State Coalition Against Domestic Violence. Pregnancy and Domestic Violence Issue Brief. Washington State Coalition Against Domestic Violence, 2013,  https://wscadv.org/wp-content/uploads/2016/12/pregnancy-dvfr-issue-brief-12-2013.pdf.World Health Organization. Abortion Care Guideline. World Health Organization, 2022.You can learn more about your options with healthcare service providers like Just the Pill. They can provide vital information and assistance with abortion, contraception, and other sexual and reproductive health services. We provide efficient and equitable access to health care by telemedicine. https://justthepill.com/about-us/You can also look into resources like Elevated Access. They are a nonprofit organization that provides free air transportation through a network of volunteer pilots, helping people travel to essential healthcare services they might not otherwise be able to reach. Their services primarily support access to abortion care and gender-affirming care by coordinating safe, confidential flights in partnership with healthcare and advocacy organizations across the United States.Be aware of Denver Metro Crisis Pregnancy Centers (CPCs):The AVI Project https://www.theaviproject.com/Alternatives Pregnancy Center (Alternatives Colorado) https://youhavealternatives.org/Bella Health and Wellness. Bella Health and Wellness.  https://bellahealthandwellness.com/.Alternatives Pregnancy Center. Alternatives Pregnancy Center.  https://youhavealternatives.org/.Marisol Health. Marisol Health.  https://marisolhealth.com/.Life Choices. Life Choices.  https://lifechoices.org/.If you are in crisis and need immediate support, please call our 24/7 interpersonal violence helpline at 303-556-2255.Request an Appointment with an Advocate athttps://www.thepca.org/online-appointment-requestRequest a Violence Prevention Presentation at https://www.thepca.org/prevention-educationInstagram @phoenixauraria

In part 1 of this episode of The Phoenix Cast, Violence Prevention Educator Cassandra Carmona-Wayman (she/hers/ella) talks with reproductive health advocate Cristina Ponce (she/hers) about how abortion care works, common myths about abortion, and the impact of post‑Dobbs restrictions. They also explore reproductive coercion as a form of abuse, its connections to interpersonal violence, and why protecting survivors' bodily autonomy and access to abortion is essential.Content warnings: discussion of intimate partner violence, reproductive coercion, sexual and physical violence, abortion (including later‑term), pregnancy loss, legal and systemic barriers to care, and brief mention of hospitalization due to assault.Additionally:We discuss healthcare clinics and abortion providers near the Denver Metro area. Please be aware of clinics that misrepresent their services and can appear misleading to patients in need of care. Some “crisis pregnancy centers” near campus and in Denver are not medical clinics and may offer misleading or incomplete information about abortion and pregnancy options. When you can, seek licensed providers or clinics that clearly offer full-spectrum reproductive healthcare, and remember you can reach out to the Phoenix Center at Auraria for confidential support and accurate referrals.Sources and Resources mentioned in the episode:American College of Obstetricians and Gynecologists. Committee Opinion No. 554: Reproductive and Sexual Coercion. American College of Obstetricians and Gynecologists, 2013.American College of Obstetricians and Gynecologists. “Reproductive and Sexual Coercion.” ACOG, Feb. 2013,  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/02/reproductive-and-sexual-coercion.Centers for Disease Control and Prevention. “About Violence and Pregnancy.” Centers for Disease Control and Prevention,  https://www.cdc.gov/intimate-partner-violence/about/violence-and-pregnancy.html.Centers for Disease Control and Prevention. “Pregnancy Resulting from Sexual Violence.” Centers for Disease Control and Prevention,  https://www.cdc.gov/sexual-violence/about/pregnancy-resulting-from-sexualviolence.html.Cobalt Abortion Fund. Cobalt Abortion Fund,  https://cobaltaf.org/.Colorado Doula Project. Colorado Doula Project,  https://www.coloradodoulaproject.org/.Foster, Diana Greene. The Turnaway Study: Ten Years, a Thousand Women, and the Consequences of Having—or Being Denied—an Abortion. Scribner, 2020.Grace, Kelsey T., and Julie C. Anderson. “Reproductive Coercion: A Systematic Review.” Journal of Midwifery & Women's Health, vol. 63, no. 4, 2018, pp. 371–84.Guttmacher Institute. U.S. Abortion Patient and Policy Reports. Guttmacher Institute, https://www.guttmacher.org.Miller, Elizabeth, et al. “Pregnancy Coercion, Intimate Partner Violence and Unintended Pregnancy.” Contraception, vol. 81, no. 4, 2010, pp. 316–22.National Abortion Federation. National Abortion Federation,  https://prochoice.org/.National Academies of Sciences, Engineering, and Medicine. The Safety and Quality of Abortion Care in the United States. National Academies Press, 2018.“North Carolina Bill Would Authorize Deadly Force for Women Seeking Abortions.” WCNC Charlotte,  https://www.wcnc.com/article/news/politics/north-carolina-politics/north-carolina-bill-would-authorize-deadly-force-for-women-seeking-abortions/275-353d54a3-9231-4341-ae44-a127546db76f.Raymond, Elizabeth G., and David A. Grimes. “The Comparative Safety of Legal Induced Abortion and Childbirth in the United States.” Obstetrics & Gynecology, vol. 119, no. 2, 2012, pp. 215–19.“Reproductive Coercion.” The National Domestic Violence Hotline,  https://www.thehotline.org/resources/reproductive-coercion/.“Reproductive Coercion: What Is It?” Teen Vogue,  https://www.teenvogue.com/story/what-is-reproductive-coercion.Sexual Assault Awareness Fund. “Bisexual Women Are More Likely to Have Abortions.” Sexual Assault Awareness Fund, https://saafund.org/bisexual-women-are-more-likely-to-have-abortions/.Society of Family Planning. #WeCount Reports on Abortion Access After Dobbs. Society of Family Planning,  https://societyfp.org/.Tarzia, Laura, et al. “Reproductive Coercion and Abuse: A Systematic Review of Qualitative Evidence.” Trauma, Violence, & Abuse,  https://pmc.ncbi.nlm.nih.gov/articles/PMC5819992/.Van Parys, An-Sofie, et al. “Prevalence and Evolution of Intimate Partner Violence before and during Pregnancy: A Cross-Sectional Study.” BMC Pregnancy and Childbirth, vol. 14, 2014, article 294,  https://doi.org/10.1186/1471-2393-14-294.Washington State Coalition Against Domestic Violence. Pregnancy and Domestic Violence Issue Brief. Washington State Coalition Against Domestic Violence, 2013,  https://wscadv.org/wp-content/uploads/2016/12/pregnancy-dvfr-issue-brief-12-2013.pdf.World Health Organization. Abortion Care Guideline. World Health Organization, 2022.You can learn more about your options with healthcare service providers like Just the Pill. They can provide vital information and assistance with abortion, contraception, and other sexual and reproductive health services. We provide efficient and equitable access to health care by telemedicine. https://justthepill.com/about-us/You can also look into resources like Elevated Access. They are a nonprofit organization that provides free air transportation through a network of volunteer pilots, helping people travel to essential healthcare services they might not otherwise be able to reach. Their services primarily support access to abortion care and gender-affirming care by coordinating safe, confidential flights in partnership with healthcare and advocacy organizations across the United States.Be aware of Denver Metro Crisis Pregnancy Centers (CPCs):The AVI Project https://www.theaviproject.com/Alternatives Pregnancy Center (Alternatives Colorado) https://youhavealternatives.org/Bella Health and Wellness. Bella Health and Wellness.  https://bellahealthandwellness.com/.Alternatives Pregnancy Center. Alternatives Pregnancy Center.  https://youhavealternatives.org/.Marisol Health. Marisol Health.  https://marisolhealth.com/.Life Choices. Life Choices.  https://lifechoices.org/.If you are in crisis and need immediate support, please call our 24/7 interpersonal violence helpline at 303-556-2255.Request an Appointment with an Advocate athttps://www.thepca.org/online-appointment-requestRequest a Violence Prevention Presentation at https://www.thepca.org/prevention-educationInstagram @phoenixauraria

Antenatal corticosteroids are a MAJOR win in the management of preterm labor. An initial course of antenatal corticosteroids has been shown to reduce morbidity and mortality in patients with preterm prelabor rupture of membranes. For patients who remain undelivered after the initial course of antenatal corticosteroids, it is uncertain whether a booster course of antenatal corticosteroids reduces neonatal morbidity or increases the infection risk. The ACOG, in its current guidance, has concluded that the current evidence is insufficient to make a recommendation. Corticosteroids, especially at the doses given, are also powerful immunosuppressants. When you administer that first course, you accept a minor, calculated risk for a massive, proven benefit. But when you introduce a second course of steroids into a uterine environment that has already been ruptured and exposed to vaginal flora for weeks, you are pouring fuel on the fire. PLUS, the environment for the fetus with prolonged preterm prelabor rupture of membranes is unique. PPPROM, the chronic exposure to ruptured membranes and the resultant oligohydramnios is theorized to trigger a kind of stress response in the fetus- so the baby may make their own endogenous corticosteroid flare. So, rescue steroids after an initial course of steroids in PPROM cases has remained controversial but we have updated data that has provided new insights. In this episode, we will highlight an RCT from 2023 and a more recent systematic review and meta-analysis from May 2026 on this very subject. Listen in for details. 1. Garite TJ, Kurtzman J, Maurel K, Clark R; Obstetrix Collaborative Research Network. Impact of a 'rescue course' of antenatal corticosteroids: a multicenter randomized placebo-controlled trial. Am J Obstet Gynecol. 2009 Mar;200(3):248.e1-9. doi: 10.1016/j.ajog.2009.01.021. Erratum in: Am J Obstet Gynecol. 2009 Oct;201(4):428. PMID: 19254583.2. Tenbrink E, Quain A, Rone V, Harris K, Hadley E, Haas D, Shanks A. Risk of Neonatal Sepsis With Rescue Steroids in Preterm Premature Rupture of Membranes. Cureus. 2023 Apr 6;15(4):e37207. doi: 10.7759/cureus.37207. PMID: 37159785; PMCID: PMC10163895.3. Melamed N, Murphy KE, Pylypjuk C, et al. Timingof Antenatal Corticosteroid Administration and Neonatal Outcomes. JAMA Netw Open. 2025;8(5):e2511315. 4. Porreco R, Garite TJ, Combs CA, Maurel K, Huls CK, Baker S, Fortner KB, Longo SA, Nageotte M, Lewis D, Tran L; Obstetrix Collaborative Research Network. Booster course of antenatal corticosteroids after preterm prelabor rupture of membranes: a double-blind randomized trial. Am J Obstet Gynecol MFM. 2023 May;5(5):100896. doi: 10.1016/j.ajogmf.2023.100896. Epub 2023 Feb 14. PMID: 36796641.5. Da Costa Y, Ramanathan V, Oliveira JA, Brito J, Yousif A. Repeat versus Single Course of Antenatal Corticosteroid in Management of Preterm Premature Rupture of Membranes: A Systematic Review and Meta-analysis. Am J Perinatol. 2026 May;43(7):925-932. doi: 10.1055/a-2708-5314. Epub 2025 Oct 9. PMID: 41067234

Today we sit down with Alex, a nurse practitioner and mama of two, who shares her journey from a scheduled breech cesarean to a fast, spontaneous VBAC at a birth center. After two unsuccessful ECV attempts, Alex planned for a cesarean with her first baby. Along the way, she also experienced the heartbreak of miscarriage before welcoming her daughter. Alex opens up about navigating conflicting medical opinions (including being told by an MFM that her baby would die– not okay!!) and how her and her medical doctor husband's views on out-of-hospital birth evolved over time. Alex also shares why practicing for labor could only take her so far before surrender became the greatest lesson, the importance of surrounding yourself with more than just a supportive provider, and how having an encouraging birth team made all the difference. Alex especially talks about how her VBAC-certified doula was an invaluable part of that team. We also discuss some of the evidence behind using ultrasounds to measure scar thickness as a predictor of a VBAC outcome or uterine rupture, and why ACOG does NOT recommend it. The Ultimate VBAC Prep Course for ParentsOnline VBAC Doula TrainingAdvertising Inquiries: https://redcircle.com/brands

John Gerardi is joined by his friend Kathryn Jean Lopez of National Review, the pro-life movement's leading chronicler and author of the Lifeline newsletter. The two dig into the biggest and most frustrating story in pro-life politics: Congress quietly letting Planned Parenthood's Medicaid funding come roaring back after just one year of defunding, and why, in KJL's words, "not enough raging" is happening in Washington. Along the way they cover the GOP's fading abortion plank and the legacy of platform warriors like Phyllis Schlafly, the New York Times' fascination with Heritage Foundation scholar "Mrs." Emma Waters and the rise of restorative reproductive medicine, and the courtroom showdown over abortion pill reversal, where the abortion lobby's star witness is crumbling under cross-examination. Then, in the final segment, John and Kathryn push back on the "toxic empathy" discourse. If pro-lifers become the movement known for being against empathy, we've lost the plot. They'll know we are Christians by our love, from the sidewalk to the Obria clinic in Fresno. Subscribe to the Lifeline at National Review and never miss an episode of Right to Life Radio, Sundays on KMJ.

Medical doctors don't always train in the states where they end up working. And for OB-GYNs in particular, that can mean navigating conflicting state laws around which procedures are allowed. Democrat U.S. Rep. Kelly Morrison is an OB-GYN who represents Minnesota's 3rd Congressional District. She has introduced a bill that would provide funding to help medical residents in states with strict abortion bans travel for some of their training. For more on the proposal, MPR News host Nina Moini talked with Dr. Erin Stevens, legislative chair of Minnesota's section of the American College of OB-GYNs, or ACOG.

Endometrial cancer is the most common gynecologic cancer in the U.S. — more common than cervical or ovarian — and both its incidence and its death rate have been climbing for decades. For years, the guideline meant to catch it in postmenopausal women missed it in Black women. Dr. Kemi Doll worked to change this. Kemi is a Gynecologic Oncologist and Professor at the University of Washington. She directs the GRACE Center in the Dept of Ob-Gyn a multidisciplinary research center focused on eliminating systemic racial and gender inequities in gynecologic care, with a specific emphasis on combating preventable deaths from endometrial cancer in Black women. She co-founded ECANA, the Endometrial Cancer Action Network for African Americans, and her research on missed diagnoses helped drive ACOG's April 2026 update to national screening guidance. Kemi is the author of A Terrible Strength: The Hidden Crisis of the Black Womb, which includes a discussion of heavy bleeding, endometriosis, fibroids, and endometrial cancer. ▶ Subscribe on YouTube @resaelewissmd — new Visible Voices episodes on Wednesdays. 

Send us Fan MailQ1 2027 cash flow crisis. That is what is waiting for every OB practice that does not have a plan in motion by October. Not because the codes are hard. Because the time ran out to prepare for them. Knowing what is changing and being ready for it are two completely different things. In the OB Global Coding Series finale, Dr. Heather Signorelli walks through the exact ninety-day month-by-month plan to be ready on January 1, 2027 — payer contracts in July, EHR templates and workflows in August, provider training and shadow audits in September, refinement through Q4. Month 1 · July · Payer contracts: Your contracts reference specific CPT codes. When 59400 and 59510 disappear January 1, those contracted rates disappear with them. Identify your top five payers by maternity volume. Reach out to each provider rep with a written timeline question. Model your current revenue per episode before negotiating. Use the ACOG payer advocacy toolkit. Submit written notice of intent to renegotiate before July 31 to get into the Q4 queue. Month 2 · August · EHR + workflows: Systems first, people second. Rebuild prenatal, postpartum (inpatient and outpatient), and labor management templates. The labor management templates are built from scratch since 59080 – 59083 have no legacy. Build the multi-provider attribution protocol, the same-day postpartum hard stop, and the modifier TH automation. Month 3 · September · Provider training + shadow audits: Mandatory training for all clinical staff. Show providers their own notes and the dollar difference between what they wrote and what they could have written. Run shadow audits monthly: twenty prenatal notes, ten labor management, ten postpartum rounding. Track results by provider. Brief the front desk on the patient-facing talking points. September 1 is the ACOG testing date — NOT a payer compliance deadline. Submit test claims to your top three payers and watch what comes back. Q4 · Refinement, not crisis: October: follow up with payers for written fee schedule confirmations. November: CMS finalizes RVUs — update your revenue model with real numbers. December: billing team readiness check. January 1: go live. The practices that did the Q3 work transition smoothly. The ones that did not are scrambling. The reframe: The elimination of the global OB codes is not a threat to your practice. It is a correction. OB/GYN has been undercompensated for the complexity of maternity care for thirty years. That ends January 2027, if you are prepared.RESOURCES BLOCK Save your seat: Live OB/GYN Global Codes Update Webinar (July 7, 2026, 4:00 PM ET) · eligibility.natrevmd.com/obgyn-global-updates-webinar Book a 1:1 with Dr. Signorelli · calendly.com/heather-natrevmd/ Full series playlist: EP188 · EP189 · EP190 · EP191 · EP192 (https://natrevmd.com/podcast/#) Practice Revenue Leak Scorecard · eligibility.natrevmd.com/nrm-revenue-scorecard-v3 Payment Posting Audit Checklist · eligibility.natrevmd.com/payment-posting-checklist RECOVER Diagnostic Quiz · natrevmd.com/quiz 

Signing the general consent form when you walk into the hospital does not mean you have agreed to everything that follows. Not the Pitocin. Not the vaginal exam. Not the electronic fetal monitor. Not the cesarean. Not the hospital policy. Every single one of those still requires your informed consent.I had the privlege of sitting down with Hermine Hayes-Klein, an attorney who has spent 25 years specializing in women's rights in pregnancy and childbirth. She moved to the Netherlands while pregnant with her first baby, watched a completely different birth system up close for five years, came home, and became a lawyer who takes the birth cases nobody else will touch. The ones where the baby is okay but the mama is not. She represents the women nobody is fighting for. And she wins.What Hermine shares about your actual rights in the birth room is the kind of information that changes how you walk into every single prenatal appointment and ultimately into your birth.  Here are some highlights from the episode:What informed consent actually means — and why signing a general consent when you walk into the hospital does not cover everything that followsThe real cases behind Hermine's work — and why she started taking them when nobody else wouldWhat hospital policies can and cannot do — and why they do not get to override your legal and constitutional rightsThe specific ACOG documents Hermine recommends having printed and highlighted in your hospital bag before labor startsThe five sets of risks every pregnant mama deserves to weigh when making birth decisions — and why providers are only ever talking about one of themInduction, breech birth, electronic fetal monitoring, AMA — what you actually need to know about each of theseThe exact language you can use to hold your ground in the birth room without being rudeConnect with Hermine:

Send us Fan MailShow notes On January 1, 2027, every global OB code your practice has billed for the last thirty years is being deleted. Seventeen CPT codes. Gone. Replaced with a completely new structure for how every dollar of maternity revenue is earned, attributed, and collected. And the real deadline for your practice is not January 1, 2027. The real deadline is right now. What is actually going away For over thirty years, OB practices have lived in a bundled global world: one patient, one pregnancy, one code. Effective January 1, 2027, 17 global obstetric CPT codes (including 59400 for a global vaginal delivery and 59510 for a global C-section) are being deleted entirely. The AMA and ACOG determined the global model no longer reflects modern OB standard of care, and so the structure is being fully replaced, not patched. The four new phases of maternity billing Phase 1, Antepartum care. All bundled antepartum codes deleted. Every prenatal visit billed as individual E/M with TH modifier (99202 through 99215). Phase 2, Labor management. New dedicated code category for the first time in CPT history. Reported per calendar day, with straightforward vs complex management distinction. Phase 3, Delivery. Vaginal vs cesarean restructured. VBAC coded differently than first-time vaginal. Add-on procedures (3rd/4th degree laceration repair, uterine tamponade) now separately billable. Phase 4, Postpartum care. All existing postpartum codes deleted. Hospital care codes for inpatient day-after-delivery. Office E/M for outpatient follow-up. Same-date postpartum bundled into delivery. Why the real deadline is Q3 and Q4 2026 Cash flow in January 2027 will be decided this Q3 and Q4. Payer contracts reference CPT codes by number, so contracts that reference deleted codes need renegotiation now. Documentation habits have to change before the new codes go live, because every prenatal visit now needs to support E/M level selection. A 200-patient OB practice undercoding prenatal visits by even $40 each is leaving close to $100,000 a year on the table from day one. The multi-provider attribution problem Under the global model, attribution was easy: one practice, one fee, regardless of which provider saw which visit. Under the new model, every encounter is attributed to the individual provider who performed it. Practices with midlevels, hospitalists, or shared call need a clear protocol for labor management billing, on-call coverage, and cross-coverage now, or they will either double-bill (compliance risk) or miss charges (phantom revenue) from day one. Three actions this week Pull a payer contract audit. List every commercial contract referencing global OB codes that needs renegotiation before January 1. Run a prenatal documentation review. Pull 10 recent prenatal charts per provider and assess them against current 99213 and 99214 E/M standards. The gap is your single biggest revenue risk. Map your provider attribution workflow. Write out exactly how labor management, on-call coverage, cross-coverage, and same-day postpartum care will be tracked when every encounter is attributed individually. Episode breakdown 1. The 17 deleted codes 2. The four new phases of maternity billing 3. Why Q3 and Q4 of this year is your real deadline 4. The multi-provider attribution gap 5. What patients will see on their EOBs 6. Your 90-day action plan 7. What is ahead in the rest of the OB Global Coding Series Resources → Live OB Global Updates Webinar (PRIMARY): eligibility.natrevmd.com/obgyn-global-updates-webinar → Book a call with Heather: calendly.com/heather-natrevmd → Payment Posting Audit Checklist: eligibility.natrevmd.com/payment-posting-checklist → Practice Revenue Leak Scorecard: eligibility.natrevmd.com/nrm-revenue-scorecard-v3 → Coming next in the series: EP189 — How to Bill Antepartum Care Under the New E/M Model 

A Podcast from Obstetrics & Gynecology highlighting the latest research and practice updates in the field. This episode features an interview with Drs. David Shalowitz and Christine Garcia, collaborators on "ACOG Clinical Practice Update: Updated Guidance Regarding the Role of Transvaginal Ultrasonography in Evaluating the Endometrium of Individuals With Postmenopausal Bleeding."

How do you decide which noninvasive prenatal testing option is best for your patient, and when should you reach for single-gene NIPT? In this episode of BackTable Women's Health, host Dr. Nicole Faulkner interviews maternal-fetal medicine specialist Dr. Andrei Rebarber to break down the evolving world of prenatal genetic testing. They discuss the importance of pan-ethnic carrier screening, the clinical scenarios where single-gene NIPT is most useful, and how to navigate counseling and follow-up for a wide range of patients. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Naterahttps://www.natera.com/info/fetal-focus --- Timestamps 00:00 - Introduction04:43 - Prenatal Genetic Testing Basics07:10 - Larger Panel Screening Benefits10:49 - Defining Single-Gene NIPT14:51 - Counseling and Invasive Options18:26 - Accuracy Data and No Call Rate22:03 - Patient Acceptance of Test24:18 - When to Test and Screen26:13 - Counseling Carrier Results30:12 - In Utero Treatment 32:36 - Workflow for Generalists35:33 - How to Interpret Literature40:08 - Closing Remarks --- More about this episode Dr. Rebarber shares how witnessing in-utero transfusions for severe Rh disease inspired his career in OBGYN and maternal-fetal medicine, highlighting the importance of treating the fetus as a patient and the rapid growth of fetal therapy. The episode reviews ACOG-guided carrier screening for conditions like cystic fibrosis and hemoglobinopathies, the trend toward larger, pan-ethnic screening panels, and why carrier findings are common but true “double-carrier” couples are relatively rare. Dr. Rebarber also discusses the clinical utility of single-gene NIPT—a cell-free placental DNA test for select recessive conditions—especially when partner testing isn't possible or when patients wish to avoid invasive procedures. The conversation compares screening and diagnostic strategies, including CVS and amniocentesis, and provides practical insight into interpreting test performance and emerging research. --- Resources EXpanding Prenatal Cell Free DNA Screening Across moNogenic Disorders (EXPAND) https://clinicaltrials.gov/study/NCT06808880?tab=study --- BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women's health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

Welcome back, everyone. Today we're diving into one of the most hotly debated topics in obstetrics- should we be treating preeclampsia without severe features with antihypertensive medications during expectant management? Now, if you've been following the literature- and our show, you know that the landmark CHAP trial changed the game for chronic hypertension in pregnancy. It showed us that targeting a blood pressure below 140 over 90 reduces serious maternal complications, without harming the baby. That was a big deal. But here's the thing, CHAP studied chronic hypertension. Then there was the CHIP trial- that also found that tight control of gestational hypertension and nonproteinuric chronic hypertension was also beneficial. These did not address preeclampsia without severe features, and yet, the ripple effects of that trial have sparked a global conversation about whether we should be extending those same treatment principles to women with preeclampsia who don't yet have severe features. And this is where it gets really interesting, because the guidelines don't agree. In the United States, ACOG and the Society for Maternal-Fetal Medicine still say: hold off on antihypertensives unless blood pressures hit the severe range at 160/110. But step outside the US, and you'll find the World Health Organization, the International Society for the Study of Hypertension in Pregnancy, FIGO, NICE, and Hypertension Canada all recommending treatment at 140 over 90, regardless of whether the diagnosis is chronic hypertension, gestational hypertension, or preeclampsia. So who's right? And more importantly what does this mean for the patient sitting in front of you right now, at 34 weeks, with a blood pressure of 150 over 95, some proteinuria, but no severe features? Today, we're going to break this down. We'll review the controversy, walk through the divergent guidelines, and most importantly talk about the real, practical implications that favor treating these patients during expectant management. Because when you're watching someone with preeclampsia, waiting for the right time to deliver, there's a strong argument that controlling their blood pressure isn't just reasonable…may be protective. So grab your coffee, settle in, and let's get into it.1. Society for Maternal-Fetal Medicine Statement: Antihypertensive Therapy For mild chronic Hypertension in Pregnancy-The Chronic Hypertension And Pregnancy Trial. American Journal of Obstetrics and Gynecology. 2022. Society for Maternal-Fetal Medicine; Publications Committee. 2. Preeclampsia. The New England Journal of Medicine. 2022. Magee LA, Nicolaides KH, von Dadelszen P.3. Antihypertensive Drug Therapy for Mild to Moderate Hypertension During Pregnancy.The Cochrane Database of Systematic Reviews. 2018. Abalos E, Duley L, Steyn DW, C.4. Prevention and Treatment of Maternal Stroke in Pregnancy and Postpartum: A Scientific Statement From the American Heart Association. Stroke. 2026. Miller EC, Bello NA, Chen PR, et al.5.Hypertension in Pregnancy: Diagnosis, Blood Pressure Goals, and Pharmacotherapy: A Scientific Statement From the American Heart Association. Hypertension. 2022. Garovic VD, Dechend R, Easterling T, et al.

Tylenol in pregnancy — safe or dangerous? In this myth-busting episode of MamaDoc BabyDoc, we break down the headlines, the fear, and the actual science behind acetaminophen use during pregnancy. We discuss what the FDA recently said, why the controversy exploded online, and what large medical organizations like ACOG are recommending right now. We dive into the studies linking Tylenol to autism and ADHD, explain the difference between association and causation, and talk about why fever treatment in pregnancy matters. Most importantly, we help pregnant patients understand how to make informed, evidence-based decisions instead of reacting to scary social media claims. If you've wondered whether Tylenol is truly safe during pregnancy, this episode gives you the facts — without the panic.

Mike Belivue, @ more assassination attempts, Polish Repro Firearms, Facebook, Winchester instead of Trapdoor, ACOG obsolete? Soviet Cosmonaut's Guns                              

Hyperemesis gravidarum (HG) represents the most severe end of the nausea and vomiting of pregnancy spectrum. It has a reported incidence of approximately 0.3–3% of pregnancies and is the most common cause of hospitalization in early pregnancy and the second most common cause of hospitalization in pregnancy overall. In June 2024, the ACOG published a Clinical Expert series summarizing the inpatient management of HG. In that guidance, it describes mirtazapine as an “alternative pharmacologic” option. How effective is this medication compared to ondansetron? A new study (published ahead of print on 12/30/25 and officially out June 2026), out of Denmark, sheds some new light on this medication. This trial is the first double-blind RCT comparing mirtazapine to ondansetron AND placebo. Although a BIG limitation of this study exists (which we will discuss), it does provide some interesting insights. Listen in for details.1. (ACOG CES) Clark, Shannon M. MD; Zhang, Xue MD; Goncharov, Daphne Arena MD. Inpatient Management of Hyperemesis Gravidarum. Obstetrics & Gynecology 143(6):p 745-758, June 2024. | DOI: 10.1097/AOG.00000000000055182. Ostenfeld, AnneDroogh, Marjoes et al.Mirtazapine or ondansetron for hyperemesis gravidarum. A randomized placebo-controlled trial. American Journal of Obstetrics & Gynecology, June 2026

We bring back the biggest takeaways from the ACOG ACSM, then move fast through the newest guidance and the newest hype shaping real OBGYN care. We focus on what the evidence actually supports, where practice still lags behind, and how “labels” can quietly push patients toward harm.• conference highlights including rural OBGYN access and what gets attention on the exhibit floor • vitamin K shot refusal trends and why late bleeding still matters weeks after birth • 2026 ACOG cervical cancer screening changes with primary HPV testing preferred for ages 30 to 65 • self-collected HPV screening and the systems needed to keep follow-up safe • why annual Pap testing and cytology-only strategies increase overdiagnosis and can miss HPV risk • postmenopausal bleeding workup shifting toward ultrasound plus endometrial biopsy up front • large baby induction data and why outcomes can worsen without neonatal benefit • third-trimester ultrasound screening performance and the real-world labeling effect • early proof-of-concept therapy for preeclampsia targeting sFlt1 removal to prolong pregnancy • hysterectomy duration and route as drivers of venous thromboembolism risk • laboring down claims from retrospective reports versus randomized trial findings • debunking physiologic third stage claims and reaffirming active management to prevent hemorrhage Be sure to check out thinkingaboutobgyn.com for more information, and be sure to follow us on Instagram.0:00 ACOG Meeting Takeaways And Rural Access3:58 Vitamin K Refusal And Newborn Bleeding6:37 Cervical Screening Moves Toward HPV14:48 Postmenopausal Bleeding Now Needs Biopsy20:00 Tylenol Data And Macrosomia Induction28:34 Ultrasound Labeling Effect And Liability Fears37:29 Removing sFlt1 To Buy Time40:14 Longer Hysterectomy Surgeries Raise VTE Risk42:14 Laboring Down Claims Versus RCT Reality49:59 Counseling Fatigue Without Ignoring Risk54:21 Third Stage Myths And Hemorrhage Prevention58:42 Evidence Literacy And Closing NotesFollow us on Instagram @thinkingaboutobgyn.

Genome-wide noninvasive prenatal testing (GW-NIPT) was introduced in 2015 and became widely available in 2019. Nonetheless, we are still learning more about this important prenatal screening test. In January 2026, the ACOG released a new PA on this, which we will also review in this episode. Our main publication ti review, however, will be the AJOG May 2026's systematic review and meta-analysis on the finding of “genome-wide” cfDNA discordant results and what this may mean for the pregnancy. Although rare, this may lead (over a third of cases) to some adverse perinatal issues. Listen in for details. 1. ACOG PA Jan 2026: Screening for Fetal Chromosomal Abnormalities2. AJOG May 2026: https://click.notification.elsevier.com/CL0/https:%2F%2Fwww.ajog.org%2Farticle%2FS0002-9378(25)00865-8%2Ffulltext%3Fdgcid=raven_jbs_etoc_email/1/0100019d9ec37d7b-c586438d-021a-4097-8db3-c158e6f97c9b-000000/Vq6ksekOuvTxcv8OEZZ2uBesCg_hG6qlhqU_BlCnAK4=452

Hey Doc,I just got back from ACOG and I'm still on a high!I went mainly to hear Michelle Obama speak and she did not disappoint. But what surprised me most was how deeply aligned her message was with everything I talk about here on Stethoscopes and Strollers.This wasn't some polished keynote speech full of inspirational fluff. It felt like sitting in on a private conversation between two accomplished Black women talking honestly about identity, confidence, womanhood, and what it takes to stay grounded in a world that constantly tries to tell women — especially Black women — who we should be.And the whole time I kept thinking:“Oh. This is exactly what I've been trying to help physician moms understand.”We talked about:Why confidence actually comes from knowing yourself deeplyHow long it can take to truly trust yourselfThe danger of shrinking your accomplishments to make other people comfortableWhy some people not connecting with you is not automatically a “you” problemHow motherhood and life transitions force you to confront who you really areThe importance of celebrating yourself unapologeticallyLearning to trust your knowing instead of overriding it with practicality or people-pleasingAlso… I found out Michelle Obama is 62 and now I need somebody to explain the sorcery immediately.Hearing someone at her level speak so openly about groundedness, self-trust, and identity felt incredibly validating. Especially as physician moms navigating careers, motherhood, marriage, leadership, ambition, and all the invisible expectations sitting on top of us every single day.If you've been questioning yourself…If you've been minimizing yourself…If you've been waiting for permission to trust your instincts…This conversation is for you.Press play, Doc.What did you think of the episode, doc? Let me know! Subscribe to ✨Stethoscopes and Strollers✨ on your favorite podcast platform so you never miss an episode.Apple Podcast | Spotify | YouTubeConnect with me: Website | Instagram | Facebook Join my Email list to get tips on navigating motherhood in the medical field.If you are going through a transition -- becoming a parent, leaving a job, figuring out how manage it all, schedule a strategy coaching session and get clarity and strategic next steps for the life and career you want.Strategy Coaching Session with Dr. Toya

Send us Fan MailPreparing your hospital bag for labor and delivery can feel overwhelming, especially when Pinterest lists make it seem like you need to pack your entire house. In this episode of The Birth Journeys Podcast®, labor and delivery nurse Kelly Hof breaks down what you actually need in your hospital bag, what the hospital already provides, and how to avoid overpacking during pregnancy.If you're a first-time mom wondering: What should I pack in my hospital bag?  What does the hospital provide after birth?  When should I pack my hospital bag?  What do I really need for labor and postpartum recovery?  What should I bring for baby? …this episode is for you.As a labor nurse with over a decade in obstetrics, Kelly shares a realistic, minimalist hospital bag checklist that helps moms feel more calm, organized, and prepared for labor, delivery, postpartum recovery, and bringing baby home.You'll learn: ✔️ What to pack in your hospital bag for labor and delivery ✔️ What NOT to pack ✔️ What hospitals typically provide postpartum ✔️ Hospital bag essentials for mom and baby ✔️ Postpartum recovery must-haves ✔️ Comfort items that actually make a difference during labor ✔️ How overpacking can increase stress and decision fatigue ✔️ A simple 5-step hospital bag packing planThis episode also covers the emotional side of birth preparation and why simplifying your hospital bag can help you feel more confident, grounded, and focused going into labor.Whether you're preparing for a hospital birth, creating your birth plan, or getting ready for postpartum recovery with a newborn, this episode will help you feel more prepared without the overwhelm.✨ Download Kelly's free Birth Plan Workshop at kellyhof.comSupport the showConnect with Kelly Hof, BSN, RNC-EFM

Hey Doc,I'm on my way to DC!My first home in this country. Howard. All of it.I'm going to ACOG's ACSM, our national meeting, which is funny, because I don't practice anymore.But this work I do with physician moms is rooted in the same transitions we see every day in medicine.Last year I went for physician wellbeing.This year, Michelle Obama is there, so… clearly I'm going.Also, it's my son's birthday weekend so I'm bringing the kids, there's a party, and yes—there will be a spa day.This episode is a little life update, a little reflection, and a reminder:You don't have to choose one version of yourself.Press play.What did you think of the episode, doc? Let me know! Subscribe to ✨Stethoscopes and Strollers✨ on your favorite podcast platform so you never miss an episode.Apple Podcast | Spotify | YouTubeConnect with me: Website | Instagram | Facebook Join my Email list to get tips on navigating motherhood in the medical field.If you are going through a transition -- becoming a parent, leaving a job, figuring out how manage it all, schedule a strategy coaching session and get clarity and strategic next steps for the life and career you want.Strategy Coaching Session with Dr. Toya

What if the test meant to reassure you… could actually miss cancer?Bleeding after menopause is often the first—and sometimes only—warning sign of uterine cancer, yet new evidence shows the way we've been evaluating it may not be enough. In this must-listen episode, Dr. Stephanie Hack, MD, MPH breaks down the latest ACOG guidelines that are reshaping care, explaining why ultrasound alone can miss serious disease and what should happen instead.If you've ever been told “everything looks normal,” or you care about a woman who has—this episode could change what happens next.REFERENCESACOG Clinical Practice Update (2026): Updated Guidance Regarding the Role of Transvaginal Ultrasonography in Evaluating the Endometrium of Individuals With Postmenopausal BleedingAmerican Cancer Society: Endometrial Cancer Statisticshttps://www.cancer.org/cancer/types/endometrial-cancer/about/key-statistics.htmlAACR (American Association for Cancer Research): Uterine Cancer Projectionshttps://www.aacr.org/about-the-aacr/newsroom/news-releases/u-s-uterine-cancer-incidence-and-mortality-rates-expected-to-significantly-increase-by-2050/NCBI/StatPearls: Endometrial Cancer Overviewhttps://www.ncbi.nlm.nih.gov/books/NBK525981/

(From our Instagram Video Post): A very quick recap of the brand new ACOG Cervcial Caner Screening Update from April 24, 2026.

The ACOG recommends a multimodal approach to postoperative pain that includes nonsteroidal NSAIDs, acetaminophen, and opioids. Ketorolac is a favored NSAID for postop pain control. However, the optimal dose of ketorolac after cesarean delivery has not been determined. In this episode, we will summarize a brand new randomized, controlled, single-blind trial of pregnant women undergoing cesarean delivery under regional anesthesia at a large academic medical center between June 2022 and October 2023. Enrolled participants were randomized to receive an initial loading dose of 60 mg (intervention) or 30 mg (control) of intravenous ketorolac in the operating room at the end of surgery.1. Pharmacologic Stepwise Multimodal Approach for Postpartum Pain Management: ACOG Clinical Consensus No. 1. Obstetrics and Gynecology. 2021.2. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstetrics and Gynecology. 2020.3. Eid, Joe MD; Caplan, Madeleine MD; Goel, Nidhi MD; Poirier, Marie-Veronique MD; Montaine-O'Brien, Skyler MS; Rood, Kara M. MD; Costantine, Maged M. MD. Two Perioperative Ketorolac Dosing Regimens After Cesarean Delivery and Opioid Use: A Randomized Controlled Trial. O&G Open 3(2):e159, April 2026. | DOI: 10.1097/og9.0000000000000159

Send us Fan MailYou've heard “30 seconds,” “a few minutes,” or “wait until it stops pulsing”… but how long should you actually delay cord clamping?In this episode, we break down what the research shows, what current guidelines from American College of Obstetricians and Gynecologists and American Academy of Pediatrics recommend, and why more time isn't always more beneficial.You'll learn: ✔️ Why at least 60 seconds is the evidence-based baseline ✔️ How placental transfusion works after birth ✔️ The real benefits for term and preterm babies ✔️ When delayed cord clamping may not be safe ✔️ How to communicate your preferences with your providerWe also cover cord blood banking, cord milking, and how to make a decision that aligns with your values.This episode will help you move from confusion to clarity—so you can feel confident in what matters most for you and your baby. 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 Hof, BSN, RNC-EFM

Neuraxial analgesia (epidural or spinal) combined withtocolytic therapy is the pain control method that best increases the success rate of external cephalic version (ECV), according to the ACOG's PB 221. However, some patients may be reluctant to use regional anesthesia and may askabout IV analgesia. A new study in the AJOG (released as an ePub on March 5, 2026) provides some insights that may be helpful for patient consultation. These investigators compared the success of external cephalic version, modes of delivery, maternal pain, and complications using three strategies: intravenous analgesia with remifentanil, epidural anesthesia, and a stepwise approach in which epidural anesthesia was administered only if intravenous analgesia was unsuccessful. Listen in for details.1.     ACOG PB 2212.     Aiartzaguena, Amaia et al. Comparativeeffectiveness of intravenous remifentanil, epidural anesthesia and a two-stepanalgesic approach for external cephalic version: a large prospectivesingle-center cohort study. American Journal of Obstetrics & Gynecology,Volume 0, Issue 03.     Hao Q, Hu Y, Zhang L, et a l. A SystematicReview and Meta-Analysis of Clinical Trials of Neuraxial, Intravenous, andInhalational Anesthesia for External Cephalic Version. Anesthesia andAnalgesia. 2020. 4.     Wilson MJA, MacArthur C, Hewitt CA, et al.5.     Intravenous Remifentanil Patient-ControlledAnalgesia Versus Intramuscular Pethidine for Pain Relief in Labour (RESPITE):An Open-Label, Multicentre, Randomised Controlled Trial. Lancet. 2018.

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The ACOG 2025 guideline specifically recommends either oral or vaginal misoprostol for cervical ripening; it does not include buccal administration among its endorsed routes. With the rising rates of both obesity and labor induction, understanding the optimal agents for induction in obese patients is crucial. In a new study released ahead of print on March 4, 2026, in the AJOG, investigators from Indianapolis released findings from a secondary analysis of the IMPROVE trial (2019, AJOG) looking at the effect of obesity on buccal vs vaginal doses of misoprostol for cervical ripening. Listen in for details.1. Haas DM, Daggy J, Flannery KM, Dorr ML, Bonsack C, Bhamidipalli SS, Pierson RC, Lathrop A, Towns R, Ngo N, Head A, Morgan S, Quinney SK. A comparison of vaginal versus buccal misoprostol for cervical ripening in women for labor induction at term (the IMPROVE trial): a triple-masked randomized controlled trial. Am J Obstet Gynecol. 2019 Sep;221(3):259.e1-259.e16. doi: 10.1016/j.ajog.2019.04.037. Epub 2019 May 7. PMID: 31075246; PMCID: PMC7692024.2. ACOG July 2025: Cervical Ripening in Pregnancy, ACOG Clinical Practice Guideline No. 93. Bynarowicz, Taylor M. et al. The impact of body mass index on misoprostol dosing for labor induction: a comparison of vaginal and buccal dosage formsAmerican Journal of Obstetrics & Gynecology, Volume 0, Issue 0: https://www.ajog.org/article/S0002-9378(26)00126-2/fulltext4. Etrusco A, Sfregola G, Zendoli F, et al. Effect of Maternal Age and Body Mass Index on Induction of Labor Using Oral Misoprostol in Late-Term Pregnancies: A Retrospective Cross-Sectional Study. Gynecologic and Obstetric Investigation. 2024. 5. Prostaglandin Versus Mechanical Dilation and the Effect of Maternal Obesity on Failure to Achieve Active Labor: A Cohort Study.6. Beckwith L, Magner K, Kritzer S, Warshak CR. The Journal of Maternal-Fetal & Neonatal Medicine : The Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. 2017.

Neither the ACOG nor SMFM recommend strict bed rest for preterm birth prevention, or nor preeclampsia. Yet tradition often conflicts with evidence. A prior 2009 survey of MFM specialists, published in the AJOG, on the use of bed rest revealed that 71% used activity restriction in their practice for arrested preterm labor, despite the majority believing it had minimal or no benefit. The authors concluded, “Because most obstetricians in our survey indicated they would prescribe bed rest believing it was associated with minimal or no benefit, it is possible that even if a randomized, prospective trial showed no benefit associated with bed rest, it would still remain a common recommendation.” This brings us to a brand new publication from the Green Journal which is an ancillary study of two randomized trials of preterm birth prevention in women with a short cervical length. These authors sought to evaluate the amount of physical activity in patients at high risk for preterm birth and pregnancy latency and preterm birth. What did they find? It is a bit shocking. Listen in for details.1. Fox, Nathan S. et al. The recommendation for bed rest in the setting of arrested preterm labor and premature rupture of membranes. American Journal of Obstetrics & Gynecology, Volume 200, Issue 2, 165.e1 - 165.e6 https://www.ajog.org/article/S0002-9378(08)00909-5/fulltext2. Sciscione, Anthony C. DO; Booker, Whitney A. for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units (MFMU) Network, Bethesda, Maryland. Activity Restriction in Pregnancy and the Risk of Early Delivery: The AWARE Study. Obstetrics & Gynecology ():10.1097/AOG.0000000000006225, February 19, 2026. | DOI: 10.1097/AOG.0000000000006225 https://journals.lww.com/greenjournal/pages/articleviewer.aspx?year=9900&issue=00000&article=01460&type=FulltextVisit our SPONSOR's Webpage for information on the Hemorrhage View C-Section Drape: www.perspectivemedical.org

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

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