Podcasts about gynecologists acog

What Every Patient and Clinician Should Know About the 2025 Guidelines for IUD Insertion Pain ManagementFor years, patients have reported severe pain during IUD insertions—only to be told it's "just a pinch." Now, the American College of Obstetricians and Gynecologists (ACOG) and the Centers for Disease Control and Prevention (CDC) have issued updated guidance that changes everything.This episode breaks down what's in the new guidelines, why it matters, and what's still standing in the way of better care.What We Cover in This EpisodeWhat ACOG and CDC now recommend for IUD pain reliefWhy misoprostol is no longer a routine optionHow reimbursement challenges affect what happens in the exam roomWhat to do if your provider isn't aware of the new guidelinesThe role of trauma-informed and shared decision-making modelsWhy this shift is critical for women's health equity and trustRelated ResourcesACOG Clinical Consensus on Pain Management (May 2025)CDC U.S. SPR Update (Aug 2024)Resources and episodes on Pelvic Health Recommended Books on Hormones and Menstrual Health **Top 50 Health Podcast of 2024** Want men to better understand how to you during your menopause journey! Tell us what you want them to know.If you're passionate about advancing women's health, there are many ways you can support and stay in touch with Fempower Health. Here's how:Subscribe and Listen: Tune in to new episodes every Tuesday by subscribing to the Fempower Health Podcast on Apple Podcast, Spotify or your favorite podcast platform. Your regular listenership is invaluable!Leave a Review: Help us grow by leaving a review on Apple, Spotify or your favorite podcast platform. Your feedback not only supports us but also helps others discover our podcast.Share with Others: Spread the word by sharing episodes with friends, family, or anyone interested in women's health. Every share helps!Engage in Discussions: Join the Fempower Health Women's Health Community. Learn more here. Find Us on Social: Follow us on LinkedIn, Instagram and TikTok, YouTube, for the latest updates and engaging content. Stay Informed: Sign up for our...

*Content warning: birth trauma, medical trauma, medical neglect, racism, death of an infant, infant loss, death, homicide, maternal loss, mature and stressful themes, sexual assault, disordered eating. *Free + Confidential Resources + Safety Tips: somethingwaswrong.com/resources Sources: American College of Nurse Midwiveshttps://midwife.org/ American College of Obstetricians and Gynecologists (ACOG)https://www.acog.org/ Authorities explain lack of charges in Fort Mill birthing center deathhttps://www.charlotteobserver.com/news/local/crime/article23277849.html Births in the United States, 2022https://www.cdc.gov/nchs/products/databriefs/db477.htm A brain-dead woman's pregnancy raises questions about Georgia's abortion lawhttps://www.npr.org/2025/05/21/nx-s1-5405542/a-brain-dead-womans-pregnancy-raises-questions-about-georgias-abortion-law A Brief History of Midwifery in Americahttps://www.ohsu.edu/womens-health/brief-history-midwifery-america Constructing the Modern American Midwife: White Supremacy and White Feminism Collidehttps://nursingclio.org/2020/10/22/constructing-the-modern-american-midwife-white-supremacy-and-white-feminism-collide/ The Controversial Birth of American Gynecologyhttps://researchblog.duke.edu/2023/10/27/the-controversial-birth-of-american-gynecology/ Direct Entry Midwives Across the Nationhttps://www.networkforphl.org/wp-content/uploads/2023/05/Direct-Entry-Midwives-50-State-Survey.pdf FDA raids Miami birth center; Placentas, medical records confiscatedhttps://mommyblawg.blogspot.com/2009/01/fda-raids-miami-birth-center-placentas.html Fort Mill birthing center closes following third child deathhttps://www.wbtv.com/story/28083972/fort-mill-birthing-center-closes-following-third-child-death/ Exhibit Recognizes African American Midwiveshttps://infocus.nlm.nih.gov/2010/02/05/exhibit_recognizes_african_ame/ Health E-Stat 100: Maternal Mortality Rates in the United States, 2023https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2023/maternal-mortality-rates-2023.htm#:~:text=In2023%2C669womendied,rateof22.3in2022 Hemolytic disease of the newbornhttps://medlineplus.gov/ency/article/001298.htm The Historical Significance of Doulas and Midwiveshttps://nmaahc.si.edu/explore/stories/historical-significance-doulas-and-midwives Home Births in the U.S. Increase to Highest Level in 30 Yearshttps://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/20221117.htm Honest Midwife Bloghttps://honestmidwife.com/ International School Of Midwiferyhttps://www.mapquest.com/us/florida/international-school-of-midwifery-531273160 March of Dimeshttps://www.marchofdimes.org/peristats/about-us March of Dimes, Delivery Method https://www.marchofdimes.org/peristats/data?dv=ms&lev=1&obj=9®=99&slev=1&stop=86&top=8& March of Dimes, Maternity Care Deserthttps://www.marchofdimes.org/peristats/data?top=23 Maternal Mortality in the United States After Abortion Banshttps://thegepi.org/maternal-mortality-abortion-bans/#:~:text=InthefirstfullyearofTexas%27sstateabortionban,15 Maternal Mortality: How the U.S. Compares to Other Rich Countrieshttps://www.usnews.com/news/best-countries/articles/2024-06-04/how-the-u-s-compares-to-other-rich-countries-in-maternal-mortality Medical Exploitation of Black Womenhttps://eji.org/news/history-racial-injustice-medical-exploitation-of-black-women/ National Midwifery Institutehttps://www.nationalmidwiferyinstitute.com/midwifery Necrotizing Fasciitishttps://my.clevelandclinic.org/health/diseases/23103-necrotizing-fasciitisNew Pregnancy Justice Report Shows High Number of Pregnancy-Related Prosecutions in the Year After Dobbshttps://www.pregnancyjusticeus.org/press/new-pregnancy-justice-report-shows-high-number-of-pregnancy-related-prosecutions-in-the-year-after-dobbs/#:~:text=Thereportdocumentsthati,%2Cpregnancyloss%2Corbirth. North American Registry of Midwives (NARM)https://narm.org/ Physician Suicidehttps://www.acep.org/life-as-a-physician/wellness/wellness/wellness-week-articles/physician-suicide Preeclampsiahttps://my.clevelandclinic.org/health/diseases/17952-preeclampsia Preeclampsia: Signs & Symptomshttps://www.preeclampsia.org/signs-and-symptomsRace Maternal Mortality in the U.S.: A History of Midwiferyhttps://wmberks.pages.wm.edu/2023/04/30/race-maternal-mortality-in-the-u-s-a-history-of-midwifery/ The Racist History of Abortion and Midwifery Banshttps://www.aclu.org/news/racial-justice/the-racist-history-of-abortion-and-midwifery-bans Reasons Obstetricians Are At High Risk For Claims Of Medical Malpracticehttps://www.gilmanbedigian.com/reasons-obstetricians-are-at-high-risk-for-claims-of-medical-malpractice/#:~:text=Overall%2Cabout85%25ofOB,about95%25ofthetime. The Regulation of Professional Midwifery in the United Stateshttps://midwife.org/wp-content/uploads/2024/09/Jefferson-2021-Regulation-Professional-Midwifery.pdf She said she had a miscarriage — then got arrested under an abortion lawhttps://www.washingtonpost.com/investigations/interactive/2024/abortion-law-nevada-arrest-miscarriage/ She was accused of murder after losing her pregnancy. SC woman now tells her storyhttps://www.cnn.com/2024/09/23/health/south-carolina-abortion-kff-health-news-partner South Carolina Department of Public Health, Midwifery Licensinghttps://dph.sc.gov/professionals/healthcare-quality/licensed-facilities-professionals/midwifery-licensing#:~:text=DPHlicensesmidwivesinaccordancewithRegulation,inadditiontootherprescribedrequirementson State investigating Dallas birth center and midwives, following multiple complaints from patientshttps://www.wfaa.com/article/news/local/investigates/state-investigating-dallas-birth-center-midwives-following-multiple-complaints-from-patients/287-ea77eb18-c637-44d4-aaa2-fe8fd7a2fcef The State of Reproductive Health in the United Stateshttps://thegepi.org/state-of-reproductive-health-united-states/ Texas Department of Licensing and Regulation (TDLR)https://www.tdlr.texas.gov/ Texas Maternal Mortality and Morbidity Review Committee and Department of State Health Services Joint Biennial Report 2024https://www.dshs.texas.gov/sites/default/files/legislative/2024-Reports/MMMRC-DSHS-Joint-Biennial-Report-2024.pdf Uses of Misoprostol in Obstetrics and Gynecologyhttps://pmc.ncbi.nlm.nih.gov/articles/PMC2760893/ Vicarious trauma: signs and strategies for copinghttps://www.bma.org.uk/advice-and-support/your-wellbeing/vicarious-trauma/vicarious-trauma-signs-and-strategies-for-coping Vital Signs: Maternity Care Experiences — United States, April 2023https://www.cdc.gov/mmwr/volumes/72/wr/mm7235e1.htm#:~:text=Discussion,%2CHispanic%2Candmultiracialmothers. 2022 Direct Entry Midwives Fact Sheethttps://www.dshs.texas.gov/sites/default/files/chs/hprc/publications/2022/DirectEntryMidwife2022FactSheetA.pdf *SWW S23 Theme Song & Artwork: Thank you so much to Emily Wolfe for covering Glad Rag's original song, U Think U for us this season!Hear more from Emily Wolfe:https://www.emilywolfemusic.com/instagram.com/emilywolfemusicGlad Rags: https://www.gladragsmusic.com/ The S23 cover art is by the Amazing Sara StewartFollow Something Was Wrong:Website: somethingwaswrong.com IG: instagram.com/somethingwaswrongpodcastTikTok: tiktok.com/@somethingwaswrongpodcast Follow Tiffany Reese:Website: tiffanyreese.me IG: instagram.com/lookiebooSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

*Content warning: birth trauma, medical trauma, medical neglect, racism, death of an infant, infant loss, death, maternal loss, mature and stressful themes.*Free + Confidential Resources + Safety Tips: somethingwaswrong.com/resources Center for Black Maternal Health & Reproductive Justice:https://blackmaternalhealth.tufts.edu/Center for Black Maternal Health & Reproductive Justice Instagram:https://www.instagram.com/cbmhrj_tufts/Center for Black Maternal Health & Reproductive Justice Facebook:https://www.facebook.com/CBMHRJTufts/Center for Black Maternal Health & Reproductive Justice LinkedIn:https://www.linkedin.com/company/cbmhrjtufts/Sources: Addressing Transportation Barriers to Improve Healthcare Access in Arizonahttps://repository.arizona.edu/handle/10150/674794 Advancing Health Equity and Value-Based Care: A Mobile Approachhttps://info.primarycare.hms.harvard.edu/perspectives/articles/mobile-clinics-in-the-us-health-system#:~:text=Mobileclinicsareaproven,thecriticalweeksafterbirth American College of Nurse Midwiveshttps://midwife.org/ American College of Obstetricians and Gynecologists (ACOG)https://www.acog.org/ Birth Centers in Massachusettshttps://baystatebirth.org/birth-centers A Brief History of Midwifery in Americahttps://www.ohsu.edu/womens-health/brief-history-midwifery-america Clinical outcomes improve when patient's and surgeon's ethnicity match, study showshttps://www.uclahealth.org/news/article/clinical-outcomes-patients-surgeons-concordanceThe Controversial Birth of American Gynecologyhttps://researchblog.duke.edu/2023/10/27/the-controversial-birth-of-american-gynecology/ 'Father Of Gynecology,' Who Experimented On Slaves, No Longer On Pedestal In NYChttps://www.npr.org/sections/thetwo-way/2018/04/17/603163394/-father-of-gynecology-who-experimented-on-slaves-no-longer-on-pedestal-in-nyc Governor Healey Signs Maternal Health Bill, Expanding Access to Midwifery, Birth Centers and Doulas in Massachusettshttps://www.mass.gov/news/governor-healey-signs-maternal-health-bill-expanding-access-to-midwifery-birth-centers-and-doulas-in-massachusetts#:~:text=GovernorHealeySignsMaternalHealthBillCExpanding,ExecutiveOfficeofHealthandHumanServices Governor Murphy Signs Bill Establishing Maternal and Infant Health Innovation Centerhttps://www.nj.gov/governor/news/news/562023/approved/20230717a.shtml Helping Mothers and Children Thrive: Rethinking CMS's Transforming Maternal Health (TMaH) Modelhttps://www.milbank.org/quarterly/opinions/helping-mothers-and-children-thrive-rethinking-cmss-transforming-maternal-health-tmah-model/#:~:text=TheTransformingMaternalHealth(TMaH)Model&text=TheTMaHModelfocuseson,midwiferyservicesanddoulacare The Historical Significance of Doulas and Midwiveshttps://nmaahc.si.edu/explore/stories/historical-significance-doulas-and-midwivesInfant Health and Mortality and Black/African Americanhttps://minorityhealth.hhs.gov/infant-health-and-mortality-and-blackafrican-americans#:~:text=In2022%2Ctheinfantmortality,Figure2 Legislature Passes Comprehensive Maternal Health Billhttps://malegislature.gov/PressRoom/Detail?pressReleaseId=136Life Story: Anarcha, Betsy, and Lucyhttps://wams.nyhistory.org/a-nation-divided/antebellum/anarcha-betsy-lucy/Management of Postpartum Hemorrhage in Low- and Middle-Income Countries: Emergency Need for Updated Approach Due to Specific Circumstances, Resources, and Availabilitieshttps://pmc.ncbi.nlm.nih.gov/articles/PMC11643001/#:~:text=EtiologyandRiskFactorsof,insufficienttreatment%E2%80%9D%5B50%5D March of Dimeshttps://www.marchofdimes.org/peristats/about-us Maternity Care Deserthttps://www.marchofdimes.org/peristats/data?top=23 Maternal deaths and mortality rates by state, 2018-2022https://www.cdc.gov/nchs/maternal-mortality/mmr-2018-2022-state-data.pdf Maternal Mortality in the United States After Abortion Banshttps://thegepi.org/maternal-mortality-abortion-bans/#:~:text=In2023%2CTexas'smaternalmortality,suffermaternaldeathin2023 Maternal Mortality in the U.S Declined, though Disparities in the Black Population Persisthttps://policycentermmh.org/maternal-mortality-in-the-u-s-a-declining-trend-with-persistent-racial-disparities-in-the-black-population/Maternal Mortality Is on the Rise: 8 Things To Knowhttps://www.yalemedicine.org/news/maternal-mortality-on-the-rise Maternal Mortality: How the U.S. Compares to Other Rich Countrieshttps://www.usnews.com/news/best-countries/articles/2024-06-04/how-the-u-s-compares-to-other-rich-countries-in-maternal-mortalityMaternal Mortality Rates in the United States, 2021https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-2021.htm#:~:text=In2021%2C1%2C205womendied,20.1in2019(Table) Medical Exploitation of Black Womenhttps://eji.org/news/history-racial-injustice-medical-exploitation-of-black-women/National Midwifery Institutehttps://www.nationalmidwiferyinstitute.com/midwifery National Counsel of State Boards of Nursinghttps://www.ncsbn.org/North American Registry of Midwives (NARM)https://narm.org/ Outcome of subsequent pregnancies in women with complete uterine rupture: A population-based case–control studyhttps://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/aogs.14338#:~:text=outcomesarerare.-,1INTRODUCTION,experienceacompleteuterinerupture.&text=Completeuterineruptureisdefined,completeruptureofthemyometrium Pregnancy-Related Deaths: Data From Maternal Mortality Review Committees in 36 U.S. States, 2017–2019https://www.cdc.gov/maternal-mortality/php/data-research/mmrc-2017-2019.html Preterm Birthhttps://www.cdc.gov/maternal-infant-health/preterm-birth/index.html#:~:text=Pretermbirthrates&text=In2022%2Cpretermbirthamong,orHispanicwomen(10.1%25) Racial Disparities in Maternal and Infant Health: Current Status and Efforts to Address Themhttps://www.kff.org/racial-equity-and-health-policy/issue-brief/racial-disparities-in-maternal-and-infant-health-current-status-and-efforts-to-address-them/The Racist History of Abortion and Midwifery Banshttps://www.aclu.org/news/racial-justice/the-racist-history-of-abortion-and-midwifery-bans Reducing Disparities in Severe Maternal Morbidity and Mortalityhttps://pmc.ncbi.nlm.nih.gov/articles/PMC5915910/#:~:text=Severemorbidityposesanenormous,ofseverematernalmorbidityevents State investigating Dallas birth center and midwives, following multiple complaints from patientshttps://www.wfaa.com/article/news/local/investigates/state-investigating-dallas-birth-center-midwives-following-multiple-complaints-from-patients/287-ea77eb18-c637-44d4-aaa2-fe8fd7a2fcef The State of Telehealth Before and After the COVID-19 Pandemichttps://pmc.ncbi.nlm.nih.gov/articles/PMC9035352/ Texas Department of Licensing and Regulation (TDLR)https://www.tdlr.texas.gov/ U.S. maternal death rate increasing at an alarming ratehttps://news.northwestern.edu/stories/2024/03/u-s-maternal-death-rate-increasing-at-an-alarming-rate/Which states have the highest maternal mortality rates?https://usafacts.org/articles/which-states-have-the-highest-maternal-mortality-rates/ Why Equitable Access to Vaginal Birth Requires Abolition of Race-Based Medicinehttps://journalofethics.ama-assn.org/article/why-equitable-access-vaginal-birth-requires-abolition-race-based-medicine/2022-03 Zucker School of Medicine, Amos Grunebaum, MDhttps://faculty.medicine.hofstra.edu/13732-amos-grunebaum/publications *SWW S23 Theme Song & Artwork: Thank you so much to Emily Wolfe for covering Glad Rag's original song, U Think U for us this season!Hear more from Emily Wolfe:On SpotifyOn Apple Musichttps://www.emilywolfemusic.com/instagram.com/emilywolfemusicGlad Rags: https://www.gladragsmusic.com/ The S23 cover art is by the Amazing Sara StewartFollow Something Was Wrong:Website: somethingwaswrong.com IG: instagram.com/somethingwaswrongpodcastTikTok: tiktok.com/@somethingwaswrongpodcast Follow Tiffany Reese:Website: tiffanyreese.me IG: instagram.com/lookiebooSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

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

*Content warning: infant loss, miscarriage, birth trauma, medical trauma, medical neglect, body image abuse, mature and stressful themes. *Free + Confidential Resources + Safety Tips: somethingwaswrong.com/resources Moms Advocating For MomsS23 survivors Markeda, Kristen and Amanda have created a nonprofit, Moms Advocating for Moms, in hopes to create a future where maternal well-being is prioritized, disparities are addressed, and every mother has the resources and support she needs to thrive: https://www.momsadvocatingformoms.org/take-actionhttps://linktr.ee/momsadvocatingformoms Please sign the survivors petitions below to improve midwifery education and regulation in Texashttps://www.change.org/p/improve-midwifery-education-and-regulation-in-texas?recruiter=1336781649&recruited_by_id=74bf3b50-fd98-11ee-9e3f-a55a14340b5a&utm_source=share_petition&utm_campaign=share_for_starters_page&utm_medium=copylink Malik's Law https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB4553 M.A.M.A. has helped file a Texas bill called Malik's Law, which is intended to implement requirements for midwives in Texas to report birth outcomes in hopes of improving transparency and data collection in the midwifery field in partnership with Senator Claudia Ordaz. *Sources:American College of Nurse Midwiveshttps://midwife.org/ American College of Obstetricians and Gynecologists (ACOG)https://www.acog.org/ Blood clots and pregnancyhttps://www.marchofdimes.org/find-support/topics/pregnancy/blood-clots-and-pregnancy#:~:text=Although%20birthing%20people%20with%20blood,both%20you%20and%20your%20baby.Chorioamnionitishttps://www.stanfordchildrens.org/en/topic/default?id=chorioamnionitis-90-P02441#:~:text=Chorioamnionitis%20is%20an%20infection%20of,smell%20from%20the%20amniotic%20fluid. Cross border reproductive care (CBRC): a growing global phenomenon with multidimensional implications (a systematic and critical review)https://pmc.ncbi.nlm.nih.gov/articles/PMC6063838/#:~:text=In%20vitro%20fertilization%20and%20intracytoplasmic,Belgium%20%5B37%E2%80%9344%5D. Detection of Proteinuria in Pregnancy: Comparison of Qualitative Tests for Proteins and Dipsticks with Urinary Protein Creatinine Indexhttps://pmc.ncbi.nlm.nih.gov/articles/PMC3809617/#:~:text=Background%20and%20Objectives%3A%20Excretion%20of,the%20patient%20or%20her%20pregnancy. Egg Donation and IVF in Czech Republichttps://www.eggdonationfriends.com/ivf-egg-donation-country-czech-republic/#:~:text=in%20Czech%20Republic-,IVF%20cost%20in%20Czech%20Republic,much%20from%20the%20European%20average.&text=It%20also%20needs%20to%20be,frozen%20embryo%20transfer Fundal Heighthttps://my.clevelandclinic.org/health/diagnostics/22294-fundal-height HELLP Syndromehttps://my.clevelandclinic.org/health/diseases/21637-hellp-syndrome High Blood Pressure–Understanding the Silent Killerhttps://www.fda.gov/drugs/special-features/high-blood-pressure-understanding-silent-killer#:~:text=Normal%20pressure%20is%20120/80,manage%20your%20high%20blood%20pressure? In vitro fertilization (IVF)https://www.mayoclinic.org/tests-procedures/in-vitro-fertilization/about/pac-20384716#:~:text=Research%20suggests%20that%20IVF%20slightly,or%20ovarian%20cancer%20after%20IVF%20. Magnesium - Uses, Side Effects, and Morehttps://www.webmd.com/vitamins/ai/ingredientmono-998/magnesium March of Dimeshttps://www.marchofdimes.org/peristats/about-us National Midwifery Institutehttps://www.nationalmidwiferyinstitute.com/midwifery North American Registry of Midwives (NARM)https://narm.org/ Placental Abruptionhttps://my.clevelandclinic.org/health/diseases/9435-placental-abruption Placenta and Heart Researchhttps://www.ohsu.edu/knight-cardiovascular-institute/placenta-and-heart-research#:~:text=By%20the%20end%20of%20pregnancy,area%20for%20uptake%20of%20nutrients. Postpartum Hemorrhagehttps://my.clevelandclinic.org/health/diseases/22228-postpartum-hemorrhage Preeclampsiahttps://my.clevelandclinic.org/health/diseases/17952-preeclampsia Preeclampsia - Signs & Symptoms https://www.preeclampsia.org/signs-and-symptoms#:~:text=Weight%20gain%20of%20more%20than,the%20kidneys%20to%20be%20excreted.&text=Do%20not%20try%20to%20lose%20weight%20during%20pregnancy%20by%20restricting%20your%20diet.Pregnancy weight gain: What's healthy?https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-weight-gain/art-20044360 Prothrombin Gene Mutationhttps://my.clevelandclinic.org/health/diseases/21810-prothrombin-gene-mutation Prothrombin 20210 Mutation (Factor II Mutation)https://www.ahajournals.org/doi/10.1161/01.cir.0000135582.53444.87#:~:text=There%20are%20also%20implications%20of,a%20baby%20of%20small%20size. The Risks of Prothrombin Gene Mutation in Pregnancyhttps://www.healthline.com/health/pregnancy/prothrombin-gene-mutation#What-Are-the-Risks-of-Prothrombin-Mutation-in-Pregnancy State investigating Dallas birth center and midwives, following multiple complaints from patientshttps://www.wfaa.com/article/news/local/investigates/state-investigating-dallas-birth-center-midwives-following-multiple-complaints-from-patients/287-ea77eb18-c637-44d4-aaa2-fe8fd7a2fcef Texas Department of Licensing and Regulation (TDLR)https://www.tdlr.texas.gov/ Texas Health, Week by Week https://www.texashealth.org/baby-care/Week-by-Week Texas Occupations Code, Chapter 203. Midwives https://statutes.capitol.texas.gov/Docs/OC/htm/OC.203.htmWhat are high blood pressure numbers?https://www.lancastergeneralhealth.org/health-hub-home/2023/february/what-are-high-blood-pressure-numbers#:~:text=Normal:%20Less%20than%20120/80,Avoid%20secondhand%20smoke. White Coat Syndromehttps://my.clevelandclinic.org/health/diseases/23989-white-coat-syndrome Why Won't an Attorney Take My Texas Medical Malpractice Case?https://www.hastingsfirm.com/your-case-and-texas-law/ Zucker School of Medicine, Amos Grunebaum, MDhttps://faculty.medicine.hofstra.edu/13732-amos-grunebaum/publications 24-Hour Urine Collectionhttps://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/24hour-urine-collection#:~:text=A%2024%2Dhour%20urine%20collection%20is%20a%20simple%20lab%20test,is%20returned%20to%20the%20lab. 40 years later, why is IVF still not covered by insurance? Economics, ignorance and sexismhttps://www.cnn.com/2018/07/25/health/ivf-insurance-parenting-strauss/index.html *SWW S23 Theme Song & Artwork: Thank you so much to Emily Wolfe for covering Glad Rag's original song, U Think U for us this season!Hear more from Emily Wolfe:On SpotifyOn Apple Musichttps://www.emilywolfemusic.com/instagram.com/emilywolfemusicGlad Rags: https://www.gladragsmusic.com/ The S23 cover art is by the Amazing Sara StewartFollow Something Was Wrong:Website: somethingwaswrong.com IG: instagram.com/somethingwaswrongpodcastTikTok: tiktok.com/@somethingwaswrongpodcast Follow Tiffany Reese:Website: tiffanyreese.me IG: instagram.com/lookiebooSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

*Content warning: birth trauma, medical trauma, medical neglect, mature and stressful themes. *Free + Confidential Resources + Safety Tips: somethingwaswrong.com/resources Moms Advocating For MomsS23 survivors Markeda, Kristen and Amanda have created a nonprofit, Moms Advocating for Moms, in hopes to create a future where maternal well-being is prioritized, disparities are addressed, and every mother has the resources and support she needs to thrive: https://www.momsadvocatingformoms.org/take-actionhttps://linktr.ee/momsadvocatingformoms Please sign the survivors petitions below to improve midwifery education and regulation in Texashttps://www.change.org/p/improve-midwifery-education-and-regulation-in-texas?recruiter=1336781649&recruited_by_id=74bf3b50-fd98-11ee-9e3f-a55a14340b5a&utm_source=share_petition&utm_campaign=share_for_starters_page&utm_medium=copylink Malik's Law https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB4553 M.A.M.A. has helped file a Texas bill called Malik's Law, which is intended to implement requirements for midwives in Texas to report birth outcomes in hopes of improving transparency and data collection in the midwifery field in partnership with Senator Claudia Ordaz. *Sources:ACTH Treatment of Infantile Spasmshttps://pmc.ncbi.nlm.nih.gov/articles/PMC3092432/ American College of Nurse Midwiveshttps://midwife.org/ American College of Obstetricians and Gynecologists (ACOG)https://www.acog.org/ Hypothermia Therapy (Neonatal Cooling)https://hiehelpcenter.org/treatment/hypothermia-therapy/#:~:text=Hypothermiatherapyinvolvescoolingthe,degreesFahrenheit Hypoxic-Ischemic Encephalopathy (HIE)https://my.clevelandclinic.org/health/diseases/hypoxic-ischemic-encephalopathy-hie Ina May's Guide to Childbirthhttps://birthworks.org/product/ina-mays-guide-to-childbirth/March of Dimeshttps://www.marchofdimes.org/peristats/about-us Meconium Aspiration Syndromehttps://www.hopkinsmedicine.org/health/conditions-and-diseases/meconium-aspiration-syndrome National Midwifery Institutehttps://www.nationalmidwiferyinstitute.com/midwifery NICU Levelshttps://www.childrenscolorado.org/doctors-and-departments/departments/neonatal-intensive-care-unit/nicu-family-resources/nicu-levels/#:~:text=WhatisaLevelIV,theirgestationalageatbirth. North American Registry of Midwives (NARM)https://narm.org/ Office for Civil Rightshttps://www.hhs.gov/ocr/index.htmlPhenobarbitalhttps://www.ncbi.nlm.nih.gov/books/NBK532277/#:~:text=Phenobarbitalsapotentcytochrome,possibleinteractionbetweenthemedications. State investigating Dallas birth center and midwives, following multiple complaints from patientshttps://www.wfaa.com/article/news/local/investigates/state-investigating-dallas-birth-center-midwives-following-multiple-complaints-from-patients/287-ea77eb18-c637-44d4-aaa2-fe8fd7a2fcef Texas Administrative Code Rule §115.117https://texas-sos.appianportalsgov.com/rules-and-meetings?interface=LANDING_PAGE Texas Department of Licensing and Regulation (TDLR)https://www.tdlr.texas.gov/ Applying for a new License with TDLR:https://www.tdlr.texas.gov/midwives/apply.htmTexas Health and Human Services Birthing Centershttps://www.hhs.texas.gov/providers/health-care-facilities-regulation/birthing-centersTotal body cooling: Saving babies' lives after emergency deliveryhttps://utswmed.org/medblog/total-body-cooling-saving-babies-lives-after-emergency-delivery/ What is ACTH Therapy (Corticotropin/ACTHAR Gel) for Infantile Spasms?https://www.med.umich.edu/1libr/Pharmacy/ACTHInjections.pdf When Do Babies Start Crawling?https://www.pampers.com/en-us/baby/development/article/when-do-babies-crawl Zucker School of Medicine, Amos Grunebaum, MDhttps://faculty.medicine.hofstra.edu/13732-amos-grunebaum/publications *SWW S23 Theme Song & Artwork: Thank you so much to Emily Wolfe for covering Glad Rag's original song, U Think U for us this season!Hear more from Emily Wolfe:On SpotifyOn Apple Musichttps://www.emilywolfemusic.com/instagram.com/emilywolfemusicGlad Rags: https://www.gladragsmusic.com/ The S23 cover art is by the Amazing Sara StewartFollow Something Was Wrong:Website: somethingwaswrong.com IG: instagram.com/somethingwaswrongpodcastTikTok: tiktok.com/@somethingwaswrongpodcast Follow Tiffany Reese:Website: tiffanyreese.me IG: instagram.com/lookiebooSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Joelle Taylor, MD, FACOG is a board-certified Reproductive Endocrinologist and a Diplomate of the American Board of Obstetrics and Gynecology. She is an active member of several leading scientific societies, including the American Society for Reproductive Medicine (ASRM), the Society of Reproductive Endocrinology and Infertility (SREI), the Society of Assisted Reproductive Technology (SART), and the American Congress of Obstetricians and Gynecologists (ACOG).   Dr. Taylor earned her medical degree from the University at Buffalo School of Medicine and Biomedical Sciences in 2006. As a recipient of the Howard Hughes Medical Institute Scholar Award, she dedicated a year to research at the National Institutes of Health during her medical training. She went on to complete her residency in Obstetrics and Gynecology at Wake Forest University in 2010, followed by a fellowship in Reproductive Endocrinology and Infertility at the renowned Jones Institute for Reproductive Medicine in Norfolk, Virginia—home to the first IVF baby in the United States.   Throughout her career, Dr. Taylor has been recognized with multiple research grants, has published extensively, and has presented her work at national conferences.   Outside of her professional pursuits, Dr. Taylor lives in Jupiter with her family and their Australian Labradoodle. She enjoys weightlifting, yoga, playing pickleball, and cooking for family and friends.

*Content warning: descriptions of medical trauma, death, infant loss, birthing trauma, medical trauma, medical neglect, mature and stressful themes. *Free + Confidential Resources + Safety Tips: somethingwaswrong.com/resources Moms Advocating For MomsS23 survivors Markeda, Kristen and Amanda have created a nonprofit, Moms Advocating for Moms, in hopes to create a future where maternal well-being is prioritized, disparities are addressed, and every mother has the resources and support she needs to thrive: https://www.momsadvocatingformoms.org/take-actionhttps://linktr.ee/momsadvocatingformoms Please sign the survivors petitions below to improve midwifery education and regulation in Texashttps://www.change.org/p/improve-midwifery-education-and-regulation-in-texas?recruiter=1336781649&recruited_by_id=74bf3b50-fd98-11ee-9e3f-a55a14340b5a&utm_source=share_petition&utm_campaign=share_for_starters_page&utm_medium=copylink Malik's Law https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB4553 M.A.M.A. has helped file a Texas bill called Malik's Law, which is intended to implement requirements for midwives in Texas to report birth outcomes in hopes of improving transparency and data collection in the midwifery field in partnership with Senator Claudia Ordaz. *Sources:American College of Nurse Midwiveshttps://midwife.org/ American College of Obstetricians and Gynecologists (ACOG)https://www.acog.org/ Birth Settings in America: Outcomes, Quality, Access, and Choice, Maternal and Newborn Care in the United Stateshttps://www.ncbi.nlm.nih.gov/books/NBK555484/#:~:text=Federal%20law%20requires%20that%20most%20insurance%20companies,if%20they%20and%20their%20babies%20are%20healthy.&text=Midwives7%20provide%20care%20throughout%20the%20prenatal%20period%20for%20families%20planning%20a%20home%20birth. Cooling Therapy Treatment for HIEhttps://birthinjurycenter.org/hypoxic-ischemic-encephalopathy-hie/cooling-treatment-for-hie/#:~:text=Clinical%20trials%20have%20shown%20that,of%20death%20or%20brain%20damage. March of Dimeshttps://www.marchofdimes.org/peristats/about-us National Midwifery Institutehttps://www.nationalmidwiferyinstitute.com/midwifery North American Registry of Midwives (NARM)https://narm.org/ Postpartum Hemorrhagehttps://my.clevelandclinic.org/health/diseases/22228-postpartum-hemorrhage Raynaud's diseasehttps://www.mayoclinic.org/diseases-conditions/raynauds-disease/symptoms-causes/syc-20363571 State investigating Dallas birth center and midwives, following multiple complaints from patientshttps://www.wfaa.com/article/news/local/investigates/state-investigating-dallas-birth-center-midwives-following-multiple-complaints-from-patients/287-ea77eb18-c637-44d4-aaa2-fe8fd7a2fcef Texas Department of Licensing and Regulation (TDLR)https://www.tdlr.texas.gov/ Zucker School of Medicine, Amos Grunebaum, MDhttps://faculty.medicine.hofstra.edu/13732-amos-grunebaum/publications *SWW S23 Theme Song & Artwork: Thank you so much to Emily Wolfe for covering Glad Rag's original song, U Think U for us this season!Hear more from Emily Wolfe:On SpotifyOn Apple Musichttps://www.emilywolfemusic.com/instagram.com/emilywolfemusicGlad Rags: https://www.gladragsmusic.com/ The S23 cover art is by the Amazing Sara StewartFollow Something Was Wrong:Website: somethingwaswrong.com IG: instagram.com/somethingwaswrongpodcastTikTok: tiktok.com/@somethingwaswrongpodcast Follow Tiffany Reese:Website: tiffanyreese.me IG: instagram.com/lookiebooSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

*Content warning: medical trauma and neglect, threat of life, mature and stressful themes, pregnancy and infant loss. *Free + Confidential Resources + Safety Tips: somethingwaswrong.com/resources Moms Advocating For MomsS23 survivors Markeda, Kristen and Amanda have created a nonprofit, Moms Advocating for Moms, in hopes to create a future where maternal well-being is prioritized, disparities are addressed, and every mother has the resources and support she needs to thrive: https://www.momsadvocatingformoms.org/take-actionhttps://linktr.ee/momsadvocatingformoms Please sign the survivors petitions below to improve midwifery education and regulation in Texashttps://www.change.org/p/improve-midwifery-education-and-regulation-in-texas?recruiter=1336781649&recruited_by_id=74bf3b50-fd98-11ee-9e3f-a55a14340b5a&utm_source=share_petition&utm_campaign=share_for_starters_page&utm_medium=copylink Malik's Law https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB4553 M.A.M.A. has helped file a Texas bill called Malik's Law, which is intended to implement requirements for midwives in Texas to report birth outcomes in hopes of improving transparency and data collection in the midwifery field in partnership with Senator Claudia Ordaz. *Sources:American College of Nurse Midwiveshttps://midwife.org/ American College of Obstetricians and Gynecologists (ACOG)https://www.acog.org/ ACOG, Fetal Heart Rate Monitoring During Laborhttps://www.acog.org/womens-health/faqs/fetal-heart-rate-monitoring-during-labor Amniotomyhttps://www.ncbi.nlm.nih.gov/books/NBK470167/#:~:text=Amniotomy%2C%20also%20known%20as%20artificial,commonly%20performed%20during%20labor%20management. March of Dimeshttps://www.marchofdimes.org/peristats/about-us National Midwifery Institutehttps://www.nationalmidwiferyinstitute.com/midwifery North American Registry of Midwives (NARM)https://narm.org/ The Second Trimesterhttps://www.hopkinsmedicine.org/health/wellness-and-prevention/the-second-trimester#:~:text=The%20second%20trimester%20is%20the,grow%20in%20length%20and%20weight. Stages of labor and birthhttps://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/stages-of-labor/art-20046545 State investigating Dallas birth center and midwives, following multiple complaints from patientshttps://www.wfaa.com/article/news/local/investigates/state-investigating-dallas-birth-center-midwives-following-multiple-complaints-from-patients/287-ea77eb18-c637-44d4-aaa2-fe8fd7a2fcef Texas Department of Licensing and Regulation (TDLR)https://www.tdlr.texas.gov/ What to Know About Cervical Dilationhttps://www.healthline.com/health/pregnancy/cervix-dilation-chart Zucker School of Medicine, Amos Grunebaum, MDhttps://faculty.medicine.hofstra.edu/13732-amos-grunebaum/publications *SWW S23 Theme Song & Artwork: Thank you so much to Emily Wolfe for covering Glad Rag's original song, U Think U for us this season!Hear more from Emily Wolfe:On SpotifyOn Apple Musichttps://www.emilywolfemusic.com/instagram.com/emilywolfemusicGlad Rags: https://www.gladragsmusic.com/ The S23 cover art is by the Amazing Sara StewartFollow Something Was Wrong:Website: somethingwaswrong.com IG: instagram.com/somethingwaswrongpodcastTikTok: tiktok.com/@somethingwaswrongpodcast Follow Tiffany Reese:Website: tiffanyreese.me IG: instagram.com/lookiebooThe Webby Awards (2025)Exciting news! Something Was Wrong is nominated for Best Crime & Justice Podcast at the 2025 Webby Awards. We'd love and appreciate your support—cast your vote today!https://vote.webbyawards.com/PublicVoting#/2025/podcasts/shows/crime-justice*Please note: the first airing of this episode stated that Rachel was a CNM, she is a CPM and LM so we corrected this error within an hour of release. See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

*Content warning: Pregnancy loss, miscarriage, death of a child, infant loss, death, birth trauma, medical trauma, medical neglect, racism, mature and stressful themes. *Free + Confidential Resources + Safety Tips: somethingwaswrong.com/resources Moms Advocating For MomsS23 survivors Markeda, Kristen and Amanda have created a nonprofit, Moms Advocating for Moms, in hopes to create a future where maternal well-being is prioritized, disparities are addressed, and every mother has the resources and support she needs to thrive: https://www.momsadvocatingformoms.org/take-actionhttps://linktr.ee/momsadvocatingformoms Please sign the survivors petitions below to improve midwifery education and regulation in Texashttps://www.change.org/p/improve-midwifery-education-and-regulation-in-texas?recruiter=1336781649&recruited_by_id=74bf3b50-fd98-11ee-9e3f-a55a14340b5a&utm_source=share_petition&utm_campaign=share_for_starters_page&utm_medium=copylink *Sources:American College of Nurse Midwiveshttps://midwife.org/ American College of Obstetricians and Gynecologists (ACOG)https://www.acog.org/ A Midwife's Approach to Getting Labor Startedhttps://avivaromm.com/labor-induction-low-natural-approaches-midwife-md/ Bathing Your Babyhttps://www.healthychildren.org/English/ages-stages/baby/bathing-skin-care/Pages/Bathing-Your-Newborn.aspx Fetal presentation before birthhttps://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/fetal-positions/art-20546850 Health Insurance Portability and Accountability Act of 1996 (HIPAA)https://www.cdc.gov/phlp/php/resources/health-insurance-portability-and-accountability-act-of-1996-hipaa.html#:~:text=The%20Health%20Insurance%20Portability%20and,from%20disclosure%20without%20patient's%20consent. March of Dimeshttps://www.marchofdimes.org/peristats/about-us National Midwifery Institutehttps://www.nationalmidwiferyinstitute.com/midwifery North American Registry of Midwives (NARM)https://narm.org/ Office for Civil Rightshttps://www.hhs.gov/ocr/index.html State investigating Dallas birth center and midwives, following multiple complaints from patientshttps://www.wfaa.com/article/news/local/investigates/state-investigating-dallas-birth-center-midwives-following-multiple-complaints-from-patients/287-ea77eb18-c637-44d4-aaa2-fe8fd7a2fcef Texas Administrative Code Title 26, Chapter 503 - Birthing Centershttps://regulations.justia.com/states/texas/title-26/part-1/chapter-503/subchapter-d/section-503-34/ Texas Department of Licensing and Regulation (TDLR)https://www.tdlr.texas.gov/ Texas Health and Human Services Birthing Centershttps://www.hhs.texas.gov/providers/health-care-facilities-regulation/birthing-centersWhat Happens at Appointments Once My Baby is Born?https://www.communitycaremidwives.com/faq.html#:~:text=Midwives%20provide%20care%20for%20both,six%20weeks%20after%20the%20birth.&text=breastfeeding%20support.,their%20family%20doctor%20for%20care. Zucker School of Medicine, Amos Grunebaum, MDhttps://faculty.medicine.hofstra.edu/13732-amos-grunebaum/publications *SWW S23 Theme Song & Artwork: Thank you so much to Emily Wolfe for covering Glad Rag's original song, U Think U for us this season!Hear more from Emily Wolfe:On SpotifyOn Apple Musichttps://www.emilywolfemusic.com/instagram.com/emilywolfemusicGlad Rags: https://www.gladragsmusic.com/ The S23 cover art is by the Amazing Sara StewartFollow Something Was Wrong:Website: somethingwaswrong.com IG: instagram.com/somethingwaswrongpodcastTikTok: tiktok.com/@somethingwaswrongpodcast Follow Tiffany Reese:Website: tiffanyreese.me IG: instagram.com/lookiebooSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

*Content warning: infant loss, death, birth trauma, medical trauma and neglect, fraud, scams. *Free + Confidential Resources + Safety Tips: somethingwaswrong.com/resources Moms Advocating For MomsMarkeda, Kristen and Amanda have created a nonprofit, Moms Advocating for Moms, in hopes to create a future where maternal well-being is prioritized, disparities are addressed, and every mother has the resources and support she needs to thrive: https://linktr.ee/momsadvocatingformoms Please sign the survivors petition below to improve midwifery education and regulation in Texas: https://tinyurl.com/SWWS23 *Sources:American College of Nurse Midwiveshttps://midwife.org/ American College of Obstetricians and Gynecologists (ACOG)https://www.acog.org/ Balance billing: Independent Dispute Resolutionhttps://www.tdi.texas.gov/medical-billing/index.html#:~:text=Texas%20and%20federal%20laws%20prohibit,with%20a%20surprise%20medical%20bill. CMS, The No Surprises Act's Prohibitions on Balancing Billinghttps://www.cms.gov/files/document/a274577-1a-training-1-balancing-billingfinal508.pdf Do Certified Professional Midwives Need Medical Malpractice Insurance? Understanding the Legal Requirementshttps://www.rcins.com/do-certified-professional-midwives-need-medical-malpractice-insurance-understanding-the-legal-requirements/#:~:text=Texas%3A%20In%20contrast%2C%20Texas%20does,to%20carry%20medical%20malpractice%20insurance. How Expanding the Role of Midwives in U.S. Health Care Could Help Address the Maternal Health Crisishttps://www.commonwealthfund.org/publications/issue-briefs/2023/may/expanding-role-midwives-address-maternal-health-crisis#:~:text=Midwives%20are%20licensed%20health%20care,women%20at%20double%20the%20rate. Implementation of 2015 Sunset Recommendationshttps://www.sunset.texas.gov/public/uploads/files/reports/Implementation%20of%202015%20Sunset%20Recommendations.pdf The Legislative Process in Texashttps://tlc.texas.gov/docs/legref/legislativeprocess.pdf National Midwifery Institutehttps://www.nationalmidwiferyinstitute.com/midwifery North American Registry of Midwives (NARM)https://narm.org/ Practicing Medicine Without a Licensehttps://www.criminaldefenselawyer.com/resources/practicing-medicine-without-a-license.htm#:~:text=Many%20states%20make%20it%20a,fine%20of%20up%20to%20%2410%2C000. Regulation of Birth Attendants in Texashttps://texashomebirth.com/regulation-2/ Texas Board of Nursing https://www.bon.texas.gov/ Texas Department of Insurance https://www.tdi.texas.gov/ Texas Department of Licensing and Regulation (TDLR)https://www.tdlr.texas.gov/ TDLR, Midwives Penalties and Sanctionshttps://www.tdlr.texas.gov/enforcement/midsanctions.htm Texas Health and Human Serviceshttps://www.hhs.texas.gov/ Texas Medical Board (TMB)https://www.tmb.state.tx.us/ State investigating Dallas birth center and midwives, following multiple complaints from patients, by Morgan Young for WFAA (March 29, 2024) https://www.wfaa.com/article/news/local/investigates/state-investigating-dallas-birth-center-midwives-following-multiple-complaints-from-patients/287-ea77eb18-c637-44d4-aaa2-fe8fd7a2fcef What Do OB/GYN Nurse Practitioners Do?https://nursa.com/specialty-post/what-do-ob-gyn-nurse-practitoners-do#:~:text=OB/GYN%20nurse%20practitioners%20are,not%20licensed%20to%20deliver%20babies. What Is the Texas Medical Malpractice Statute of Limitations?https://www.nolo.com/legal-encyclopedia/what-the-texas-statute-limitations-medical-malpractice-lawsuits.html#:~:text=Like%20a%20lot%20of%20states,and%20Remedies%20Code%20section%2074.251. Which states have the highest maternal mortality rates?https://usafacts.org/articles/which-states-have-the-highest-maternal-mortality-rates/ Why Won't an Attorney Take My Texas Medical Malpractice Case?https://www.hastingsfirm.com/your-case-and-texas-law/#:~:text=Texas%20law%20has%20made%20medical,and%20many%20hours%20of%20deposition. Zucker School of Medicine, Amos Grunebaum, MDhttps://faculty.medicine.hofstra.edu/13732-amos-grunebaum/publications *SWW S23 Theme Song & Artwork: Hear more from Emily Wolfe:On Spotify // On Apple Music // https://www.emilywolfemusic.com/ // instagram.com/emilywolfemusicGlad Rags: https://www.gladragsmusic.com/ The S23 cover art is by the Amazing Sara StewartSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

*Content warning: death of an infant, infant loss, death, birth trauma, medical trauma, medical neglect, racism, mature and stressful themes. *Free + Confidential Resources + Safety Tips: somethingwaswrong.com/resources Moms Advocating For MomsS23 survivors Markeda, Kristen and Amanda have created a nonprofit, Moms Advocating for Moms, in hopes to create a future where maternal well-being is prioritized, disparities are addressed, and every mother has the resources and support she needs to thrive: https://www.momsadvocatingformoms.org/take-actionhttps://linktr.ee/momsadvocatingformoms Please sign the survivors petitions below to improve midwifery education and regulation in Texashttps://www.change.org/p/improve-midwifery-education-and-regulation-in-texas?recruiter=1336781649&recruited_by_id=74bf3b50-fd98-11ee-9e3f-a55a14340b5a&utm_source=share_petition&utm_campaign=share_for_starters_page&utm_medium=copylink Malik's Law https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB4553 M.A.M.A. has helped file a Texas bill called Malik's Law, which is intended to implement requirements for midwives in Texas to report birth outcomes in hopes of improving transparency and data collection in the midwifery field in partnership with Senator Claudia Ordaz. *Sources:American College of Nurse Midwiveshttps://midwife.org/ American College of Obstetricians and Gynecologists (ACOG)https://www.acog.org/ Electronic Records and Audit Trailshttps://www.millerweisbrod.com/docs/max/Electronic_Records_and_Audit_Trails.pdf?utm_source=chatgpt.com Intravenous nutrient therapy: the "Myers' cocktail"https://pubmed.ncbi.nlm.nih.gov/12410623/ It's dangerous for Black women to give birth in Texas, and it could be about to get worsehttps://www.theguardian.com/global-development/2023/mar/17/texas-black-women-maternal-healthcare-crisis-medicaid March of Dimeshttps://www.marchofdimes.org/peristats/about-us Meconiumhttps://my.clevelandclinic.org/health/body/24102-meconium Midwifery Education Accreditation Council (MEAC)https://www.meacschools.org/ National Midwifery Institutehttps://www.nationalmidwiferyinstitute.com/midwifery North American Registry of Midwives (NARM)https://narm.org/ Oxytocin: The love hormonehttps://www.health.harvard.edu/mind-and-mood/oxytocin-the-love-hormone Racism in the health care system is killing Black pregnant Texanshttps://www.texasstandard.org/stories/racism-in-the-health-care-system-is-killing-black-pregnant-texans/ Racism, Sexism, and the Crisis of Black Women's Healthhttps://www.bu.edu/articles/2023/racism-sexism-and-the-crisis-of-black-womens-health/ State investigating Dallas birth center and midwives, following multiple complaints from patientshttps://www.wfaa.com/article/news/local/investigates/state-investigating-dallas-birth-center-midwives-following-multiple-complaints-from-patients/287-ea77eb18-c637-44d4-aaa2-fe8fd7a2fcef Texas Department of Licensing and Regulation (TDLR)https://www.tdlr.texas.gov/ Zucker School of Medicine, Amos Grunebaum, MDhttps://faculty.medicine.hofstra.edu/13732-amos-grunebaum/publications *SWW S23 Theme Song & Artwork: Thank you so much to Emily Wolfe for covering Glad Rag's original song, U Think U for us this season!Hear more from Emily Wolfe:On SpotifyOn Apple Musichttps://www.emilywolfemusic.com/instagram.com/emilywolfemusicGlad Rags: https://www.gladragsmusic.com/ The S23 cover art is by the Amazing Sara StewartFollow Something Was Wrong:Website: somethingwaswrong.com IG: instagram.com/somethingwaswrongpodcastTikTok: tiktok.com/@somethingwaswrongpodcast Follow Tiffany Reese:Website: tiffanyreese.me IG: instagram.com/lookiebooSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

A short story on a woman contemplating a VBAC after two Cesarean Deliveries.  Vaginal birth after cesarean (VBAC) after two cesarean deliveries (VBAC-2) is considered a viable option for many women, though it carries certain risks.   The success rate for VBAC-2 is approximately 71.1%, which is slightly lower than the success rate for VBAC after one cesarean (VBAC-1). The risk of uterine rupture in VBAC-2 is 1.36%, which is higher compared to VBAC-1 (0.72%). Additionally, the hysterectomy rate for VBAC-2 is 0.55%, compared to 0.19% for VBAC-1.   The American College of Obstetricians and Gynecologists (ACOG) supports offering VBAC-2 to women who are appropriate candidates, emphasizing the importance of individualized counseling regarding the risks and benefits.   A retrospective study found that VBAC-2 had a success rate of 76.1%, with no significant differences in neonatal outcomes compared to elective repeat cesarean delivery  VBAC-2 is a viable option with a success rate of around 71.1%, but it carries a higher risk of uterine rupture and other complications compared to VBAC-1. Proper counseling and careful selection of candidates are crucial to optimizing outcomes.   YouTube: https://www.youtube.com/maternalresources Instagram: https://www.instagram.com/maternalresoruces/ Facebook: https://www.facebook.com/IntegrativeOB Thank you for being part of our community, and until next time, let's continue to support, uplift, and celebrate the incredible journey of working moms and parenthood. Together, we can create a more equitable and nurturing world for all. Shop our book!  The NatureBack Method for Birth https://naturebackbook.myshopify.com/

*Content warning: death, infant loss, pregnancy and birth trauma, medical trauma, medical neglect, racism*Free + Confidential Resources + Safety Tips: somethingwaswrong.com/resources ABC's new show, Familicide: https://www.familicide.net/Melissa Espey-Mueller's North Dallas Doula Associates:Website: https://www.northdallasdoulas.com/ Instagram: https://www.instagram.com/northdallasdoulas/ Moms Advocating For MomsS23 survivors Markeda, Kristen and Amanda have created a nonprofit, Moms Advocating for Moms, in hopes to create a future where maternal well-being is prioritized, disparities are addressed, and every mother has the resources and support she needs to thrive: https://www.momsadvocatingformoms.org/take-actionhttps://linktr.ee/momsadvocatingformoms Please sign the survivors petitions below to improve midwifery education and regulation in Texas:https://www.change.org/p/improve-midwifery-education-and-regulation-in-texas?recruiter=1336781649&recruited_by_id=74bf3b50-fd98-11ee-9e3f-a55a14340b5a&utm_source=share_petition&utm_campaign=share_for_starters_page&utm_medium=copylink Malik's Law https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB4553 M.A.M.A. has helped file a Texas bill called Malik's Law, which is intended to implement requirements for midwives in Texas to report birth outcomes in hopes of improving transparency and data collection in the midwifery field in partnership with Senator Claudia Ordaz. *Sources:Best Doulahttps://bestdoulatraining.com/ CAPPAhttps://cappa.net/training-certification/ DONA Internationalhttps://www.dona.org/ Madriellahttps://madriella.org/ ProDoulahttps://www.prodoula.com/ American College of Nurse Midwiveshttps://midwife.org/ American College of Obstetricians and Gynecologists (ACOG)https://www.acog.org/ A Brief History of Midwifery in Americahttps://www.ohsu.edu/womens-health/brief-history-midwifery-america CDC, Maternal Mortality Rates in the United States, 2023https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2023/maternal-mortality-rates-2023.htm CDC, Working Together to Reduce Black Maternal Mortalityhttps://www.cdc.gov/womens-health/features/maternal-mortality.html Geospatial distribution of relative cesarean section rates within the USAhttps://pmc.ncbi.nlm.nih.gov/articles/PMC9284873/ In Mexico, Midwives Offer Care Rooted In Ancestral Traditionhttps://www.pih.org/article/mexico-midwives-offer-care-rooted-ancestral-tradition Insights into the U.S. Maternal Mortality Crisis: An International Comparisonhttps://www.commonwealthfund.org/publications/issue-briefs/2024/jun/insights-us-maternal-mortality-crisis-international-comparison?utm_source=chatgpt.com March of Dimeshttps://www.marchofdimes.org/peristats/about-us Maternal Mortality and Maternity Care in the United States Compared to 10 Other Developed Countrieshttps://www.commonwealthfund.org/publications/issue-briefs/2020/nov/maternal-mortality-maternity-care-us-compared-10-countries National Midwifery Institutehttps://www.nationalmidwiferyinstitute.com/midwifery North American Registry of Midwives (NARM)https://narm.org/ Racism During Pregnancy and Birthing: Experiences from Asian and Pacific Islander, Black, Latina, and Middle Eastern Womenhttps://pmc.ncbi.nlm.nih.gov/articles/PMC9713108/ Texas Department of Licensing and Regulation (TDLR)https://www.tdlr.texas.gov/ US Has Highest Infant, Maternal Mortality Rates Despite the Most Health Care Spendinghttps://www.ajmc.com/view/us-has-highest-infant-maternal-mortality-rates-despite-the-most-health-care-spending What is a freebirth?https://www.pregnancybirthbaby.org.au/what-is-freebirth *SWW S23 Theme Song & Artwork: Thank you so much to Emily Wolfe for covering Glad Rag's original song, U Think U for us this season!Hear more from Emily Wolfe:On SpotifyOn Apple Musichttps://www.emilywolfemusic.com/instagram.com/emilywolfemusicGlad Rags: https://www.gladragsmusic.com/ The S23 cover art is by the Amazing Sara StewartSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

*Content warning: death of an infant, infant loss, death, birth trauma, medical trauma, medical neglect, racism, mature and stressful themes. *Free + Confidential Resources + Safety Tips: somethingwaswrong.com/resources *Sources:American College of Nurse Midwiveshttps://midwife.org/ American College of Obstetricians and Gynecologists (ACOG)https://www.acog.org/ Birth Centers Offer Potential to Transform Maternity Care Through Community-Led Approaches that Focus on Families of Colorhttps://ccf.georgetown.edu/2024/08/19/birth-centers-offer-potential-to-transform-maternity-care-through-community-led-approaches-that-focus-on-families-of-color/ CDC, Maternal Mortality Rates in the United States, 2023https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2023/maternal-mortality-rates-2023CDC, Working Together to Reduce Black Maternal Mortalityhttps://www.cdc.gov/womens-health/features/maternal-mortality.html Center for Black Maternal Health and Reproductive Justice: https://blackmaternalhealth.tufts.edu/Comparative Analysis of Therapeutic Showers and Bathtubs for Pain Management and Labor Outcomes—A Retrospective Cohort Studyhttps://pmc.ncbi.nlm.nih.gov/articles/Fetal Heart Monitoringhttps://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/fetal-heart-monitoring Fundal Heighthttps://my.clevelandclinic.org/health/diagnostics/22294-fundal-height Health Equity Among Black Women in the United Stateshttps://pmc.ncbi.nlm.nih.gov/articles/PMC8020496/ Insights into the U.S. Maternal Mortality Crisis: An International Comparisonhttps://www.commonwealthfund.org/publications/issue-briefs/2024/jun/insights-us-maternal-mortality-crisis-international-comparison March of Dimeshttps://www.marchofdimes.org/peristats/about-us March of Dimes, Data: Heath Insurance/Incomehttps://www.marchofdimes.org/peristats/data?reg=99&top=11&stop=653&lev=1&slev=4&obj=1&sreg=48https://www.marchofdimes.org/peristats/data?reg=99&top=11&stop=154&lev=1&slev=4&obj=1&sreg=48Midwifery Education Accreditation Council (MEAC)https://www.meacschools.org/ Monitoring Baby's Heart Rate During Laborhttps://familydoctor.org/monitoring-babys-heart-rate-labor/ Mucus Plughttps://my.clevelandclinic.org/health/symptoms/21606-mucus-plugNasal Cannulahttps://my.clevelandclinic.org/health/treatments/25187-nasal-cannula National Midwifery Institutehttps://www.nationalmidwiferyinstitute.com/midwifery CDC, National Vital Statistics Reportshttps://www.cdc.gov/nchs/data/nvsr/nvsr73/nvsr73-05.pdf North American Registry of Midwives (NARM)https://narm.org/ State investigating Dallas birth center and midwives, following multiple complaints from patientshttps://www.wfaa.com/article/news/local/investigates/state-investigating-dallas-birth-center-midwives-following-multiple-complaints-from-patients/287-ea77eb18-c637-44d4-aaa2-fe8fd7a2fcef Texas Department of Licensing and Regulation (TDLR)https://www.tdlr.texas.gov/ Water breaking: Understand this sign of laborhttps://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/water-breaking/art-20044142Zucker School of Medicine, Amos Grunebaum, MDhttps://faculty.medicine.hofstra.edu/13732-amos-grunebaum/publications*SWW S23 Theme Song & Artwork: Thank you so much to Emily Wolfe for covering Glad Rag's original song, U Think U for us this season!Hear more from Emily Wolfe:On SpotifyOn Apple Musichttps://www.emilywolfemusic.com/instagram.com/emilywolfemusicGlad Rags: https://www.gladragsmusic.com/ The S23 cover art is by the Amazing Sara StewartFollow Something Was Wrong:Website: somethingwaswrong.com IG: instagram.com/somethingwaswrongpodcastTikTok: tiktok.com/@somethingwaswrongpodcast Follow Tiffany Reese:Website: tiffanyreese.me IG: instagram.com/lookiebooSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

*Content warning: birth trauma, medical trauma, medical neglect, death, mature and stressful themes. *Free + Confidential Resources + Safety Tips: somethingwaswrong.com/resources *Sources:American College of Nurse Midwiveshttps://midwife.org/ American College of Obstetricians and Gynecologists (ACOG)https://www.acog.org/ CDC, Health E-Stats, Maternal Mortality Rates in the United States, 2023https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2023/Estat-maternal-mortality.pdfCDC, Maternal Mortality Rates in the United States, 2023https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2023/maternal-mortality-rates-2023CDC, Working Together to Reduce Black Maternal Mortalityhttps://www.cdc.gov/womens-health/features/maternal-mortality.html Center for Black Maternal Health and Reproductive Justice: https://blackmaternalhealth.tufts.edu/Comparative Analysis of Therapeutic Showers and Bathtubs for Pain Management and Labor Outcomes—A Retrospective Cohort Studyhttps://pmc.ncbi.nlm.nih.gov/articles/Fetal Heart Monitoringhttps://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/fetal-heart-monitoring Fundal Heighthttps://my.clevelandclinic.org/health/diagnostics/22294-fundal-height Health Equity Among Black Women in the United Stateshttps://pmc.ncbi.nlm.nih.gov/articles/PMC8020496/ Insights into the U.S. Maternal Mortality Crisis: An International Comparisonhttps://www.commonwealthfund.org/publications/issue-briefs/2024/jun/insights-us-maternal-mortality-crisis-international-comparison March of Dimeshttps://www.marchofdimes.org/peristats/about-us Midwifery Education Accreditation Council (MEAC)https://www.meacschools.org/ Monitoring Baby's Heart Rate During Laborhttps://familydoctor.org/monitoring-babys-heart-rate-labor/ Mucus Plughttps://my.clevelandclinic.org/health/symptoms/21606-mucus-plugNasal Cannulahttps://my.clevelandclinic.org/health/treatments/25187-nasal-cannula National Midwifery Institutehttps://www.nationalmidwiferyinstitute.com/midwifery CDC, National Vital Statistics Reportshttps://www.cdc.gov/nchs/data/nvsr/nvsr73/nvsr73-05.pdf North American Registry of Midwives (NARM)https://narm.org/ State investigating Dallas birth center and midwives, following multiple complaints from patientshttps://www.wfaa.com/article/news/local/investigates/state-investigating-dallas-birth-center-midwives-following-multiple-complaints-from-patients/287-ea77eb18-c637-44d4-aaa2-fe8fd7a2fcef Texas Department of Licensing and Regulation (TDLR)https://www.tdlr.texas.gov/ Water breaking: Understand this sign of laborhttps://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/water-breaking/art-20044142Zucker School of Medicine, Amos Grunebaum, MDhttps://faculty.medicine.hofstra.edu/13732-amos-grunebaum/publications*SWW S22 Theme Song & Artwork: Thank you so much to Emily Wolfe for covering Glad Rag's original song, U Think U for us this season!Hear more from Emily Wolfe:On SpotifyOn Apple Musichttps://www.emilywolfemusic.com/instagram.com/emilywolfemusicGlad Rags: https://www.gladragsmusic.com/ The S23 cover art is by the Amazing Sara StewartFollow Something Was Wrong:Website: somethingwaswrong.com IG: instagram.com/somethingwaswrongpodcastTikTok: tiktok.com/@somethingwaswrongpodcast Follow Tiffany Reese:Website: tiffanyreese.me IG: instagram.com/lookiebooSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

*Content warning: pregnancy, birth, infant & pregnancy loss, medical negligence, medical trauma. *Free + Confidential Resources + Safety Tips: somethingwaswrong.com/resources Amy Giles' Birth Center & Bio:Allen Midwifery & Family Wellness: https://allenmidwifery.com/ Amy's Bio: https://nursing.baylor.edu/person/l-amy-giles-dnp-cnm-cne-facnm *Sources:After a C-section, women who want a vaginal birth may struggle to find carehttps://www.pbs.org/newshour/health/c-section-vbac-vaginal-maternal-health American College of Nurse Midwiveshttps://midwife.org/ American College of Obstetricians and Gynecologists (ACOG)https://www.acog.org/ Cardiac conditions in pregnancy and the role of midwives: A discussion paperhttps://pmc.ncbi.nlm.nih.gov/articlesC-Section Rates By Hospitalhttps://www.leapfroggroup.org/sites/default/files/Files/C-Section-Graphic-final.pdf March of Dimeshttps://www.marchofdimes.org/peristats/about-us Midwifery Education Accreditation Council (MEAC)https://www.meacschools.org/ National Midwifery Institutehttps://www.nationalmidwiferyinstitute.com/midwifery North American Registry of Midwives (NARM)https://narm.org/ Postpartum Hemorrhagehttps://www.chop.edu/conditions-diseases/postpartum-hemorrhage Postpartum Hemorrhagehttps://my.clevelandclinic.org/health/diseases/22228-postpartum-hemorrhage Practice profile of members of the American College of Nurse-Midwives. https://pubmed.ncbi.nlm.nih.gov/9277066/ Salary and Workload of Midwives Across Birth Center Practice Types and State Regulatory Structureshttps://pubmed.ncbi.nlm.nih.gov/35191600/ State investigating Dallas birth center and midwives, following multiple complaints from patientshttps://www.wfaa.com/article/news/local/investigates/state-investigating-dallas-birth-center-midwives-following-multiple-complaints-from-patients/287-ea77eb18-c637-44d4-aaa2-fe8fd7a2fcef Texas Administrative Codehttps://texreg.sos.state.tx.us/publicTexas Department of Licensing and Regulation (TDLR)https://www.tdlr.texas.gov/ Thyroid Disease & Pregnancyhttps://www.niddk.nih.gov/health-information/endocrine-diseases/pregnancy-thyroid-disease Zucker School of Medicine, Amos Grunebaum, MDhttps://faculty.medicine.hofstra.edu/13732-amos-grunebaum/publications *SWW S22 Theme Song & Artwork: Thank you so much to Emily Wolfe for covering Glad Rag's original song, U Think U for us this season!Hear more from Emily Wolfe:On SpotifyOn Apple Musichttps://www.emilywolfemusic.com/instagram.com/emilywolfemusicGlad Rags: https://www.gladragsmusic.com/ The S23 cover art is by the Amazing Sara StewartFollow Something Was Wrong:Website: somethingwaswrong.com IG: instagram.com/somethingwaswrongpodcastTikTok: tiktok.com/@somethingwaswrongpodcast Follow Tiffany Reese:Website: tiffanyreese.me IG: instagram.com/lookiebooSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

*Content warning: birth trauma, medical trauma and neglect, death, infant loss, pregnancy loss, SIDS, postpartum depression. *Free + Confidential Resources + Safety Tips: somethingwaswrong.com/resources *Sources:American College of Nurse Midwiveshttps://midwife.org/ American College of Obstetricians and Gynecologists (ACOG)https://www.acog.org/ APGAR Scorehttps://medlineplus.gov/ency/article/003402.htm Birth Traumahttps://my.clevelandclinic.org/health/diseases/birth-trauma Breech Babyhttps://my.clevelandclinic.org/health/diseases/21848-breech-baby Intravenous nutrient therapy: the "Myers' cocktail"https://pubmed.ncbi.nlm.nih.gov/12410623/ March of Dimeshttps://www.marchofdimes.org/peristats/about-us Maternal placental abnormality and the risk of sudden infant death syndromehttps://pubmed.ncbi.nlm.nih.gov/10192307/ Midwifery Education Accreditation Council (MEAC)https://www.meacschools.org/ National Midwifery Institutehttps://www.nationalmidwiferyinstitute.com/midwifery North American Registry of Midwives (NARM)https://narm.org/ Preeclampsiahttps://www.mayoclinic.org/diseases-conditions/preeclampsia/symptoms-causes/syc-20355745 Pseudocholinesterase deficiencyhttps://www.mayoclinic.org/diseases-conditions/pseudocholinesterase-deficiency/symptoms-causes/syc-20354543 State investigating Dallas birth center and midwives, following multiple complaints from patientshttps://www.wfaa.com/article/news/local/investigates/state-investigating-dallas-birth-center-midwives-following-multiple-complaints-from-patients/287-ea77eb18-c637-44d4-aaa2-fe8fd7a2fcef Succinylcholine injectionhttps://my.clevelandclinic.org/health/drugs/20755-succinylcholine-injection Sudden infant death syndrome (SIDS)https://www.mayoclinic.org/diseases-conditions/sudden-infant-death-syndrome/symptoms-causes/syc-20352800 Tawagi, George. "Compound Presentations." Oxorn-Foote Human Labor & Birth, 6e Eds. Glenn D. Posner, et al. McGraw-Hill Medical, 2014, https://obgyn.mhmedical.com/content.aspx?bookid=1247§ionid=75163840. Umbilical Cord Prolapsehttps://my.clevelandclinic.org/health/diseases/12345-umbilical-cord-prolapse Texas Department of Licensing and Regulation (TDLR)https://www.tdlr.texas.gov/ Zucker School of Medicine, Amos Grunebaum, MDhttps://faculty.medicine.hofstra.edu/13732-amos-grunebaum/publications *SWW S22 Theme Song & Artwork: Thank you so much to Emily Wolfe for covering Glad Rag's original song, U Think U for us this season!Hear more from Emily Wolfe:On SpotifyOn Apple Musichttps://www.emilywolfemusic.com/instagram.com/emilywolfemusicGlad Rags: https://www.gladragsmusic.com/ The S23 cover art is by the Amazing Sara StewartFollow Something Was Wrong:Website: somethingwaswrong.com IG: instagram.com/somethingwaswrongpodcastTikTok: tiktok.com/@somethingwaswrongpodcast Follow Tiffany Reese:Website: tiffanyreese.me IG: instagram.com/lookieboo See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

*Content warning: infant loss, birth trauma, medical trauma and neglect, death, pregnancy loss, mature content. *Free + Confidential Resources + Safety Tips: somethingwaswrong.com/resources *Sources:American College of Nurse Midwiveshttps://midwife.org/ American College of Obstetricians and Gynecologists (ACOG)https://www.acog.org/ Gestational diabeteshttps://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339 Insights into the U.S. Maternal Mortality Crisis: An International Comparisonhttps://www.commonwealthfund.org/publications/issue-briefs/2024/jun/insights-us-maternal-mortality-crisis-international-comparison March of Dimeshttps://www.marchofdimes.org/peristats/about-us Maternal Mortality, A National Institutes of Health Pathways to Prevention Panel Reporthttps://pmc.ncbi.nlm.nih.gov/articles/PMC10863655/ Maternal Mortality Rates in the United States, 2022https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2022/maternal-mortality-rates-2022.pdf Midwifery Education Accreditation Council (MEAC)https://www.meacschools.org/ National Midwifery Institutehttps://www.nationalmidwiferyinstitute.com/midwifery Neonatal mortality is more than tripled at planned out-of-hospital births attended by direct-entry midwives. Grunebaum, Amos et al. American Journal of Obstetrics & Gynecology, Volume 222, Issue 1, S45. https://www.ajog.org/article/S0002-9378(19)31440-1/fulltext North American Registry of Midwives (NARM)https://narm.org/ Placental abruptionhttps://www.mayoclinic.org/diseases-conditions/placental-abruption/symptoms-causes/syc-20376458 Preeclampsiahttps://www.mayoclinic.org/diseases-conditions/preeclampsia/symptoms-causes/syc-20355745 Severe Maternal Morbidity and Mortality Among Indigenous Women in the United Stateshttps://pmc.ncbi.nlm.nih.gov/articles/PMC7012336/ State investigating Dallas birth center and midwives, following multiple complaints from patientshttps://www.wfaa.com/article/news/local/investigates/state-investigating-dallas-birth-center-midwives-following-multiple-complaints-from-patients/287-ea77eb18-c637-44d4-aaa2-fe8fd7a2fcef Texas Department of Licensing and Regulation (TDLR)https://www.tdlr.texas.gov/ *SWW S22 Theme Song & Artwork: Thank you so much to Emily Wolfe for covering Glad Rag's original song, U Think U for us this season!Hear more from Emily Wolfe:On SpotifyOn Apple Musichttps://www.emilywolfemusic.com/instagram.com/emilywolfemusicGlad Rags: https://www.gladragsmusic.com/ The S23 cover art is by the Amazing Sara StewartFollow Something Was Wrong:Website: somethingwaswrong.com IG: instagram.com/somethingwaswrongpodcastTikTok: tiktok.com/@somethingwaswrongpodcast Follow Tiffany Reese:Website: tiffanyreese.me IG: instagram.com/lookieboo See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Jim manned the microphone and presented listeners worldwide with many headlines to prayerfully consider. Here's a sample of what the broadcast had to offer-----A CNN panel laughed and joked how they can now criticize Donald Trump concerning his age claiming he's -diminished-.----Congressman Jamie Raskin jumped upon his party's wild claims that Donald Trump is an insurrectionist. Now Raskin appears to be planning his own insurrection by having Congress deny Trump the presidency should he win in November. ----The campaign of Vice President Kamala Harris has attempted to moderate her image on border security. Her campaign chief suggested that she should keep in place a Biden era executive order cracking down on illegal border crossings. This is in spite of the fact that as a Senator from California she actively opposed border enforcement proposals and immigration enforcement advocates. ----The Harris campaign has altered it's biography of Minnesota Governor Tim Walz on his campaign website, making a change in its reference to his military service amid ongoing scrutiny.--The second quarter hour featured an interview with Dr. Patti Giebink, M.D., a board certified OB-GYN, a former abortion doctor, and the author of the book Unexpected Choice. A South Dakota native currently residing in Chamberlain, she has delivered hundreds of babies both domestically and in hospitals overseas. She's a Fellow at the American College of Obstetricians and Gynecologists -ACOG-, and a member of the South Dakota State Medical Association. Dr. Giebink talked about misinformation taking place in that state pertaining to Amendment G which will be coming up on their November ballot.

Jim manned the microphone and presented listeners worldwide with many headlines to prayerfully consider. Here's a sample of what the broadcast had to offer-----A CNN panel laughed and joked how they can now criticize Donald Trump concerning his age claiming he's -diminished-.----Congressman Jamie Raskin jumped upon his party's wild claims that Donald Trump is an insurrectionist. Now Raskin appears to be planning his own insurrection by having Congress deny Trump the presidency should he win in November. ----The campaign of Vice President Kamala Harris has attempted to moderate her image on border security. Her campaign chief suggested that she should keep in place a Biden era executive order cracking down on illegal border crossings. This is in spite of the fact that as a Senator from California she actively opposed border enforcement proposals and immigration enforcement advocates. ----The Harris campaign has altered it's biography of Minnesota Governor Tim Walz on his campaign website, making a change in its reference to his military service amid ongoing scrutiny.--The second quarter hour featured an interview with Dr. Patti Giebink, M.D., a board certified OB-GYN, a former abortion doctor, and the author of the book Unexpected Choice. A South Dakota native currently residing in Chamberlain, she has delivered hundreds of babies both domestically and in hospitals overseas. She's a Fellow at the American College of Obstetricians and Gynecologists -ACOG-, and a member of the South Dakota State Medical Association. Dr. Giebink talked about misinformation taking place in that state pertaining to Amendment G which will be coming up on their November ballot.

Jim manned the microphone and presented listeners worldwide with many headlines to prayerfully consider. Here's a sample of what the broadcast had to offer:--A CNN panel laughed and joked how they can now criticize Donald Trump concerning his age claiming he's "diminished".--Congressman Jamie Raskin jumped upon his party's wild claims that Donald Trump is an insurrectionist. Now Raskin appears to be planning his own insurrection by having Congress deny Trump the presidency should he win in November. --The campaign of Vice President Kamala Harris has attempted to moderate her image on border security. Her campaign chief suggested that she should keep in place a Biden era executive order cracking down on illegal border crossings. This is in spite of the fact that as a Senator from California she actively opposed border enforcement proposals and immigration enforcement advocates. --The Harris campaign has altered it's biography of Minnesota Governor Tim Walz on his campaign website, making a change in its reference to his military service amid ongoing scrutiny.The second quarter hour featured an interview with Dr. Patti Giebink, M.D., a board certified OB/GYN, a former abortion doctor, and the author of the book Unexpected Choice. A South Dakota native currently residing in Chamberlain, she has delivered hundreds of babies both domestically and in hospitals overseas. She's a Fellow at the American College of Obstetricians and Gynecologists (ACOG), and a member of the South Dakota State Medical Association. Dr. Giebink talked about misinformation taking place in that state pertaining to Amendment G which will be coming up on their November ballot.

Jim manned the microphone and presented listeners worldwide with many headlines to prayerfully consider. Here's a sample of what the broadcast had to offer-----A CNN panel laughed and joked how they can now criticize Donald Trump concerning his age claiming he's -diminished-.----Congressman Jamie Raskin jumped upon his party's wild claims that Donald Trump is an insurrectionist. Now Raskin appears to be planning his own insurrection by having Congress deny Trump the presidency should he win in November. ----The campaign of Vice President Kamala Harris has attempted to moderate her image on border security. Her campaign chief suggested that she should keep in place a Biden era executive order cracking down on illegal border crossings. This is in spite of the fact that as a Senator from California she actively opposed border enforcement proposals and immigration enforcement advocates. ----The Harris campaign has altered it's biography of Minnesota Governor Tim Walz on his campaign website, making a change in its reference to his military service amid ongoing scrutiny.--The second quarter hour featured an interview with Dr. Patti Giebink, M.D., a board certified OB-GYN, a former abortion doctor, and the author of the book Unexpected Choice. A South Dakota native currently residing in Chamberlain, she has delivered hundreds of babies both domestically and in hospitals overseas. She's a Fellow at the American College of Obstetricians and Gynecologists -ACOG-, and a member of the South Dakota State Medical Association. Dr. Giebink talked about misinformation taking place in that state pertaining to Amendment G which will be coming up on their November ballot.

Jim manned the microphone and presented listeners worldwide with many headlines to prayerfully consider. Here's a sample of what the broadcast had to offer-----A CNN panel laughed and joked how they can now criticize Donald Trump concerning his age claiming he's -diminished-.----Congressman Jamie Raskin jumped upon his party's wild claims that Donald Trump is an insurrectionist. Now Raskin appears to be planning his own insurrection by having Congress deny Trump the presidency should he win in November. ----The campaign of Vice President Kamala Harris has attempted to moderate her image on border security. Her campaign chief suggested that she should keep in place a Biden era executive order cracking down on illegal border crossings. This is in spite of the fact that as a Senator from California she actively opposed border enforcement proposals and immigration enforcement advocates. ----The Harris campaign has altered it's biography of Minnesota Governor Tim Walz on his campaign website, making a change in its reference to his military service amid ongoing scrutiny.--The second quarter hour featured an interview with Dr. Patti Giebink, M.D., a board certified OB-GYN, a former abortion doctor, and the author of the book Unexpected Choice. A South Dakota native currently residing in Chamberlain, she has delivered hundreds of babies both domestically and in hospitals overseas. She's a Fellow at the American College of Obstetricians and Gynecologists -ACOG-, and a member of the South Dakota State Medical Association. Dr. Giebink talked about misinformation taking place in that state pertaining to Amendment G which will be coming up on their November ballot.

Jim manned the microphone and presented listeners worldwide with many headlines to prayerfully consider. Here's a sample of what the broadcast had to offer:--A CNN panel laughed and joked how they can now criticize Donald Trump concerning his age claiming he's "diminished".--Congressman Jamie Raskin jumped upon his party's wild claims that Donald Trump is an insurrectionist. Now Raskin appears to be planning his own insurrection by having Congress deny Trump the presidency should he win in November. --The campaign of Vice President Kamala Harris has attempted to moderate her image on border security. Her campaign chief suggested that she should keep in place a Biden era executive order cracking down on illegal border crossings. This is in spite of the fact that as a Senator from California she actively opposed border enforcement proposals and immigration enforcement advocates. --The Harris campaign has altered it's biography of Minnesota Governor Tim Walz on his campaign website, making a change in its reference to his military service amid ongoing scrutiny.The second quarter hour featured an interview with Dr. Patti Giebink, M.D., a board certified OB/GYN, a former abortion doctor, and the author of the book Unexpected Choice. A South Dakota native currently residing in Chamberlain, she has delivered hundreds of babies both domestically and in hospitals overseas. She's a Fellow at the American College of Obstetricians and Gynecologists (ACOG), and a member of the South Dakota State Medical Association. Dr. Giebink talked about misinformation taking place in that state pertaining to Amendment G which will be coming up on their November ballot.

Christie Allen, Senior Director of Quality Improvement and Programs at the American College of Obstetricians and Gynecologists (ACOG), and Dr. Veronica Gillispie-Bell are back to explore the complexities of sustaining momentum in maternal health quality. After reflecting on last season, they discuss the concept of "health equity tourism" and the importance of true community integration. Dr. Gillispie-Bell shares her insights on embedding sustainable, equitable practices in healthcare beyond initial surges of interest.  This show is brought to you by the Alliance for Innovation on Maternal Health (AIM). Join us in the journey toward safer, more equitable maternal care and learn more about AIM at saferbirth.org.This podcast is supported by the Health Resources and Services Administration, HRSA, of the United States Department of Health and Human Services, HHS, as part of an initiative to improve maternal health outcomes.

Are you noticing changes in your body that feel like uncharted territory? You're not alone, and we're here to illuminate the path through one of motherhood's less talked about chapters: perimenopause. It knocks quietly but changes everything. Today I'm sharing personal experiences and vital information that every mom should have as they approach this life stage.   I share: The ins and outs of perimenopause and why it's more than just irregular periods How hormone replacement therapy turned the tide for me Practical strategies for managing symptoms from weight gain to mood swings Navigating intimate changes and reclaiming your sexual health with confidence The emotional rollercoaster and the power of open conversations Lifestyle tips to stay on top of your game   Resource Recommendations:   * The North American Menopause Society [NAMS]: https://www.menopause.org/ (Provides educational resources and healthcare professional directories)   * The American College of Obstetricians and Gynecologists [ACOG]: https://www.acog.org/ (Offers patient education resources on perimenopause)   Need more support? Let's chat! https://scottiedurrett.com/contact   INSTAGRAM SOURCES:   https://www.instagram.com/menopause.nutritionist/   https://www.instagram.com/drshahzadiharper/   Drop me a DM: @scottiedurrett on IG

This episode is sponsored by HCA Midwest Health. One of the first of many decisions you'll have to make once you find out you're having a baby is choosing a healthcare practitioner. Some women choose an obstetrician, while others opt for a midwife. Today we are chatting with Kim Boote, a Certified Nurse Midwife with Kansas City Women's Clinic, part of HCA Midwest Health, to learn about the benefits of choosing a midwife. Meet Kim Boote Kim Boote, CNM, MSN, C-EFM is a Certified Nurse Midwife with Kansas City Women's Clinic seeing patients in Kansas City, Olathe, and Lansing, KS. She is affiliated with Overland Park Regional Medical Center. Kim is a member of the American College of Nurse-Midwives (ACNM), the American College of Obstetricians and Gynecologists (ACOG), and the American Society for Colposcopy and Cervical Pathology (ASCCP). She received her Bachelor of Science in Nursing (BSN) from the University of Iowa, her Master of Science in Nursing (MSN) from Case Western Reserve University, and her Nurse-Midwifery certificate from Frontier Nursing University. Kim and her family enjoy vacationing in warm climates where they can hike, snorkel, or just enjoy the ocean. She loves learning where all her patients have traveled to update her bucket list for new destinations. Kim has four kids that keep her busy! Connect with Megan and Sarah We would love to hear from you! Send us an e-mail or find us on Instagram or Facebook!        

Episode 162: Early-Onset Sepsis      Dr. Kooner explains how to diagnose early-onset sepsis by using clinical evaluation and clinical tools. Dr. Schlaerths describes the signs and symptoms of sepsis in neonates, and Dr. Arreaza adds comments about GBS bacteriuria.  Written by Lovedip Kooner, MD, editing Hector Arreaza, MD, and comments by Katherine Schlaerth, MD. Rio Bravo Family Medicine Residency Program.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Introduction:Neonatal sepsis is defined as pathogenic bacterial growth from blood or cerebral spinal fluid culture within the first 28 days of life. Neonatal sepsis can be divided into two categories: early-onset sepsis (EOS) and late-onset.  EOS is neonatal sepsis within 72 hours or 7 days after birth, depending on the specialist. How common is early-onset sepsis (EOS)?According to the CDC, the infant mortality rate rose for the first time in 20 years in the USA. In the U.S., the incidence of EOS is 0.5 in 1,000 live births and carries a mortality rate of about 3%. What causes EOS?Most infections are due to ascending lower vaginal tract flora. Other causes include intra-amniotic infections and maternal hematogenous spread of systemic infections. Group B streptococcus (S. agalactiae) accounts for about 1/3 of the infectious organisms, followed by E. coli which accounts for about 1/4, and Viridans streptococci account for about 1/5 of infections. Cases of E. coli are seen more often with prolonged rupture of membranes and intrapartum antibiotic exposure. Other notable infections are Listeria monocytogenes, coagulase-negative staphylococci (CoNS), herpes simplex virus, and enteroviruses. The role of GBS.Approximately 30% of women have vaginal and rectal GBS colonization and 50% will transmit it to the newborn. Without maternal antibiotic treatment, 1-2% of those infants will develop EOS. The American College of Obstetricians and Gynecologists (ACOG) recommends universal culture-based screening for GBS at 36-37 weeks and 6 days regardless of mode of delivery. GBS bacteriuria: Treat it (symptomatic and asymptomatic) if >105 CFU/mL. Do not treat it in asymptomatic patients if GBS 18 hours, intrapartum fever, or GBS positive in previous pregnancy.Nucleic acid amplification test: NAAT in pregnancy is not recommended to determine colonization status. However, if NAAT is obtained in the intrapartum period, give IAP if positive. But, you must also give IAP if negative + mentioned risk factors (18h, Maternal fever >100.4F)What is considered adequate intrapartum antibiotic prophylaxis? Penicillin and ampicillin are the recommended antibiotics for prophylaxis. Cefazolin can be given if there is a penicillin-allergy with a low risk for anaphylaxis. Clindamycin and vancomycin are reserved for cases of maternal penicillin allergy. Specifically, clindamycin can be used only if GBS is known to be sensitive to clindamycin. Vancomycin must be used if GBS is resistant to clindamycin. Do not use erythromycin. You will Administered at least 4 hours before delivery.IAP is believed to reduce neonatal GBS disease by: (1) temporarily reducing maternal vaginal GBS colonization; (2) preventing colonization of the fetus or newborn's surfaces and mucous membranes; and (3) achieving antibiotic levels in the newborn's bloodstream sufficient to surpass the minimum inhibitory concentration (MIC) for eliminating group B streptococci.Diagnosis of EOS:Clinical presentation: Tachycardia, tachypnea, temperature instability, supplemental oxygen requirement, and lethargy. Hypoglycemia should not be considered a sign of EOS.Diagnosing early-onset sepsis is achieved through blood or cerebrospinal fluid (CSF) cultures. Not effective methods for diagnosing EOS include laboratory tests, such as a complete blood cell count or C-reactive protein (CRP), as well as surface cultures, gastric aspirate analysis, or urine culture.Most infants will generally show signs of EOS GBS infection within the initial 24 hours of birth, with approximately 85% exhibiting symptoms during this timeframe.Waiting for cultures and/or signs can delay lifesaving treatment.Management:According to the American Academy of Pediatrics (AAP), the management of term and late-term infants is undertaken via the clinical condition assessment, the categorical risk factor assessment, and the multivariate risk assessment. As a part of the 2015 AAP guidelines, the Categorical Risk Factor Assessment is more of an algorithmic approach based on the presence or absence of specific risk factor threshold values such as:Ill-appearing infant. Mother diagnosed with chorioamnionitis.Mother GBS positive with inadequate intrapartum prophylaxis.ROM >18 hours.Birth before 37 weeks of gestation.Antibiotics are not always needed, and they can even cause damage. Information taken from the American Academy of Pediatrics, “Management of Neonates Born at ≥35 0/7 Weeks' Gestation With Suspected or Proven Early-Onset Bacterial Sepsis,” published on December 1, 2018:(1) Any newborn infant who is ill-appearing or (2) when the mother has a clinical diagnosis of chorioamnionitis -> laboratory testing must be ordered, and empirical antibiotic therapy should be started.(3) A mother who is colonized with GBS and who received inadequate intrapartum antibiotic prophylaxis, with a duration of ROM being >18 hours or birth before 37 weeks' gestation -> laboratory testing should be ordered.(4) A mother who is colonized with GBS who received inadequate IAP but with no additional risk factors -> observation in the hospital for ≥48 hours.______________________________Conclusion: Now we conclude episode number 162, “Early-onset Sepsis Introduction.” Dr Kooner explained the role of GBS in the pathophysiology of EOS, Dr. Schlaerth discussed the importance of clinical evaluation and Dr. Arreaza explained that GBS screening in the third trimester is not needed when there is a GBS positive urine culture early in pregnancy. Don't miss part 2 of this discussion. By the way, we do not recommend using feces to prevent or treat sepsis, we just shared anecdotal information to end with a funny note.This week we thank Hector Arreaza, Lovedip Kooner, and Katherine Schlaerth. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Neonatal Early-Onset Sepsis Calculator by Kaiser Permanente, available at: https://neonatalsepsiscalculator.kaiserpermanente.org/.Espinosa K, Brown SR. Neonatal Early-Onset Sepsis Calculator. Am Fam Physician. 2021;104(6):636-637.https://www.aafp.org/pubs/afp/issues/2021/1200/p636.html.Puopolo KM, Benitz WE, Zaoutis TE; COMMITTEE ON FETUS AND NEWBORN; COMMITTEE ON INFECTIOUS DISEASES. Management of Neonates Born at ≥35 0/7 Weeks' Gestation With Suspected or Proven Early-Onset Bacterial Sepsis. Pediatrics. 2018 Dec;142(6):e20182894. doi: 10.1542/peds.2018-2894. PMID: 30455342. https://pubmed.ncbi.nlm.nih.gov/30455342/.Briggs-Steinberg C, Roth P. Early-Onset Sepsis in Newborns. Pediatr Rev. 2023 Jan 1;44(1):14-22. doi: 10.1542/pir.2020-001164. PMID: 36587021. https://pubmed.ncbi.nlm.nih.gov/36587021/.Flannery DD, Puopolo KM. Neonatal Early-Onset Sepsis. Neoreviews. 2022 Nov 1;23(11):756-770. doi: 10.1542/neo.23-10-e756. PMID: 36316253. https://pubmed.ncbi.nlm.nih.gov/36316253/.Polin RA; Committee on Fetus and Newborn. Management of neonates with suspected or proven early-onset bacterial sepsis. Pediatrics. 2012 May;129(5):1006-15. doi: 10.1542/peds.2012-0541. Epub 2012 Apr 30. PMID: 22547779. https://pubmed.ncbi.nlm.nih.gov/22547779/.Royalty-free music used for this episode: Good Vibes_Adventure Time by Simon Pettersson, downloaded on July 20, 2023, from https://www.videvo.net/  

Episode 156: Obesity, Fertility, and PregnancyFuture Dr. Hamilton defines obesity and explains the pathophysiology of obesity and its effects on fertility and pregnancy. Dr. Arreaza adds some input about the impact of epigenetics on newborn babies.  Written by Shelby Hamilton, MS3, American University of the Caribbean School of Medicine. Editing by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Definition of obesityObesity is a multifactorial chronic disease that is increasing in prevalence across the globe. It can be defined as a body mass index (or BMI) greater than 30 kg/m2. According to the CDC from 2017-March 2020, the prevalence of obesity in United States adults was 41.9%.Classification of obesity by BMI.Obesity can further be divided into three classes: class I which is a BMI between 30-34.9; class II which is a BMI between 35-39.5; and class III which is a BMI greater than 40. We recommend avoiding the term “morbid obesity” because of the negative connotation of the word “morbid.” Class III or severe are better terms in those cases. This classification is based on the individual risk of cardiovascular disease. One of the greatest health consequences affecting individuals with obesity is the cardiovascular effects including hypertension, dyslipidemia, and coronary artery disease. Other effects include insulin resistance and diabetes, cholelithiasis, non-alcoholic fatty liver disease, osteoarthritis, and even depression.How Does Obesity Affect Fertility?Obesity can have an extensive effect on the overall health of an individual. In addition to these commonly discussed effects, obesity can also influence a person's fertility. This is especially observed in women with polycystic Ovary Syndrome (PCOS) who have a greater BMI and also have symptoms of anovulation. Excess adipose tissue plays a role in the effects that obesity has on fertility. White adipose tissue can secrete a specific group of cytokines known as ‘adipokines'. These adipokines include leptin, ghrelin, resistin, visfatin, chemerin, omentin, and adiponectin. With a greater percentage of adipose tissue, there are higher rates of hypothalamic gonadotropin hormonal dysregulation, which can be combined with insulin-related disorders, low sex hormone binding proteins, and high levels of androgens. The combination of these factors can result in decreased ovarian follicle development and decreased progesterone levels.Hormonal changesObesity is an endocrine disorder. One specific adipokine that affects the hypothalamic-gonadotropin axis is chemerin. Chemerin impairs the release of follicle-stimulating hormone (FSH) from the pituitary gland. This reduction in FSH release consequently leads to anovulation, meaning that no egg will be released from an ovarian follicle, contributing to infertility. Shelby: Another adipokine affecting fertility is adiponectin. The receptors of adiponectin are predominantly expressed in reproductive tissues, including the ovaries and endometrium. In individuals with a greater BMI, a decrease in adiponectin secretion has been observed, resulting in decreased stimulation of its receptors, especially in the endometrium, which has been linked to recurrent implantation failure. Adiponectin has also been shown to affect glucose uptake in the liver. With reduced adiponectin levels, there is reduced hepatic glucose uptake, leading to insulin resistance. As tissues become less sensitive to insulin, the body compensates by secreting higher amounts of insulin, leading to hyperinsulinemia. Higher levels of circulating insulin have also been proven to cause hyperandrogenemia in women by blocking the hepatic production of sex hormone-binding globulin. Insulin can also act on the IGF-1 receptors in the theca cells, increasing steroidogenesis, and thus, increasing androgens. With hyperandrogenemia, there is also increased granulosa cell apoptosis as well as increased peripheral conversion of androgens into estrogen. This creates negative feedback to the hypothalamic-pituitary axis to decrease the release of gonadotropins such as FSH which are critical in ovulation.Leptin is another adipokine that is shown to be increased in obesity. Studies on mice have shown that leptin impairs the development of ovarian follicles, resulting in a decrease in ovulation. In these studies, it was also observed that leptin reduces the production of estriol by the granulosa cells in the ovarian follicles as well as increases the rate of apoptosis in granulosa cells, both of which affect ovulation. Leptin decreases hunger, but persons with obesity may be resistant to its effects and that's why they have higher levels than a person with normal weight. They have high levels of leptin but are still hungry because they have leptin resistance.Studies have also shown that the fatty acid composition of follicular fluid found in ovarian follicles also plays a role in fertility. In individuals with a high BMI, this fluid contains high levels of oleic acid, which can cause embryo fragmentation after fertilization occurs. Stearic acid is another fatty acid found in elevated levels in the follicular fluid of women with a greater BMI, which can also affect the quality of the embryo while in the blastomere stage.The bottom line is obesity decreases fertility. It does not mean that patients with obesity will not get pregnant, but it can make it harder to get pregnant. Female patients who are losing weight must be warned about their improved fertility once they start to lose weight.What effect does obesity have on pregnancy?While obesity may make it more difficult for a woman to get pregnant, it is not impossible. However, there are potential risks both to the mother's health as well as the baby's health. Therefore, it is very important to monitor these patients even more carefully.Women who have a greater BMI pre-pregnancy are at a greater risk of developing gestational hypertension. Gestational hypertension is defined as blood pressure greater than 140/90 on more than one reading in the second half of pregnancy. Hypertension during pregnancy can also have serious complications such as kidney failure, stroke, myocardial infarction, or even heart failure. Gestational hypertension can also result in preterm birth or low birth weight.Treatment of mild hypertension in pregnancyRecent studies published in the AFP Journal support the treatment of mild hypertension in pregnancy. It states that “evidence and expert opinion support treating mild chronic hypertension in pregnancy with approved antihypertensives, with a strength of recommendation: B”. There was a randomized control trial with about 2,000 women who were randomized to receive antihypertensive treatment vs no treatment. The treatment group had a lower incidence of preeclampsia with severe features, preterm birth, placental abruption, and neonatal or fetal death. There was not an increase in fetal growth restriction or maternal or neonatal complications. So, it is advisable to treat chronic, mild hypertension in pregnancy, according to the AFP Journal.PreeclampsiaPreeclampsia is another condition that is at a higher risk in women with obesity, which is a more serious manifestation of hypertension in the second half of pregnancy. Along with high blood pressure, there are also effects on the kidneys and liver. Hypertension accompanied by proteinuria is indicative of preeclampsia and should be taken seriously. Preeclampsia can become eclampsia, where the patient also experiences seizures. There is also the risk for stroke, HELLP syndrome, placenta abruption, preterm birth, and fetal growth restriction.Gestational diabetesAnother risk is gestational diabetes. Elevated blood glucose during pregnancy can result in a larger baby and delivery by cesarean. There may also be a greater risk of the mother and child developing diabetes mellitus later on in life.OSAWomen with a greater BMI may also be at risk of developing obstructive sleep apnea during pregnancy. Not only can this result in fatigue but can also contribute to the development of gestational hypertension and preeclampsia.Effect of obesity on the fetusAs mentioned, there are some risks to the fetus in women with a greater pre-pregnancy BMI. There is a greater risk for these babies to be born with birth defects such as congenital heart defects and neural tube defects. Another risk previously discussed is macrosomia, or large for gestational age. Larger babies are also at increased risk for shoulder dystocia during delivery as well as resulting clavicle fractures, brachial plexus injuries, and nerve palsies. Preterm birth is another risk, which also increases the risk of short-term and long-term health complications. Lastly, a higher BMI is directly correlated with the risk of spontaneous abortion or stillbirth.SummaryAs the prevalence of obesity increases, it is important to discuss the health risks that are associated with this disease. In our patients of childbearing age and who may be hoping to conceive, it is even more important to discuss how a higher BMI may affect fertility and pregnancy. While discussing these topics with patients, it is important to try our best to build rapport with the patient so that the discussion is seen more as one of concern and support rather than one of criticism regarding their weight. We may want to help by not only telling patients to “lose weight” or “diet”, but we can also provide them with resources regarding dietary adjustments and ways they can incorporate physical activity into their lives without just telling them to eat less and move more. Stay tuned for our episode on the management of obesity in pregnancy.ConclusionNow we conclude episode number 156, “Obesity, fertility, and pregnancy.” Future Dr. Hamilton explained how obesity affects the hormonal regulation of fertility. She also explained the obstetrical risks associated with obesity. Primary care professionals need to educate our patients about the benefits of preconception weight control. Dr. Arreaza explained that hypertension is a common condition in pregnant patients with obesity and mentioned the benefits of treating mild hypertension in pregnancy. We hope to bring you an episode on the management of obesity in pregnancy soon, so stay tuned! This week we thank Hector Arreaza and Shelby Hamilton. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Gautam, D., Purandare, N., Maxwell, C., Rosser, M., O'Brien, P., Mocanu, E., McKeown, C., Malhotra, J., & McAuliffe, F. (2023) The challenges of obesity for fertility: A FIGO literature review. International Journal of Gynecology & Obstetrics, 160(S1), 50-55. https://doi.org/10.1002/ijgo.14538Pandey, S., Pandey, S., Maheshwari, A., & Bhattacharya, S. (2010). The impact of female obesity on the outcome of fertility treatment. Journal of Human Reproductive Science, 3(2), 62-67. https://doi.org/10.4103/0974-1208.69332.Perreault L. Obesity in adults: Prevalence, screening, and evaluation. In: UpToDate, Pi Sunyer FX (Ed) Wolters Kluwer. https://www.uptodate.com (Accessed on October 6, 2023).Obesity and Pregnancy FAQ, The American College of Obstetricians and Gynecologists (ACOG), https://www.acog.org/womens-health/faqs/obesity-and-pregnancy, Accessed on October 10, 2023.Adult Obesity Facts, Centers for Disease Control and Prevention (CDC), https://www.cdc.gov/obesity/data/adult.html, Accessed on October 7, 2023. Dresang L, Vellardita L. Should Medication Be Prescribed for Mild Chronic Hypertension in Pregnancy?. Am Fam Physician. 2023;108(4):411-412. Royalty-free music used for this episode: "I Think We Have a Chance."  downloaded on November 11, 2023,  from https://www.videvo.net/.

In a recent article, it was revealed that the interim head of the American College of Obstetricians and Gynecologists (ACOG) is a proponent of unrestricted access to abortion. Christopher M. Zahn and Jenni Villavicencio, leaders within ACOG, jointly authored an op-ed in The Washington Post, wherein they voiced their support for unrestricted abortion access. This response came in the wake of an op-ed authored by Susan B. Anthony Pro-Life America President Marjorie Dannenfelser and former senior counselor to the president Kellyanne Conway.The ACOG leaders argue that abortion is not only safe but also plays a role in improving and saving lives. They firmly believe that it should be available without any restrictions, positioning it as an essential component of healthcare.This article underscores the ongoing debate surrounding abortion rights, with ACOG advocating for a comprehensive approach to access, while other voices in the public discourse are pushing for limitations and restrictions on abortion.Read here: https://www.christianpost.com/news/ob-gyn-group-head-calls-for-unrestricted-abortion-access.htmlJoin us for an engaging episode of I Am Refocused Radio, as your host Shemaiah chats with Chelsey Youman, Texas State Director and National Legislative Advisor for Human Coalition. In this conversation, we delve into the ongoing discussions around abortion rights, where medical professionals have recently called for extending abortion access, and some Democrats remain steadfast supporters.Chelsey offers a warm and informative perspective on the dedicated work of Human Coalition. Their mission is to ensure that every woman has access to the care, resources, and support needed to make choices about their preborn child's future.Discover the compassionate initiatives Human Coalition is spearheading to create a more understanding and supportive environment for women facing these challenging decisions. Learn about the importance of rallying pro-life advocates to appreciate the complexity of these situations and the urgency of the need for change.In this episode, we aim to provide valuable insights into the ongoing dialogue surrounding abortion and efforts to promote alternatives that empower women and honor the sanctity of life. So, tune in and join us as we explore these essential topics with Chelsey Youman.Chelsey Youman Texas State Director and National Legislative AdvisorChelsey Youman, Esq., serves the pro-life coalition, as well as women and their preborn children, by advocating for pro-life policies and jurisprudence; mobilizing and unifying local grassroots to strengthen the pro-life movement and its footprint; and engaging with the public to ultimately strengthen our community's desire to enable women and protect preborn children.Chelsey's professional experience includes working as senior counsel and chief of staff for First Liberty Institute, concentrating on religious liberty matters and First Amendment rights. At First Liberty Institute, she litigated on behalf of and advised hundreds of clients regarding conscience rights nationwide. Chelsey has also worked in private practice, where she successfully litigated corporate fraud matters, complex commercial litigation, and consumer rights issues in both federal and state jurisdictions.Chelsey holds a Bachelor of Arts degree in Political Science from Texas A&M, and a J.D. from Southern Methodist University.Chelsey is happily married with two children. Her family is active in their church, serving in the premarital and pro-life ministries there. They enjoy traveling, adventuring, and eating good food.https://hucoaction.org/https://www.humancoalition.org/bios/chelsey-youman/For more interviews visit: www.iamrefocusedradio.com

A viral video is making the rounds, which shows an enraged husband's mission of vengeance storming the stage during a medical conference to slap the hell out of the gynecologist he alleges committed sexual assault on his wife. The dramatic scene played out right in the middle of the annual American College of Obstetricians and Gynecologists (ACOG), last month in Baltimore and the furious man confronted the physician while he was standing at a podium delivering a speech. The man grabbed the doctor by his shirt and b-slapped him across the face multiple times, yelling, "You know what you did!" You touched my wife 7 years ago in New York. Don't be an ass****, bitch!" Surprisingly, the doctor did not press charges against the man. And here to talk about the importance of trust between a gynecologist and his patients, is our resident physician. Listen to Lamont & Tonelli Monday through Friday, 6-10am, on 107.7 The Bone in the San Francisco Bay Area. Follow Lamont & Tonelli:Website: http://www.landtradio.com/Facebook: http://www.facebook.com/lamontandtonelliTwitter: http://www.twitter.com/landtshowInstagram: http://www.instagram.com/landtshowSee omnystudio.com/listener for privacy information.

A viral video is making the rounds, which shows an enraged husband's mission of vengeance storming the stage during a medical conference to slap the hell out of the gynecologist he alleges committed sexual assault on his wife. The dramatic scene played out right in the middle of the annual American College of Obstetricians and Gynecologists (ACOG), last month in Baltimore and the furious man confronted the physician while he was standing at a podium delivering a speech. The man grabbed the doctor by his shirt and b-slapped him across the face multiple times, yelling, "You know what you did!" You touched my wife 7 years ago in New York. Don't be an ass****, bitch!" Surprisingly, the doctor did not press charges against the man. And here to talk about the importance of trust between a gynecologist and his patients, is our resident physician. Listen to Lamont & Tonelli Monday through Friday, 6-10am, on 107.7 The Bone in the San Francisco Bay Area. Follow Lamont & Tonelli:Website: http://www.landtradio.com/Facebook: http://www.facebook.com/lamontandtonelliTwitter: http://www.twitter.com/landtshowInstagram: http://www.instagram.com/landtshowSee omnystudio.com/listener for privacy information.

No episódio de hoje, você ficará por dentro das principais temáticas abordadas no American College of Obstetricians and Gynecologists – ACOG 2023, que ocorreu dos dias 19 a 21 de maio de 2023, em Baltimore. Entre elas: saúde mental da mulher; novo dispositivo para a hemorragia pós-parto; Espectro da Placenta Acreta, Fezolinetante e mais! Confira esse e outros posts no Portal PEBMED e siga nossas redes sociais! Facebook Instagram Linkedin Twitter

Dr. Christina Francis, CEO of the American Association of Pro-Life OB/Gyns (AAPLOG), discusses the cancellation of a pro-life booth at a recent American Congress of Obstetricians and Gynecologists (ACOG) conference.  What does this mean for the medical community and culture? Make A Gift To The LoveX2 Project Music Title: Children of the Son Author: Pipe Choir Souce: www.pipechoir.com Licenses: Creative Commons Attribution 4.0 International  

A scar pregnancy is a rare type of ectopic pregnancy where the fertilized egg implants in the scar tissue of a previous cesarean section or other surgical procedure in the uterus, rather than in the lining of the uterus where a normal pregnancy should occur. This can occur when the scar tissue is not fully healed or is weakened, allowing the fertilized egg to implant and grow in the scar tissue where the uterine muscle can be weakened. Scar pregnancy can be dangerous, as the scar tissue may not be able to support the growing embryo and can rupture or cause other complications, but it is not always associated with miscarriage or loss of the pregnancy. A scar pregnnacy can actually produce a live. birth. In addition, scar pregnancy can be difficult to diagnose, as it may not produce typical pregnancy symptoms and may not be visible on a standard ultrasound. A highly trained expert sonographer is generally what is needed for diagnosis.  Dr. Ilan Timor is an expert OB/GYN with extensive years in scanning for these types of pregnancies and is world-renown in how to treat and diagnosis these types of pregnancies.  Fortunate of us a Maternal Resources, he has recenlty joined our team and can assist us in the diagnosis, treatment and managment of different types of pregnancies.  From Dr. Timor's perspective he doesn't alwasy consider a scar pregnancy an ectopic pregnancy. It is generally accepted in the medical community that a scar pregnancy is a type of ectopic pregnancy, despite the fact that the gestational sac is located within the uterus. This is because the fertilized egg has implanted in scar tissue outside of the normal location in the endometrial lining of the uterus. In fact, the American College of Obstetricians and Gynecologists (ACOG) defines an ectopic pregnancy as "any gestation that implants outside the endometrial lining of the uterine cavity." This includes implantation in the fallopian tube (the most common location for ectopic pregnancy), as well as other locations outside the uterus, such as the cervix, ovaries, and abdominal cavity. While scar pregnancy is a relatively rare type of ectopic pregnancy, it can still pose serious health risks and requires prompt medical attention and treatment. Treatment for scar pregnancy typically involves surgical removal of the ectopic pregnancy and the scar tissue, in order to prevent further complications and preserve the health of the uterus.   Maintaining the integrity of the uterus is very important in scar pregnancies. When a fertilized egg implants in the scar tissue of a previous cesarean section or other surgical procedure, it can weaken the scar tissue and put the integrity of the uterus at risk. Scar tissue may be thinner and more prone to tearing, which can lead to bleeding and other complications. If a scar pregnancy is not treated promptly, it can result in further damage to the uterus and potentially require more extensive surgical intervention, such as a hysterectomy. Therefore, early detection and prompt treatment of scar pregnancy is important to preserve the health and integrity of the uterus. Treatment typically involves the removal of the ectopic pregnancy and scar tissue, which may be done through surgery or medication depending on the severity of the case. If you suspect you may have a scar pregnancy, it is important to seek medical attention right away. Your healthcare provider can perform an ultrasound and other diagnostic tests to determine the best course of treatment for your individual situation.   Dr. Timor can be found in our practice at www.maternalresources.org He is currently accepting patients and consults in our New York City office to reach us call (201) 487-8600   As always, we'd love to hear from you! Connect with us on our website at www.truebirthpodcast.com or send us an email at info@maternalresources.org     Remember to subscribe wherever you listen and considering leaving us some feedback at info@maternalresoruces.org or writieng a review.  Our Social Channels are as follows Twitter: https://twitter.com/integrativeobYouTube: https://www.youtube.com/maternalresources IG: https://www.instagram.com/integrativeobgyn/ Facebook: https://www.facebook.com/IntegrativeOB

VBAC stands for Vaginal Birth After Cesarean, which is a delivery method chosen by women who have previously had a c-section but want to deliver vaginally for their next birth. VBAC2, on the other hand, refers to the second or subsequent vaginal birth after a c-section. VBAC and VBAC2 are two different terms that can be confusing for new parents. Women who have had a previous c-section may be wondering about their options for future deliveries. So, let's break down the difference between these two terms. VBAC: Vaginal Birth After Cesarean, or VBAC, is a safe and successful option for many women who have previously delivered by c-section. The American College of Obstetricians and Gynecologists (ACOG) states that women who have had one prior low transverse uterine incision are candidates for VBAC. The success rate for VBAC is high, around 60-80%, and it has several benefits over repeat c-section, including a shorter recovery time, a reduced risk of surgical complications, and a lower risk of infections. However, VBAC is not recommended for all women, as it carries a small risk of uterine rupture, which can be life-threatening for both mother and baby. Other factors, such as the reason for the previous c-section, may also play a role in determining whether VBAC is a safe option for a woman. However, just like with VBAC, there are factors to consider when deciding whether VBAC2 is a safe option. Women who have had multiple c-sections or a previous uterine rupture may not be good candidates for VBAC or VBAC2, yet VBAC2 may still be safe and recommended or some women. VBAC and VBAC2 are both viable options for women who have previously had a c-section and want to deliver vaginally in the future. VBAC is a safe option for most women with one or two prior low transverse uterine incisions. It is important to discuss your options with your healthcare provider, who can help you make an informed decision based on your medical history and individual circumstances. As always, we'd love to hear from you! Connect with us on our website at www.truebirthpodcast.com or send us an email at info@maternalresources.org   Maternal Resources' website is:  https://www.maternalresources.org/   Remember to subscribe wherever you listen, and leave us a review!   Our Social Channels are as follows Twitter: https://twitter.com/integrativeobYouTube: https://www.youtube.com/maternalresources IG: https://www.instagram.com/integrativeobgyn/ Facebook: https://www.facebook.com/IntegrativeOB

Episode 126: Caffeine and AKI.  January 20, 2023. Olivia and Janelli explain that caffeine intake during pregnancy may cause short height in babies, and Anthony discusses the definition, evaluation, and management of AKI with Dr. Kooner. Introduction: Caffeine consumption during pregnancy. Written by Olivia Weller, MS3, American University of the Caribbean School of Medicine; and Janelli Mendoza, MS3, Ross University School of Medicine.Current Guidelines about caffeine during pregnancy: The American College of Obstetricians and Gynecologists (ACOG) current recommendations are to limit caffeine consumption during pregnancy to 200 mg of caffeine per day. Anything exceeding a moderate level of caffeine intake has been linked to an increased risk for preterm birth and miscarriage. [8 oz of brewed coffee has approximately 137mg of caffeine. Other drinks and foods contain caffeine: Brewed tea 48mg; Decaf coffee (12 oz), 9-15 mg; caffeinated soft drink (12 oz) 37mg, Dark chocolate (1.45 oz) 30mg] New Evidence: More recent data disclosed that moderate levels of caffeine consumed during pregnancy led to newborns being small for gestation age (SGA). This information was taken further, and scientists began to monitor these children as they aged. Researchers studied newborns born to mothers who consumed zero caffeine during pregnancy versus women who consumed moderate levels of caffeine. They tracked height, weight, BMI, and obesity risk but only found statistical differences in height. So far, they have only investigated children up to the age of 8 and found that the variance in height increased as the children got older. Therefore, even consuming a moderate level of caffeine during pregnancy can have lasting effects on a child's height, which likely persists into adulthood. Some professionals are now saying there may be no amount of caffeine that is safe to consume during pregnancy. American Family Physician Journal, 2009: “Caffeine intake is directly correlated with small but notable fetal growth restriction. Although a safe threshold cannot be determined, maternal caffeine intake of less than 100 mg per day minimizes the risk of fetal growth restriction.”Why does smaller birth size matter? Caffeine crosses the placenta and acts as a vasoconstrictor which reduces the blood supply to the fetus and thus hinders proper growth. It is a sympathomimetic agent that can affect fetal stress hormones and increase the risk for rapid weight gain after birth. Although height is not a pressing issue, children are potentially more susceptible to increased risk for certain conditions later in life, such as obesity, heart disease, and diabetes. More research is needed on this front to make the conclusion that these differences do in fact persist into adulthood and lead to adverse health outcomes. Conclusions and limitations. Pregnant women and children remain as a group with the least amount of research due to the potential adverse life outcomes. For this reason, the studies that have been done on caffeine consumption during pregnancy are comprised of self-reported data. Due to the association between high caffeine consumption and smoking, it is difficult to distinguish the two. Therefore, there is no clear cause-and-effect relationship between caffeine and intrauterine growth restriction (IUGR), leading to shorter stature later in life. However, the potential adverse health outcomes outweigh the psychological benefits of caffeine during the gestational period. If mothers can give up alcohol, drugs, smoking, raw fish, and so much more during pregnancy, why not caffeine too? With the emergence of this new information, perhaps it is time for a review of those guidelines. Welcome: You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Acute Kidney Injury. January 20, 2023. Written by Anthony Floresca, MS4, American University of the Caribbean School of Medicine; edited by Hector Arreaza, MD; recording done with Gagan Kooner, MD.Definition of Acute Kidney Injury (AKI): Acute kidney injury is a clinically relevant disease process that often occurs during hospitalizations but can also occur as a result of pre-existing diseases such as diabetes mellitus, hypertension, and congestive heart failure, usually referred to as “AKI on CKD,” i.e., acute kidney injury can present as a worsening of renal function in a patient who already has decreased renal function at baseline. AKI is defined as a sudden onset decrease in renal function that can be diagnosed as early as 6 hours from disease onset. To diagnose AKI, specific parameters to consider are creatinine and urine output. Kidney Disease: Improving Global Outcomes or KDIGO established criteria in 2012 for diagnosing AKI:An increase in serum creatinine of ≥ 0.3 mg/dL within 48 hours, [for example, a serum creatinine increasing from 1.3 (baseline) to 1.6]An increase in serum creatinine ≥ 1.5 times baseline within the past week, [for example, an increase in serum creatinine from 1.3 (baseline) to 1.95]A decrease in urine output < 0.5 mL/kg/hr within 6 hours, [for example, a man who weighs 70 kg and is urinating less than 35mL of urine per hour]Classification:The severity of AKI is defined under the 2012 KDIGO guidelines: Stage ICreatinine 1.5-1.9 times greater than baseline or  ≥ 0.3 mg/dL increase in serum creatinine.Urine volume < 0.5 mL/kg/hr for ≥ 6-12 hoursStage IICreatinine 1.5-1.9 times greater than baseline or  ≥ 0.3 mg/dL increase in serum creatinine.Urine volume < 0.5 mL/kg/hr for ≥ 6-12 hoursStage IIICreatinine 3 times higher than baseline OR ≥ 4.0 mg/dL increase in serum creatinine(Kooner: For example, if a creatinine at baseline is 0.8 and it increases to 2.4, it is stage III)Anthony: Yes, it is stage III if the patient initiates renal replacement therapy (hemodialysis), OR a decrease in GFR to < 35 mL/min per 1.73 m^2 in patients

Families and individuals visiting Woodstock Funeral Home who are grieving the loss of a loved one will find that there is a kind and calming presence there with them to show support. Ginger, an 8-year-old red standard poodle, was adopted in February 2020 by Paige Fowler-Ogle from Georgia Poodle Rescue, a nonprofit in Alpharetta run by Deborah Blatchley. Fowler-Ogle is the location manager at Woodstock Funeral Home, where Ginger is a regular. The first thing Ginger does is greet the individual or family at the door. Ginger then walks with them to the office, where she usually sits with Fowler-Ogle and the individual or family who are setting up the funeral arrangements. During this time, she will show her support by letting the person or family pet her, hold her, sit with her — any way she can help, Fowler-Ogle said. Sometimes, Ginger will also walk and sit with families at the viewing, giving emotional support to children and adults. Ginger is not the first poodle in the Fowler-Ogle household, though she is the first to show this level of understanding and support, her owner said. Since Fowler-Ogle became the location manager a little over a year ago, Ginger has been by her side every day at the office. Ginger often wears a bow that matches her owner's outfit for the day, which is always a topic of conversation with  visitors and adds to the welcoming feel of the funeral home, Fowler-Ogle said. Fowler-Ogle also paints her dog's nails. Fowler-Ogle said she knew Ginger would be perfect in this type of environment after seeing her dog's kindness to her young son. The duo recently visited Manor Lake assisted living in BridgeMill in Canton, where Fowler-Ogle said Ginger was “a big hit.” A Marietta man has been indicted after authorities say he drowned a cat in Cherokee County this summer. Austin Hedgeman is charged with one felony count of aggravated cruelty to animals, according to an indictment filed December 12. The indictment charges Hedgeman with causing a cat's death by drowning around July 6. In an arrest warrant filed July 6 by the Cherokee Marshal's Office, officers say Hedgeman caused “physical pain, suffering or death to an animal” July 3 and could be heard on a recording saying he held the cat down “until he stopped moving.” Authorities say the drowning was at a southwest Cherokee County home, near Woodstock. Court records show the marshal's office originally charged Hedgeman with a misdemeanor count of animal cruelty but the charge was upgraded to a felony. Hedgeman was arrested July 6 and released July 8 on a $1,000 bond, according to the Cherokee Sheriff's Office. He has a hearing scheduled for January 11, according to court documents. An indictment is a formal charge of felony offenses, and defendants are assumed innocent until proven guilty. Northside Hospital is the first hospital system in the United States to receive Maternal Levels of Care Verification from The Joint Commission, the commission and the Georgia Department of Public Health announced. Northside Hospital also is the first in the state to receive a Level IV Maternal Center Designation from DPH. The United States has a higher maternal mortality rate than many other developed countries. Georgia is taking action to help improve care for women and newborns. It is one of a handful of states to review risk-appropriate care and the first to collaborate on a program with an accreditation organization. In 2022, DPH announced a partnership with The Joint Commission, recognizing its MLC Verification program. The program, offered in collaboration with the American College of Obstetricians and Gynecologists (ACOG), is a verification process that involves an on-site comprehensive review of a hospital's maternal capabilities and policies, as well as a level of maternal care determination. Through the partnership, hospitals may seek the optional Maternal Center Designation with The Joint Commission's MLC Verification program. For details on the designation process, visit dph dot Georgia dot gov. Most bills the General Assembly passes each year take effect on July 1. But a smattering of new laws enacted during the 2022 legislative session will kick in this Sunday, Jan. 1, including a bill making it easier for food trucks to do business and several new or expanded tax credits. The food truck legislation does away with a current requirement in Georgia law that food truck operators obtain a permit and inspection in every county where they do business. While the tax credit bills technically became effective last summer, they don't really become reality until New Year's Day, the beginning of the tax year. Three of the measures create new income tax credits. House Bill 424 will provide a tax credit to Georgia taxpayers who contribute to nonprofit organizations that help foster children about to age out of the foster care system. More than 700 young men and women age out of the system each year. Senate Bill 361, which was championed by Lieutenant Governor Geoff Duncan, will provide a dollar-for-dollar income tax credit on contributions to public safety initiatives in the taxpayer's community. Law enforcement agencies will be able to use the money for police officer salary supplements, to purchase or maintain department equipment and/or to establish or maintain a co-responder program.  Senate Bill 87, the Jack Hill Veterans' Act, honors the late state Sen. Jack Hill of Reidsville, who died in 2020. It provides income tax credits in exchange for contributions to scholarships for service-disabled veterans through the Technical College System of Georgia Foundation. Another bill that will take effect on Sunday, Senate Bill 332, also known as the Inform Consumers Act, is aimed at preventing criminals from selling goods stolen from retail stores on any online marketing platform. It establishes financial and contact information requirements for high-volume sellers to online marketplaces and requires such platforms to establish an option for consumers to report suspicious activity A Canton pediatrician's office is closed after a burst pipe damaged the building December 24. A major sprinkler pipe burst in the ceiling of the office of DV Pediatrics on the morning of December 24, resulting in major damage to the entire building. Although firefighters quickly responded and turned the water off around noon to limit the damage, the damage has prompted a long-term closure for repairs, DV Pediatrics announced. Repairs are estimated to take four to six months. Until they have a working office space, DV Pediatrics will provide home visits, or house calls, phone consultations and telemedicine appointments for sick patients. The pediatric office said the staff are doing everything possible to provide the same level of healthcare services for the families they care for. #CherokeeCounty #Georgia #LocalNews           -          -          -          -          -          -          The Cherokee Tribune Ledger Podcast is local news for Woodstock, Canton, and all of Cherokee County. Register Here for your essential digital news.             This podcast was produced and published for the Cherokee Tribune-Ledger and TribuneLedgerNews.com by BG Ad Group     For more information be sure to visit https://www.bgpodcastnetwork.com/    https://cuofga.org/   https://www.drakerealty.com/   https://www.esogrepair.com/                         See omnystudio.com/listener for privacy information.

Catherine Dezynski is a licensed certified nurse midwife and women's health nurse practitioner. Her clinical areas of expertise include family planning, colposcopy, office-based gynecology, and labor management. Catherine is a member of the American College of Obstetricians and Gynecologists (ACOG), Nurse Practitioners in Women's Health (NPWH), and the American Society for Colposcopy and Cervical Pathology (ASCCP). Catherine is also a medical science liaison for BD, a global medical technology company and the creator of advanced cervical cancer screening tests.   In this episode, we talk about why cervical cancer is underdiagnosed, shocking statistics on the rates of diagnosis and death, how the testing innovations at BD help women prevent cervical cancer before it starts, why HPV testing is recommended alongside Pap smears, what you need to know about the HPV vaccine, and so much more! To learn more, visit https://nicolejardim.com/podcasts/advanced-cervical-cancer-testing-that-could-save-your-life-catherine-dezynski/. This episode is brought to you by Knix. Visit Knix.com to shop for period underwear and more. Podcast Production Support: Amazing Gains | https://listenerstoclients.com

On this episode, BackTable VI host Dr. Christopher Beck shares the mic with two Maternal Fetal Medicine (MFM) specialists, Drs. Roxane Rampersad at Washington University and Tony Shanks at Indiana University, to discuss cross-specialty management of postpartum hemorrhage (PPH) between OBGYN and interventional radiology (IR). --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/ASxPdP --- SHOW NOTES To set the stage, Drs. Rampersad and Shanks explain the definition of PPH based on the American College of Obstetricians and Gynecologists (ACOG) guidelines. They further describe the differences between early / acute versus late blood loss, in addition to the most common etiologies using the “Four T's” pneumonic: tone, trauma, tissue, thrombin. Drs. Rampersad and Shanks then describe their approach to the workup and management of PPH. The group discusses topics such as uterine massage, oxytocin, hemabate / methergine, tamponade (e.g. Bakri balloon, the JADA System), embolization, and hysterectomy. The physicians then describe the role of cross-specialty collaboration between OBGYN and IR, specifically in the management of PPH. When highlighting the role of IR, Dr. Beck describes how he counsels patients for uterine artery embolization (UAE), and he provides an anecdote regarding a repeat UAE. He also shares his perspective with utilization of gel foam versus coils. The group then transitions to describe diagnosis and management of placenta accreta spectrum (PAS), its association with PPH, and the role of radiology in this disease process. Lastly, Drs. Rampersad and Shanks allude to what the future may hold for PPH, including more personalized medicine and potential technologies to prevent PAS. The group ends the episode by providing IR colleagues with insight to what may strengthen the collaboration between OBGYN and IR in order to provide optimal care for patients with PPH. --- RESOURCES Silver RM, et al. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol. 2006 Jun;107(6):1226-32. doi: 10.1097/01.AOG.0000219750.79480.84. PMID: 16738145. Bienstock RM, Eke AC and Hueppchen NA; Postpartum Hemorrhage. New England Journal of Medicine 2021 Vol. 384 Issue 17 Pages 1635-1645. Accession Number: 33913640 DOI: 10.1056/NEJMra1513247. https://www.nejm.org/doi/full/10.1056/NEJMra1513247 ACOG Postpartum Hemorrhage: https://www.acog.org/en/clinical/clinical-guidance/practice-bulletin/articles/2017/10/postpartum-hemorrhage

With Blyss busy on Halloween doing birthing stuff, Dr. Stu cleans out his mental attic and finds some scary stuff. Today, he's unpacking recent updates from The American College of Obstetricians and Gynecologists (ACOG) on vaccine recommendations and how hospitals should navigate the current “oxytocin” shortage, along with a breakdown of why some vaccine studies and articles need to be questioned.In this episode of Birthing Instincts:ACOG updates: jab recommendations & “oxytocin” shortageQuestionable studies: C*VID jab during pregnancyCDC recommendations, FDA approval, & vaccine safetyBreech babies & bodily autonomySelf-advocacy for hospital birthsThis show is supported by:LMNT | Go to drinklmnt.com/birthinginstincts to get a free sample pack!Resources:Article: FDA Approves…FAQ on Oxytocin ShortageResearch on Peripartum Outcomes…Book: Male Practice: How Doctors Manipulate WomenConnect with Dr. Stu:Instagram: @birthinginstinctsWebsite: birthinginstincts.comConnect with Blyss:Instagram: @birthingblyssWebsite: birthingblyss.comThis show is produced by Soulfire Productions

Michele Bratcher Goodwin, JD (Center for Biotechnology and Global Health Policy, University of California, Irvine), Molly Meegan, JD (American College of Obstetricians and Gynecologists), and Lisa Harris, MD, PhD (University of Michigan) discuss how new abortion bans in the US are creating serious legal and ethical dilemmas for clinicians. Hosted by JAMA Legal and Global Health Correspondent Lawrence O. Gostin, JD (Georgetown University). Related Content: Legal Risks and Ethical Dilemmas for Clinicians in the Aftermath of Dobbs The Future of Ob-Gyn Training in the US Post-Dobbs Medical Indications for Abortion   Conflict of Interest Disclosures: Lawrence O. Gostin, JD, is the Legal and Global Health Correspondent for JAMA and Faculty Director of the O'Neill Institute for National and Global Health Law at Georgetown University.  No other disclosures were reported. Michele Bratcher Goodwin, JD, LLM, SJD is Director of the Center for Biotechnology and Global Health Policy at University of California, Irvine.  No other disclosures were reported.  Lisa Harris, MD, PhD, is the F. Wallace and Janet Jeffries Collegiate Professor of Reproductive Health, and Professor and Associate Chair in the Department of Obstetrics and Gynecology at University of Michigan. She is also a Professor in the Department of Women's Studies.  No other disclosures reported.  Molly Meegan is the Chief Legal Officer and General Counsel for the American College of Obstetricians and Gynecologists (ACOG).  No other disclosures reported.

We love bringing you guests who are not only doing impactful work in Women's Health but also have interesting stories to share. This episode with LaToshia Rouse delivers in both areas. LaToshia is a certified DONA International doula and owner of Birth Sisters Doula Services. She has a passion for helping parents develop their voice in the care of their children and helping medical staff learn from and make improvements in care based on the parent perspective. She also strives to find ways for clinicians and patients to have a true partnership and improve outcomes. LaToshia has served as a subject matter expert and expert team member for the Perinatal Quality Collaboratives across the country, American Board of Pediatrics (ABP), American College of Obstetricians and Gynecologists (ACOG), Center for Medicare and Medicaid Services (CMS), National Quality Forum (NQF) and several other organizations. Her work as an advisor, speaker, facilitator and doula all began after having triplets at 26 weeks gestation via an emergency vaginal delivery. Our discussion today included: Latoshia's birth story of her triplets and emergency vaginal delivery. Motherhood advice from a mom of four. Her findings while working with NICU's, including her discoveries, improvements needed and what they are doing right. LaToshia's suggestions on how to best advocate for your children. The definition of who a doula is, what they do, and how LaToshia explains her role as a doula. Changing how birth doula's are accepted in the birthing community and how she knew being a doula was her calling. Working with highly reputable organizations and whether she gets intimidated. LaToshia's story of how she was a victim of not receiving equal access to care. From her perspective, LaToshia discusses whether she truly believes that we can create a healthcare system where clinicians and patients have a true partnership and improve outcomes. Ideas on how to make this partnership happen so it is inclusive of all socioeconomic platforms and accessible to all. Sponsorship: Davis Family Chiropractic: www.Davischironc.com and @davischironc Dr. Charryse Johnson: https://www.charrysejohnson.com Expired Mindsets by Dr. Charryse Johnson --- Support this podcast: https://anchor.fm/herhealthcollective/support

Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Are c-sections underrated?, published by braces on October 1, 2022 on LessWrong. Summary I think so. Correlations tend to show worse outcomes for c-sections, but the guidelines take this evidence too literally. Careful causal evidence finds that it's more of a mixed bag. Moderate negative effects on subsequent births seem more robust. An elective c-section might be the defensible choice for someone's final pregnancy. Disclaimer: Not a doctor. The official guidelines C-sections cost about twice as much as vaginal delivery and are associated with worse health outcomes for infants and moms. These facts are concerning enough to the US Medicaid system that one of their “Improvement Initiatives” is reducing low-risk cesarean delivery. They write: “Cesarean delivery poses a greater risk of maternal morbidity and mortality for low-risk pregnancies when compared to vaginal births, a risk that ideally should be avoided.” They lead seminars with slides like this, highlighting that everything bad is correlated with c-sections: Hospitals have been falling in line. UCSF boasts: “Our view of labor and childbirth as a natural process has helped keep our overall Cesarean rate at 20 percent, among the lowest rates in California.Our threshold for making the decision to recommend a C-section is a lot higher than in other places.” The American College of Obstetricians and Gynecologists (ACOG) has similar advice, and to their credit they spell out the evidence and their reasoning. The main paper they cite is this Canadian study of 2.3m vaginal and 46k c-section deliveries. “A large population-based study from Canada found that the risk of severe maternal morbidities.was increased threefold for cesarean delivery as compared with vaginal delivery.” But what really should we make of the association between c-sections and bad outcomes? The observed correlation is ripe for reverse causality, for the same reason that going to the hospital is correlated with dying: c-sections are often performed because of some dangerous condition (e.g., preeclampsia). In the Canadian study, the treatment group was mothers who had scheduled a c-section due to breech position, and breech is correlated with other negative outcomes. In other studies, the c-sections could happen for reasons that are never recorded in hospital data, so even lots of control variables should make you worried about selection effects. The causal effect of a c-section A new paper by Card, Fenizia, and Silver, using data from California births, takes the question of causality seriously. It appears to be the only careful attempt at separating correlation and causation. C-sections are not randomly assigned. How can we use observational data to arrive at a causal estimate? Their approach combines the facts that hospitals exhibit stable differences in their (risk-adjusted) c-section rates and that moms often give birth at the hospital closest to them. Together, these mean that some moms will have c-sections by virtue of living close to a hospital that performs more of them. In essence, a causal estimate can be derived by comparing the outcomes of mothers who live near vs. far from high c-section hospitals. You might be concerned that certain kinds of moms live next to certain kinds of hospitals. But in detailed tests, the authors find no signs of problematic selection along this distance-to-hospital dimension (although with these kinds of designs it's reasonable to worry that something not measured could still bias the estimates). And they show that the distance measure does have a large effect on c-sections for the group they study: low-risk first births. (Why restrict to this sample? High-risk births are often defaulted to c-sections, and a c-section in a first birth means you should probably only get c-sections in subsequent births—so this ...

Episode 111: Pregnancy FAQ  Dr. Urso answers commonly asked questions during pregnancy.  You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Written by Carmen Urso, MD. Edited by Hector Arreaza, MD.Pregnancy is one of the most exciting moments of a woman's life, but at the same time, it could be a little scary because whatever the mother does may affect the baby. This is why it is so important to make sure about general recommendations during pregnancy. The information I present here is evidence-based. 1. Should I take prenatal vitamins?The goal of prenatal supplements is to provide the vitamins and minerals needed to promote normal fetal development. Some studies have shown that in high-income countries where the food is vitamin-fortified, and typically people are well-nourished, vitamin supplementation has not proved to improve maternal and neonatal outcomes. However, a Cochrane review of randomized trials in low- and middle-income countries with vitamin and mineral diet deficiency found that supplementation reduces the risk of low birth weight and small for gestational age. Because you don't always know the nutritional status of a patient, it is advised to use a standard prenatal vitamin. What are the most important vitamins in the prenatal period? The 2 most important elements are folic acid and iron, which can be found in regular prenatal vitamins. The American College of Obstetrics and Gynecology (ACOG) recommends multivitamins with: -Folic acid: 400mcg to 800mcg daily to reduce the risk of neural tube defects. It is recommended to start before pregnancy until the end of the first trimester (12 weeks). Patients with a history of fetal neural tubal defect should take 4000 mcg (4mg) daily. The USPSTF recommends (Grade A, 2017) to supplement with folic acid for all women of childbearing before pregnancy. Supplementation should start at least one month before pregnancy, according to CDC. -Iron: 30 mg/day to prevent maternal anemia. The formulation should contain 15-30 mg/dl. Most prenatal contain about 30 mg, which is considered a “low” dose, and 65 mg of elemental iron is equivalent to 325 mg of ferrous sulfate, which is a common supplement given to patients in our clinics. So, patients could take one tablet of 325 mg of ferrous sulfate daily and have enough for their pregnancy, or take it every other day if they are intolerant to iron]-Vitamin D: Vitamin D deficiency is associated with preterm birth and preeclampsia. 200-600 international units are recommended. ACOG does not recommend screening for vitamin D deficiency before or during pregnancy. The USPSTF concluded there is insufficient evidence to recommend for or against Vitamin D deficiency screening in asymptomatic adults. This is a Grade I recommendation.-Calcium: Supplements should contain 1000 mg/dL. Most multivitamins have 200-300mg; the rest of the daily calcium should come from dietary sources. Foods rich in calcium include dairy products such as milk, yogurt, cheese, soybeans, seeds, beans, lentils, and dark-green leafy vegetables like kale, spinach, and collard greens. Another source of vitamin D is sun exposure. We do not recommend sun exposure as a source of vitamin D, but there are benefits to sun exposure for other reasons, for example, mood.2. Should I be eating for 2 while I am pregnant?It is a misconception. Pregnant women do not have to eat for 2. Caloric intake will depend on the number of fetuses (single or multiple), the trimester, and the pre-pregnancy weight. During the first trimester, no extra daily calories are needed. In the second trimester, a pregnant person will need 340 extra calories/day, and in the third, 450 extra calories/day for a total of 2200 to 2900 kcal/day. The weight gain will be based on pre-pregnancy BMI (body mass index). For example, a patient who is overweight (BMI 20-29) should gain 15-25 lbs. in the whole pregnancy, but a patient with obesity (BMI above 30) should gain 11-20 lbs. only. These are the recommendations by the National Academy of Medicine.Interestingly, if you are underweight before pregnancy, you can gain 30-40 pounds.National Academy of Medicine Recommendations for Weight Gain in Pregnancy:Pre-pregnancy BMI Category (kg/m2)                  Recommended Weight Gain (lbs.) Underweight (less than 18.5)                                                       28–40 Normal weight (18.5-24.9)                                                              25-30Overweight (25.0-29.9)                                                                    15-25Obese (30 or greater)                                                                         11-203. Can I drink alcohol?There is not a safe level of alcohol during pregnancy. Alcohol can cause life-long birth defects. Even little amounts can cause problems to the baby, such as coordination, behavior, attention, and learning disability. Heavy drinking can cause fetal alcohol syndrome, characterized by developmental delay, short stature, abnormal facial features, small head size, vision impairments, and hearing difficulty. It is recommended to avoid alcohol at all costs during pregnancy. 4. Can I drink coffee? Caffeine increases catecholamine levels in the maternal blood, and it crosses the placenta. Caffeine was thought to increase the risk of spontaneous miscarriage, but recent studies showed that moderate caffeine intake was not related to miscarriage or preterm birth. ACOG states that low to moderate intake, less than 200mg (6 oz per day), does not appear to be associated with adverse effects. The amount of caffeine varies in different foods. For example, 8 oz of brewed coffee has approximately 137mg of caffeine. Also, we must remember that caffeine is in other drinks like soda and tea.Content of caffeine in different drinks: -Instant Coffee 76mg -Tea, Brewed 48mg; Instant 26-36mg-Caffeinated soft drink (12 oz) 37mg-Hot cocoa (12oz) 8-12mg-Chocolate milk (8oz) 5-8mg-Dark chocolate (1.45 oz) 30mg -Milk chocolate (1.55oz) 11mg -Semi-sweet chocolate (1/4 cup) 26-28mg -Chocolate syrup (tbsp) 3 mg-Coffee ice cream or frozen yogurt 2mg 5. Can I eat fish?Fish is an excellent source of omega 3, which is associated with improved neurodevelopment in children, decreased risk of preterm birth, and reduced allergy and atopic disease. Fish also contains mercury which can cause fetal neurologic damage. All fish contain mercury, but some have more than others. This is why it is so important to know what fish has more mercury content.ACOG recommends 2 to 3 servings per week. Pregnant women can have fish high in omega 3 and low in mercury. Some examples of fish that are high in omega 3 and low in mercury are anchovies, Atlantic herring, Atlantic mackerel, mussels, oysters, farmed and wild salmon, sardines, snapper, and trout. Seafood that is low in mercury and low in omega 3 includes shrimp, pollock, tilapia, cod, and catfish. Fish high in mercury include king mackerel, marlin, orange roughy, shark, swordfish, tilefish, and tuna bigeye. 6. Can I eat sushi?Raw fish can carry bacteria or parasites. Therefore, it is recommended not to have raw fish, but you can have cooked options like tempura sushi. For example, all ingredients are cooked in the California roll except the cucumber and avocado.7. Can I exercise?Yes. If you do not have any complications (healthy pregnancy), it is recommended that you have moderate-intensity aerobic exercise for 30 minutes, 5-7 days a week. Moderate exercise means you can carry on a normal conversation during exercise. For example, brisk walking, gardening, and dancing. The benefits of exercising during pregnancy go beyond maintaining a good weight. Exercise also decreases muscle discomfort (back pain, pelvic pain), makes the pelvic floor strong, and decreases the risk of urinary incontinence. Avoid exercises with a higher risk of injuries, such as skiing, horseback riding, scuba diving, hot yoga o hot Pilates (for the risk of overheating), and skydiving. 8. Hot tubs and swimmingHot tubs are not recommended during pregnancy, especially in the first trimester, because higher body temperature has been associated with neural tube defects and miscarriage. Swimming does not appear to have any teratogenic effect because pools are typically cooler than body temperature. 9. Can I dye my hair? There is limited data on the safety of cosmetics. Because it is a topical product, systemic absorption is supposed to be low unless the skin is compromised. However, it is recommended to avoid ammonia-based products. Plant-based hair dyes are probably safe. Also, using these products in a well-ventilated area is recommended to avoid allergies. 10.  Is it safe to have sex during pregnancy?Sex is safe if you do not have any complications such as placenta previa, vaginal bleeding, cervical incompetence, preterm labor, risk of preterm labor, or leaking of amniotic fluid. Sex does not increase the risk of complications during pregnancy, but like in the general population, there is a risk of sexually transmitted diseases during pregnancy. During pregnancy, the vaginal circulation is increased, and the cervix is more sensitive, so may have scant vaginal bleeding during intercourse but if the bleeding is heavy, patients should be evaluated.Conclusion: Now we conclude our episode number 111 “Pregnancy FAQ.” Dr. Urso explained that pregnancy is one of the most exciting moments in a woman's life. Special care is needed to make sure both mother and baby are healthy and safe during this special time. Appropriate vitamin supplementation, a nutritious diet, adequate exercise, and avoiding alcohol are key elements of prenatal care. We were reminded that sex is generally safe in uncomplicated pregnancies. This week we thank Hector Arreaza, Carmen Urso, Gagan Kooner, and Arianna Lundquist. Audio by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Fox, N.S. “Do and Don'ts in pregnancy, truths and myths”. Obstetrics & Gynecology, vol 131, issue 4, 2018, pp.713–21. DOI:10.1097/AOG.0000000000002517. https://journals.lww.com/greenjournal/Fulltext/2018/04000/Dos_and_Don_ts_in_Pregnancy__Truths_and_Myths.16.aspx. Accessed 7 July. 2022.Advice about eating fish. For those who might become or are pregnant or breastfeeding and children ages 1- 11 years. https://www.fda.gov/food/consumers/advice-about-eating-fish. Accessed 1 August 2022.Garner C.D. Nutrition in pregnancy: Dietary requirements and supplements. Up to Date, last updated April 14, 2022. https://www.uptodate.com/contents/nutrition-in-pregnancy-dietary-requirements-and-supplements. Accessed 4 August 2022.Lockwood, C.J. Prenatal care: Patient education, health promotion, and safety of commonly used drugs. Up to Date, last updated August 16, 2022.https://www.uptodate.com/contents/prenatal-care-patient-education-health-promotion-and-safety-of-commonly-used-drugs. Accessed 1 August 2022.Goetzl, L.M. Folic acid supplementation in pregnancy. Up to Date, Last Updated Jun 16, 2022. https://www.uptodate.com/contents/folic-acid-supplementation-in-pregnancy. Accessed 2 August 2022.Haider BA, Bhutta ZA. Multiple-micronutrient supplementation for women during pregnancy. Cochrane Database Syst Rev. 2017 Apr 13;4(4):CD004905. doi: 10.1002/14651858.CD004905.pub5. Update in: Cochrane Database Syst Rev. 2019 Mar 14;3:CD004905. PMID: 28407219; PMCID: PMC6478115. https://pubmed.ncbi.nlm.nih.gov/28407219/. Accessed 2 August 2022.“Moderate Caffeine Consumption During Pregnancy”, The American College of Obstetrics and Gynecologists (ACOG). Committee Opinion, Number 462, August 2010. (Reaffirmed 2020). https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2010/08/moderate-caffeine-consumption-during-pregnancy. Accessed 1 August 2022.Royalty-free music used for this episode: Good Vibes Alt Mix by Videvo, downloaded on May 06, 2022 from https://www.videvo.net/royalty-free-music-track/good-vibes-alt-mix/1017292/

Molly Broache serves as Associate Director, US Region, Medical Affairs for BD Integrated Diagnostic Solutions (IDS) and is also licensed as a women's health nurse practitioner in both Maryland and Virginia. Molly manages a team of medical science liaisons responsible for specimen management, microbiology, and women's health & cancer. Molly's clinical areas of expertise include women's healthcare, gynecology, infectious disease diagnostic tests, and women's health screening guidelines. Molly is a member of the American College of Obstetricians and Gynecologists (ACOG), Nurse Practitioners in Women's Health (NPWH), American Society for Colposcopy and Cervical Pathology (ASCCP), and the Medical Science Liaison Society (MSLS). She serves on the membership committee for ASCCP and the Cervical Cancer Screening Initiative – Provider Workgroup for the American Cancer Society. Molly holds two Bachelor's degrees from Johns Hopkins University, in both molecular biology and nursing. She also holds a master's degree in nursing from Georgetown University, where she received her training as a nurse practitioner. Molly is currently completing her Doctor of Nursing Practice degree at the University of Maryland, Baltimore.BD is one of the largest global medical technology companies in the world and is advancing the world of health by improving medical discovery, diagnostics and the delivery of care. The company supports the heroes on the frontlines of health care by developing innovative technology, services and solutions that help advance both clinical therapy for patients and clinical process for health care providers. BD and its 75,000 employees have a passion and commitment to help enhance the safety and efficiency of clinicians' care delivery process, enable laboratory scientists to accurately detect disease and advance researchers' capabilities to develop the next generation of diagnostics and therapeutics. BD has a presence in virtually every country and partners with organizations around the world to address some of the most challenging global health issues. By working in close collaboration with customers, BD can help enhance outcomes, lower costs, increase efficiencies, improve safety and expand access to health care.LinkedIn: www.linkedin.com/company/bd1/ | Twitter @BDandCo | Instagram: @becton_dickinson

Doctors are worried gray areas in new abortion bans force a choice between breaking their oath and breaking the law. Today on “Post Reports,” we talk to an OB/GYN about what those decisions are like. Plus, how to cover your digital trail if you seek an abortion.Read more:Health and science reporter Ariana Eunjung Cha recently wrote about the fear and confusion many doctors are facing since Roe was overturned.. The American College of Obstetricians and Gynecologists (ACOG) joined numerous other professional organizations and medical journals over the past few days in warning that the ruling will affect health care beyond abortion, creating new risks for patients and potentially increasing maternal mortality. We interviewed Nisha Verma, an OB/GYN in Atlanta who is also a fellow at ACOG. She talked about the gray areas these laws and restrictions don't cover. “These laws don't make any sense,” Verma told Elahe Izadi. While lawmakers point out that there are exceptions for the life of the pregnant person, Verma says it's very unclear what that means. “There's not a moment in time. This line where someone goes from being completely fine to dying. It's a continuum. People get sicker and sicker. And so we have to be able to make decisions in that continuum with all of the training that we have without having to worry about whether the person was sick enough or whether we're going to get in trouble under the law,” Verma said. Also on the show, tech reporter Heather Kelly explains how to protect your privacy if you're seeking abortion care — and why period-tracking apps are best avoided.

In today's episode of the VBAC podcast, we're going to answer questions like "What is ACOG?" "What are ACOG Guidelines" and what does ACOG say about vaginal birth after cesarean? When you meet with an OBGYN about you VBAC birth plans, he or she is likely to refer to the American College of Obstetricians and Gynecologists (ACOG) guidelines for VBAC management. However, women frequently find themselves in a situation where their OBGYN is making VBAC recommendations that do not follow ACOG guidelines. While guidelines are not rules, and it is up to each provider and patient to consider benefits and risks TOGETHER, too often, ACOG's guidelines are being misapplied or blatantly ignored and warped. Mothers planning a Vaginal Birth After Cesarean should take the time to get to know the ACOG VBAC Guidelines published in the ACOG VBAC Practice Bulletin. In this episode of the VBAC podcast, we will explore what exactly ACOG says about vaginal birth after cesarean, the risks, the benefits, and the birth plan options available to VBAC candidates.  This episode of theVBACpodcast will discuss benefits of VBAC, risks of VBAC, the option of repeat cesarean, and who is a good candidate for VBAC: including more information on special scars and VBAC, Due Dates and VBAC, recommendations for Vaginal Birth After Multiple Cesareans (VBAMC), planning a VBAC with a 'Large for Gestational Age" (LGA) baby (also called macrosomia), and many more VBAC candidacy variables.    Be on theVBACpodcast or submit an ASK JAIMIE question: www.littlebearlactation.com/podcast FREE Combatting Fear During VBAC Class: https://view.flodesk.com/pages/627c013046c9ddac8218a3a0 VBAC With Confidence Complete Birth Prep Program: https://www.littlebearlactation.com/vbacwithconfidence247 VBAC Consulting With Jaimie: www.littlebearlactation.com/consulting Social Media: instagram.com/thevbacpodcast

VBAC, or vaginal birth after cesarean, is becoming a more desired option verses simply having a repeat c-section. Unfortunately, many care providers still do NOT support VBAC and will tell women their only option is a repeat cesarean birth. Many women simply do not know they have alternative options, either. In this episode, the founder of VBACFacts.com, Jen Kamel, talks with me about VBAC options and how to navigate getting the VBAC you desire!VBAC and VBA2C are both supported by evidence!VBAC after 3 or more cesareans is not studied enough to state if it is supported by evidence or not; Mom should get to make the final choiceThe American College of Obstetrics and Gynecologists (ACOG) states that informed consent & refusal is vital to healthcare, even during birthHow do you deal with an unsupportive care provider?! We cover that, too!Buy Me a Coffee- DONATION PAGEResources Mentioned:Jen Kamel- VBAC FactsVaginal Birth After 2 Cesareans- Fact SheetVBAC Facts Parent Courses & Free HandoutVBAC Facts Professional MembershipACOG's Committee Opinion on Informed RefusalDoula MatchNOW IT'S YOUR TURN!The NaturalBirth Site Read *natural birth stories*- and submit your ownSign up for the NaturalBirth Education course to best prepare your body & mind for natural birthShare with anyone interested in natural birthShare my podcast with anyone you know who is interested in natural birth!"Like" my Facebook and Instagram pagesSubscribe to my YouTube Channel