Podcasts about maternal fetal medicine

In this eye-opening episode, Sarah and Dr. Kevin Shrestha have an honest conversation about preeclampsia—one of the silent but serious dangers of pregnancy. They share the signs every woman should watch for, why your instincts matter, and how speaking up when something doesn't feel right can truly save your life. Whether you're expecting, recovering, or supporting someone who is—this episode is a must-listen.Dr. Kevin Shrestha MD, MPH, is board certified OBGYN and currently a Maternal Fetal Medicine fellow.Home - Preeclampsia Foundation

Julie Arafeh and Dr. Stephanie Martin discuss 3 commonly encountered issues with communication during obstetric emergencies.The experts at Clinical Concepts in Obstetrics pool their decades of experience caring for critically ill pregnant women to discuss the challenges encountered in caring for these vulnerable women. Dr Stephanie Martin is the Medical Director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist with expertise in critical care obstetrics. Suzanne McMurtry Baird, DNP, RN is the Nursing Director for Clinical Concepts in Obstetrics with many years of experience caring for critically ill pregnant women. Julie Arafeh, RN, MS is the Simulation Director for Clinical Concepts in Obstetrics and a leading expert in simulation.Critical Care Obstetrics Academy: https://www.clinicalconceptsinob.com/Follow us: Instagram: https://www.instagram.com/criticalcareob/Dr Martin's LinkedIn: http://linkedin.com/in/stephanie-martin-65b07112aCCOB LinkedIn: https://www.linkedin.com/company/clinical-concepts-in-obstetrics/Twitter/X: https://twitter.com/OBCriticalCareCCOB Facebook: https://www.facebook.com/clinicalconceptsinobstetricsDr Ma...

Dr. James A. Thorp is a board-certified obstetrician-gynecologist and maternal-fetal medicine specialist with over 44 years of clinical experience. A U.S. veteran and widely published physician, he has testified internationally, served as a journal peer reviewer, Board Member of the Society for Maternal-Fetal Medicine, and Examiner for the American Board of Obstetrics and Gynecology. He is the author of “Sacrifice: How the Deadliest Vaccine in History Targeted the Most Vulnerable.” Dr. Thorp also serves as the Chief of Maternal Medicine and Prenatal Medicine for the Wellness Company.  Follow Dr. James A. Thorp on X: @jathorpmfm VISIT: https://drjamesthorp.com/ & https://abrg.org ORDER: https://sacrifice2024.com/

In this Maternal-Fetal Medicine (MFM) Rafael Medina Subspecialty episode, Dr. Mary Peeler presents a case of headache in a pregnant patient to Dr. Greg Kirschen. Session facilitator: Maddy Conte Case Discussant: Dr. Greg Kirschen is a Maternal-Fetal Medicine fellow at the Hospital of the University of Pennsylvania with a particular interest in pharmacology and metabolism in… Read More »Episode 397: Rafael Medina Subspecialty Episode – Hypertension in Pregnancy

I'm honored to have Dr. Jie Deng  as a guest on The Egg Whisperer Show podcast today. She is not only an Obgyn and Maternal Fetal Medicine specialist (did extra training studying high risk pregnancies), she is also a fertility doctor at Stanford University finishing up her Reproductive Endocrinology and Infertility Fellowship. We are talking about the risks of birth defects, autism and cancer with IVF treatment. She's also answering questions about whether ICSI increases the risk of birth defects as well as: should all IVF pregnancies have a fetal echocardiogram? Dr. Deng is so well versed in the topic IVF risks and high risk pregnancies, and I am excited to talk to her! Read the full show notes on Dr. Aimee's website Do you have questions about IVF?Click here to join Dr. Aimee for The IVF Class. The next live class call is on Monday, April 22, 2024 at 4pm PST, where Dr. Aimee will explain IVF and there will be time to ask her your questions live on Zoom.   Dr. Aimee Eyvazzadeh is one of America's most well known fertility doctors. Her success rate at baby-making is what gives future parents hope when all hope is lost. She pioneered the TUSHY Method and BALLS Method to decrease your time to pregnancy. Learn more about the TUSHY Method and find a wealth of fertility resources at www.draimee.org. Other ways to connect with Dr. Aimee and The Egg Whisperer Show: Subscribe to my YouTube channel for more fertility tips!Subscribe to the newsletter to get updates

Lily Nichols is a Registered Dietitian and the author three books designed to support healthy conception, birth and postpartum, including how to prevent and manage gestational diabetes.Her books are Real Food for Fertility (co-authored by Lisa Hendrickson-Jack), Real Food For Pregnancy and Real Food for Gestational Diabetes.Lily shares important information all women should know about optimizing their diet for fertility, pregnancy, and postpartum from a scientific perspective. Even for women who aren't currently in the pregnancy state of mind, knowing this information early on helps everyone to make better choices down the road.Connect with Lily Nichols lilynicholsrdn.com | InstagramLearn more The Institute for Prenatal Nutrition | Postpartum Recovery Meals | Fourth Trimester Soups and Stews Collection | Nutrition and Nourishment - The EssentialsResources HelloGaia Parenting Copilot | FREE DOWNLOAD Customizable Birth Plan | FREE DOWNLOAD Customizable Fourth Trimester PlanConnect with Fourth Trimester Facebook | InstagramWant trustworthy parenting data at your fingertips? Download HelloGaia Parenting Copilot for FREE today. The app uses reliable sources like ACOG, AAP, The Society for Maternal-Fetal Medicine. FREE app available now on Apple & Google Play

In this episode Stephanie talks with HeHe Stewart, a Birth Doula aiming to help women avoid birth trauma & prepare for a confident and informed hospital birth. She has her own podcast The Birth Lounge and an active social media presence educating women about all things birth related. We talk about what it takes to become a Doula and the role a Doula can play in high-risk or critical illness situation. She explains challenges she has faced while interacting with the medical team and how she handles them. Find her here:Childbirth Education: https://www.thebirthlounge.comDoula Services: https://www.tranquilitybyhehe.comIG: https://www.instagram.com/tranquilitybyhehe/The experts at Clinical Concepts in Obstetrics pool their decades of experience caring for critically ill pregnant women to discuss the challenges encountered in caring for these vulnerable women. Dr Stephanie Martin is the Medical Director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist with expertise in critical care obstetrics. Suzanne McMurtry Baird, DNP, RN is the Nursing Director for Clinical Concepts in Obstetrics with many years of experience caring for critically ill pregnant women. Julie Arafeh, RN, MS is the Simulation Director for Clinical Concepts in Obstetrics and a leading expert in simulation.Critical Care Obstetrics Academy: https://www.clinicalconceptsinob.com/Follow us: Instagram: https://www.instagram.com/criticalcareob/Dr Martin's LinkedIn: http://linkedin.com/in/stephanie-martin-65b07112aCCOB LinkedIn: https://www.linkedin.com/company/clinical-concepts-in-obstetrics/Twitter/X: https://twitter.com/OBCriticalCareCCOB Facebook: https://www.facebook.com/clinicalconceptsinobstetricsDr Ma...

Equity is not just a box to check; it is the framework for lasting change. In this week's BackTable podcast, guest host Dr. Veronica Lerner speaks with Dr. Ebony Carter, a high-risk obstetrician and Division Director for Maternal-Fetal Medicine at the University of North Carolina at Chapel Hill. Dr. Carter shares insights into her career journey, which was influenced by her mother's activism in health equity, her work on reproductive health disparities, and community engagement projects. ---SYNPOSISThe conversation underscores the importance of patient participation and agency in clinical decision-making. Dr. Carter and Dr. Lerner also discuss the development of an equity rubric for peer-reviewed journals, highlighting the need for inclusive and intentional research practices. They explore practical applications of the rubric, including the proper acknowledgment of contributors to foundational concepts. The episode further delves into Dr. Carter's mentorship initiatives at the Green Journal and her guiding philosophy of pursuing impactful, community-driven work rooted in passion and purpose.---TIMESTAMPS00:00 - Introduction02:06 - Dr. Carter's Journey and Inspiration05:19 - Community Engagement and Health Equity06:19 - Patient Advocacy and Shared Decision Making08:54 - Collaborative Research and Community Partnerships16:58 - Addressing Bias in Medical Practice22:12 - Equity in Academic Publishing28:26 - Diversifying the Peer Review Pool30:33 - Creating and Implementing the Equity Rubric31:17 - The Impact and Application of the Equity Rubric33:31 - Personal Reflections on Equity and Research35:25 - Citing Foundational Work38:48 - Mentorship and Training Future Leaders47:05 - Career Transitions and Future Goals52:36 - Final Thoughts and Advice for Aspiring Professionals---RESOURCESFull Equity Rubric:https://journals.lww.com/greenjournal/Documents/OnG_Equity_Rubric_1.pdf ​Equity Rubric Introduction Video:https://youtu.be/Jh5_L-pYkuE?si=JREjSSCr98jqjVVB Equity Rubric Introduction Video Slide Deck:https://journals.lww.com/greenjournal/Documents/Green%20Journal%20Equity%20Rubric%20YouTube_final_2022_01_16%20(Slides).pdf

We are joined by Dr. Alexis DiSilvestro, a maternal fetal medicine specialist at St. Peter's Maternal Fetal Medicine. Ray Graf hosts.

In this empowering episode, we invite you to get up close and personal with the part of your body that's about to do something extraordinary—birth your baby. Many parents enter labor feeling disconnected from their vaginas and pelvises, but our guest Britt Fohrman offers a different path—one grounded in awareness, preparation, and trust. Drawing from over two decades as a doula, yoga teacher, birth educator, and pleasure coach, Britt shares practical tools to help you prepare your vagina for birth with more ease, confidence, and connection. By deepening your relationship with your body, you not only support a smoother birth experience, but also lay a strong foundation for your baby's arrival and your own empowered parenting journey.Full show notes: fourthtrimesterpodcast.comConnect with Britt Fohrman brittfohrman.com | Instagram | Facebook | LinkedInBritt's Classes (Code is FOURTHTRIMESTER for 10% OFF for on-demand course) Preparing Your Vagina for Birth In person - San Francisco | Preparing Your Vagina for Birth On Demand | Yoga for Your Yoni | 7 Days to Becoming More Confident in Opening for Birth with Britt-Free Video Series | Practices for Body Awareness | Prenatal Partners Yoga and Massage: Conscious Connection for Birth and BeyondLearn more Somatic Experiencing Can Build Attachment Between Parent And ChildResources HelloGaia Parenting Copilot | FREE DOWNLOAD Customizable Birth Plan | FREE DOWNLOAD Customizable Fourth Trimester PlanConnect with Fourth Trimester Facebook | InstagramWant trustworthy parenting data at your fingertips? Download HelloGaia Parenting Copilot for FREE today. The app uses reliable sources like ACOG, AAP, The Society for Maternal-Fetal Medicine. FREE app available now on Apple & Google...

Julie, Stephanie and Suzanne address listener questions posted about hypertensive disorders. We address questions about treatment of refractory severe hypertension, medication protocols, use of magnesium and delivery timing questions.The experts at Clinical Concepts in Obstetrics pool their decades of experience caring for critically ill pregnant women to discuss the challenges encountered in caring for these vulnerable women. Dr Stephanie Martin is the Medical Director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist with expertise in critical care obstetrics. Suzanne McMurtry Baird, DNP, RN is the Nursing Director for Clinical Concepts in Obstetrics with many years of experience caring for critically ill pregnant women. Julie Arafeh, RN, MS is the Simulation Director for Clinical Concepts in Obstetrics and a leading expert in simulation.Critical Care Obstetrics Academy: https://www.clinicalconceptsinob.com/Follow us: Instagram: https://www.instagram.com/criticalcareob/Dr Martin's LinkedIn: http://linkedin.com/in/stephanie-martin-65b07112aCCOB LinkedIn: https://www.linkedin.com/company/clinical-concepts-in-obstetrics/Twitter/X: https://twitter.com/OBCriticalCareCCOB Facebook: https://www.facebook.com/clinicalconceptsinobstetricsDr Ma...

What do GLP-1 medications like Ozempic®, Wegovy®, and Mounjaro® mean for pregnancy, fertility, and breastfeeding? In this episode of The MotherToBaby Podcast, host and genetic counselor Chris Stallman welcomes Dr. Christina Han—Professor of Obstetrics and Gynecology and division director of Maternal-Fetal Medicine at UCLA, co-director of the Diabetes in Pregnancy Program, and Board Member of the Society for Maternal-Fetal Medicine. Dr. Han breaks down current knowledge about GLP-1 receptor agonists and how they may impact people planning to conceive, those who are pregnant, and those breastfeeding. She also discusses considerations for people using these medications to manage type 2 diabetes or for weight loss.

In this special episode of TrueBirth, Dr. Yaakov Abdelhak, a board-certified OB/GYN and Maternal Fetal Medicine specialist, relays his inspiring story of how he founded Maternal Resources in 2002. From a solo practice to a thriving multi-location center of excellence with 4 physicians, 3 midwives, over 30 dedicated team members including sonographers, physician assistants, nurse practitioners, billers, and administrators—Dr. Abdelhak shares how he scaled a vision rooted in compassionate, comprehensive maternity care into one of the most trusted women's health practices in the region. Connect With Us: YouTube: Dive deeper into pregnancy tips and stories atyoutube.com/maternalresources. Instagram: Follow us for daily inspiration and updates at @maternalresources. Facebook: Join our community at facebook.com/IntegrativeOB Tiktok: NatureBack Doc on TikTok Grab Our Book! Check out The NatureBack Method for Birth—your guide to a empowered pregnancy and delivery. Shop now at naturebackbook.myshopify.com.

Dual-PhD researcher Celeste Beck is a leading maternal health researcher at Heluna Health who just published a groundbreaking study on vitamin D and pregnancy.It turns out something as simple as your vitamin D levels could have a major impact on your pregnancy, postpartum recovery, and your baby's health. With over 15 years in public health and a dual PhD in Nutritional Science and Clinical and Translational Science, Celeste breaks down what every parent needs to know—how to recognize the risks of deficiency, when and how to supplement, and why this one nutrient can make a lifelong difference for your baby.If you're pregnant, postpartum, or supporting someone who is, this episode gives you the critical info your doctor might not be talking about - yet. Advocating for yourself with the right information empowers you and gives your baby the healthiest start possible.Full show notes fourthtrimesterpodcast.comConnect with Celeste Beck PhD LinkedInCeleste's research in the American Journal of Clinical Nutrition Maternal vitamin D status, fetal growth patterns, and adverse pregnancy outcomes in a multisite prospective pregnancy cohortLearn more Evidence Based Care for Improving Postpartum Recovery - Advice From Dr Rebecca Dekker | Morning Sickness Causes and Cures: Hyperemesis Genetic Link and Practical Advice from USC Geneticist Dr Marlena FejzoResources HelloGaia Parenting Copilot | FREE DOWNLOAD Customizable Birth Plan | FREE DOWNLOAD Customizable Fourth Trimester PlanConnect with Fourth Trimester Facebook | InstagramWant trustworthy parenting data at your fingertips? Download HelloGaia Parenting Copilot for FREE today. The app uses reliable sources like ACOG, AAP, The Society for Maternal-Fetal Medicine. FREE app available now on Apple & Google Play

Julie, Stephanie and Suzanne address listener questions posted about obstetric hemorrhage. We talk about transfusion thresholds, vital signs in hemorrhage, QBL, postpartum monitoring and many other aspects of hemorrhage management and recognition.The experts at Clinical Concepts in Obstetrics pool their decades of experience caring for critically ill pregnant women to discuss the challenges encountered in caring for these vulnerable women. Dr Stephanie Martin is the Medical Director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist with expertise in critical care obstetrics. Suzanne McMurtry Baird, DNP, RN is the Nursing Director for Clinical Concepts in Obstetrics with many years of experience caring for critically ill pregnant women. Julie Arafeh, RN, MS is the Simulation Director for Clinical Concepts in Obstetrics and a leading expert in simulation.Critical Care Obstetrics Academy: https://www.clinicalconceptsinob.com/Follow us: Instagram: https://www.instagram.com/criticalcareob/Dr Martin's LinkedIn: http://linkedin.com/in/stephanie-martin-65b07112aCCOB LinkedIn: https://www.linkedin.com/company/clinical-concepts-in-obstetrics/Twitter/X: https://twitter.com/OBCriticalCareCCOB Facebook: https://www.facebook.com/clinicalconceptsinobstetricsDr Ma...

Our inspiring guest today is Top Doctor, Lexi Hill, an MD licensed in over 20 states specializing in obstetrics, gynecology and pregnancy. She practices telemedicine full-time, offering concierge consultations and assisting underserved communities. She is extensively involved with the Society for Maternal-Fetal Medicine as she is a passionate advocate for maternal health care. She has also spent time as an assistant professor and is published in numerous medical journals and textbooks and hosts her own podcast! Mark and Dr. Lexi have some enlightening conversations about health & wellness, nutrition, pregnancy and modern-day medicine. Learn more at www.drlexihill.comFor photos and more on this podcast episode and all our past episodes, visit www.candelariadesign.com

In this episode of the SMFM Podcast, Dr. Shad Deering welcomes Dr. Sindhu Srinivas, the newly appointed President of the Society for Maternal-Fetal Medicine. Dr. Srinivas shares her journey to becoming an MFM, reflects on the mentors who shaped her path, and discusses her early involvement in advocacy and organized medicine. She also offers insight into her leadership vision for SMFM, including expanding member engagement, strengthening advocacy efforts, and advancing educational initiatives like the newly launched Pregnancy Journal. Whether you're a fellow, early-career MFM, or a long-time member, this episode highlights the many ways to get involved and stay inspired within the MFM community. Click here for the full episode transcript.

“Disability is so unique from one person to the next in terms of how it impacts them outside of pregnancy and well as pregnancy.” Dr. Anne Berndl (MD MSc FRCSC) is the director of the Accessible Care Pregnancy Clinic at Sunnybrook Health Sciences Centre in the Division of Maternal-Fetal Medicine. The clinic provides holistic, individualized obstetrical care to patients living with physical disabilities. Care options are individualized to each patient and their family, with the goal of providing seamless and holistic care throughout planning, pregnancy, labour and the postpartum period.The Accessible Care Pregnancy Clinic opened in March 2017 and is the first of its kind in North America. It strives to improve obstetrical care for pregnant people living with physical disabilities. *This episode was recorded in 2024. Please download, subscribe, follow and share.

The experts at Clinical Concepts in Obstetrics pool their decades of experience caring for critically ill pregnant women to discuss the challenges encountered in caring for these vulnerable women. Dr Stephanie Martin is the Medical Director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist with expertise in critical care obstetrics. Suzanne McMurtry Baird, DNP, RN is the Nursing Director for Clinical Concepts in Obstetrics with many years of experience caring for critically ill pregnant women. Julie Arafeh, RN, MS is the Simulation Director for Clinical Concepts in Obstetrics and a leading expert in simulation.Critical Care Obstetrics Academy: https://www.clinicalconceptsinob.com/Follow us: Instagram: https://www.instagram.com/criticalcareob/Dr Martin's LinkedIn: http://linkedin.com/in/stephanie-martin-65b07112aCCOB LinkedIn: https://www.linkedin.com/company/clinical-concepts-in-obstetrics/Twitter/X: https://twitter.com/OBCriticalCareCCOB Facebook: https://www.facebook.com/clinicalconceptsinobstetricsDr Ma...

In this episode, we are discussing 2 articles focused on cardiovascular genetics. In the first segment, Khalida talks to authors Marianne and Erin about their research exploring the opportunities for downstream revenue of cardiac genetic counseling services in a pediatric medical center. In the second segment, Naomi chats with Jodie and Erin about the recent NSGC Practice Resource about genetic testing and counseling for hypertrophic cardiomyopathy. Segment 1: Cardiac genetic counseling services: Exploring downstream revenue in a pediatric medical center Marianne Olson, MS, CGC is a genetic counselor at Baptist Health in Kentucky. She provides prenatal genetic counseling at Maternal Fetal Medicine clinics in Louisville and Lexington. Marianne graduated from the Cincinnati Genetic Counseling Graduate Program in 2024. Prior to working as a genetic counselor, Marianne taught high school chemistry and biology for 12 years. Erin Miller is an Associate Professor in the University of Cincinnati College of Medicine. Erin is a genetic counselor IN THE DIVISION OF CARDIOLOGY at Cincinnati Children's Hospital Medical Center. She leads the cardiology genetic counseling team in providing genetic counseling services to individuals of all ages with and at risk for cardiovascular disease. Erin is focused on improving access to genetics services for families with inherited cardiovascular diseases. In this segment we discuss: - What sparked the decision to explore downstream revenue (DSR) in a cardiac genetic counseling setting - Financial challenges institutions face when hiring genetic counselors, especially around reimbursement - The role of genetic counseling in reducing costs by guiding risk stratification and avoiding unnecessary testing - Limited uptake of cardiac screening among at-risk relative and strategies that could help improve adherence - How findings from this study can support the case for sustaining genetic counseling roles within pediatric cardiology - Potential to adapt the study's methodology to other specialties like neurology or prenatal genetics, and considerations for doing so   Segment 2: Genetic testing and counseling for hypertrophic cardiomyopathy: An evidence-based practice resource of the National Society of Genetic Counselors Erin Miller (she/her) is an Associate Professor in the College of Medicine at the University of Cincinnati and a cardiac genetic counselor at Cincinnati Children's Hospital Medical Center in the Division of Cardiology. She leads the cardiology genetic counseling team in providing genetic counseling services to individuals of all ages with and at risk for cardiovascular disease. Erin is focused on improving access to genetics services for families with inherited cardiovascular diseases. Associate Professor Jodie Ingles (she/her)  is Head of the Clinical Genomics Laboratory and Program Director of Genomics and Inherited Disease Program at Garvan Institute of Medical Research. She is a cardiac genetic counsellor in the Department of Cardiology, Royal Prince Alfred Hospital Sydney. Her team is focused on using genomics to improve diagnosis and care of families with inherited cardiovascular diseases. In this segment we discuss: - The motivation behind creating an official practice resource focused on genetic testing and counseling for HCM - Deep dive into the first major recommendation: offering genetic testing to all individuals with a suspected or confirmed diagnosis of HCM, paired with appropriate genetic counseling - Exploration of the second recommendation: ensuring that genetic tests are selected, ordered, and interpreted within the context of genetic counseling, and the complexities that come with this process - Discussion of the third recommendation: providing cardiac and cascade genetic testing to at-risk relatives, without age limitations, and why this is critical for effective family-based care - A look at the barriers to integrating genetic services into cardiology practices, especially in settings without dedicated genetics expertise   Would you like to nominate a JoGC article to be featured in the show? If so, please fill out this nomination submission form here. Multiple entries are encouraged including articles where you, your colleagues, or your friends are authors. Stay tuned for the next new episode of DNA Dialogues! In the meantime, listen to all our episodes Apple Podcasts, Spotify, streaming on the website, or any other podcast player by searching, “DNA Dialogues”.  For more information about this episode visit dnadialogues.podbean.com, where you can also stream all episodes of the show. Check out the Journal of Genetic Counseling here for articles featured in this episode and others.  Any questions, episode ideas, guest pitches, or comments can be sent into DNADialoguesPodcast@gmail.com.  DNA Dialogues' team includes Jehannine Austin, Naomi Wagner, Khalida Liaquat, Kate Wilson and DNA Today's Kira Dineen. Our logo was designed by Ashlyn Enokian. Our current intern is Sydney Arlen.  

Dr. Shilpa Babbar, a double board-certified maternal-fetal medicine specialist and OB/GYN, joins Dr. Rebecca Dekker to discuss the role of integrative obstetrics in pregnancy and birth. Dr. Babbar shares her journey into maternal-fetal medicine, how she became interested in yoga and breathing techniques, and the growing body of research on prenatal yoga. They discuss how breathwork can support pregnant individuals, the physiological effects of deep breathing, and how birth workers can incorporate these techniques into prenatal care. Dr. Babbar also shares her experience using alternate nostril breathing to manage blood pressure during pregnancy and her vision for making integrative therapies a standard part of obstetric care.   (01:41) Dr. Babbar's Journey into Maternal-Fetal Medicine (04:16) How Yoga and Prenatal Yoga Research Began (09:37) Studying the Effects of Prenatal Yoga on Pregnancy (12:46) Yoga's Impact on Labor Duration (14:33) The Role of Breathwork in Pregnancy (17:48) How Dr. Babbar Used Breathing Techniques for Her Own Pregnancy (22:30) The Science Behind Alternate Nostril Breathing (28:52) Guided Demonstration of Deep Breathing Techniques (35:10) Applying Breathwork During Pregnancy and Labor (39:08) The Future of Integrative Obstetric Care   Resources Learn more about Dr. Shilpa Babbar's work at drshilpababbar.com Follow the Integrative Obstetric Care Conference on Instagram: @IOBCare   For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.

Send us a textWelcome to the fourth episode of season five, in conversation with Professor Eduard Gratacós. Professor Gratacós' Bio Prof. Eduard Gratacós is director and professor at BCNatal, a referral clinical and research center in Maternal-Fetal Medicine at the University Hospitals Clinic and Sant Joan de Déu in Barcelona. Among other international positions, he has been Board and Scientific Chair at ISUOG, Editor-in-Chief at Fetal Diagnosis and Therapy and Director of the Erasmus Mundus European Doctorate in Fetal Medicine. His main research lines have been placental insufficiency, fetal programming and fetal therapy in general, including most recently artificial placenta. He has published +600 peer reviewed papers, directed +60 national and international research projects and +40 doctoral theses. He has provided training in maternal-fetal medicine to +400 specialists. He is the founder of Fetal Medicine Barcelona, which offers worldwide medical training, with over 25,000 users.Podcast information:We have not included any patient identifiable information, and this podcast is intended for professional education rather than patient information (although welcome anyone interested in the field to listen). Please get in touch with feedback or suggestions for future guests or topics: conversationsinfetalmed@gmail.com, or via Twitter (X), Bluesky or Instagram via @fetalmedcast.Music by Crowander ('Acoustic romance') used under creative commons licence. Podcast created, hosted and edited by Dr Jane Currie.

In this episode of the SMFM Podcast, Dr. Amy Valent welcomes back Dr. Ebony Carter, Division Director of Maternal-Fetal Medicine at UNC Chapel Hill, for a deeper discussion on community engagement in MFM practice. Building on the insights from Community Engagement 101, Dr. Carter shares her experiences in developing meaningful community partnerships that drive health equity and improve patient care. From navigating the complexities of building trust to ensuring patient voices shape interventions, Dr. Carter provides practical advice on engaging with communities in a way that is collaborative, sustainable, and impactful. She reflects on lessons learned in St. Louis, the challenges of starting over in a new community, and the importance of listening before leading. Join us for an inspiring conversation on how MFMs can integrate community engagement into their research, practice, and advocacy efforts. Subscribe to the SMFM Podcast for more discussions on high-risk pregnancy care, and explore additional resources at education.smfm.org. Full transcript.  Additional Resources: SMFM Podcast Community Engagement 101   The Public Health System Components: Clinicians who are related to Maternal-Fetal Medicine program is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award to the Society for Maternal-Fetal Medicine (SMFM) totaling $200,000 with 100 percent funded by CDC/HHS. The contents are those of the authors and do not necessarily represent the official views of nor endorsement, by CDC/HHS or the U.S. Government.

After a brief hiatus (thanks to my laptop taking an unfortunate dive and suffering water damage—RIP, old friend), I'm back with exciting fertility planning updates!For the first time in a while, I'm feeling hopeful and optimistic. Douglas and I are re-engaging with our fertility specialists at Maternal Fetal Medicine and Shady Grove, and we're making progress on a new plan to help us find a solution before trying to conceive again.Join me as I share the latest insights, developments, and the journey ahead.Follow Your Host:Insta:⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/rumor_in_stpetersburg ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠TikTok:⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.tiktok.com/@rumor_in_stpetersburg ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠FB Page: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.facebook.com/theluxuryofselfcare⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Spotify: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://open.spotify.com/user/ahnastasia88?si=ab36621742b4474c⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Photo and Music Credit:Cover Art Photography by Tori Radick⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/toricophotography/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Intro/Outro Music Produced by Ryan Blivhovde⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/ryanblihovde/⁠⁠⁠⁠

More and more people are waiting until their 40s to start their families, but what does that mean for fertility and pregnancy? In this episode, I'm joined by Dr. Shannon Clark, a double board-certified Maternal-Fetal Medicine specialist, to discuss the realities of getting pregnant and having a healthy pregnancy after 40. Dr. Clark shares her expertise on the unique challenges and considerations for pregnancy later in life, including egg quality, fertility treatments, and the risks and benefits of advanced maternal age pregnancies. She also offers practical advice for optimizing your chances of conceiving, the role of assisted reproductive technology, and what to expect during pregnancy after 40. If you're considering having a baby in your 40s or want to understand more about this stage of fertility, this episode is for you! In this episode, we cover: The most common fertility challenges for women over 40 How egg quality and quantity impact pregnancy chances Fertility treatment options for women in their 40s The role of IVF, egg freezing, and donor eggs Risks and benefits of pregnancy at an advanced maternal age How to prepare for a healthy pregnancy after 40 Read the full show notes on my website. Visit Dr. Shannon Clark's website here.  IVF Class: Do you have questions about IVF? Click here to join me for The IVF Class. The next live class call is on Monday, March 10, 2025, at 4pm PST, where I'll explain IVF and Egg Freezing, and there will be time to ask your questions live on Zoom. Other ways to reach me: Visit my YouTube channel for more fertility tips! Subscribe to the newsletter to get updates. Join Egg Whisperer School. Request a Consultation with me. Dr. Aimee Eyvazzadeh is one of America's most well-known fertility doctors. Her success rate at baby-making gives future parents hope when all hope is lost. She pioneered the TUSHY Method and BALLS Method to decrease your time to pregnancy. Learn more about the TUSHY Method and find a wealth of fertility resources at www.draimee.org.

In this episode, Julie Arafeh and Suzanne McMurtry Baird discuss scope of services for obstetrics. A scope of services outlines the patients you will care for and those who would be transferred or transported to a higher level of care. This information also drives your training and education programs. The experts at Clinical Concepts in Obstetrics pool their decades of experience caring for critically ill pregnant women to discuss the challenges encountered in caring for these vulnerable women. Dr Stephanie Martin is the Medical Director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist with expertise in critical care obstetrics. Suzanne McMurtry Baird, DNP, RN is the Nursing Director for Clinical Concepts in Obstetrics with many years of experience caring for critically ill pregnant women. Julie Arafeh, RN, MS is the Simulation Director for Clinical Concepts in Obstetrics and a leading expert in simulation.Critical Care Obstetrics Academy: https://www.clinicalconceptsinob.com/Follow us: Instagram: https://www.instagram.comDr Martin's LinkedIn: http://linkedin.com/in/stephanie-martin-65b07112aCCOB LinkedIn: https://www.linkedin.com/company/clinical-concepts-in-obstetrics/Twitter/X: https://twitter.com/OBCriticalCareCCOB Facebook: https://www.facebook.com/clinicalconceptsinobstetricsDr Martin's Facebook: ...

https://professional.heart.org/en/education/role-of-cardiovascular-health-in-maternal-health/#preeclampsiaThe experts at Clinical Concepts in Obstetrics pool their decades of experience caring for critically ill pregnant women to discuss the challenges encountered in caring for these vulnerable women. Dr Stephanie Martin is the Medical Director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist with expertise in critical care obstetrics. Suzanne McMurtry Baird, DNP, RN is the Nursing Director for Clinical Concepts in Obstetrics with many years of experience caring for critically ill pregnant women. Julie Arafeh, RN, MS is the Simulation Director for Clinical Concepts in Obstetrics and a leading expert in simulation.Critical Care Obstetrics Academy: https://www.clinicalconceptsinob.com/Follow us: Instagram: https://www.instagram.comDr Martin's LinkedIn: http://linkedin.com/in/stephanie-martin-65b07112aCCOB LinkedIn: https://www.linkedin.com/company/clinical-concepts-in-obstetrics/Twitter/X: https://twitter.com/OBCriticalCareCCOB Facebook: https://www.facebook.com/clinicalconceptsinobstetricsDr Martin's Facebook: ...

In this episode of the SMFM Podcast Series, Dr. Rupesh Patel speaks with Dr. Ashley Battarbee and Dr. Judette Louis about the CDC's Hypertension in Pregnancy Change Package (HPCP)—a comprehensive resource designed to improve the identification, management, and prevention of complications related to hypertension in pregnancy. Dr. Battarbee and Dr. Louis discuss the collaborative effort behind developing the HPCP, its key components, and how it can be implemented in outpatient settings to enhance patient care. They highlight practical strategies for clinicians, address common challenges, and explore the role of the change package in fostering interdisciplinary collaboration. Additionally, they delve into the postpartum aspects of hypertension management and the importance of continuity of care. Tune in to learn how the HPCP serves as a structured, evidence-informed tool to optimize hypertension care in pregnancy and postpartum. Additional Resources: Hypertension - Society for Maternal-Fetal Medicine Hypertension in Pregnancy Change Package Education.smfm.org The Public Health System Components: Clinicians who are related to Maternal-Fetal Medicine program is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award to the Society for Maternal-Fetal Medicine (SMFM) totaling $320,000 with 100 percent funded by CDC/HHS. The contents are those of the authors and do not necessarily represent the official views of nor endorsement, by CDC/HHS or the U.S. Government.      

The experts at Clinical Concepts in Obstetrics pool their decades of experience caring for critically ill pregnant women to discuss the challenges encountered in caring for these vulnerable women. Dr Stephanie Martin is the Medical Director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist with expertise in critical care obstetrics. Suzanne McMurtry Baird, DNP, RN is the Nursing Director for Clinical Concepts in Obstetrics with many years of experience caring for critically ill pregnant women. Julie Arafeh, RN, MS is the Simulation Director for Clinical Concepts in Obstetrics and a leading expert in simulation.Critical Care Obstetrics Academy: https://www.clinicalconceptsinob.com/Follow us: Instagram: https://www.instagram.comDr Martin's LinkedIn: http://linkedin.com/in/stephanie-martin-65b07112aCCOB LinkedIn: https://www.linkedin.com/company/clinical-concepts-in-obstetrics/Twitter/X: https://twitter.com/OBCriticalCareCCOB Facebook: https://www.facebook.com/clinicalconceptsinobstetricsDr Martin's Facebook: ...

We continue our NextGen Journeys series today featuring fresh perspectives on education, medicine, and the future of health care with an impressive medical student who was brought to our attention by a previous podcast guest, Dr. Michael Foti, whom we'd like to thank for the recommendation. Nikolas Bletnitsky is in his third year at Touro College of Osteopathic Medicine, Middletown, but that's just one element in his medical education. Over the last several years, Nick has done extensive work in the field of OB-GYN -- completing clinical electives in Paris, France and Bologna, Italy, in addition to the Mayo Clinic -- where he has pursued his intense interest in a variety of subspecialties, including maternal fetal medicine. “Right now I'm doing a lot because I'm young and I have the energy and I want to see a lot to give me different perspectives on things so that I can incorporate them into my own practice,” he tells host Michael Carrese. Join us for a wide-ranging conversation in which you'll learn about current practice in OB-GYN in the US and Europe, neonatal palliative care and advances in fetal surgery, along with what Nick has learned about having crucial conversations with the parents of patients when tough news needs to be discussed.Mentioned in this episode: Touro College of Osteopathic Medicine, If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/raisethelinepodcast

In this episode, Suzanne and Stephanie talk about how to be prepared and manage an eclamptic patient. We give 3 scenarios of eclampsia to stimulate thought about where and how you would manage.The experts at Clinical Concepts in Obstetrics pool their decades of experience caring for critically ill pregnant women to discuss the challenges encountered in caring for these vulnerable women. Dr Stephanie Martin is the Medical Director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist with expertise in critical care obstetrics. Suzanne McMurtry Baird, DNP, RN is the Nursing Director for Clinical Concepts in Obstetrics with many years of experience caring for critically ill pregnant women. Julie Arafeh, RN, MS is the Simulation Director for Clinical Concepts in Obstetrics and a leading expert in simulation.Critical Care Obstetrics Academy: https://www.clinicalconceptsinob.com/Follow us: Instagram: https://www.instagram.comDr Martin's LinkedIn: http://linkedin.com/in/stephanie-martin-65b07112aCCOB LinkedIn: https://www.linkedin.com/company/clinical-concepts-in-obstetrics/Twitter/X: https://twitter.com/OBCriticalCareCCOB Facebook: https://www.facebook.com/clinicalconceptsinobstetricsDr Martin's Facebook: ...

In this episode of the SMFM Podcast Series, Dr. Jamie Lo is joined by Dr. Rolanda Lister, Officer of Health Equity at Vanderbilt University Medical Center, and Dr. Ann Borders, Executive Director of the Illinois Perinatal Quality Collaborative, to explore the essentials of community engagement in maternal-fetal medicine. Learn how partnering with community stakeholders, engaging patient voices, and addressing social drivers of health can improve birth outcomes and promote health equity. The discussion highlights practical strategies, real-world examples, and emerging data supporting the transformative impact of community engagement on clinical care, quality improvement, and research. Stay tuned for insights on building relationships with community organizations, fostering long-term partnerships, and integrating patient-centered approaches into practice. Plus, hear about SMFM's upcoming 2025 postgraduate course, Building Bridges Between Hospitals and Community Partners to Promote Birth Equity and Improved Birth Outcomes. Additional Links/Resources SMFM's 2025 Postgrad Course - Building Bridges Between Hospitals and Community Partners to Promote Birth Equity and Improved Birth Outcomes. Engaging Communities to Improve Perinatal Outcomes Special Interest Group Visit education.smfm.org for more educational  Click here for the episode transcript.  Funding Acknowledgement: The Public Health System Components: Clinicians who are related to Maternal-Fetal Medicine program is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award to the Society for Maternal-Fetal Medicine (SMFM) totaling $200,000 with 100 percent funded by CDC/HHS. The contents are those of the authors and do not necessarily represent the official views of nor endorsement, by CDC/HHS or the U.S. Government.

Dr Stephanie Martin talks with Andrea, a patient, survivor of postpartum septic shock and advocate. Hear her incredible story and decide how you would have handled things differently. https://www.endsepsis.org/about-rory-staunton/https://www.cdc.gov/hearher/maternal-warning-signs/index.htmlhttps://www.mommasvoices.org/The experts at Clinical Concepts in Obstetrics pool their decades of experience caring for critically ill pregnant women to discuss the challenges encountered in caring for these vulnerable women. Dr Stephanie Martin is the Medical Director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist with expertise in critical care obstetrics. Suzanne McMurtry Baird, DNP, RN is the Nursing Director for Clinical Concepts in Obstetrics with many years of experience caring for critically ill pregnant women. Julie Arafeh, RN, MS is the Simulation Director for Clinical Concepts in Obstetrics and a leading expert in simulation.Follow us: Instagram: https://www.instagram.comDr Martin's LinkedIn: http://linkedin.com/in/stephanie-martin-65b07112aCCOB LinkedIn: https://www.linkedin.com/company/clinical-concepts-in-obstetrics/Twitter/X: https://twitter.com/OBCriticalCareCCOB Facebook: https://www.facebook.com/clinicalconceptsinobstetricsDr Martin's Facebook: https://www.facebook.com/profile.php?id=100024366859192

NatureBack is the expression of Dr. Yaakov Abdelhak's obstetrical philosophy after more than 3 decades in the field of high-risk perinatology Maternal-Fetal Medicine. It is a goal-oriented practical method that can mitigate or possibly even eliminate the need for a cesarean delivery. Now you can read Dr. Abdelhak's first hand experience in his new book The NatureBack Method.   The NatureBack Philosophy starts at the beginning of pregnancy, with recognition of the factors that can lead to cesarean delivery. The risk of cesarean delivery doesn't arise when a woman goes into labor; it's set long before any medical intervention. In many pregnancies, a cesarean delivery is initiated during the first trimester, and there are steps that can be taken in each trimester and during birth to reduce the need for surgical intervention. Most are familiar with the cesarean epidemic where cesareans account for more than 30 percent of all deliveries in the United States. This is a dramatic increase from the mere five percent of babies delivered by cesarean delivery in 1970. Fingers often point at the bias of overworked obstetricians who want to hurry things along, labor induction, and other seemingly counterproductive medical interventions. There is also the widespread use of the external fetal monitor, which is blamed for fueling the anxiety of litigation-weary obstetricians. Some of these usual suspects have earned their dubious reputation, while others are completely innocent—as the NatureBack philosophy details. NatureBack proports the honest truth about the largest contributing factor to the cesarean wave which is that many babies are just too big. They're so big, in fact, that many can't fit through the pelvis. A very popular, powerful cultural belief is that Mother Nature–the time-tested, proven, physiological, and finely-tuned process–will not let us down. Women have been birthing vaginally for millennia. Is there any reason to believe that a woman would—or even could!—grow a baby so large that it's physically impossible for the baby to safely pass through her birth canal? That Mother Nature would provide each mom with a baby that fits her body seems like common sense. The thing is, we no longer live in Mother Nature's world. Instead, we live in a world very different from the one we adapted to throughout the millennia of human evolution. The process of vaginal birth has remained the same; it's our lifestyles that have changed. We have deviated from nature—and mightily so. Our diets, our activity levels, and our expectations have all evolved (some might say devolved). For most of us, modern society means a sedentary lifestyle. It is synonymous with processed food, with the result that we are now consuming carbohydrates on a scale unprecedented in human history. As a result, babies are growing bigger in gestation than ever before. With the abundance of calories at our disposal, growing babies are turning out to be easier than delivering them. At Maternal Resources, the team is ready to safely guide you and your family through a healthy pregnancy utilizing the NatureBack method to achieve all your pregnancy goals including Natural Vaginal Delivery, if you so choose. You can get your copy of the book on SHOPIFY.  Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners. For additional resources and information, be sure to visit our website at Maternal Resources: https://www.maternalresources.org/. You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement: ORDER NOW  

Emily Schlussel Markovic is an obstetrician gynecologist, completing a fellowship in Maternal Fetal Medicine at Maimonides Medical Center and a smitten mother of two girls. She draws on her own patient experiences with infertility and chronic disease to be a more caring and empathic medical provider. Emily enjoys hiking, traveling and really good vegetarian food.    CONNECT DVORA ENTIN: Website: https://www.dvoraentin.com/ Instagram: https://www.instagram.com/dvoraentin YouTube: https://www.youtube.com/@misconceptionspodcast

In the last vital signs are vital series, Dr. Stephanie Martin and Suzanne McMurtry Baird discuss maternal temperature. Understand the WHY and conditions of hypothermia and hyperthermia. The experts at Clinical Concepts in Obstetrics pool their decades of experience caring for critically ill pregnant women to discuss the challenges encountered in caring for these vulnerable women. Dr Stephanie Martin is the Medical Director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist with expertise in critical care obstetrics. Suzanne McMurtry Baird, DNP, RN is the Nursing Director for Clinical Concepts in Obstetrics with many years of experience caring for critically ill pregnant women. Julie Arafeh, RN, MS is the Simulation Director for Clinical Concepts in Obstetrics and a leading expert in simulation.Follow us: Instagram: https://www.instagram.comDr Martin's LinkedIn: http://linkedin.com/in/stephanie-martin-65b07112aCCOB LinkedIn: https://www.linkedin.com/company/clinical-concepts-in-obstetrics/Twitter/X: https://twitter.com/OBCriticalCareCCOB Facebook: https://www.facebook.com/clinicalconceptsinobstetricsDr Martin's Facebook: https://www.facebook.com/profile.php?id=100024366859192

Join us for the 5th Annual JOWMA Conference: Transforming Healthcare Through Innovation & Research on January 5, 2025, from 8am to 5pm in NYC! Spend the day immersed in expert-led scientific sessions, hands-on surgical simulations, specialty roundtables, and a networking lunch tailored for healthcare professionals and students. PLUS, we're offering a full premed program with panels, roundtables, and networking dedicated to aspiring medical students.

Dr. Stephanie Martin and Suzanne McMurtry Baird discuss the technology of pulse oximetry. Understand the WHY of SpO2 values.The experts at Clinical Concepts in Obstetrics pool their decades of experience caring for critically ill pregnant women to discuss the challenges encountered in caring for these vulnerable women. Dr Stephanie Martin is the Medical Director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist with expertise in critical care obstetrics. Suzanne McMurtry Baird, DNP, RN is the Nursing Director for Clinical Concepts in Obstetrics with many years of experience caring for critically ill pregnant women. Julie Arafeh, RN, MS is the Simulation Director for Clinical Concepts in Obstetrics and a leading expert in simulation.Follow us: Instagram: https://www.instagram.comDr Martin's LinkedIn: http://linkedin.com/in/stephanie-martin-65b07112aCCOB LinkedIn: https://www.linkedin.com/company/clinical-concepts-in-obstetrics/Twitter/X: https://twitter.com/OBCriticalCareCCOB Facebook: https://www.facebook.com/clinicalconceptsinobstetricsDr Martin's Facebook: https://www.facebook.com/profile.php?id=100024366859192

In this episode of 'Hot for Your Health,' Dr. Vonda Wright is joined by Dr. Rizwana Fareeduddin (“Dr. Fareed”), a trailblazer in women's health and the Executive Medical Director for Women Services at AdventHealth. With over a decade of leadership experience in Obstetrics and Gynecology, Maternal Fetal Medicine, and healthcare strategy, Dr. Fareed is passionate about addressing health equity and advancing women's care. Together, they dive into the pressing issue of maternity care deserts, where access to OB/GYNs and birthing centers is alarmingly scarce. Dr. Fareed sheds light on the growing physician shortage and how workforce challenges demand systemic reforms, such as integrating telemedicine and multidisciplinary care teams. They also explore changing trends in maternity, including increasing maternal age and rising health risks like obesity and hypertension, emphasizing the need for preventative care and health optimization before pregnancy. The conversation extends to empowering women through better access to healthcare, combatting misinformation online, and embracing innovative solutions like AI in medicine. Dr. Fareed's insights inspire hope for a future where every woman can access compassionate, high-quality care. Tune in to learn how we can collectively improve women's healthcare and advocate for lasting change. ••• Connect with AdventHealth: Facebook:: AdventHealth for Women Instagram: @AdventHealthWomen&Children ••• Make sure to follow Dr. Vonda Wright: Instagram: @drvondawright Youtube: https://www.youtube.com/@vondawright Tiktok: https://www.tiktok.com/@drvondawright LinkedIn: https://www.linkedin.com/in/vonda-wright-md-ms-2803374 Website: http://www.DrVondaWright.com ••• If you enjoyed this episode, Subscribe to “HOT For Your Health” for more inspiring episodes. Apple Podcast: https://podcasts.apple.com/us/podcast/hot-for-your-health/id1055206993 Spotify: https://open.spotify.com/show/1Q2Al27D79jCLAyzp4hKBv?si=b62b374994884eed We'd love to hear your thoughts on this episode! Share your comments or join the discussion on social media using #HotForYourHealthPodcast.  

In this episode, Dr. Stephanie Martin and Dr. Suzanne McMurtry Baird discuss the importance of taking a respiratory rate and understanding the WHY of a low or high rate. The experts at Clinical Concepts in Obstetrics pool their decades of experience caring for critically ill pregnant women to discuss the challenges encountered in caring for these vulnerable women. Dr Stephanie Martin is the Medical Director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist with expertise in critical care obstetrics. Suzanne McMurtry Baird, DNP, RN is the Nursing Director for Clinical Concepts in Obstetrics with many years of experience caring for critically ill pregnant women. Julie Arafeh, RN, MS is the Simulation Director for Clinical Concepts in Obstetrics and a leading expert in simulation.Follow us: Instagram: https://www.instagram.comDr Martin's LinkedIn: http://linkedin.com/in/stephanie-martin-65b07112aCCOB LinkedIn: https://www.linkedin.com/company/clinical-concepts-in-obstetrics/Twitter/X: https://twitter.com/OBCriticalCareCCOB Facebook: https://www.facebook.com/clinicalconceptsinobstetricsDr Martin's Facebook: https://www.facebook.com/profile.php?id=100024366859192

This is the 2nd podcast in our series on Vital Signs are Vital. Tune in to hear Dr. Stephanie Martin and Dr. Suzanne McMurtry Baird discussing blood pressure. We will go over hypotension, hypertension, and understanding the WHY.The experts at Clinical Concepts in Obstetrics pool their decades of experience caring for critically ill pregnant women to discuss the challenges encountered in caring for these vulnerable women. Dr Stephanie Martin is the Medical Director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist with expertise in critical care obstetrics. Suzanne McMurtry Baird, DNP, RN is the Nursing Director for Clinical Concepts in Obstetrics with many years of experience caring for critically ill pregnant women. Julie Arafeh, RN, MS is the Simulation Director for Clinical Concepts in Obstetrics and a leading expert in simulation.Follow us: Instagram: https://www.instagram.comDr Martin's LinkedIn: http://linkedin.com/in/stephanie-martin-65b07112aCCOB LinkedIn: https://www.linkedin.com/company/clinical-concepts-in-obstetrics/Twitter/X: https://twitter.com/OBCriticalCareCCOB Facebook: https://www.facebook.com/clinicalconceptsinobstetricsDr Martin's Facebook: https://www.facebook.com/profile.php?id=100024366859192

The Filtrate:Joel TopfSwapnil HiremathWith Special Guest:Michelle Hladunewich, Nephrologist at the University of TorontoMir Melamed, Maternal-Fetal Medicine at the University of TorontoEditor Simon TopfShow NotesPriscilla Smith's letter:Dear Joel and the Freely Filtered team,I am a long-time fan of your podcast and was looking forward to hearing your recently aired discussion of the Praecis study of sflt1:PlGF use in preeclampsia. Preeclampsia and renal disease in pregnancy are areas that many nephrologists report a lack of knowledge or confidence in discussing and managing. I am a nephrologist who has been co-leading a renal pregnancy clinic in London while writing a PhD on progression of renal disease in pregnancy. I have had the immense privilege of working with experts and key opinion leaders in preeclampsia research both in the UK and internationally. As you know, preeclampsia is a serious and significant condition contributing to global maternal mortality and is also associated with future CKD and CVD risk so is both relevant and important within our professional group.Sadly, I found myself disappointed by the episode and felt it was a missed opportunity. I appreciate that you had difficulties obtaining appropriate experts to join the discussion, but perhaps it would have been better to delay production. While you all valiantly proceeded to discuss this important study, the topic is complex and there appeared to be a lack of understanding of the surrounding literature and pathogenesis of preeclampsia. Sadly, the maternal medicine expert's comments at the end of the podcast added little as she seemed determine to negate any benefit from the results despite declaring she had no experience or expertise in the use of these biomarkers.There are many people who understand the clinical aspects of preeclampsia as well as having direct experience of the use and utility of these biomarkers who would have been able to contribute much to your conversation. I look forward to future discussions of renal disease in pregnancy on your podcast and would be happy to suggest some expert panellists if you ever find yourself stuck.Kind regards,Priscilla Excess placental soluble fms-like tyrosine kinase 1 (sFlt1) may contribute to endothelial dysfunction, hypertension, and proteinuria in preeclampsia (JCI 2003)sFlt background: Pathogenesis of Preeclampsia and Therapeutic Approaches Targeting the Placenta (PubMed)PlGF background: Perspectives on the Use of Placental Growth Factor (PlGF) in the Prediction and Diagnosis of Pre-Eclampsia: Recent Insights and Future Steps (PubMed)The PRAECIS trial (NephJC | NEJM Evidence)

This is the first episode in our series "Vital Signs are Vital". In this episode we discuss the significance of heart rate in the assessment of vital signs.  The experts at Clinical Concepts in Obstetrics pool their decades of experience caring for critically ill pregnant women to discuss the challenges encountered in caring for these vulnerable women. Dr Stephanie Martin is the Medical Director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist with expertise in critical care obstetrics. Suzanne McMurtry Baird, DNP, RN is the Nursing Director for Clinical Concepts in Obstetrics with many years of experience caring for critically ill pregnant women. Julie Arafeh, RN, MS is the Simulation Director for Clinical Concepts in Obstetrics and a leading expert in simulation.Follow us: Instagram: https://www.instagram.comDr Martin's LinkedIn: http://linkedin.com/in/stephanie-martin-65b07112aCCOB LinkedIn: https://www.linkedin.com/company/clinical-concepts-in-obstetrics/Twitter/X: https://twitter.com/OBCriticalCareCCOB Facebook: https://www.facebook.com/clinicalconceptsinobstetricsDr Martin's Facebook: https://www.facebook.com/profile.php?id=100024366859192

The experts at Clinical Concepts in Obstetrics pool their decades of experience caring for critically ill pregnant women to discuss the challenges encountered in caring for these vulnerable women. Dr Stephanie Martin is the Medical Director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist with expertise in critical care obstetrics. Suzanne McMurtry Baird, DNP, RN is the Nursing Director for Clinical Concepts in Obstetrics with many years of experience caring for critically ill pregnant women. Julie Arafeh, RN, MS is the Simulation Director for Clinical Concepts in Obstetrics and a leading expert in simulation.Follow us: Instagram: https://www.instagram.comDr Martin's LinkedIn: http://linkedin.com/in/stephanie-martin-65b07112aCCOB LinkedIn: https://www.linkedin.com/company/clinical-concepts-in-obstetrics/Twitter/X: https://twitter.com/OBCriticalCareCCOB Facebook: https://www.facebook.com/clinicalconceptsinobstetricsDr Martin's Facebook: https://www.facebook.com/profile.php?id=100024366859192

A recent practice guideline provides updated evidence-based conclusions and recommendations regarding in utero effects of anti-seizure medications and folic acid supplementation on the prevalence of major congenital malformations, adverse perinatal outcomes, and neurodevelopmental outcomes. Dr. Parthvi Ravat interviewed Dr. Alison Pack about the guideline, which was produced by the American Academy of Neurology, American Epilepsy Society, and Society for Maternal-Fetal Medicine.Review the practice guideline: Teratogenesis, perinatal, and neurodevelopmental outcomes after in utero exposure to antiseizure medication (Neurology, May 2024)Other studies mentioned in the episode: Risk of major congenital malformations and exposure to antiseizure medication monotherapy (JAMA Neurology, March 2024) Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, X (Twitter), Instagram, and LinkedIn.

Julie and Stephanie explain what a recap is and how it can be used to communicate effectively during simulation and during actual emergencies. The experts at Clinical Concepts in Obstetrics pool their decades of experience caring for critically ill pregnant women to discuss the challenges encountered in caring for these vulnerable women. Dr Stephanie Martin is the Medical Director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist with expertise in critical care obstetrics. Suzanne McMurtry Baird, DNP, RN is the Nursing Director for Clinical Concepts in Obstetrics with many years of experience caring for critically ill pregnant women. Julie Arafeh, RN, MS is the Simulation Director for Clinical Concepts in Obstetrics and a leading expert in simulation.Follow us: Instagram: https://www.instagram.comDr Martin's LinkedIn: http://linkedin.com/in/stephanie-martin-65b07112aCCOB LinkedIn: https://www.linkedin.com/company/clinical-concepts-in-obstetrics/Twitter/X: https://twitter.com/OBCriticalCareCCOB Facebook: https://www.facebook.com/clinicalconceptsinobstetricsDr Martin's Facebook: https://www.facebook.com/profile.php?id=100024366859192

We know that exercise is recommended when everything is okay in pregnancy … but what about when complications come up? That's where Dr. Rosner comes in Jonathon is a maternal fetal medicine specialist or high risk OB who works at Mount Sinai South Nassau. In todays episode, he answers listeners questions, gives some ideas of how HE prescribes exercise and overall gives lots of wonderful information on how he comes alongside mamas to be when things are a little bit scary and stressful. Dr. Rosner asked for one clarification: I'd like to clarify that for patients without any significant medical history, those patients can see either a midwife or an obgyn. However patients with a significant medical history such as hypertension, diabetes, or patients who develop a routine pregnancy complication such as hypertension or those who wish to undergo a repeat section should consider going to an obgyn. ___________________________________________________________________________Don't miss out on any of the TEA coming out of the Barbell Mamas by subscribing to our newsletter You can also follow us on Instagram and YouTube for all the up-to-date information you need about pelvic health and female athletes. Interested in our programs? Check us out here!

Suzanne and Stephanie review another maternal death situation and discuss what they think happened. Listen and decide what you think it was.The experts at Clinical Concepts in Obstetrics pool their decades of experience caring for critically ill pregnant women to discuss the challenges encountered in caring for these vulnerable women. Dr Stephanie Martin is the Medical Director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist with expertise in critical care obstetrics. Suzanne McMurtry Baird, DNP, RN is the Nursing Director for Clinical Concepts in Obstetrics with many years of experience caring for critically ill pregnant women. Julie Arafeh, RN, MS is the Simulation Director for Clinical Concepts in Obstetrics and a leading expert in simulation.Follow us: Instagram: https://www.instagram.comDr Martin's LinkedIn: http://linkedin.com/in/stephanie-martin-65b07112aCCOB LinkedIn: https://www.linkedin.com/company/clinical-concepts-in-obstetrics/Twitter/X: https://twitter.com/OBCriticalCareCCOB Facebook: https://www.facebook.com/clinicalconceptsinobstetricsDr Martin's Facebook: https://www.facebook.com/profile.php?id=100024366859192

In this episode, Dr Stephanie Martin has a discussion with Jamie Agunsday, MA, MSN, RNC-OB, a nurse abstractor for the New Jersey Maternal Mortality Review Committee. We talk about what is an MMRC, how maternal deaths are reviewed and the importance of the data that is leaned from an MMRC. She also outlines what she wants every OB healthcare provider to know about an MMRC.Jamie Agunsday is a master's prepared Registered Nurse who has spent the last decade serving women and birthing families in New Jersey. As a staff nurse in Labor and delivery in one of NJ's busiest birthing hospitals, Jamie was deeply impacted by seeing women experience serious pregnancy related complications. For the last 4 years, Jamie has worked to support the review of maternal deaths as a maternal mortality nurse abstractor where she tells the stories of those who died from complications of their pregnancies. Through all of her work, Jamie seeks to center the voices and amplify the stories of those most impacted by adverse outcomes to help make meaningful improvements in the health of all people giving birth.https://www.cdc.gov/maternal-mortality/php/data-research/mmrc-2017-2019.htmlhttps://www.cdc.gov/maternal-mortality/php/data-research/index.html#:~:text=Characteristics%20of%20Pregnancy%2DRelated%20Deaths,in%2038%20U.S.%20States%2C%202020&text=Race%20or%20ethnicity%20was%20missing,1.3%25)%20pregnancy%2Drelated%20deaths.The experts at Clinical Concepts in Obstetrics pool their decades of experience caring for critically ill pregnant women to discuss the challenges encountered in caring for these vulnerable women. Dr Stephanie Martin is the Medical Director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist with expertise in critical care obstetrics. Suzanne McMurtry Baird, DNP, RN is the Nursing Director for Clinical Concepts in Obstetrics with many years of experience caring for critically ill pregnant women. Julie Arafeh, RN, MS is the Simulation Director for Clinical Concepts in Obstetrics and a leading expert in simulation.Follow us: Instagram: https://www.instagram.comDr Martin's LinkedIn: http://linkedin.com/in/stephanie-martin-65b07112aCCOB LinkedIn: https://www.linkedin.com/company/clinical-concepts-in-obstetrics/Twitter/X: https://twitter.com/OBCriticalCareCCOB Facebook: https://www.facebook.com/clinicalconceptsinobstetricsDr Martin's Facebook: https://www.facebook.com/profile.php?id=100024366859192

Women of Strength, how many of you have “failure to progress” on your operative report as the reason for your Cesarean(s)? Meagan and Julie talk ALL about failure to progress today– how it led to their own Cesareans and how after breaking it down, they both realized that neither of them actually qualified for that label. When is it failure to progress and when is it failure to wait? What does failure to progress actually mean? This is an episode you will want to listen to over and over again. From learning all of the ways a cervix changes other than just dilation to all of the possible positions you can try during a lull in labor, Meagan and Julie share invaluable current research and personal experiences on this hot topic! ACOG Article: Limiting Interventions During Labor and BirthAJOG Article: Safe Prevention of a Primary Cesarean DeliveryThe Journal of Perinatal Education: Preventing a Primary CesareanOBG Project ArticleThe VBAC Link Blog: Failure to ProgressHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello. I am with Julie today and we are going to be talking about failure to progress. If you have been diagnosed with failure to progress– and I say diagnosed because they actually put them on our op reports like it's a diagnosis of failure of progress meaning our cervix does not know what to do. It cannot make it to 10 centimeters or it hasn't or it will not in the future, then I am telling you right now that this is definitely a great episode for you. Even if you haven't been told, it's going to be a great episode because we are going to talk about some other great things in the end about what to do in labor position-wise and all of the things. So we're going to get going, but Julie apparently has a Review of the Week. We weren't going to do one, but she says she has a Review of the Week. So, Julie? I will turn the time over to you. Julie: This is my review. Are you ready? Meagan: I'm actually really curious. Julie: “I'm so excited. Thank you so much, Meagan and Julie. I love The VBAC Link!” Signed, lots of people everywhere. Meagan: I love it. Julie: We don't have a Review of the Week so I just made one up. Boom. There. Signed, AnonymousMeagan: All right, you guys. Failure to progress: what it is and what it isn't. Let's talk about what it is. What does it mean? Essentially, it means that your provider believes that your cervix did not progress in an adequate amount of time and there's also failure to progress as in your body may have gone into or you are going in for an induction and then they couldn't even get labor going which we all know is usually not the case that your body really couldn't do it, but failure to progress is when your cervix does not continually dilate in an adequate amount of time. Would you change anything about that, Julie, or add anything to that? Julie: Sorry, I didn't hear half of that. I was just going through it. I was going through the things just to make sure that we are 100% accurate on what we are about to say. Whatever you said, yeah. That sounds great. Yeah. Let's go with it. Meagan: Failure to progress– the cervix is not dilating in an adequate amount of time. Julie: Basically, yeah. Your cervix isn't changing so you've got to do a C-section because it's not working basically. Meagan: Okay, so what it isn't– do you want to talk about what it isn't? Julie: What it isn't? It isn't– sorry, I'm trying to say it. Meagan: It isn't true most of the time. Julie: Most of the time it's not true. It isn't what we think it is and if it is, it's not a sign that your body is broken. It's not exclusion. It's not a reason to exclude you from trying for a VBAC. It's not your fault. It usually is a failure from the system where people are in a rush or in a hurry and just not knowing how to move past a stall in labor or not understanding the true flow of how some labors take. I mean, I was diagnosed with failure to progress. You were diagnosed with failure to progress and I know that both of our literal clinical outlook at the time we were diagnosed with failure to progress was not true failure to progress. Meagan: Mhmm. Julie: According to what the actual guidelines and requirements are. So I always say, yeah. What you said, it is not true. Meagan: It is not true.Julie: We joke about that and use it loosely. Sometimes it is true. I've seen one true failure to progress diagnosis in over 100 births, but I feel like most of us listening and most of us who have C-sections have them because of failure to progress. Now, mine when I was in labor, I was not told failure to progress. I was told fetal heart tones, but that's another topic for another episode– what we are told versus what is in our op reports. So yeah, let's do a little plug-in about getting your op report. Find out what is actually in the notes that say why your C-section was called because it's not uncommon for what it was written down to be different than what you were told in the moment. I feel like having an accurate clinical understanding of what your Cesarean looks like on paper to another doctor who is reviewing your birth is super important. Meagan: Absolutely. I agree and also, I think that it's important to note that if you have been told this and you have doubt in your body, that it is normal to have doubt because we have been told that we can't do something and that our body can't dilate, but I also want to plug-in that really try not to believe that. Try your hardest. Do whatever you can to not believe that. It's going to help you. Believe the opposite. Believe that your body can do it. Believe that you were most likely set up in a less-ideal circumstance that created that result, right? Like an induction– it was a failure to descend, not progress, but I just recorded a story the other day where her water was broken at 6 centimeters, baby came down wonky. They couldn't get baby out and they diagnosed her with CPD. There are these things that are happening a lot of the time where we are walking in to be induced way too early or really any time we are being induced could be too early especially if it's just an elective. It can definitely be too early and our body is not ready so our body is not responding or our body is overwhelmed because it's been given so much so fast and it doesn't know what to do so it doesn't react the way a provider wants it to by our cervix dilating. It almost is reacting in the reverse way where it's tense and tight and like, No. I'm not ready and I'm not letting this baby out. Don't you feel like you've seen that? Julie: Yeah. We've seen lots of things. I feel like that's the tricky thing. We as doulas and birth photographers really do get to see the whole gamut of everything from home to birth center to hospital and everything. I feel like we have such a unique perspective on how labor is managed in and out of hospitals and how stalls or lulls in labor are managed in both places. Let me tell you, it's often way smoother and in my opinion way better outcomes when you are out of the hospital and that happens. Meagan: Mhmm. Labor at home as long as you can. Yeah. I mean, one of the stories that I just recorded was an accidental home birth. It was not her plan, not even close, and it will for sure come across that way when she is telling the story, but there were so many things that she did within that labor like movement from the shower to the toilet to walking down the stairs to moving back to the toilet. There was all of this movement that sometimes doesn't happen in a hospital or we've got, like I said, “Let's break your water. Let's do these things.” We've got these interventions that may help, but doesn't always. It may also cause problems. Okay, so we have some updates for you on the safe prevention of a primary Cesarean delivery that Julie has found and then we also want to talk about what is adequate labor too? What does that mean and where do we decide or where does a provider decide if labor is not adequate? Julie, do you want to talk about this for a minute on what you found from the OB/GYN Project? Julie: That's just a really nice summary. I really like it because it is all laid out really nicely. I am seeking out different pieces of information because there is updated information so I'm just looking for that. I'm not quite 100% certain I can speak to when it came out. Evidence-Based Birth has some great information. They did a podcast episode on the Friedman's curve. We know that dilating 1 centimeter an hour is based on the study that Friedman did. That's incredibly flawed but there is new updated, more evidence-based information that has come out. I'm trying to find out when it came out actually because the Friedman curve was established I think in 1956 and let's see. In the 2010's there were big shifts in the evidence. In 2014, ACOG had a study. Maternal Fetal Medicine published new guidelines on labor progress. Okay, so 2014 it looks like which is actually not that new anymore because it's 10 years later. That was, I think– I don't think it's actually shifted that much at all. I'm just trying to figure that out right now. I'm sorry. Let's see. The Practice Bulletin– yeah. You go. Safe Prevention of the Primary Cesarean Delivery. Meagan: I think we are looking at approaches to limit interventions during labor and birth, but we know that a lot of the time when we are introducing interventions, that is where we often will receive a failure to progress diagnosis because we are really introducing things, like I said earlier, when the body is not quite ready or the baby is not quite ready. Maybe the baby was already too high and was trying to make their way around and into the pelvis but now we've got an asynclitic baby or a transverse baby or an OP baby.This one, Number 766 which we will have in today's show notes actually originally replaced the committee of 687 in February 2017. The 766 was in 2019 and reaffirmed in 2021. Something that I like that it goes through is recommendations for women who are at term and spontaneous labor it happening. It talks about admission upon labor. It talks about premature rupture of membrane or rupturing of membranes which I think is a big one. Really, through my own experience but also doula experience, I've seen so many people go through membrane rupturing whether artificially or spontaneously and then nothing is happening so we go in and we get induced. Or we are told the second our water breaks that we have to go in, then labor has not started yet so we are intervening. One of the things it says is, “When membranes rupture at term before the onset of labor, approximately 77-79% of women will go into labor spontaneously within 12 hours. 95% will start labor within 24-28 hours.” I just had this experience with a VBAC client just the other day. Her water broke and within about 9 hours, she was starting to contract and within less than that, she actually progressed really quickly. Baby was born. That was really great but then there are situations like myself where it takes forever for labor to even start. It took 18 hours for my very first contraction with my second baby to even start and then by 24-28 hours, I was in a repeat C-section because my body didn't progress fast enough according to my provider.It says that, “The median time to delivery for women managed expectantly is 33 hours and 95% had delivered by 94-107 hours after rupture of membranes.” I think that is something also really important to note that if your water breaks, it doesn't mean we're just having a baby right away. It doesn't mean that our body is failing because we haven't started labor. 94-107 hours after the rupture of membranes is when the baby had been born. That's some time. We need to allow for the time. Julie: That's why I hate it when hospitals say, “If your water breaks, come in right now.” No. Meagan: I know. My provider did that too because it makes sense in our heads. They're saying, “Oh, just come in because we have to monitor baby because of infection and all of this stuff.” But we also have to take a step back and realize that once we go into that environment, one, that's a new environment. We're not familiar with that. All of those germs in that environment, we're not accustomed to. We're not immune to them. And then two, we know that the second we go into labor and delivery units, what happens? They want to check our cervix which means–Julie: Bacteria. Meagan: There is bacteria that is possibly being exposed to the vaginal canal, right? Even if it's a sterile glove, that still raises chances. Julie: Yeah, sterile gloves really are not as sterile as people think. Meagan: There are these things to keep in mind, but it's so hard because for me, I had premature rupture of membranes. My body didn't start labor, but I was told failure to progress after 12 hours for only reaching 3 centimeters. I was told failure to progress. I just really liked that. I mean, I like a whole bunch of this but I really liked that part of the rupture of membranes because I think so often we are told, “Oh, your water is broken. You're not progressing. You are a failure to progress.” Or we are not progressing so we have to break our water to try and speed our labor up and then that doesn't happen and then we are failure to progress. Can you see the problem here? Julie: Total problem. Meagan: It's a problem. Julie: It is a problem. So many problems. It's fine. I just dropped two different links to the updated guidelines because it's really funny. I've been going down the rabbit hole now while you've been talking so if I'm repeating things like I tend to do on you sometimes, please forgive me. I just think it's interesting. There is starting to be a shift in pulling away from Friedman's curve and going into a different way to consider an actual progression of labor which is a really cool, nice little shifty-shift here. I feel like maybe let's talk about what failure to progress really is. What are the guidelines for it? What is real failure to progress versus what you've probably been told about it? First of all, let's just talk about– nothing. Meagan: Can we use my own birth example just as a starting point to what this evidence is showing us or what the guidelines are? My water had broken spontaneously. It took a little bit to start labor. Within 12 hours, I was 3 centimeters and was told that my pelvis was too small and that I was failure to progress. Water broken, I was 3 centimeters 12 hours into labor. all right, Julie. What am I? Am I real, true failure to progress or not? Julie: No, you're not. Absolutely not, are you kidding me? Because you were still in the first stage of labor. That is the number one thing. According to clinical guidelines, it is not failure to progress until you're in the second stage of labor which is at least 6 centimeters dilated. So guess what, friends? If you got called failure to progress before you were 6 centimeters dilated– mine was labeled failure to progress at 4 centimeters so that rules me out. I mean, there are lots of things that rule me out and Meagan. But if you are less than 6 centimeters, it is not failure to progress. Meagan: Yeah, it even says right here. “Active phase arrest is defined as a woman at or beyond 6 centimeters dilation with ruptured of membranes who fails to progress despite 4 hours of adequate uterine activity or at least 6 hours of oxytocin administration with an adequate uterine activity and no cervical change.” Can we talk about that too? Adequate uterine activity. You guys, at 3 centimeters with my water broken, I was still not in an active pattern to progress. It takes time. Our uterus doesn't just start contracting regularly and adequately. It takes time. Then at that, I was only on oxytocin for 2 hours. Julie: Pitocin. You were on Pitocin. Meagan: Sorry. That's what I meant. Pitocin. I'm looking at the word oxytocin administration. Pitocin. Julie: We all know the truth. Meagan: We all know that Pitocin is not oxytocin. Julie: That is a soapbox for another day. Meagan: I was only on Pitocin for 2 hours. 2 hours. At the top, it says, “Slow but progressive labor in the first stage of labor should not be an indication for a Cesarean. With a few exceptions, prolonged late phase greater than 20 hours in a first-time mother and greater than 14 hours in a multi (so a mom who is not a first-time mom) should not be an indication for Cesarean as long. As the mother and the baby are doing well, cervical dilation of 6 centimeters should be the threshold of an active phase of labor.”Julie: Exactly. That's it too. Later on after this, we're going to talk about all the different ways a cervix can change because can I just tell you what? Someone says, “I'm 5 centimeters. I'm still 5 centimeters, great. Cool. What else has your cervix been doing? We're going to talk about that in just a second.” But yes, that's the thing. It's not failure to progress before 6 centimeters. It has to be 4 hours of adequate uterine activity which means strong, consistent contractions. Contractions that are strong enough. We could talk about the Montevideo units which is another measurement of the strength of contractions. We're not going to talk about that because we just don't have time, but are your uterine contractions strong enough? Yes? Then it's got to be at least 4 hours without cervical change. No? Then great. Let's do Pitocin and the inadequate amount of uterine activity. It says 6 hours or more of Pitocin without adequate uterine activity. If you've been on Pitocin for 6 hours and your contractions– which has caused that adequate contractions– and there is still no cervical change, then you are failure to progress Let's talk about cervical change though because the cervix goes through so many things. When I was doula-ing, I talked about this a lot in our second prenatal visit about how a lot of times you'll be like, Oh, cervical change. Yeah, dilation. Am I 4, 5, 6, 7, 8? But listen. The cervix goes through changes in 6 different ways. It moves forward so from posterior pointing backward toward to your spine. It straightens out to a more downward position. It softens so it goes from hard like your forehead to hard like your nose to softer like your chin. It softens. It effaces which means it thins out so it starts thick. It thins out which is effacement. It dilates obviously which is the opening and then baby's station like where baby is in the pelvis. Baby drops down, rotates, and descends. If you were 3 centimeters at your last cervical check and 60% effaced and 2 hours later at your next cervical check, you are 3 centimeters and 80% effaced, your cervix has thinned by 20% which is a good amount of cervical change. Meagan: Good change, yeah. Julie: If you were 6 centimeters and your baby was at a -2 station and at your next cervical check, you are 6 centimeters and your baby is -1 station which means your baby is lower in the pelvis, that is a cervical change. All of these things are shifting so I feel like it's important that when we are talking about failure to progress or when we are talking about labor progress that we consider all of the things the cervix does.I was just at a birth yesterday– not yesterday, two days ago. I don't know. It was all night and it was long for me. All night is long. It doesn't matter if i was there for 6 hours or 20 hours. If it was all night, I'm going to call it long as I'm getting older. The client was still 4-5 centimeters but the cervix was a lot softer or stretchier I think at the one before this. Oh yeah, your cervix is super stretchy now. Those are all great cervical changes even though the dilation number hasn't changed. Meagan: Yeah, so coming forward, thinning out, really softening up, baby dropping– all of these things are signs of progression and so it's something to keep in mind if a provider is like, “Well, you've been sitting at 6.5 centimeters now for 9 hours,” or whatever, but at the same time, your cervix went from 40% to 80% thinned and it went from super posterior to more mid-line and baby went from -3 to a 0. These are changes. These are absolutely changes and there are so many things that go into that. If a baby is high and not well-applied because they are trying to work their way down to the pelvis and our cervix is working on coming forward, there is so much that goes into that where now we're going to have a baby. If that change was made, now maybe we can have a baby that was well-applied to the cervix creating good pressure. Uterine activity is getting stronger. Things are progressing in the right way.So in the ACOG thing, it does say that in contrast to the prior suggested threshold of 4 centimeters which we know is very outdated, the onset of active labor–Julie: Right, that was according to the Friedman's curve. Friedman's curve called active labor at 4 centimeters but now we are getting all of this new information that yeah, it's probably at 6. I feel like when you and me started as doulas 9-10 years ago, it was 4 centimeters, but a couple years after that, everything started shifting into 6. So it's actually not that new, but kind of new. Sorry, keep going. Meagan: Yeah. I want to get into our positions really quickly, but it does say even in here, the onset of labor for many women may not occur until 5-6 centimeters. May not occur until then and then we know that sometimes around 6 centimeters, it takes some time. We're going to make sure all of these links here are in the show notes so you can check it out. Meagan: But we only have a few minutes left so I really want to talk about positions, okay? So positions in my opinion can truly change failure to progress. Julie: Yes. If there is a lull in labor, they're getting close to calling a C-section, what can we do about that? Nobody wants to hang out at 4 centimeters forever. Nobody does so what can we do about that? Yes, Meagan? Sorry, go ahead. Meagan: Movement. If you do not have an epidural, obviously movement is a lot more free. Moving around, just walking. Just flat-out walking. If we've got a higher baby and we're trying to get a baby down, really think about that femur rotation turning out. You can walk and sometimes I've had my clients do this little step dance thing where you step really wide and out and then left and right and left and right. We are doing this weird-looking dance thing, but you're grooving. Julie: You're grooving. Meagan: That can really help. Or thinking about really big asymmetrical movements so put your leg up on the bed or on a stool or on a whatever and leaning over. Bigger movements and outward movements. If you have an epidural at this point, same thing. Rotate on your side and really open those knees up really, really wide. Try to keep those movements consistent. If you're exhausted and you have an epidural because you need sleep, I really, really believe in sleep and I think it's very powerful. Find a good position. Sleep in that position and when you wake up, get going. Get active. But every 5 or so contractions, if you can, if not, make it 8, make some changes. It doesn't have to be too dramatic. It sounds weird, but if you are at home, crawling up your stairs. Crawling up your stairs on your hands and knees is weird but it works or standing up and down going from the side– one side going down, standing back up, turning and walking back up, turning around, doing the other side down and coming back up. Those things are going to help. Doing big figure 8's or hip dips. As the baby gets lower, all of those things are really still important. We are going to be less focused on big open wide because now we're going to want to get baby in and then down. So if you think about a pelvis, when the femur rotation goes out, the bottom goes in. Femur rotation in, bottom goes out. Thinking about these movements as you're laboring and as you're working through these things, as you're in these positions. Think about our hips, our pelvis, and even doing some cat-cows in labor is really good. We know there is the flying cowgirl. That is a really good one in labor too to get baby down and in. Julie: Walcher's. Meagan: Walcher's is not as fun, but it can be very good. Julie: It is magical. I've seen it push labor through so well. I had a doctor once at the U come in. I had a client who was 5 centimeters. Baby wasn't looking too great. She had been 5 centimeters for a while and we were doing Walcher's. They came in because the heart rate– Walcher's sometimes makes it hard to get a fetal heart rate so the nurses come in. They were talking about C-section and they were prepping, bringing in all of the C-section stuff for her partner to get ready. They were like, “You can't do this. Baby's heart rate is not tolerating it.” I'm like, “No. It's just not picking up the heart rate.” I'm like, “Okay, just one more contraction.” One more contraction later, she comes up and starts pushing 2 minutes later and her baby is born. the doctors are freaking out because, “Oh my gosh, the bed's not designed to labor like this.” Not everyone, sorry, but those are a little couple of pushbacks I've gotten sometimes. Meagan: It's weird-looking. It's funky. It's uncomfortable. Julie: Yeah. It's curious and some staff at hospitals do not– if they see something new and they don't know about it, they automatically assume it's not good because they need to keep everything in line and to the protocol and all of those things. But yeah, it's just really a magical thing. Meagan: There's also the abdominal lift. You can abdominal lift. I think actively moving through the contraction which can get really hard in that active phase, but through the contraction can actually help. Hands and knees, sacrum, and all of those things. Holy cow, there are so many positions. Julie: Yeah, can I just touch back? When you said about the epidural, I love when you're not resting, I think sometimes it's easy to get discouraged if you want an epidural but you also want to move during labor. I want to expound on that a little bit because you can move with an epidural still and here's how you do it. My favorite labor position with an epidural is sitting up in the throne. You lay the head of the bed all the way up, drop the feet down, then you crisscross your legs. Put the peanut ball under your right leg. Five contractions later, peanut ball under your left leg. Five contractions later, criss-cross your legs again or stretch them out straight and then repeat. Do you know what? There are so many magical ways that that helps. It keeps your pelvis moving and shifting and growing. I swear that is the most magical position for laboring with an epidural because you are upright. Baby is going to move down. The pelvis is moving and shifting so it creates lots of movement and space and I have seen that progress labors relatively quickly to how they have been going before we set up the throne so many times. I love that. I will swear. I will die on that hill. If you are failure to progress and things aren't moving, sit up, drop your legs, get the peanut ball. It doesn't even have to be the peanut ball. Maybe you don't have one in your hospital but stack a couple of pillows but put one leg up. Put your foot flat on the bed so your knee is making a triangle. I don't know how to describe it the right way and then drop it and put the other leg up and then criss-cross your legs then stick them out straight like two little sticks. Meagan: Every five. Every five, have subtle changes. Every five, subtle changes. Keep that in mind when you are laboring. Women of Strength, know that failure to progress is rarely truly failure to progress. We get it. We've been told the same thing. We see it all of the time as doulas. There's more. There's more and don't feel like you have to say, “Okay” to a Cesarean if your cervix hasn't dilated to a certain amount that the provider is wanting. Assuming you and baby are doing well, you can always ask for more time. Okay, we are on a soapbox. We could probably continue for a whole while longer, but Julie, thank you for joining me today and talking about failure to progress and what it is and what it isn't. Julie: You're welcome. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands