Podcasts about Obstetrics

Think about the last time you had to time something perfectly. Maybe it taking that perfect swing at the baseball, or catching a flight after a commute, or making a high-stakes decision. In the world of high-risk pregnancy, clinicians play a constant game of high-stakes timing with a usual medication called antenatal corticosteroids. Given to moms at risk of giving birth early, these steroids are a gamechanger for a preterm neonate. But there's a catch. If you give them too early, the benefits fade. If you give them too late and she delivers very quickly, they don't have time to work. A brand-new study published in the journal Obstetrics & Gynecology by Mark Clapp et al reveals just how incredibly difficult this balancing act is. This data shows that nearly 26% of pregnant individuals who received these steroids actually went on to deliver completely full-term, exposing babies to medications they might not have needed. So how do we as clinicians solve this OB Goldilocks problem where the stakes are a newborn baby's health? On today's episode, we break down the data behind 'maximizing benefit while avoiding overuse' and what it means for real world practice.Strong Coffee Company - Protein Coffee PLUS MORE; Get 20% OFF | Promo Code: CHAPANOSPINOBG https://promocode.to/strong-coffee-company/chapanospinobg-hbv1. Clapp, Mark A. MD, MPH; Li, Siguo MS; Melamed, Alexander MD, MPH; Reiff, Emily MD; Gyamfi-Bannerman, Cynthia MD, MS; Kaimal, Anjali J. MD, MAS. Maximizing Benefit From Antenatal Steroid Use While Avoiding Overuse. Obstetrics & Gynecology 148(1):p e33-e42, July 20262. FIGO good practice recommendations on the use of prenatal corticosteroids to improve outcomes and minimize harm in babies born preterm. Int J Gynaecol Obstet. 2021 Oct;155(1):26-303. Society for Maternal-Fetal Medicine Special Statement: Quality metrics for optimal timing of antenatal corticosteroid administration; 2022

Many people with infertility use in vitro fertilisation (IVF), however the probability of having a baby following IVF is only approximately 30-40% per cycle and decreases significantly with age. It can be a lengthy and expensive process. Providers sometimes offer ‘add-ons', additional treatments that they claim could help patients conceive, which are themselves also usually expensive. In Australia, New Zealand and the United Kingdom more than 70% of patients pay for at least one of these add-ons. A new review published in The Lancet Obstetrics, Gynaecology, & Women's Health journal has found that evidence on the benefits of these add-on treatments is unclear. Claudia Hammond speaks to Dr Sarah Lensen, Senior Research Fellow in the Department of Obstetrics, Gynaecology and Newborn Health at the University of Melbourne.Joining Claudia from Ghana is genito-urinary consultant and HIV expert, Vanessa Apea. Claudia and Vanessa discuss a draft African Charter on Family, Sovereignty and Values, which claims that comprehensive sex education, as well as a range of sexual and reproductive health rights, are a threat to African families from foreign ideologies.They also discuss a report from the Office of Inspector General of US Agency for International Development (USAID) which reveals that President Donald Trump's administration has spent hundreds of thousands of dollars in storage and transportation costs for $9.7 million worth of contraceptives that are being stored in Belgium rather than distributed to the various low-income countries they were intended for. Many of the withheld contraceptives are now expired or unusable due to their removal from temperature-controlled storage.We also hear from Health Check reporter Jane Chambers in the Chilean city of Valdivia, where wetlands are part of everyday life—and increasingly, part of people's health. And we hear how faecal-microbiome transplants could improve the efficacy of some antidepressants in patients with major depressive disorder.Presenter: Claudia Hammond Producers: Jonathan Blackwell & Georgia Christie

When Ashley Womble decides she wants to start a family, she worries she'll need to stop taking her antidepressant medication. Instead of finding clear guidance, she runs head-first into a troubling reality: many of the questions pregnant women and their physicians face about medication safety remain difficult to answer because pregnant women have historically been excluded from medical research. This episode looks at the ethical trade offs of leaving pregnant women out of medical research—and what happens when they and their doctors must make high stakes healthcare decisions without high quality evidence.This episode features:Ashley Womble, MPH: Writer and marketing professional.Ruth Faden, PhD, MPH: Philip Franklin Wagley Professor of Biomedical Ethics at the Johns Hopkins Berman Institute of Bioethics.Crystal Clark, MD, MSc: Associate Professor, Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto.Marika Toscano, MD, MS: Assistant Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine.This episode contains references to suicide, which may be distressing for some listeners. If you or someone you know is struggling, support is available.In the U.S., you can call or text the Suicide and Crisis Lifeline at 988 or the National Maternal Mental Health Hotline at 1-833-TLC-MAMA.For listeners outside the U.S., the International Association for Suicide Prevention can help connect you with support in your area: www.iasp.info/suicidalthoughts/“playing god?” is a podcast by the iDeas Lab at the Johns Hopkins Berman Institute of Bioethics. To read a transcript of this episode, visit the iDeas Lab website at https://bioethics.jhu.edu/pgs2e6.The Johns Hopkins University Sesquicentennial is proud to support this podcast. JHU celebrates 150 years of pioneering education and research—advancing knowledge to meet the challenges of every generation. Learn more at 150.jhu.edu.

Lower C-section rates, faster deliveries, and less physician burnout: could the OB hospitalist model deliver all three? In this episode of BackTable Women's Health, host Dr. Nicole Faulkner interviews Dr. Maliha Sayla, a board-certified OBGYN and medical director of labor and delivery at Northwestern Medicine Delnor Hospital, to explore how the OB hospitalist model is reshaping care for physicians, patients, and healthcare systems. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction 03:27 - Why Hospitalists Matter05:33 - How Their Model Works07:15 - Managing Pushback10:18 - Measuring Better Outcomes15:58 - Drills and Emergencies19:50 - Staffing and Transition24:33 - ROI and OB-ED26:33 - Residents and Teaching30:52 - Future Flexible OB Careers34:14 - Patient Acceptance of Model36:47 - Collaboration and Lifestyle Balance40:00 - Conclusion --- More about this episode Dr. Sayla shares her journey from traditional private practice to full-time OB hospitalist work, explaining how this model reduces physician burnout by making labor and delivery a dedicated role rather than one juggled alongside clinic visits, surgeries, and administrative responsibilities. She details her institution's staffing structure, where hospitalists provide continuous labor and delivery coverage, allowing generalist OBGYNs to focus on outpatient care. Dr. Sayla highlights the benefits of having dedicated physicians available for bedside counseling, fetal monitoring, and real-time decision-making. The episode explores improvements in communication, collaboration, and patient outcomes, including lower NTSV (Nulliparous, Term, Singleton, Vertex) cesarean rates and shorter induction-to-delivery times after adopting the hospitalist model. Additionally, she discusses the hospitalist role in obstetric emergency preparedness and interdisciplinary collaboration, patient perspectives, and the potential of hospitalist programs to address OBGYN workforce shortages. --- BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women's health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

*** Learn how the TALK tool enhances team communication in critical care settings. Discover its benefits, implementation strategies, and key takeaways for healthcare professionals.Article referenced: Iago Enjo-Perez, Cristina Diaz-Navarro, Esther Leon-Castelao, Miquel Sanz-Moncusí, Inma Carmona-Delgado, Javier Pérez-Dueñas, Rocío Ponce-Muñoz, Sara Fernandez-Mendez, Jose-Ramón Alonso-Viladot, Jose María Nicolàs-Arfelis, Pedro Castro; Use of the TALK Tool for Interprofessional Team Self-Debrief During Everyday Opportunities for Learning in Critical Care. Am J Crit Care 1 May 2026; 35 (3): 171–181. doi: https://doi.org/10.4037/ajcc2026814The 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:Patreon: patreon.com/CCOBYouTube: @CriticalCareOBPodcastInstagram: 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: ...

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-490 Overview: In the US, maternal morbidity and mortality rates are among the highest in the western world, and stroke is one of the leading causes—responsible for 1 of 12 maternal deaths. This rate is estimated to be much higher in high-risk pregnancies. Join us as we discuss a recent study examining rates of maternal stroke in which 1 in 4 women with stroke experienced a missed diagnostic opportunity and hear what these findings mean for your practice. Episode resource links: Haghighi N, Bourscheid RM, Shang C, et al. Identifying missed diagnostic opportunities in maternal stroke. Stroke. 2026;57(2). doi:10.1161/STROKEAHA.125.052995 Chen Y, Shiels MS, Uribe-Leitz T, et al. 2025. Pregnancy-Related Deaths in the US, 2018-2022. JAMA Network Open.  Lappen JR, Pettker CM, Louis JM. 2021. American Journal of Obstetrics and Gynecology. Society for Maternal-Fetal Medicine Consult Series #54: Assessing the Risk of Maternal morbidity and Mortality. American Journal of Obstetrics and Gynecology. Miller EC, Bello NA, Chen PR, et al 2026. Prevention and Treatment of Maternal Stroke in Pregnancy and Postpartum: A Scientific Statement from the American Heart Association. Stroke.  Bushnell C, Kernan WN, Sharrief AZ, et al. 2024. Guideline for the Primary Prevention of Stroke: A Guideline from the American Heart Association/¬American Stroke Association. Stroke.  Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-490 Overview: In the US, maternal morbidity and mortality rates are among the highest in the western world, and stroke is one of the leading causes—responsible for 1 of 12 maternal deaths. This rate is estimated to be much higher in high-risk pregnancies. Join us as we discuss a recent study examining rates of maternal stroke in which 1 in 4 women with stroke experienced a missed diagnostic opportunity and hear what these findings mean for your practice. Episode resource links: Haghighi N, Bourscheid RM, Shang C, et al. Identifying missed diagnostic opportunities in maternal stroke. Stroke. 2026;57(2). doi:10.1161/STROKEAHA.125.052995 Chen Y, Shiels MS, Uribe-Leitz T, et al. 2025. Pregnancy-Related Deaths in the US, 2018-2022. JAMA Network Open.  Lappen JR, Pettker CM, Louis JM. 2021. American Journal of Obstetrics and Gynecology. Society for Maternal-Fetal Medicine Consult Series #54: Assessing the Risk of Maternal morbidity and Mortality. American Journal of Obstetrics and Gynecology. Miller EC, Bello NA, Chen PR, et al 2026. Prevention and Treatment of Maternal Stroke in Pregnancy and Postpartum: A Scientific Statement from the American Heart Association. Stroke.  Bushnell C, Kernan WN, Sharrief AZ, et al. 2024. Guideline for the Primary Prevention of Stroke: A Guideline from the American Heart Association/¬American Stroke Association. Stroke.  Guest: Susan Feeney, DNP, FNP-BC, NP-C   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Send us Fan Mail Cardio Obstetrics: What is it?  | MedStar Health DocTalkPregnancy is often described as a natural stress test for the body, and especially for the heart. In this episode of MedStar Health DocTalk, host Debra Schindler sits down with cardiologist and cardio-obstetrics specialist Dr. Minhal Makshood to explore the growing field of cardio obstetrics and why pregnancy can reveal important clues about a woman's long-term cardiovascular health.Dr. Makshood explains how conditions such as preeclampsia, gestational hypertension, gestational diabetes, and peripartum cardiomyopathy can affect both mother and baby, and why these pregnancy-related complications may increase a woman's risk of future heart disease, heart failure, stroke, and other cardiovascular conditions.The conversation also highlights the importance of prenatal counseling for women with existing heart conditions, the role of multidisciplinary care teams, and why the postpartum period—sometimes called the “fourth trimester”—is a critical time for monitoring heart health.In this episode, you'll learn:• What cardio obstetrics is and why the specialty is rapidly growing• How pregnancy can uncover previously undiagnosed heart conditions• The warning signs of heart complications during and after pregnancy• Why preeclampsia and gestational diabetes are more than temporary pregnancy complications• How pregnancy history can help predict future cardiovascular risk• The importance of coordinated care between cardiologists, obstetricians, and maternal-fetal medicine specialists• What every woman should know about protecting her heart before, during, and after pregnancyWhether you're planning a pregnancy, currently expecting, recently delivered a baby, or simply interested in women's heart health, this episode provides valuable insights that could have lifelong implications.If you have a heart condition, experienced complications during pregnancy, or want to learn more about protecting your cardiovascular health before, during, or after pregnancy, schedule an appointment with the Women's Health and Cardio Obstetrics Clinic at MedStar Health. Call 301-570-7404 to learn more or make an appointment.Guest: Dr. Minhal Makshood, Cardiologist and Cardio-Obstetrics SpecialistHost: Debra SchindlerFor more episodes of MedStar Health DocTalk, go to medstarhealth.org/doctalk.

The latest public version of ChatGPT can be made to generate sexualised images or depict scenes of graphic violence with a simple prompt, researchers have told the BBC. British AI security startup Mindgard figured out how to make ChatGPT create graphic pictures by slightly altering a widely-shared instruction, or prompt, which was originally designed to produce humorous results. To find out more, Anita Rani speaks to Technology correspondent Chris Vallance and Mindgard's Peter Garraghan. A spokesperson for Open AI said: "We take these reports seriously. After investigating this trend, we've introduced additional safeguards against this type of prompt. Our safety systems are designed to block potentially harmful images that are uploaded to ChatGPT and we analyse whether the AI generated image violates our policies before we show the image to the user. We also combine automated systems and human review to identify and block harmful material.”Jon Snow, the lead presenter of Channel 4 News for 32 years, has revealed he has Alzheimer's disease. During his career, he reported on stories including the fall of the Berlin Wall, the release of Nelson Mandela and Barack Obama's inauguration, receiving numerous awards including the BAFTA Fellowship in 2015. In a new Channel 4 documentary, made in conjunction with the Alzheimer's Society, Jon Snow: A Last Big Story, he is seen uncovering an environmental disaster in Zambia. In her first broadcast interview since the diagnosis was announced, Jon's wife, Dr Precious Lunga, joins Anita to talk about how they are navigating life now. Testing the microbiome of your vagina is increasing in popularity, with direct-to-consumer companies offering at-home tests and claiming that this information is critical to women's health. Anita speaks with Dame Lesley Regan, Professor of Obstetrics and Gynaecology at Imperial College London, and Dr Caroline Mitchell, Professor of Obstetrics, Gynaecology and Reproductive Biology at Harvard Medical School, to discuss what we know about the vaginal microbiome and the recent surge in private testing. New novel Mrs Dickens by Emily Howes, tells the imagined story of Kate Hogarth, wife of the writer and journalist Charles Dickens. She is much loved at first, but as Charles finds fame and the family rise through the ranks of Victorian society, Charles's attitude towards Kate changes and she is devastated. Emily talks to Anita about how she pieced together and embellished the invisible life of Kate, a woman who bore Charles 10 children during a 22-year marriage and had an unparalleled view of one of the world's greatest writers.Presenter: Anita Rani Producer: Corinna Jones

On today's show, host Dana Pellebon is in conversation with Dr. Mary Fariba Afsari about her new memoir, Labor: One Woman’s Work. Dr. Afsari is a child of Iranian immigrants, a working mother, and the founder of a mobile health clinic, bringing reproductive healthcare to rural patients in the Pacific Northwest. In 2015, Dr. Afsari literally mobilized her practice to meet women where they are. Her clinic on wheels–FemForward Health–travels throughout rural Oregon because too many of these communities lack full-scale OB-GYN services. Dr. Afsari says that people have started driving to find her because they've been recommended by word of mouth. It's a sign of how broken the healthcare system is that a mobile RV clinic is providing better care than industrial medicine to women of color and rural women. Post Dobbs, Dr. Afsari says the fight for reproductive justice is more important than ever.  Dr. Afsari's memoir chronicles her career serving women like her grandmother who died of a pregnancy related complication. She says she wants readers to get a sense of the range of experiences she has from obstetric emergencies to joyous births. They also discuss Dr. Afsari's philosophy of meeting patients with curiosity, how race plays a central role in whether a woman will survive a pregnancy, the lack of gender-affirming care, and the criminalization of OB-GYNs post Dobbs.  Residents of Dane County may be aware of a similar service providing  mobile forensic nurse exams. Mary Fariba Afsari, DO, is a board-certified OB-GYN and the founder of FemForward Health, a mobile women’s health clinic in Portland, Oregon. She completed her medical school at Touro University college of Osteopathic Medicine, her Obstetrics and Gynecology residency at the University of Connecticut School of Medicine and holds an MS in Health Communication from the Tufts University/Emerson College joint program. Dr. Afsari is a passionate advocate for healthcare equity and reproductive justice. She speaks widely on the intersections of medicine, identity, and systemic healthcare reform. Her debut memoir, Labor: One Woman’s Work, was published by Avid Reader Press in April.  Featured image of the cover of Labor: One Woman’s Work. Did you enjoy this story? Your funding makes great, local journalism like this possible. Donate hereThe post One Mobile Clinic Practices Reproductive Justice in Rural Areas appeared first on WORT-FM 89.9.

Kia ora e te whānau. This week, we bring you a double header of epic proportions. First, you'll hear the 2026 Ultra Trail Australia Women in Trail panel. This episode features elite trail runners Beth McKenzie, Charlie Simpson, Lydia O'Donnell, and Olympian triathlete Sophie Linn. Next, Ali speaks to Dr. Pelle Kempe, a specialist Obstetrician and Gynaecologist based in Palmerston North. He is the Medical Lead for the Obstetrics and Gynaecology service at Palmerston North Hospital. Dr. Kempe also serves as Chair of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists. A passionate trail runner, Pelle is dedicated to improving women's health. This conversation explores the intersection of trails and health, the changes and challenges for female athletes, and possible ways forward. (Note for the fellas: Women's health affects everyone. Stick around, learn something, and enjoy the chat.) Dirt Church Radio—Best Enjoyed Running.--- --- --- Episode Links Beth McKenzie InstagramSophie Linn InstagramCharlie Simpson InstagramLydia O'Donnell InstagramDr Pelle Kempe InstagramSign up for the DCR AidStation newsletter.Dirt Church Radio on InstagramDirt Church Radio on FacebookFurther Faster New ZealandEnjoy!Music by Andrew McDowall, Digicake

CommonSpirit Health hosted a Grand Rounds session discussing the treatment of menopausal symptoms in women with cancer. The discussion included strategies on optimizing quality of life with oncologic safety. Speaker:Marina Frimer, MD, FACOG, FACS, Associate Chief, Research and Academic Development, Central Region; Director, Clinical Cancer Research,  Northwell Health Cancer Institute at Rego Park; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Long Island Jewish Medical Center; Associate Professor, Donald and Barbara Zucker School of Medicine at Hofstra/NorthwellPanelist:Claire Hoppenot, MD, Assistant Professor, Gynecologic Oncology, Dan L. Duncan Comprehensive Cancer Center, Baylor College of MedicineModerator: Amy Brockmeyer, MD, Section Head of Gynecologic Oncology, Department of Surgery, Virginia Mason Franciscan Health

Podcast Family, in this episode we will focus on the “20-minute rule” for vacuum assisted vaginal delivery. This is an important aspect of neonatal safety and is a vital part of procedure documentation. Documentation for vacuum assisted vaginal delivery should include station at application, number of tractions, number of pop-offs and the total traction time and the vacuum trackable time (time from first application to delivery). This has historical roots as well as new data to validate it (March 2026). Listen in for details. 1. ACOG PB 219; 20202. Preuss E, Porto A, Sheiman V, Bitton M, Tovbin J, Kedem HI, Barzilay E. When to stop? A single center experience on vacuum-assisted deliveries. Eur J Obstet Gynecol Reprod Biol. 2026 Mar 25;320:114983. 3. Teng FY, Sayre JW. Vacuum Extraction: Does Duration Predict Scalp Injury?.Obstetrics and Gynecology. 1997. 4. Tsakiridis I, Giouleka S, Mamopoulos A, et al.Operative Vaginal Delivery: A Review of Four National Guidelines. Journal of Perinatal Medicine. 2020. 16% OFF TONA ACTIVE WEAR PROMO: https://tonaactive.com/discount/CHAPANOSPINOBG

For most people, donor eggs is at the bottom of the list. It is not where you wanted to land. And if your clinic is recommending it, something in you is saying there has to be more to look at first. Here is what we see every week. The donor egg recommendation rarely arrives after a complete workup. It arrives after looking at the AMH, the FSH, the follicle count, maybe a basic semen analysis, and maybe being told your TSH is normal. Those numbers are real. The diagnosis is real. What gets called complete is the question. This episode is the 11 specific things we most often find skipped before the recommendation gets made. Pull it up. Take notes. Bring it to your next appointment. The 11 patterns: 1. Thyroid, the full panel, not just TSH 2. The gut, including H. pylori 3. Hidden food sensitivities 4. Medications you are already on that affect fertility 5. The vaginal microbiome 6. The seminal microbiome 7. The male partner's full bloodwork 8. Sperm DNA fragmentation 9. Vaginal and seminal cross-contamination between partners 10. The nervous system and HPA axis 11. Liver function and hormone clearance These are the tests that sit outside the standard fertility workup. A 2024 study in Archives of Gynecology and Obstetrics found that ovarian reserve markers like AMH do not significantly predict natural conception in women with regular cycles. The donor egg recommendation comes from one snapshot, not the full investigation. If this is the first episode you have landed on in this series, go back and listen to "Told Donor Eggs Are Your Only Option? Ask This First," then "How Long Should I Try With My Own Eggs Before Donor Eggs?" then "The Gut Findings Your Clinic Did Not Look For," and "Multiple Failed IVF And Told Donor Eggs?" This episode brings all of it together. WHAT YOUR CLINIC MISSED The companion guide walks through all 11 of these patterns in more detail, so you can take it to your next appointment and ask the questions. Email hello@fabfertile.ca, subject line MISSED, and we will send you the guide. FUNCTIONAL FERTILITY SECOND OPINION A free 45-minute call where I review your labs, your history, and your partner's results with you. You leave knowing what your biology has been telling you and what your next decision could be. Email hello@fabfertile.ca, subject line FERTILE, or book here. ABOUT THE HOST I'm Sarah Clark, founder of Fab Fertile and host of Get Pregnant Naturally, a podcast with over one million downloads. My functional fertility team works with couples navigating low AMH and failed IVF, reviewing functional lab results, gut microbiome, food sensitivity, vaginal microbiome, nutrigenomics, HTMA, DUTCH, toxin testing, and bloodwork alongside nervous system work, to help identify patterns that may not have been considered. We work alongside your medical team, not instead of them. Sarah Clark, founder of Fab Fertile, host of Get Pregnant Naturally (1M+ downloads), and author of Fabulously Fertile. If this episode helped, leave a review on Apple Podcasts. It is how other women find this work. TIMESTAMPS 00:00 The Donor Egg Recommendation and What Gets Called Complete 01:00 Who's Reviewing Your Case at Fab Fertile 02:00 Thyroid: The Full Panel, Not Just TSH 03:00 The Gut and H. pylori 04:00 Hidden Food Sensitivities 05:00 Medications That Affect Fertility 06:30 The Vaginal Microbiome 08:00 The Seminal Microbiome 08:30 The Male Partner's Full Bloodwork 09:00 Sperm DNA Fragmentation 09:30 Cross-Contamination Between Partners 11:00 The Nervous System and HPA Axis 11:30 Liver Function and Hormone Clearance 13:00 The Functional Fertility Second Opinion

The March 2026 ACC/AHA Guideline on the Management of Dyslipidemia made a major pivot regarding Lipoprotein(a) by establishing a formal recommendation for universal screening in adults. This 2026 guideline, published in the Journal of the American College of Cardiology, issued a Class 1 recommendation stating that every adult should have their Lp(a) measured at least once in their lifetime. Because Lp(a) levels are genetically determined and remain highly stable throughout a person's life, a single lifetime check is sufficient for the vast majority of the population to establish their baseline risk. Well, that's great for Family medicine or internal medicine, but how does that affect us in women's health? Well, it's complicated: lipoprotein(a) has been associated with an increased risk of VTE and has also been associated, in some studies, with FGR, preeclampsia, and preterm birth! So, can these patients receive oral contraceptives? What about Perioperative and postop care? Do these patients require anticoagulation? What about pregnancy- is LDA recommended here? And lastly, what about TXA use in patients with HMB? This podcast topic comes from one of our podcast family members who is an OBGYN military personnel caring for our wonderful troops overseas. Listen in for details!16% OFF TONA ACTIVE WEAR PROMO: https://tonaactive.com/discount/CHAPANOSPINOBG1. Ezzat, D., Lopez, D. M., Claggett, B. L., Li, L., Mohammadnia, N., Schuermans, A., Hemeryck, J., Chang, A., Murillo, S., O'Donoghue, M. L., Bikdeli, B., Yu, Z., Natarajan, P., Patel, A. P., Pabon, M. A., & Honigberg, M. C. (2026). Lipoprotein(a) and incident venous thromboembolism in pre- and postmenopausal women, and in men. European Heart Journal, ehag252. https://doi.org/10.1093/eurheartj/ehag2522.ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Dyslipidemia Writing Committee. (2026). 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia. Circulation, 153, e1155–e1300. https://doi.org/10.1161/CIR.00000000000014233. CDC MEC 4. Prevention of Venous Thromboembolism in Gynecologic Surgery: ACOG Practice Bulletin, Number 232. Obstetrics and Gynecology. 2021. Committee on Practice Bulletins—Gynecology5. Sofi F, Marcucci R, Abbate R, Gensini GF, Prisco D.Lipoprotein(a) as a Risk Factor for Venous Thromboembolism: A Systematic Review and Meta-Analysis of the Literature.Seminars in Thrombosis and Hemostasis. 2017. Dentali F, Gessi V, Marcucci R, et al. Lipoprotein (A) and Venous Thromboembolism in Adults: The American Journal of Medicine. 2007.

In this week's episode, Rex Nelson talks with Dr. Nirvana Manning, head of Obstetrics and Gynecology at UAMS, about maternal health in Arkansas. Manning discusses recent statistics on maternal health in the state and the work needed to improve how Arkansas delivers maternal care. Podcast on Apple, Spotify, and YouTube, or visit arkansasonline.com/podcast23 for an exclusive subscription offer available only to podcast listeners Chapters (00:00:00) - Southern Fried Podcast: Dr. Nirvana Manning(00:01:49) - Physician and Vanderbilt grad on the podcast(00:02:45) - Arkansas maternal health issues(00:08:43) - Arkansas maternal and infant health: Victories and challenges(00:13:36) - Arkansas' problems with rural healthcare(00:17:17) - How do we better educate mothers about pregnancy and maternal health?(00:20:06) - Arkansas Pro-Prenatal Care Program 1(00:24:27) - UAMS Chancellor Dr. Manning at the 2017 Arkansas Healthcare Conference

Hey everyone, thanks for tuning in. If you've spent any time in the OR during a cesarean delivery, you know that the choice between uterine exteriorization and in situ repair usually comes down to how you were trained or personal surgeon preference. It's a debate as old as modern obstetrics. But a major piece of clarity is coming down the pipeline. This episode, we are getting a sneak peek at a brand-new systematic review and meta-analysis dropping this July 2026 in the European Journal of OBGYN. We're asking the big question: is this the study that finally settles the debate once and for all? Grab your coffee, stick around, and let's find out.16% OFF TONA ACTIVE WEAR PROMO: https://tonaactive.com/discount/CHAPANOSPINOBG​ Coutinho, I. C., Ramos de Amorim, M. M., Katz, L., & Bandeira de Ferraz, Á. A. (2008). Uterine exteriorization compared with in situ repair at cesarean delivery: A randomized controlled trial. Obstetrics & Gynecology, 111(3), 639–647. https://doi.org/10.1097/aog.0b013e31816521e2 . (One of the most heavily cited clinical trials on the subject. It established that women in the exteriorized group experienced a 41% greater risk of moderate-to-severe pain at 6 hours postoperatively compared to the non-exteriorized cohort).​ Tan, H. S., Taylor, R. C., Sharawi, N., Sultana, R., Barton, K. D., & Habib, A. S. (2021). Uterine exteriorization versus in situ repair in Cesarean delivery: A systematic review and meta-analysis. Canadian Journal of Anaesthesia, 69(2), 216–233. https://doi.org/10.1007/s12630-021-02142-8​ Fonseca Queiroz L, Lemos M, Pereira da Silva D . Uterine exteriorization versus in-situ uterine repair during cesarean delivery: a systematic review and meta-analysis of randomized controlled trial. European Journal of Obstetrics and Gynecology and Reproductive Biology, 2026; 323

Declan and Sarah discuss strategies for obstetric questions in the ANZCA final exam.

In episode #443 of The Hormone Puzzle Podcast, our guest, Dr. Maribelle Verdiales, talks about Hormonal Changes After 40 and Fertility. More about Dr. Maribelle Verdiales: Dr. Verdiales was born in Puerto Rico, where she completed her medical degree in 2001. She relocated to New York City, where she completed a residency in Obstetrics and Gynecology. Reproductive endocrinology, minimally invasive surgery and pelvic reconstructive procedures became her main points of interest. In 2009, Dr. Verdiales relocated to Georgia with her family to start a private practice. As her practice evolved, she sought a more holistic approach to healthcare for her patients. In 2017 she completed a doctor of naturopathy degree and was able to expand her practice even further by adding new modalities to achieve wellbeing. Today, she is a pioneer in the areas of regenerative and anti-aging medicine. In 2023, she incorporated stem cell and other cell therapies to her toolbox. "The worst question is the one that is not asked", she says frequently. She continues to seek solutions to the challenges faced by her patients, and aims at helping them achieve their maximum potential through a tailored patient specific approach. Thank you for listening! This episode is brought to you in partnership with The Becoming Her Retreat — a transformational experience for women ready to turn their infertility journey into healing, purpose, and impact. Learn more and join the Becoming Her Masterclass at www.fertilitycoachingmastery.com/retreat-masterclass. Follow Dr. Verdiales on Instagram: @‌verdialesmd Follow Dr. Kela on Instagram: @‌kela_healthcoach Get your FREE Fertility Meal Plan: https://hormonepuzzlesociety.com/ Want Dr. Kela to review your case and learn more about working with her and her team, book a telehealth appointment here - https://hormonepuzzlesociety.com/fertility-deep-dive-call/  FTC Affiliate Disclaimer: The disclosure that follows is intended to fully comply with the Federal Trade Commission's policy of the United States that requires to be transparent about any and all affiliate relations the Company may have on this show. You should assume that some of the product mentions and discount codes given are "affiliate links", a link with a special tracking code This means that if you use one of these codes and purchase the item, the Company may receive an affiliate commission. This is a legitimate way to monetize and pay for the operation of the Website, podcast, and operations and the Company gladly reveals its affiliate relationships to you. The price of the item is the same whether it is an affiliate link or not. Regardless, the Company only recommends products or services the Company believes will add value to its users. The Hormone Puzzle Society and Dr. Kela will receive up to 30% affiliate commission depending on the product that is sponsored on the show. For sponsorship opportunities, email HPS Media at media@hormonepuzzlesociety.com

In the ACOG PB 231, Multifetal Gestations Twin Triplet and Higher-Order Multifetal Pregnancies, it states, “based on the improved outcomes reported in singleton gestations, the National Institutes of Health recommends that, unless a contraindication exists, a course of antenatal corticosteroids should be administered to all patients who are at risk of delivery within 7 days and who are between 24 weeks and 34 weeks of gestation, irrespective of the fetal number”. But a BRAND NEW meta-analysis is saying the exact opposite- with a catch. Listen in for details.1. ACOG PB 2312. Felippe, Carolina Alves MS; Ruiz, Sinrraim dos Santos Chaves MD; de Souza, Rebeca Ferreira MS; de Lima, Aliny Silva MS; dos Santos, Priscila Luiza MS; Fonseca, Pandora Eloa Oliveira MS; de Almeida Silva, Ingryd MS; Montes-de-Oca-Saucedo, Carlos Roberto MD; Santana, Ana Cecília Oliveira MS; Veta Darkovski, Jasmina MD; Matlaw, Hadas Rachel MD; Fonseca Queiroz, Laura MD. Antenatal Corticosteroid Use in Twin Pregnancies: A Systematic Review and Meta-analysis. Obstetrics & Gynecology ():10.1097/AOG.0000000000006344, June 4, 2026. | DOI: 10.1097/AOG.000000000000634416% OFF TONA ACTIVE WEAR PROMO: https://tonaactive.com/discount/CHAPANOSPINOBG

# Understanding Amniotic Fluid Embolism: Key Insights and Management StrategiesLearn about amniotic fluid embolism (AFE), its diagnosis, and management strategies. Essential for healthcare providers dealing with maternal emergencies.In this blog post, we delve into the complexities of amniotic fluid embolism (AFE), a rare but critical condition that can occur during or after labor. As healthcare professionals, understanding AFE is crucial, given its potential to cause rapid maternal deterioration. We will explore its diagnostic criteria, management strategies, and why effective communication within the healthcare team is vital.## What is Amniotic Fluid Embolism?Amniotic fluid embolism is often misunderstood. It is not simply a blockage caused by amniotic fluid but rather a severe reaction that occurs when amniotic fluid, fetal cells, or other debris enter the mother's bloodstream, resulting in an acute immune response. This condition can lead to serious complications, including cardiac arrest and significant hemorrhage.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:Patreon: patreon.com/CCOBYouTube: @CriticalCareOBPodcastInstagram: 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: ...

You have done IVF more than once. Maybe twice. Maybe three times. Maybe more. Each cycle they tweaked the protocol. Higher dose. Lower dose. Different stimulation drug. Different trigger. Added growth hormone. Added DHEA. Mini IVF. Dual stim. Each cycle the protocol changed. And now they are telling you donor eggs. Here is the question this episode is about. They changed the protocol every time. Did anyone look at what was already in your body when each of those protocols arrived? That is what this episode is about. The layer underneath every protocol. In this episode: - Protocol vs system: what your clinic was trained to adjust, and what nobody adjusted across any of your cycles - Why the donor egg conversation arrives after the only variable your clinic was trained to address has been exhausted, not after a full review of your body - The thyroid, iron, B12, vitamin D, inflammation, gut, cortisol, mineral, vaginal microbiome, and blood sugar markers that did not change between cycle 1 and cycle 5 - Why we look at ferritin against 80 to 100 going into IVF, not the lab reference of 15 - What a 2024 study in Archives of Gynecology and Obstetrics found about ovarian reserve markers and natural conception — and why donor eggs gets recommended on markers the literature itself does not support If this is the first episode you have landed on in this series, go back and listen to "Told Donor Eggs Are Your Only Option? Ask This First," then "How Long Should I Try With My Own Eggs Before Donor Eggs?" and "The Gut Findings Your Clinic Did Not Look For." This episode builds on all three. ——— WHAT YOUR CLINIC MISSED The full thyroid panel, not just a TSH. The iron panel that flags ferritin against the fertility target. The gut microbiome testing your REI does not order. The inflammatory markers they tell you are normal. And the male side that almost nobody investigates. Email hello@fabfertile.ca, subject line MISSED, and we will send you the guide. ——— FUNCTIONAL FERTILITY SECOND OPINION A free 45-minute call where I review your labs, your history, and your partner's results with you. You leave knowing what your biology has been telling you and what your next decision could be. Email hello@fabfertile.ca, subject line FERTILE, or book here. ——— ABOUT THE HOST I'm Sarah Clark, founder of Fab Fertile and host of Get Pregnant Naturally, a podcast with over one million downloads. My functional fertility team works with couples navigating low AMH and failed IVF, reviewing functional lab results, gut microbiome, food sensitivity, vaginal microbiome, nutrigenomics, HTMA, DUTCH, toxin testing, and bloodwork alongside nervous system work, to help identify patterns that may not have been considered. We work alongside your medical team, not instead of them. Sarah Clark, founder of Fab Fertile, host of Get Pregnant Naturally (1M+ downloads), and author of Fabulously Fertile. ——— If this episode helped, leave a review on Apple Podcasts. It is how other women find this work. ——— TIMESTAMPS 00:00 The Protocol Changed Every Time. Did Anyone Change You? 01:00 Who's Reviewing Your Case at Fab Fertile 02:00 Protocol vs System: The Layer Underneath Every IVF 03:00 What Your Body Brought to Every Cycle 04:30 What the 2024 Research Says About AMH 06:00 The Markers That Did Not Change Between Cycles 07:30 Why Multiple Tests Are Not One Test 09:00 The Donor Egg Recommendation With Half the Data 10:30 The Functional Fertility Second Opinion

Dr Philip Smith, Digital and Education Editor of Gut and Honorary Consultant Gastroenterologist at the Royal Liverpool Hospital, Liverpool, UK interviews Professor Wei Wang from the Department of Gynaecology and Obstetrics, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China and the Department of Gynaecology, Shanghai Key Laboratory of Maternal Foetal Medicine, Shanghai Institute of Maternal-Foetal Medicine and Gynaecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China, on the paper "Intraperitoneal translocation of gut microbiota induces NETosis and promotes endometriosis" published in paper copy in Gut in June 2026. Please subscribe to the Gut podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3UOTwqS) or Spotify (https://bit.ly/4rRJeUI).

Your clinic told you donor eggs. You walked out wondering how much time you actually have left. Whether waiting six months means missing your window. Whether trying with your own eggs one more time is brave or stupid. The honest answer is longer than your clinic implied. And the window is not your AMH number. In this episode: - Why a 2024 study in Archives of Gynecology and Obstetrics found that ovarian reserve markers like AMH do not significantly predict natural conception in women with regular cycles - What the 90-day window before ovulation actually is, and why the eggs you work with six months from now are not the eggs you are working with today - The inputs your clinic's timeline assumed would not change: mitochondrial function, inflammation, iron, B12, zinc, vitamin D, cortisol patterns, toxic load - The clinical pattern we see over more than a decade of cases: month zero to six is where the picture comes into view, twelve to eighteen months is where it can start to move substantially - Why some pictures do not move, and why that is still a reason to look before you decide If this is the first episode you have landed on in this series, go back and listen to "Told Donor Eggs Are Your Only Option? Ask This First" and then "The Gut Findings Your Clinic Did Not Look For." This episode builds on both. ——— WHAT YOUR CLINIC MISSED The full thyroid panel, not just a TSH. The iron panel that flags ferritin. The gut microbiome testing that your REI does not order. The inflammatory markers no one notices. The male side that almost no one investigates. Email hello@fabfertile.ca, subject line MISSED, and we will send you the guide. ——— FUNCTIONAL FERTILITY SECOND OPINION A free 45-minute call where I review your labs, your history, and your partner's results with you. You leave knowing what your biology has been telling you and what your next decision could be. Email hello@fabfertile.ca, subject line FERTILE, or book here. ——— ABOUT THE HOST Now in its eighth year, Get Pregnant Naturally was one of the first podcasts dedicated to the functional fertility approach for low AMH and failed IVF. Hosted by Sarah Clark, founder of Fab Fertile, author of Fabulously Fertile, and host of a podcast with over one million downloads. Fab Fertile is a functional fertility team that works with couples to review the lab work most fertility clinics do not run: gut microbiome, food sensitivity, vaginal microbiome, nutrigenomics, HTMA, DUTCH, full thyroid panel, the iron panel, and inflammation markers, alongside nervous system work. Each week Sarah brings you what the team sees across more than a decade of cases. Sarah Clark, founder of Fab Fertile, host of Get Pregnant Naturally (1M+ downloads), and author of Fabulously Fertile. ——— If this episode helped, leave a review on Apple Podcasts. It is how other women find this work. ——— TIMESTAMPS 00:00 The Donor Egg Recommendation and the Real Question 01:00 Who's Reviewing Your Case at Fab Fertile 01:30 AMH Is Not the Countdown Clock 03:00 The 90-Day Window Before Ovulation 04:30 What Actually Changes In 90 Days 07:00 The Fab Fertile Method: What We Investigate 08:30 Why Some Cases Do Not Shift 09:30 The Functional Fertility Second Opinion

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

Welcome to Fertility & Sterility Roundtable, hosted by Dr. Emily Barnard and Dr. Ben Peipert! Each week, we will host a discussion with the authors of "Views and Reviews" and "Fertile Battle" articles published in a recent issue of Fertility & Sterility.  Today, we will be discussing the Fertile Battle episode from the April 2026 edition of Fertility and Sterility entitled "Is Concurrent Gestational Surrogacy an Ethical Practice?" Concurrent surrogacy involves two gestational carriers being engaged simultaneously—or whose pregnancies overlap—to allow a single intended parent or couple to have children born without the usual spacing between births  Dr. Michelle Bayefsky is a second year Reproductive Endocrinology and Infertility fellow at the Icahn School of Medicine at Mount Sinai. She has written a book and more than 30 peer-reviewed papers on issues related to reproductive ethics and fertility preservation. She is currently a member of the ASRM Ethics Committee. For the purposes of this discussion, Dr. Bayefsky authored the Pro side of the argument that concurrent gestational surrogacy is an ethical practice.  Dr. Caroline Violette is a second year Reproductive Endocrinology & Infertility Fellow at Brown University. Prior to fellowship, Dr. Violette obtained her medical degree from Emory University School of Medicine and completed her residency in Obstetrics and Gynecology at the University of Southern California. Her research interests include oncofertility and addressing healthcare disparities related to access to fertility treatment in the United States. For the purposes of this discussion, Dr. Violette authored the "con" side of the argument that these concurrent surrogacy arrangements are unethical.  Dr. Arthur Caplan is a Professor and founding head of the Division of Medical Ethics at NYU School of Medicine in New York City. Dr. Caplan has served on a number of national and international committees, including chair of the Advisory Committee to the United Nations on Human Cloning, a member of the advisory committee to the International Olympic Committee on genetics and gene therapy, and co-director of the Joint Council of Europe/United Nations Study on Trafficking in Organs and Body Parts. He is the author or editor of thirty-five books and over 890 papers in peer reviewed journals. Dr. Caplan authored the pro side of the argument.  Read the Fertile Battle from Volume 125, Issue 4 p598-604 in the April 2026 issue View Fertility and Sterility at https://www.fertstert.org/  

In this re-aired episode, HeHe sits down with Dr. Heather Florescue for an incredibly important and deeply educational conversation about stillbirth prevention, placental health, and the warning signs families deserve to know during pregnancy. Together, they unpack why conversations around stillbirth are so often avoided, how education can empower—not scare—parents, and what proactive care can look like when we truly prioritize maternal and fetal health. Dr. Florescue explains the role of placental function in pregnancy outcomes, why estimated placental volume matters, and how recognizing changes in fetal movement and maternal intuition can be life-saving. She also shares current research, discusses risk factors that are often overlooked, and highlights protocols used in places like the UK and Australia that have helped reduce stillbirth rates through earlier intervention and better patient education. This episode is not about fear. It's about informed awareness, advocacy, and helping families understand that paying attention to your body and your baby matters. If you've ever felt dismissed during pregnancy or wondered whether you were “overreacting” to a concern, this conversation is such an important reminder that your instincts deserve to be heard.   Guest Bio: Dr. Florescue is an ob.gyn. in private practice at Women Gynecology and Childbirth Associates in Rochester, N.Y. She delivers babies at Highland Hospital in Rochester, NY.  She received her medical degree at the University of Rochester School of Medicine & Dentistry, completed her internship and residency in obstetrics & gynecology at the University of Rochester Medical Center.  She is certified by the American Congress of Obstetrics & Gynecology.  She and her husband are parents to a set of triplets.  Dr. Florescue is passionate about the prevention of pregnancy and infant loss and the care for families who suffer these terrible tragedies.  SOCIAL MEDIA: Connect with HeHe on Instagram: https://www.instagram.com/tranquilitybyhehe/  Connect with Dr. Florescue on IG: https://www.instagram.com/drflorescueobgyn/  BIRTH EDUCATION: Learn how to stay in control of your birth and reduce the risk of unnecessary interventions in our Avoid a C-Section Webinar. HeHe breaks down the cascade of interventions, explains what's really happening in the hospital, and shares practical strategies to protect your birth plan, advocate for yourself, and navigate labor with confidence. Perfect for anyone who wants a positive, informed hospital birth experience: https://www.thebirthlounge.com/csection Feeling nervous about speaking up in labor? Our Scripts for Advocacy give you the exact words to handle the most common conversations that can make or break your birth experience. From declining unnecessary interventions to asking the right questions about procedures, these scripts empower you to stay in control, speak confidently, and protect your birth plan — even when the pressure is on. Think of it as your personal toolkit for advocating like a pro, so you can focus on your baby, not the stress: https://www.thebirthlounge.com/Scripts-for-Advocacy And if you haven't grabbed it yet… Snag my free Pitocin Guide to understand the risks, benefits, and red flags your provider may not be telling you about, so you can make informed, powerful decisions in labor: https://www.thebirthlounge.com/pitocin Join The Birth Lounge for judgment-free, evidence-based childbirth education from HeHe that shows you exactly how to navigate hospital policies, avoid unnecessary interventions, and have a trauma-free labor experience, all while feeling wildly supported every step of the way: https://www.thebirthlounge.com/ Want prep delivered straight to your phone? Download The Birth Lounge App for bite-sized birth and postpartum tools you can use anytime, anywhere: https://www.thebirthlounge.com/app   LINKS MENTIONED: Star Legacy Foundation: https://starlegacyfoundation.org/ Count the Kicks: https://countthekicks.org/ PUSH Pregnancy: https://www.pushpregnancy.org/ Tommys.org: https://www.tommys.org/pregnancy-information Saving Babies Lives Care Bundles: https://www.england.nhs.uk/wp-content/uploads/2019/03/Saving-Babies-Lives-Care-Bundle-Version-Two-Updated-Final-Version.pdf

The American College of Obstetricians and Gynecologists (ACOG) does not recommend routine ultrasound measurement of the lower uterine segment (LUS) thickness as part of the evaluation for trial of labor after cesarean delivery (TOLAC). ACOG Practice Bulletin No. 205 (2019) on Vaginal Birth After Cesarean Delivery does not include LUS measurement among its recommendations for TOLAC candidacy assessment. The guideline focuses on clinical factors such as type of prior uterine incision, number of prior cesarean deliveries, and other obstetric history to determine TOLAC candidacy, and emphasizes that most women with one previous low-transverse cesarean delivery should be counseled about and offered TOLAC. But what if you find a likely uterine window at the LUS? Does that mandate a repeat C-section? This topic comes from Serena, one of our podcast family members. Listen in for details. 1. Dr. Chapa's Clinical Pearls, Dec 31., 2023: LUST FOR TOLAC; and follow up episode Jan 15, 20242. ACOG Practice Bulletin No. 205: Vaginal Birth After Cesarean Delivery. Committee on Practice Bulletins—Obstetrics Obstetrics and Gynecology. 2019;133(2):e110-e127. doi:10.1097/AOG.0000000000003078.3. Rozenberg P, Sénat MV, Deruelle P, et al. Evaluation of the Usefulness of Ultrasound Measurement of the Lower Uterine Segment Before Delivery of Women With a Prior Cesarean Delivery: A Randomized Trial. American Journal of Obstetrics and Gynecology. 2022. 4. Swift BE, Shah PS, Farine D. Sonographic Lower Uterine Segment Thickness After Prior Cesarean Section to Predict Uterine Rupture: A Systematic Review and Meta-Analysis. Acta Obstetricia Et Gynecologica Scandinavica. 2019. 5. McLeish SF, Murchison AB, Smith DM, et al. Predicting Uterine Rupture Risk Using Lower Uterine Segment Measurement During Pregnancy With Cesarean History: How Reliable Is It? A Review. Obstetrical & Gynecological Survey. 2023. 6. Jastrow N, Demers S, Chaillet N, et al. Lower Uterine Segment Thickness to Prevent Uterine Rupture and Adverse Perinatal Outcomes: A Multicenter Prospective study.7. American Journal of Obstetrics and Gynecology. 2016. 8. Guerby P, Bujold E, Chaillet N. Impact of Third-Trimester Measurement of Low Uterine Segment Thickness and Estimated Fetal Weight on Perinatal Morbidity in Women With Prior Cesarean Delivery. Journal of Obstetrics and Gynaecology Canada. JOGC. 2022.

Catherine Birndorf, MD, is a Reproductive Psychiatrist, the Co-Founder, CEO, and Medical Director of The Motherhood Center of New York. Dr. Birndorf is the Founding Director of the Payne Whitney Women's Program at Weill Cornell Medicine – New York-Presbyterian Hospital. In addition, she is a Clinical Associate Professor of Psychiatry and Obstetrics & Gynecology. A graduate of Smith College, Dr. Birndorf attended Brown University Medical School and did her Psychiatry Residency at New York-Presbyterian Hospital. A past Postpartum Support International board member, Dr. Birndorf now serves on the President's Advisory Council. For ten years, Dr. Birndorf was a regular mental health columnist for Self Magazine and has appeared on numerous television programs, including The TodayShow, Good Morning America, MSNBC, and CNN. Dr. Birndorf recently consulted on a special postpartum episode of Law & Order. Dr. Birndorf's first book, The Nine Rooms of Happiness, was an NYTimes bestseller published in 2010. Her most recent book, published by Simon &Schuster in 2019, is entitled What No One Tells You: A Guide to Your Emotions from Pregnancyto Motherhood.Dr. Birndorf joins us on The Vault to dispel myths around antidepressant use during and after pregnancy, to discuss how hormones play a role in our mental health and wellbeing and to discuss the unique challenges and treatments for women's mental health. She also discusses how men may struggle during the postpartum period and how those trying to become pregnant have their own unique challenges with regard tomental health. How to diagnosis postpartum depression. How men struggle in the postpartum period Infertility and mental health. How treat postpartum depression. What causes postpartum depression? Can I take antidepressants during pregnancy? How to diagnosis OCD in pregnancy? How to cope with burnout as a Physician. How to Cope with High Functioning Depression.Follow Dr. Birndorf and Learn more about The Motherhood Center.Dr. Cathrine Birndorf Instagram https://www.instagram.com/drcatherinebirndorf/The Motherhood Center https://themotherhoodcenter.com/Dr. Catherine Birndorf's Books:The Nine Rooms Of HappinessWhat No One Tells You: A Guide to Your Emotions From Pregnancy to Motherhood and Beyond. Follow Dr. Judith:Instagram: https://instagram.com/drjudithjoseph TikTok: https://www.tiktok.com/@drjudithjoseph Facebook: https://www.facebook.com/drjudithjoseph Website: https://www.drjudithjoseph.com/Sign up for my newsletter here: https://www.drjudithjoseph.com/newsletter-sign-upDisclaimer: You may want to consider your individual mental health needs with a licensed medical professional. This page is not medical advice.

If Part 1 was about the field of sexual medicine, Part 2 is about the marriage at the center of it. Dr. Jenni Skyler and Daniel Lebowitz return to their conversation with Dr. Irwin and Sue Goldstein, and this time, the questions get more personal. How do you stay married for fifty years? What does great sex actually look like across the decades? And what happens when a woman who has spent her career in sexual medicine starts experiencing low desire herself? Sue Goldstein opens up about her own journey through peri-menopause and the slow erosion of her libido- what she calls "duty sex", and the medications that brought not just her sex drive back, but a playfulness in her marriage she hadn't realized had gone missing. She walks listeners through her menopause toolbox of five treatments, explains why she's "76 and feels like she's in her 50s", and dismantles the lingering fears from the Women's Health Initiative that have kept generations of women in what she calls hormone prison. Dr. Irwin shares his own daily protocols for sexual health, why he believes most older men are leaving capacity on the table, and the surprising data from their own clinic- that more than half the Vyleesi prescriptions they write are off-label for men. They explore why dopamine is dopamine, regardless of gender. The reality of persistent genital arousal disorder. And a remarkable story of a teenage horseback rider whose chronic arousal turned out to be a herniated disc. This episode is full of practical wisdom, clinical innovation, and one of the most real conversations about long-term love you'll hear all year. The Goldsteins' secret to fifty years of marriage? Best friends, good sex, and the willingness to keep trying new things — including a chocolate sauce on the day before you change the sheets. Irwin Goldstein, MD, IF (he/him/his). Director, San Diego Sexual Medicine 5555 Reservoir Drive, Suite 300, San Diego, CA 92120, Director, Sexual Medicine, UC San Diego Health East Campus, San Diego, CA. Clinical Professor of Urology, University of California at San Diego. Voluntary Clinical Professor of Obstetrics, Gynecology and Reproductive Services Past President, International Society for the Study of Women’s Sexual Health. Past President, Sexual Medicine Society of North America. Editor Emeritus, Sexual Medicine Reviews, The Journal of Sexual Medicine, International Journal of Impotence Research. Phone: 619 265-8865 - Mobile: 619 987-7432. Email: dr.irwingoldstein@gmail.com. http://www.sandiegosexualmedicine.com. Like us on Facebook: https://www.facebook.com/SDSexMed. X: http://twitter.com/SDSexualMedSee omnystudio.com/listener for privacy information.

OA1264 - Sherise Doyley was in the early stages of labor, in a hospital bed, preparing to deliver her baby, when nurses wheeled in a computer. On the screen was a judge, notifying her of an emergency order by the State of Florida to attempt to force her to undergo a C-section, instead of first attempting vaginal delivery. For 3 hours she advocated for herself, without an attorney, barely covered in a hospital gown. How was any of this legal? What is happening? Jenessa breaks down the history of our rights to make our own medical decisions and how that is legally modified in pregnancy, Lydia shares her own birth experience and how these situations could be handled with actual compassion, and Thomas holds very still in hopes our eyes are based on movement (just kidding, Thomas is very supportive and also outraged). Come rage against the machine with us and hopefully breathe life into a revived pro-choice movement, before it's too late. Amy Yurkanin (Mar. 14, 2026), They Didn't Want to Have C-Sections. A Judge Would Decide How They Gave Birth, ProPublica. Video clips of Doyley hearing, provided by ProPublica's Facebook page Anuli Njoku, Marian Evans, Lillian Nimo-Sefah, & Jonell Bailey (2023). Listen to the Whispers before They Become Screams: Addressing Black Maternal Morbidity and Mortality in the United States, 11 Healthcare 438. Brad N. Greenwood, Rachel R. Hardeman, Laura Huang, & Aaron Sojourner (2020), Physician–patient racial concordance and disparities in birthing mortality for newborns, 117 Proceedings of the National Academy of Sciences 21194. Maternal Mortality Prevention (Dec. 18, 2025). Data from the Pregnancy Mortality Surveillance System, CDC. Bracey Harris & Elizabeth Chuck (Jan. 9, 2026), 'Her worst fear has come to pass': Midwife who advocated for Black women dies after giving birth, NBC News. Camila Domonoske (Apr. 17, 2018), 'Father Of Gynecology,' Who Experimented On Slaves, No Longer On Pedestal In NYC, NPR. Megan L. Swanson, Sara Whetstone, Tushani Illangasekare, & Amy (Meg) Autry (2021), Obstetrics and Gynecology and Reparations: The Debt We Owe (and Continue to Accumulate), 5 Health Equity 353. Nicole Loy (May 16, 2025), Pain and Gynecology: Raising Standards of Care, The Healthcare Review at Cornell University. Jess Mador (July 29, 2025), A Brain-Dead Pregnant Woman Was Kept Alive in Georgia. It's Unclear if State Law Required It, KFF Health News. (June 2025), Pregnancy Exceptionalism: A Review of Restrictions on Advance Directives, Pregnancy Justice. U.S. Const. amend. IX Jacobson v. Massachusetts, 197 U.S. 11 (1905) Rochin v. California, 342 U.S. 165 (1952) Cruzan v. Director, Missouri Dep't of Health, 497 U.S. 261 (1990) Washington v. Harper, 494 U.S. 210 (1990) Roe v. Wade, 410 U.S. 113 (1973) Planned Parenthood of Southeastern Pa. v. Casey, 505 U.S. 833 (1992) Dobbs v. Jackson Women's Health Organization, 597 U.S. 215 (2022) Heller v. Doe, 509 U.S. 312 (1993) State Dept. of Human Services v. Northern, 563 S.W.2d 197 (1978) Lane v. Candura, 6 Mass. App. Ct. 377 (1978) Koskenoja v. Whitmer, Mich. Ct. Cl. (2026) (Apr. 20, 2026), Michigan Pregnancy Exclusion Law is Unconstitutional, Compassion & Choices. Check out the OA Linktree for all the places to go and things to do!  

In the world of healthcare, documentation is more than just a routine task—it's a crucial aspect of patient care that can have significant legal implications. Have you ever considered how your notes could be interpreted in a court of law? In this post, we'll explore essential tips for effective medical documentation and why it matters for both patient care and legal protection.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:Patreon: patreon.com/CCOBYouTube: @CriticalCareOBPodcastInstagram: 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: ...

Outside of pregnancy, guidelines emphasize diabetes self-management education and support to facilitate informed decision making, self-care behaviors, problem solving, and active collaboration with health care professionals. This includes, in those with good health literacy, the concept of patient-led self-titration of basal insulin results which has data that it improves glycemic management compared with clinician-led titration for type 2 diabetes among nonpregnant adults. But what about for GDM? Can patient's self manage their BASAL insulin? In this episode, we will review a new RCT published in April 2026 in the Green Journal on this very subject. As novel as this is, it is not the first to report on this as it was also published (retrospective study in the UK) in 2022. This is a novel approach to insulin in GDM but there are some questions that remain. Listen in for details.1. Boonpattharatthiti K, Wechkunanukul K, Mayang N, et al . Comparison of Insulin Titration Strategies for Glycemic Control in Type 2 Diabetes: A Systematic Review and Network Meta-Analysis.Diabetes Care. 2025. 2. Valent, Amy M. DO, MCR; Barbour, Linda A. MD, MSPH. Insulin Management for Gestational and Type 2 Diabetes in Pregnancy. Obstetrics & Gynecology 144(5):p 633-647, November 2024. | DOI: 10.1097/AOG.00000000000056403. Wang, Xiao-Yu MD; Gabbe, Steven MD; Landon, Mark B. MD; Venkatesh, Kartik K. MD, PhD et al. Patient-Led Insulin Titration for Glycemic Management With Gestational Diabetes Mellitus: A Randomized Controlled Trial. Obstetrics & Gynecology 147(4):p 501-509, April 2026. 4. McGovern AP, Hirwa KD, Wong AK, et al. Patient-led rapid titration of basal insulin in gestational diabetes is associated with improved glycaemic control and lower birthweight. Diabet Med. 2022;39:e14926. doi: 10.1111/dme.14926

Black women face higher rates of uterine fibroids compared to white women. They’re less likely to get accurate diagnoses for endometriosis. And they’re twice as likely to die from uterine cancer than white women. Dr. Kemi Doll considers these disparities part of the evidence for a broader health crisis in gynecological care for Black women. Why hasn’t the medical community done more to address these problems? And how can patients and practitioners navigate a system that consistently overlooks Black women? Doll's new book, "A Terrible Strength: The Hidden Crisis of the Black Womb and Your Survival Guide to Healing,” works to answer those questions. Guest: Dr. Kemi Doll, a professor of Obstetrics and Gynecology at the University of Washington and the author of "A Terrible Strength." Related links: A Terrible Strength by Kemi Doll | Penguin Random House Spotlighting a common female cancer, and a health disparity - UW Medicine Newsroom Why Black women are at greater risk for fibroids and endometrial cancer | Scientific American Understanding the gynecological health crisis facing Black women | Science Friday Thank you to the supporters of KUOW, you help make this show possible! If you want to help out, go to kuow.org/donate/soundsidenotes Soundside is a production of KUOW in Seattle, a proud member of the NPR Network.See omnystudio.com/listener for privacy information.

Gina, a perinatal fitness trainer, birth doula, and founder of MamasteFit in North Carolina, explains how exercising during pregnancy improves quality of life during pregnancy and postpartum—not just birth outcomes—while noting prenatal exercise research is still limited. She highlights a 2025/2026 American Journal of Obstetrics and Gynecology systematic review (11 RCTs) finding the strongest biomarker benefits from 12+ week programs done 2–3 times/week at moderate-to-vigorous intensity, including reduced pro-inflammatory markers, improved glucose/insulin regulation (supporting lower gestational diabetes risk), better lipid regulation, and favorable hormone/growth-factor changes linked to placental function and possibly baby brain development. Another 2025 review (9 RCTs, 1,500+ participants) suggests strength training may reduce excessive weight gain, low back/sciatic pain, and improve mood, sleep, fatigue, and well-being. She also cites studies indicating high-intensity lifting and even Valsalva can be well-tolerated with adequate rest and self-monitoring, then outlines MamasteFit's endurance-focused programming (compound lifts, accessory multi-plane work, myofascial slings, and posterior-chain emphasis) and promotes their app/video programs with a discount code.00:00 Why Prenatal Exercise Matters00:46 Meet Gina and MamasteFit01:38 What Research Can Tell Us02:23 Biomarkers and Training Dose05:11 Inflammation and Glucose Control08:05 Lipids Hormones and Baby Brain10:46 Strength Training Quality of Life13:17 Heavy Lifting and Valsalva Safety18:03 Listening to Your Body18:58 How to Program Prenatal Lifting20:54 Movement Variety and Posterior Chain23:04 Programs and Final Takeaways————

Dr. Irwin Goldstein didn't set out to become a pioneer of sexual medicine. He was a biomedical engineer turned urology resident who, as he tells it, asked one stupid question during a 1976 surgery: "Could you explain the physiology of erection to me?" The surgeon shrugged. Irwin spent the next decade figuring it out. Along the way, he co-discovered that nitric oxide, the elephant of our air, is what makes erections possible. He published the first paper on it in 1991. Seven years later, he became the first author on the New England Journal of Medicine paper that introduced Viagra to the world. But that's only half the story. The other half is Sue Goldstein, Irwin's college sweetheart turned partner in life, parenting, and eventually the practice itself. Sue spent decades raising their family while quietly absorbing the science her husband brought home. She is now an AASECT-certified educator, a published researcher, and one of the most outspoken patient advocates in the field. Together, they run San Diego Sexual Medicine, a clinic where every patient gets a three-hour visit, full education, and an entire team practicing what they call true bio-psycho social care. In this first half of our two-part conversation, Dr. Jenni Skyler and Daniel Lebowitz sit with the Goldsteins and explore how a field gets built, and how it still leaves so many patients behind. They cover prostate cancer and the silent erectile crisis that follows it. The buccal grafting innovation that's helping women with severe vestibular pain finally get answers. Why women, on average, see ten or twelve doctors before they get a real diagnosis. And Sue's pet peeve, medical gaslighting and what to do when a doctor says "there's nothing that can be done." This is a conversation for anyone who has ever felt unheard by a clinician, dismissed by their own body, or convinced they were the problem. The Goldsteins want you to know — you're not. You just haven't been to the right office yet. Irwin Goldstein, MD, IF (he/him/his)Director, San Diego Sexual Medicine5555 Reservoir Drive, Suite 300, San Diego, CA 92120Director, Sexual Medicine, UC San Diego Health East Campus, San Diego, CAClinical Professor of Urology, University of California at San DiegoVoluntary Clinical Professor of Obstetrics, Gynecology and Reproductive ServicesPast President, International Society for the Study of Women’s Sexual HealthPast President, Sexual Medicine Society of North AmericaEditor Emeritus, Sexual Medicine Reviews, The Journal of Sexual Medicine, International Journal of Impotence Researchphone: 619 265-8865fax: 619 265-7696mobile: 619 987-7432dr.irwingoldstein@gmail.comhttp://www.sandiegosexualmedicine.comLike us on Facebook: https://www.facebook.com/SDSexMedtwitter.com/SDSexualMedSee omnystudio.com/listener for privacy information.

High blood pressure disorders during pregnancy, including preeclampsia, can raise a lot of questions and anxiety for expectant parents. In this episode of The MotherToBaby Podcast, host Chris Stallman, genetic counselor, mom of four, and teratogen information specialist, sits down with maternal-fetal medicine specialist and member of the Society for Maternal-Fetal Medicine (SMFM) Dr. Karen Florio to discuss what pregnant women should know about hypertensive disorders in pregnancy and the role low dose aspirin can play in reducing certain risks. Dr. Florio shares both her professional expertise caring for high-risk pregnancies and her personal experience navigating a high-risk pregnancy herself. Together, Chris and Dr. Florio break down the warning signs of preeclampsia, when to contact a healthcare provider, and why low dose aspirin may be recommended in some pregnancies, even though regular aspirin is typically avoided during pregnancy. The conversation also explores how common hypertensive disorders are, what patients can do to advocate for themselves, and reassuring, evidence-based guidance for anyone currently pregnant and feeling worried about blood pressure concerns. In this episode, we discuss: • What "high blood pressure in pregnancy" and hypertensive disorders actually mean • Signs and symptoms of preeclampsia to watch for • Why low dose aspirin may be recommended during pregnancy • Who may benefit from low dose aspirin therapy • When to reach out to a healthcare provider • How patients can feel informed and empowered during pregnancy About Our Guest: Dr. Karen Florio is a maternal-fetal medicine specialist at the University of Missouri and currently serves as Vice Chair of Patient Safety and Quality for the Department of Obstetrics and Gynecology, as well as Director of Labor and Delivery. Her work focuses on hypertensive disorders of pregnancy and heart disease in pregnancy, and she has held leadership roles with Missouri's Pregnancy-Associated Mortality Review Board and the Missouri Perinatal Quality Collaborative. Learn more about MotherToBaby: https://mothertobaby.org/ Listen to more episodes of The MotherToBaby Podcast: https://mothertobaby.org/podcast/

Our guests this week are two accomplished sexuality professionals – Ms. Sue Goldstein and Dr. Irwin Goldstein. Ms. Sue Goldstein, a graduate of Brown University, is Sexuality Educator and Clinical Research Manager at San Diego Sexual Medicine (SDSM), responsible for sexual medicine educational programming and clinical research. She works with the SDSM team to develop clinical research projects, write protocols and oversee clinical trials. Ms. Goldstein co-authored When Sex Isn't Good to provide education and empowerment to women with sexual dysfunction. She is an associate editor of Textbook of Female Sexual Function and Dysfunction, and Female Sexual Pain Disorders, and author of multiple peer reviewed papers. Ms. Goldstein is past president of the International Society for the Study of Women's Sexual Health (ISSWSH). She served on committees in the International Society for Sexual Medicine (ISSM) and Sexual Medicine Society of North America (SMSNA). She is also a member of the American Association of Sex Educators, Counselors and Therapists (AASECT), the Association of Clinical Research Professionals (ACRP) and the International Society for Medical Shockwave Therapy. Ms. Goldstein, an ISSWSH Fellow, received the Distinguished Service Award from ISSWSH in 2017 as well as from SMSNA in 2017, and along with her husband, the Transformatory Team Award from ISSM in 2024. Dr. Irwin Goldstein has been involved with sexual dysfunction research since the late 1970s. He has authored more than 380 publications as well as multiple book chapters and edited 7 textbooks in the field. His interests include surgery for dyspareunia, sexual health management post cancer treatment, persistent genital arousal disorder/genital dysesthesia, physiologic investigation of sexual function, and diagnosis and treatment of sexual dysfunction in all genders. Dr. Goldstein is Director of Sexual Medicine at University of California San Diego East Campus, and sees patients in his private practice, San Diego Sexual Medicine. He is a Clinical Professor of Urology and Voluntary Clinical Professor of Obstetrics, Gynecology, & Reproductive Sciences at University of California San Diego. He is past Editor-in-Chief of the International Journal of Impotence Research, The Journal of Sexual Medicine, and Sexual Medicine Reviews. He is Past President of the International Society for the Study of Women's Sexual Health (ISSWSH) and the Sexual Medicine Society of North America (SMSNA). He holds a degree in engineering from Brown University and received his medical degree from McGill University. The World Association for Sexual Health awarded the Gold Medal to Dr. Goldstein in 2009 in recognition of his lifelong contributions to the field, in 2012 he received the ISSWSH Award for Distinguished Service in Women's Sexual Health, in 2013 he received the Lifetime Achievement Award from the SMSNA, and in 2014 he received the Lifetime Achievement Award from the International Society for Sexual Medicine (ISSM). He is happily married to his college sweetheart Sue, and together they have three children and five grandchildren. Sue and Irwin Goldstein have been titans in the field of sexology for some time now; they were there on May 14, 1998 when the first article on sildenafil (Viagra) was published with Irwin Goldstein as the first author. Listeners, if you would like to reach out to Ms. Sue Goldstein and/or Dr. Irwin Goldstein, check out the San Diego Sexual Medicine website! If you want to catch up on other shows, just visit our website and please subscribe! We love our listeners and welcome your feedback, so if you love Our Better Half, please give us a 5-star rating and follow us on Facebook and Instagram. It really helps support our show! As always, thanks for listening!  

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

Two articles in CMAJ look at endometriosis from sharply different angles. One shows how devastating delayed recognition can be, following a patient whose deep infiltrating endometriosis led to renal atrophy, bowel obstruction, sciatic nerve impingement and a permanent ostomy. The other offers a more reassuring picture, finding only a small increased risk of congenital anomalies among infants born to patients with endometriosis. Together, they show why endometriosis deserves earlier recognition, better imaging and more serious clinical attention.Dr. Sony Singh, chair of the Department of Obstetrics and Gynecology at the University of Ottawa and head of the Department of Obstetrics, Gynecology and Newborn Care at The Ottawa Hospital, discusses the CMAJ practice article, “Renal atrophy, bowel obstruction, and sciatic nerve impingement secondary to endometriosis”. He explains how deep infiltrating endometriosis can invade adjacent organs and cause severe fibrosis when left untreated.Bailey Milne, a PhD candidate in epidemiology at Queen's University, discusses the CMAJ article, Risk of congenital anomalies for infants born to patients with endometriosis: a population-based cohort study. She emphasizes that although the study found a small increased risk of congenital anomalies, the overall risk remains low.For physicians, the episode highlights the importance of considering endometriosis in patients with cyclical pelvic, abdominal, bowel, urinary or sexual pain, even when initial imaging is normal.For more information from our sponsor, go to md.ca/lifeplanComments or questions? Text us.Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X  @BlairBigham and @DrmojolaomoleX (in English):  @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

In 2022, the US Supreme Court overturned Roe v Wade, which guaranteed a constitutional right to an abortion. But previously the Court had allowed restrictions on abortions, making access quite challenging in a large part of the country. In response to these restrictions, women had gained access through prescription drugs, or what is called medication abortion. This involves two prescription drugs, mifepristone and misoprostol. Last week, a federal court issued an order disallowing mifepristone to be prescribed via telehealth and then distributed by mail. As we record today, the Supreme Court is expected to rule on this federal court order. So on today's show, we take account to the status of access to medication abortion and what it means both for reproductive rights and health and for the law on this issue. [ dur: 58mins. ] Rachel Rebouché is Professor of Law at the University of Texas at Austin. She is the author of Abortion Rights as Human Rights and co-author of The New Abortion Battleground and Abortion Pills (with David S. Cohen and Greer Donley). Carole Joffe is Professor in the Department of Obstetrics, Gynecology & Reproductive Sciences at the University of California, San Francisco. She is the author of Doctors of Conscience: The Struggle to Provide Abortion before and after Roe v. Wade and the co-author of After Dobbs: How the Supreme Court ended Roe but not Abortion with David Cohen. Natalie Fixmer-Oriaz, F Wendell Miller Associate Professor of Communication Studies and Gender, Woman's the Sexuality Studies at the University of Iowa. She is author of Homeland Maternity: US Security Culture and the New Reproductive Regime (2019) and Doing Gender Justice: Queering Reproduction, Kin, and Care (2025; with Shui-yin Sharon Yam). This program is produced by Doug Becker, Ankine Aghassian, Maria Armoudian, Anna Lapin and Sudd Dongre. Health, Medicine, Reproductive Health, Courts, Feminism, Mothers

Cervical exams can be tricky for the novice practitioner. Think about this: it's a blind exam, we measure that distance using only two fingers, through a layer of tissue, sometimes with a patient moving up on the bed as we examine. That is the reality of a cervical exam. Intrapartum, some nursing staff and clinicians use qualitative descriptors like "a tight 4" or "a generous 5" to convey nuance. In line with this, some report cervical examinations in “half- centimeters”. This sounds like this: “well, her last cervical exam was 5cm but now she is 5 and a half”. Is that a thing? What does the data say? Listen in for details. 1. Hamilton EF, Zhoroev T, Warrick PA, et al. New Labor Curves of Dilation and Station to Improve the Accuracy of Predicting Labor Progress. American Journal of Obstetrics and Gynecology. 2024. 2. Hanidu A, Kovalenko M, Usman S, et al. Intrapartum Ultrasound for Cervical Dilatation: Inter- And Intra-Observer Agreement. Acta Obstetricia Et Gynecologica Scandinavica. 2024. 3. Abedi, P. (n.d.). Accuracy of ultrasound methods versus other methods for detecting of cervical dilatation during labor, a protocol for systematic review. ECronicon.

Editor's Choice:  Optimization of methylated DNA markers to rule out endometrial cancer in patients with abnormal uterine bleedingEditorial: Tampon-based methylated DNA testing for endometrial cancer: Promising innovation, but prudence before practiceHosted by: Charles N. Landen Jr., MD; University of Virginia Charlottesville, VA, USAFeaturing: Jamie N. Bakkum-Gamez, MD; Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USAJohn B. Kisiel, MD; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USAJoy M. Davis MD; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USACheck out more content on the journal's homepage  at https://www.gynecologiconcology-online.net

As I have said many times before, some podcast ideas come from REAL clinic encounters. In this episode, Dr Hanna V, our dedicated PGY1 on our call team, and I will answer TWO real questions which arose just today on morning rounds, on our service: 1. Does NORMOTENSIVE HELLP still need Mag Sulfate? And 2. Does an indwelling foley s/p iatrogenic bladder injury at CS require prophylactic antibiotic coverage for urinary infection? Yep: It's a BOGO sale on today's podcast- Buy ONE GET ONE! Listen in for details.1. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222.Obstetrics and Gynecology. 2020. Committee on Practice Bulletins—ObstetricsGuideline2. Woudstra DM, Chandra S, Hofmeyr GJ, Dowswell T.SR. Corticosteroids for HELLP (Hemolysis, Elevated Liver Enzymes, Low Platelets) Syndrome in Pregnancy.The Cochrane Database of Systematic Reviews. 2010. 3. Joshi D, James A, Quaglia A, Westbrook RH, Heneghan MA.Liver Disease in Pregnancy. Lancet. 2010. Review4. Rimaitis K, Grauslyte L, Zavackiene A, et al.Observational. Diagnosis of HELLP Syndrome: A 10-Year Survey in a Perinatology Centre. International Journal of Environmental Research and Public Health. 20195. Reau N, Munoz SJ, Schiano T.Guideline Liver Disease During Pregnancy.The American Journal of Gastroenterology. 2022. 6. ACG Clinical Guideline: Liver Disease and Pregnancy.The American Journal of Gastroenterology. 2016. Tran TT, Ahn J, Reau NS.7. ACOG Practice Bulletin No. 195: Prevention of Infection After Gynecologic Procedures. Obstetrics and Gynecology. 2018. Committee on Practice Bulletins—Gynecology Guideline8. Niels Johnsen, Hunter Wessells, Krystal Archer-Arroyo, et al. Best Practices Guidelines Management of Gentiunrinary Injuries.American College of Surgeons (2025). 20259. Fletke KJ, Jeong DH, Herrera AV . Urinary Catheter Management. American Family Physician. 2024..

Hantavirus was first discovered in the early 1950s near the Hantaan River in South Korea. The US has seen this before: the 1993 Four Corners outbreak was the first recognition of the virus in the United States, causing a deadly respiratory syndrome. Now, Hantavirus is in the news again with 17 Americans currently (5.10.26) enroute back to the US for specialized observation. In this episode, we will briefly review what this virus does and cover the SPARSE data we have regarding hantavirus infection in pregnancy. 1. Gilson GJ, Maciulla JA, Nevils BG, et al. Hantavirus Pulmonary Syndrome Complicating Pregnancy. American Journal of Obstetrics and Gynecology. 1994. 2. 5.10.26: https://www.nbcnews.com/health/health-news/hantavirus-stricken-cruise-ship-arrives-tenerife-rcna3443183. Janwadkar RS, Ritchie HM, Johnson CA. Unexpected Challenges: A Case Report of Hantavirus Infection in a Pregnant Patient in a Rural Emergency Department. The Journal of Emergency Medicine. 2025.

Navigating the Challenges of Free Birth: Insights from the Critical Care Obstetrics Podcast** Discover the complexities of free birth and the challenges faced in emergency settings. Learn from experts in maternal-fetal medicine about patient care without medical intervention.OpeningMany expectant mothers are opting for free birth—a choice that has gained traction despite the risks involved. In this post, we'll explore the insights shared by Dr. Stephanie Martin and nursing director Suzanne McMurtry Baird in their podcast about the challenges healthcare providers face when dealing with such patients. By understanding these dynamics, you can better appreciate the importance of trust and support in maternal care.Understanding Free Birth and Its ImplicationsFree birth, defined as delivering without medical assistance, raises critical questions about safety and maternal care. - **Why This Matters:** Many women believe they can have a safe delivery outside of traditional medical settings. However, statistics show that maternal mortality rates have significantly decreased with medical interventions. - **What the Transcript Reveals:** Dr. Martin emphasizes that while women have been giving birth for centuries, the medical system has evolved to ensure safer childbirth through interventions. - **How to Apply This Insight:** If you're considering a free birth, it's essential to weigh the risks versus benefits and understand the potential complications that could arise. The Role of Trust in Maternal HealthcareThe erosion of trust in the medical community has led many to seek alternatives, such as free birth.  - **Conventional Thinking:** Traditionally, patients trusted their healthcare providers to guide them in their decisions. - **Current Reality:** As discussed in the podcast, factors like social media misinformation and experiences during the pandemic have contributed to a decline in trust. - **Key Insight:** Building relationships and open communication can help restore this trust, making patients feel more comfortable with medical interventions when necessary. The Importance of Support During LaborSupport systems play a crucial role in the birthing process, especially for women who choose to free birth.  - **What We Learned:** During the podcast, it became evident that patients often arrive at the hospital without adequate support, which cThe 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:Patreon: patreon.com/CCOBYouTube: @CriticalCareOBPodcastInstagram: 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: ...

In 2024 Novo Nordisk announced it would discontinue Levimir insulin.. leaving many people scrambling and kind of stunned. There's no other insulin on the market quite like this long-acting – and it turns out the community wasn't letting it go without a fight. My guests are going to tell you more about why. I'm taking to Alison Smart, founder of The Alliance to Protect Insulin Choice – her daughter lives with type 1 as well as two doctors: Florence Brown and Amy Valent. Dr. Brown is Co-Director Joslin and BIDMC Diabetes in Pregnancy Program, Assistant Professor of Medicine, Harvard Medical School. Dr. Valent Assistant Professor of Obstetrics and Gynecology, School of Medicine at Oregon Health and Science University. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Announcing Community Commericals! Learn how to get your message on the show here. Learn more about studies and research at Thrivable here Please visit our Sponsors & Partners - they help make the show possible! Omnipod - Simplify Life All about Dexcom  All about VIVI Cap to protect your insulin from extreme temperatures The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com 

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

Fertility is a powerful reflection of your overall health—not a separate or isolated system. In this episode, fertility expert Dr. Natalie Crawford breaks down what's really happening physiologically as fertility shifts in midlife, connecting the dots between hormones, metabolism, inflammation, and egg quality.  We dive into the everyday habits quietly disrupting fertility—from chronic stress and blood sugar imbalances to inflammation—and how these factors directly impact ovulation and hormone signaling.  Dr. Crawford also cuts through the noise around age, offering a more nuanced, science-backed perspective on what you can actually do to support your fertility at any stage.  You'll learn that it's the simple shifts each month that can make a meaningful difference starting now.  Ready to support your body from the inside out? Tune in here! Natalie Crawford, MD  Dr. Natalie Crawford is board-certified in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility and is co-founder of Fora Fertility, a boutique fertility practice in Texas. She's the CEO and co-founder of Pinnacle, a professional network for women in medicine. Dr. Crawford is a digital health educator on social media and hosts the podcast  “As a Woman” with over 6 million downloads. Her new book, “The Fertility Formula”, will be released this spring.  IN THIS EPISODE How is fertility a reflection of your body's overall environment?  Accurate cycle tracking and what signals to pay attention to  Factors that disrupt fertility and how to catch issues early on  How inflammation and metabolic health are deeply tied to fertility  5 non-negotiables when it comes to women's health and wellness High-impact changes to help support your fertility  Fertility recommendations for women 35 and older  Dr. Crawford's fertility story and how to get her new book, The Fertility Formula QUOTES“The follicular phase and luteal phase are the two phases of the cycle, and learning to track your ovulation specifically is a really important tool because the early stages of ovulatory dysfunction all occur within a normal cycle, meaning the first stage is a short luteal defect.” “I can't control everything, but I want to control what I can, so I have the easiest time getting pregnant, I feel my best, I have the best odds of success if I have to do fertility treatments. That's the zone we want to live in, and we want to lower that inflammatory burden on the day-to-day, not to be all or nothing, but to really cultivate that body resilience so we can handle the challenges of life that we know are coming.” “It's your body's data. You're gonna find out one way or another, and I think you deserve to know it sooner.” RESOURCES MENTIONED Order my new book: The Perimenopause Revolution HERE! https://peri-revolution.com/ Pre-order The Fertility Formula https://www.nataliecrawfordmd.com/book Dr. Natalie Crawford on socials:  Instagram TikTok YouTube Dr. Crawford's Podcast: As A Woman RELATED EPISODES  691: The Fertility Crisis No One Talks About: Why Your Health Today Impacts Future Generations with Dr. Ann Shippy 530: The Critical Role That Nutrient Deficiencies Play In Fertility and Conception And How To Close The Gap with Lisa Dreher 687: The Period Brain: Why You Feel Like a Different Person Every Month And How To Stop Fighting Your Cycle and Start Thriving in It with Sarah Hill 735: The Stress–Metabolism Connection: Why You're Gaining Weight, Craving Sugar & Struggling with Energy

Natalie Crawford, MD is board certified in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility and is co-founder of Fora Fertility, a boutique fertility practice in Austin, Texas. Dr. Crawford is CEO and co-founder of Pinnacle, a professional network for women in medicine. She completed her undergraduate at Auburn University obtaining a degree in Nutrition Science, Medical School at UTMB, OBGYN Residency at UTSW, and REI Fellowship at UNC, concurrently obtaining a Master of Science in Clinical Research. Dr. Crawford is a digital health educator on social media, YouTube, and hosts the podcast  “As a Woman” with over 6 million downloads. Her debut book, “The Fertility Formula”, will be released by Penguin Random House.   Follow Dr. Crawford on Instagram at @nataliecrawfordmd and check out her book, The Fertility Formula.   Related Episodes: Ep 155 - Dr. Marguerite Duane on FACTS about Fertility Ep 314 - The Fertility Crisis + Support for Couples with Ronit Menashe + Vida Delrahim   If you like this episode, please subscribe to Pursuing Health on iTunes and give it a rating or share your feedback on social media using the hashtag #PursuingHealth. I look forward to bringing you future episodes with inspiring individuals and ideas about health.   Disclaimer: This podcast is for general information only, and does not provide medical advice.  I recommend that you seek assistance from your personal physician for any health conditions or concerns.