We examine why U.S. maternal mortality headlines mislead, showing overdose and violence dominate early postpartum deaths while obstetric causes decline. We then cover strong evidence for opportunistic salpingectomy, debunk a shaky Cochrane-fueled home birth claim, clarify Nexplanon’s five-year approval and bleeding management, confirm no Tylenol-autism link, and walk through modern syphilis testing in pregnancy before closing with pragmatic magnesium use after delivery.

• overdose and violence as leading postpartum deaths
• pitfalls of cross-country maternal mortality comparisons
• fentanyl trends and infant risk
• opportunistic salpingectomy reduces ovarian cancer risk
• how bad meta-analyses distort home birth safety claims
• intent-to-treat and risk matching in birth setting data
• Nexplanon five-year efficacy and bleeding treatments
• no association between acetaminophen and autism
• syphilis screening algorithms and pregnancy timing
• magnesium postpartum as seizure prophylaxis, not BP treatment

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0:00 Setting The Agenda: What Really Kills Moms

0:33 Redefining Maternal Mortality And Comparisons

2:11 Violence, Overdose, And Postpartum Risk

5:33 State Variability And Media Narratives

8:15 Data On Drugs, Fentanyl, And Infant Harm

11:06 Opportunistic Salpingectomy: New Evidence

14:06 Population Study And Risk Reduction Ranges

16:16 Cochrane Review And Home Birth Claims

20:24 Why Bad Meta-Analyses Mislead

24:15 Real-World Data And Intent-To-Treat For Birth Setting

28:02 Pain, Epidurals, And Cultural Narratives

31:00 Nexplanon Five Years And Bleeding Fixes

35:21 Tylenol And Autism: Meta-Analysis Revisited

38:04 Syphilis Testing In Pregnancy: Why It’s Hard

42:25 Traditional Vs Reverse Algorithms Explained

47:05 Managing Discordant Results And Reinfection

50:11 History, Ethics, And Tuskegee Lessons

54:15 Listener Question: Magnesium Duration Postpartum

59:05 Clinical Judgment Over Dogma And Wrap

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We map a prevention-first approach to OBGYN surgical complications—from environmental fixes and technique to early detection, skilled repair, and honest recovery—so fewer patients are harmed and clinicians carry less hidden burden. Practical steps, board-level reasoning, and real cases bring it to life.

• applying primordial to quaternary prevention to surgical harm
• avoiding unnecessary hysterectomy and favoring safer routes
• bladder repair tactics by size and location
• ureter injury recognition, stenting, and reimplant options
• bowel injury triage, Lembert technique, and resection thresholds
• four practical tips to prevent bowel injury
• vascular control from aorta to epigastrics and presacral bleeds
• preventing neuropathies with smarter positioning and retractors
• disclosure with HEAL and supporting clinicians with just culture
• key historical insights 

0:00 Framing Complications With Prevention

2:55 Primordial To Quaternary: The Model

7:30 Urologic Risks: Bladder First

16:20 Trigone, Stents, And Calling For Help

23:45 Ureter Injury Playbook

33:20 Delayed Ureter Injuries And Management

38:05 Small Bowel: From Serosa To Resection

46:30 Colon Injuries: Repair Or Resect

52:40 Four Tips To Prevent Bowel Injury

58:10 Vascular Injury: Aorta To Epigastrics

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We unpack new studies that reshape how we counsel on VBAC after short intervals, update what we tell BRCA carriers about estrogen therapy, and explore how self-collected HPV tests can reduce screening gaps. We also question surgical marketing, workforce trends, and the shaky evidence behind aspirin dosing for preeclampsia.

• Short interpregnancy interval as a VBAC risk factor, not a contraindication
• Absolute uterine rupture rates in spontaneous vs induced labor
• Estrogen therapy in BRCA carriers and treated gyn cancers
• Cervical screening overuse and underscreening in insured populations
• Self-collected HPV testing intervals and access benefits
• OB-GYN workforce shortages and rural distribution gaps
• Endometriosis surgery indications versus fertility claims
• Robotics versus laparoscopy outcomes and training priorities
• Aspirin dose trials, lack of placebo arms, and abruption signals
• Reading statistics correctly and demanding better editorial standards

0:00 Setting The Agenda: New Studies

0:40 Short Interval Pregnancy And VBAC Risk

3:10 Quantifying Uterine Rupture By Spacing

8:10 Induction, Augmentation, And Rupture Math

9:40 HRT In BRCA Carriers: New Evidence

13:05 Estrogen After Gyn Cancers: Practice Gaps

17:40 Cervical Screening: Overuse And Underscreening

22:30 Self-Collected HPV Testing Guidance

27:00 OB-GYN Shortages And Distribution

33:20 Endometriosis Surgery And Fertility Claims

41:20 Robotics Vs Laparoscopy: Outcomes And Training

47:20 Aspirin Dosing For Preeclampsia: No Signal

55:30 Interpreting Stats And Editorial Standards

59:20 Closing Notes And Next Steps

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Jamie Perry joins this episode as we share ten standout women’s health breakthroughs from 2025 and then get practical about value in endoscopic hysterectomy. The focus is simple: cut waste, save time, protect quality, and expand access through better selection, technique, and team flow.

• Key 2025 breakthroughs shaping care and counseling
• Why OR time outweighs device price
• Preference cards as a lever to reduce waste
• Three-arm robotics and smarter instrument choices
• Laparoscopic tips: barbed suture, simulation, quadrant workflow, vessel skeletonization
• Robotic tips: patient selection, docking discipline, turnover efficiency, data tracking
• Same-day discharge and ERAS as non-negotiables
• When vaginal route is truly better and why referrals matter

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0:00 Setting The Stage: Why Endoscopy

1:12 Ground Rules And Focus On Value

2:12 Top 10 Women’s Health Breakthroughs Of 2025

15:56 Defining Value In Hysterectomy

18:20 Preference Cards And Instrument Waste

21:28 Three-Arm Robotics And Instrument Costs

24:04 Time As The Biggest Cost Driver

29:56 Same‑Day Discharge And ERAS

33:44 Four Laparoscopic Efficiency Tips

41:28 Four Robotics Efficiency Tips

47:02 When To Choose Vaginal Hysterectomy

54:10 Data Tracking, Referrals, And Culture Change

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We unpack what WHI actually showed about estrogen-only therapy and breast cancer in light of new supporting data, then confront the free birth trend’s preventable harms and the business model behind it. We share clear tools to spot false claims, review new aspirin data on preeclampsia, and outline twelve practical ways to cut waste in gyn surgery.

• estrogen-only therapy associated with lower breast cancer diagnosis and mortality
• combined estrogen plus progestogen neutralizing estrogen’s protective signal
• rare abdominal pregnancy case illustrating basic testing safeguards
• free birth movement risks, censorship of bad outcomes, and money incentives
• red flags in birth-related posts and the SIFT fact-checking method
• four quick filters to vet social content before sharing
• nuanced view on aspirin for preeclampsia with mixed trial evidence
• twelve surgical sustainability steps that save cost and reduce waste

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1:11 Estrogen Therapy And Breast Cancer Risk

6:41 What WHI Actually Showed

11:22 Progesterone, HRT Fads, And Risks

15:35 Wild Case: Abdominal Pregnancy Behind Tumor

20:42 Free Birth Trend And Tragic Outcomes

25:37 How The Misinformation Business Works

30:10 Red Flags In Birth Content Online

35:10 The SIFT Method For Fact-Checking

40:20 Four Tips To Vet Social Posts

46:25 Live Walkthrough: Debunking A Viral Post

52:40 Digital Hygiene And Curating Feeds

56:48 Aspirin For Preeclampsia: Mixed Evidence

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We trace the arc from variolation and Jenner to mRNA, show how vaccines leverage natural immunity, and explain why maternal shots protect both parent and newborn. Data, history, and personal stories make the case that prevention beats cure for OBGYN care.

• pertussis surge in Kentucky and preventable infant deaths
• child mortality then and now and what changed
• variolation to Jenner and the origins of vaccination
• how innate and adaptive immunity learn and remember
• vaccine types and why today’s antigens are fewer
• effectiveness data across polio, measles, rubella, Hib
• sanitation myths versus vaccine impact
• Wakefield’s fraud and why autism claims fail
• three major studies debunking autism myths
• essential pregnancy vaccines and timing
• RSV options and COVID safety during pregnancy
• herd immunity as protection for newborns

0:02 Setting The Stage: Vaccines Under Fire

1:09 Pertussis Surge And Preventable Tragedy

2:20 Child Mortality Then And Now

4:19 What Killed Children In 1850

5:31 Out Of Sight, Out Of Mind

9:51 Origins Of Vaccination: Variolation To Jenner

15:20 Vaccines Use Natural Immunity

20:00 Types Of Modern Vaccines Explained

25:30 Innate And Adaptive Immunity 101

28:40 How Effective Are Vaccines Really

33:40 Polio’s Human Cost And Iron Lungs

39:00 Measles, Rubella, And Pregnancy Risks

44:20 Sanitation Myths Versus Vaccine Impact

47:05 The Wakefield Fraud And Aftermath

52:20 Big Studies Debunk Autism Claims

55:20 Essential Vaccines In Pregnancy

58:00 Takeaways And Next Steps

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We share a practical, clinic‑tested system for hereditary cancer screening that standardizes intake and education, then confront how malpractice pressures distort obstetric decision‑making, fetal monitoring, and access to care. Former ACOG president Dr. Richard Waldman offers data, history, and solutions we can use now.

• digital workflow that screens every patient annually from age 18 
• video education improving informed consent and test completion 
• one in four patients meeting hereditary testing criteria 
• management changes after testing including MRI, meds, referrals 
• addressing cost and genetic discrimination concerns 
• OBGYNs as leaders in genetics amid counselor shortages 
• malpractice landscape, rising verdicts, and physician burnout 
• neonatal encephalopathy criteria grounding courtroom science 
• fetal monitoring limits, category II overreaction, cesarean pressure 
• VBAC safety tied to selection, readiness, and team systems 
• safety culture, simulation, and checklists reducing risk

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Antonia and special guest Kristi Angevine explore how physicians can rethink habits beyond routines to include default thoughts, feelings, and reactions, and how that shift relieves burnout and restores purpose. Practical micro-habits, internal validation, and redefining productivity help us lead better and live better.

• habits as automatic thoughts, feelings, reactions
• perfectionism, people pleasing, catastrophizing as learned solutions
• survival seasons and low‑friction wins
• two micro‑habits: emotional check‑ins and box breathing
• escaping all‑or‑nothing with iterative learning
• redefining productivity around alignment, not to‑do lists
• internal validation and making yourself make sense
• training culture, criticism, and choosing supportive mentors
• identity beyond “doctor first” to include rest and health
• coaching options: group community and private work

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0:01 Setting The Stage: Habits In Medicine

0:32 Introducing Dr. Kristi Angevine

2:05 Redefining What A Habit Really Is

4:20 Perfectionism, People Pleasing, Catastrophizing

7:12 Coping Gone Sideways And Burnout Risk

11:21 Unrealistic Standards And The Inner Critic

15:54 When Work Ethic Becomes Self-Neglect

19:30 Why Simple Routines Aren’t Easy

23:12 Survival Seasons And Low-Hanging Fruit

26:12 Two Five-Minute Habits That Stick

30:45 Escaping All-Or-Nothing Thinking

36:05 Internal Validation As A Mental Habit

41:05 Success Beyond The To-Do List

48:39 Burnout’s Roots And Moral Injury

52:42 Training Culture, Criticism, And Resilience

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We challenge long-held beliefs about fibroids, highlight new ectopic pregnancy nuances, and dig into real-world dermoid cyst outcomes. We also unpack the evidence and ethics of 39-week induction after IVF and ICSI, balancing small absolute risks with maternal tradeoffs.

• Evidence overturning links between fibroids and miscarriage, PROM and abruption
• Distinguishing spontaneous versus iatrogenic preterm birth in fibroid pregnancies
• Why myomectomy can raise early delivery and cesarean rates in some patients
• Ectopic care updates: tube-sparing choices, HCG thresholds, two-dose methotrexate
• Experimental adjuncts to methotrexate remain unproven
• Dermoid data supporting laparoscopy, irrigation, and specimen bags over open surgery
• Surgical decision making during pregnancy and avoiding uterine manipulators
• IVF and ICSI timing: late stillbirth risk signals, limits of testing, 39-week logic
• Shared decision making when absolute risks are low but values differ

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1:33 Fibroids And Miscarriage Myths

5:53 Preterm Birth, PROM, And Hemorrhage

9:31 Myomectomy: Risks, Scars, And Outcomes

13:25 Ectopic Pregnancy: What’s New

18:37 Surgery Versus Methotrexate Nuances

22:05 Experimental Add-Ons To Medical Therapy

27:47 Dermoid Cysts: Real-World Data

32:48 Laparoscopy, Spillage, And Pregnancy

36:06 When Open Surgery Makes Things Worse

40:34 IVF, ICSI, And 39-Week Induction

48:05 Stillbirth Risk: What The Data Shows

55:20 Testing, Timing, And Shared Decisions

1:04:10 Practical Counseling And Tradeoffs

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In this episode, Howard and Maddie White challenge shaky claims linking autism to circumcision and Tylenol, then zero in on speed as the byproduct of essential, evidence-based surgery. We show how essentialism, confidence, and efficiency reduce complications, lower costs, and improve outcomes in the OR.

• correlation vs causation in autism narratives and bias in research
• why operative time predicts complications across procedures
• surgeon volume, variability, and outcome differences
• evidence-based cesarean steps that cut time and bleeding
• tool and method choices that are safer and faster
• confidence as self-efficacy, not arrogance
• practical efficiency: setup, flow, visualization, debrief
• lean thinking, standardization, and reducing variation

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00:00:00 Opening Banter & Autism Claims

00:02:35 Circumcision, Bias, and Correlation vs Causation

00:09:54 Why Speed in Surgery Matters

00:15:35 Surgeon Variability and Outcomes

00:19:35 Evidence-Based Cesarean: Essential Steps

00:27:20 Less Bleeding Through Minimal Dissection

00:31:20 Choosing Methods and Tools that Save Time

00:35:05 Confidence vs Arrogance in the OR

00:40:05 Practical Efficiency: Filming, Flow, and Setup

00:45:05 Visualization, Assisting, and Debriefing

00:50:00 Tools, Tech, and Mastering Basics

00:55:00 Standardization, Lean Thinking, and Takeaways

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