For years on True Birth and in their OB/GYN practice, Dr. Abdelhak & Kristin Mallon have made an unpopular argument: when a baby is measuring big, the safest move is usually to induce, not to wait. The conventional literature did not back them up, and plenty of academics pushed back with the same line every time, that induction does not lower the risk of a cesarean or a shoulder dystocia. In this episode they walk through two pieces of high level evidence that land squarely on their side, and they explain why this was common sense all along.

They start with the bigger cultural point. We do not have natural pregnancies anymore, so it is unrealistic to expect a uniformly natural birth. Electricity, processed food, far fewer daily steps, and later maternal age all push birth weights up, which means more babies are simply too big to deliver without help. Kristin brings the midwife lens to this, including a frank look at the Ina May Gaskin farm numbers and what they actually showed. From there they get into the data, share a real shoulder dystocia save from the floor, and detour into the things that genuinely scare them in delivery, like postpartum hemorrhage, plus Dr. Abdelic's running theory that growth problems are usually about the cord, not the placenta.

The take home is blunt. If your provider tells you the baby is measuring large, the right question is not whether to induce. It is when.

What we cover

• Why "natural birth" is a moving target in a non natural world
• The Ina May Gaskin farm numbers and what they really tell us
• The landmark randomized trial on inducing large for date babies
• The brand new 2026 meta analysis on induction at 38 weeks
• How estimated fetal weight, the 90th and 95th percentiles, and hospital induction rules actually play out in practice
• A real time shoulder dystocia at the bedside, handled without the fanfare
• Why hemorrhage, not shoulder dystocia, is the emergency that worries them most
• "It is all about the cord," and why placental insufficiency is the wrong framing
• The difference between cervical insufficiency and true preterm labor
• How to filter real clinical advice from social media noise

The research referenced

The randomized controlled trial (the Lancet study): Boulvain M, Senat MV, Perrotin F, et al. Induction of labour versus expectant management for large for date fetuses: a randomised controlled trial. Lancet. 2015;385(9987):2600 to 2605. A pragmatic trial across 19 centers in France, Switzerland, and Belgium. Women with singleton fetuses above the 95th percentile were randomized to induction between 37 0/7 and 38 6/7 weeks or to expectant management. Induction significantly reduced the composite of shoulder dystocia and associated morbidity, relative risk 0.32, 95% CI 0.15 to 0.71, p equals 0.004, without raising the cesarean rate and with more spontaneous vaginal deliveries.

The 2026 meta analysis (the AJOG MFM study): Paladino, et al. Induction at 38 weeks for large for gestational age or macrosomic fetuses decreases the incidence of cesarean delivery: meta analysis of randomized controlled trials. Am J Obstet Gynecol MFM. 2026. Five randomized trials, 4,083 pregnant individuals, most induced at 38 0/7 to 38 4/7 weeks for an estimated weight above the 90th percentile. Induction lowered the cesarean rate and cut macrosomia (relative risk 0.53 for 4,000 grams or more, and 0.22 for 4,500 grams or more). Shoulder dystocia and fetal fracture both trended down but did not reach significance, which is expected for outcomes this rare. Roughly 25 inductions in this window prevent one cesarean.

Key takeaways

A big baby is the single biggest risk factor for shoulder dystocia, and a baby does not get smaller between 38 and 40 weeks. The evidence now shows that inducing for a large for date baby reduces shoulder dystocia and cesarean delivery and increases the odds of a vaginal birth. If you are told your baby is measuring large, come prepared to ask for induction rather than waiting to be offered it. And take advice from clinicians who have actually cared for patients with your condition recently, not from a single viral story.

Connect

New episodes drop weekly. If you have a question or a topic you want covered, reach out, and please subscribe and leave a review wherever you listen. More at www.trubirthpodcast.com.

In this episdoe, we respond to a viral opinion piece by CCRM's Dr. Brian Levine, who argues that OBGYNs are fueling the IVF boom by failing to counsel women on their fertility at annual visits , and that it's costing women their chance at motherhood.

In this episode:

• What Dr. Levine got right — and where his argument falls apart
• Why the 7-minute annual visit was never designed to cover fertility, mental health, cancer screening, genetics, and everything else specialists wish it did
• The "Renaissance doctor" problem: why OBGYNs are expected to be everything at once
• Why IVF clinics have little financial incentive to counsel borderline-fertile patients early
• The real reason birth rates are declining — and why it has almost nothing to do with missed fertility counseling
• The OBGYN workforce crisis: fewer providers, shorter careers, and a system burning people out
• Why standardizing medicine may be one of the most dangerous things we can do
• What women can actually do right now to advocate for themselves within a broken system

Since the release of this episode: Brian Levine and The Free Press updated the title of the article referenced in this episode. The original title read: "Business Is Booming Because OB/GYNs Are Not Doing Their Job." It has since been changed to: "I'm an IVF Doctor. The Annual OB-GYN Visit Needs a Redesign."

Got something you want to share or ask? Keep it coming. We love hearing from you. Email us or send a voice memo, and you might just hear it on the next episode.

Don't forget to like, comment, and subscribe your questions could be featured in our next episode.

For additional resources and information, be sure to visit our website at Maternal Resources: https://www.maternalresources.org/

You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement:

• YouTube: youtube.com/maternalresources

• Instagram: @maternalresources

• Facebook: facebook.com/IntegrativeOB

• TikTok: NatureBack Doc on TikTok

Grab Our Book: The NatureBack Method for Birth—your guide to an empowered pregnancy and delivery. Shop now at naturebackbook.myshopify.com

In this episode of the TrueBirth Podcast, Dr. Yaakov Abdelhak discusses two women diagnosed with second trimester PPROM who received completely different prognoses for very different clinical reasons. Through these stories, we explore one of the most important realities in obstetrics: the same diagnosis does not always mean the same outcome. From fluid levels and infection risk to fetal development and maternal health, this conversation highlights the nuance, complexity, and individualized decision making required in high risk pregnancy care.

Got something you want to share or ask? Keep it coming. We love hearing from you. Email us or send a voice memo, and you might just hear it on the next episode.

Don't forget to like, comment, and subscribe your questions could be featured in our next episode.

For additional resources and information, be sure to visit our website at Maternal Resources: https://www.maternalresources.org/

You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement:

• YouTube: youtube.com/maternalresources

• Instagram: @maternalresources

• Facebook: facebook.com/IntegrativeOB

• TikTok: NatureBack Doc on TikTok

Grab Our Book: The NatureBack Method for Birth—your guide to an empowered pregnancy and delivery. Shop now at naturebackbook.myshopify.com

Two hundred episodes in, and we're taking a moment to look back at the conversations - the good and the bad.

This episode is a reflection on the moments that stayed with us, the topics that resonated most deeply with you, and the clinical truths that continue to guide how we think about pregnancy, birth, and postpartum care. It is equal parts gratitude and perspective.

We revisit the episodes that sparked the most conversation, shifted the way patients advocate for themselves, and reframed what thoughtful, evidence-based care can look like in real life.

Our two most listened-to episodes:

• C-Section Done Right: Episode #50 https://www.truebirthpodcast.com/050-c-section-delivery-done-right/ A deep dive into what a thoughtful, patient-centered cesarean can and should look like. This episode challenges the idea that a C-section is something that simply happens to you and instead reframes it as an experience that can be done with intention, respect, and clinical excellence.

• Epidurals #78 https://www.truebirthpodcast.com/078-epidurals-in-labor-delivery/ One of our most shared conversations. We unpack what epidurals actually do, how they impact labor, and how to think about them not as a binary choice, but as a tool that can be used thoughtfully within the context of your birth.

Whether you are preparing for your first pregnancy or your fourth, these episodes remain essential listening.

Thank you for being here, for listening, and for continuing to push the conversation forward with us.

Got something you want to share or ask? Keep it coming. We love hearing from you. Email us or send a voice memo, and you might just hear it on the next episode.

Don't forget to like, comment, and subscribe your questions could be featured in our next episode.

For additional resources and information, be sure to visit our website at Maternal Resources: https://www.maternalresources.org/

You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement:

• YouTube: youtube.com/maternalresources

• Instagram: @maternalresources

• Facebook: facebook.com/IntegrativeOB

• TikTok: NatureBack Doc on TikTok

Grab Our Book: The NatureBack Method for Birth—your guide to an empowered pregnancy and delivery. Shop now at naturebackbook.myshopify.com

*]:pointer-events-auto scroll-mt-(--header-height)" dir="auto" style= "font-style: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration: none; caret-color: #000000; color: #000000;" tabindex="-1" data-turn-id="af44cd60-405f-40bf-b2f0-7ef47dac043d" data-testid="conversation-turn-3" data-scroll-anchor="false" data-turn="user"> In this episode of The True Birth Podcast, we examine the history of proprietary medicine in obstetrics and how guarded knowledge shaped the evolution of childbirth. Before obstetrics became a formal medical specialty, barber-surgeons practiced a blend of grooming and surgical care, operating in a space between trade and medicine. We discuss the Chamberlen family and their forceps, which were kept secret for generations and brought into birth rooms concealed in ornate boxes to protect their design. What did it mean for a potentially life-saving instrument to be privately controlled? And how did the protection of medical knowledge influence the shift of birth from midwives and community care into the hands of surgical practitioners? *]:pointer-events-auto scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]" dir="auto" style= "font-style: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration: none; caret-color: #000000; color: #000000;" tabindex="-1" data-turn-id= "request-WEB:d79f0144-9a06-46a2-ae31-e3556041d47f-1" data-testid= "conversation-turn-4" data-scroll-anchor="true" data-turn= "assistant">

We also explore how obstetrics transitioned from guild-style secrecy to standardized and regulated medical practice. As forceps became more widely available, childbirth changed clinically and culturally. This conversation considers what was gained in terms of surgical safety and intervention, and what may have been altered in the process. By revisiting barber-surgeons and the history of the Chamberlen forceps, we reflect on how medicine is shaped by power, access, and innovation, and how those forces continue to influence birth today.

Got something you want to share or ask? Keep it coming. We love hearing from you. Email us or send a voice memo, and you might just hear it on the next episode.

Don't forget to like, comment, and subscribe your questions could be featured in our next episode.

For additional resources and information, be sure to visit our website at Maternal Resources: https://www.maternalresources.org/

You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement:

• YouTube: youtube.com/maternalresources

• Instagram: @maternalresources

• Facebook: facebook.com/IntegrativeOB

• TikTok: NatureBack Doc on TikTok

Grab Our Book: The NatureBack Method for Birth—your guide to an empowered pregnancy and delivery. Shop now at naturebackbook.myshopify.com

Pregnancy is one of the only times in life where we're asked to think in weeks instead of months, and for many people, it's confusing, frustrating, and sometimes anxiety-provoking.

In this episode, we break down how pregnancy is actually counted, why clinicians use weeks and days instead of months, and how to make sense of phrases like "halfway there," "almost seven months," or "full term." We also explain where these conventions came from, what they're used for medically, and how patients can translate them into something that feels more intuitive and human.

If you've ever wondered:

• Why pregnancy is 40 weeks but "nine months"

• Why doctors talk in weeks and days

• What "halfway" really means

• Or why your app, your provider, and your friends all seem to be using different math

This episode is for you.

At Maternal Resources, we believe understanding your body and your pregnancy shouldn't feel like decoding a foreign language. Clear information is a form of care.

What You'll Learn in This Episode

• How pregnancy is dated and why it starts before conception

• Why weeks (not months) matter for medical decision-making

• How months map onto weeks and where the confusion comes from

• What people mean when they say "halfway through pregnancy"

• How due dates are estimates, not expiration dates

• How to think about pregnancy in a way that's both medically accurate and emotionally grounded

Pregnancy Counting, Explained

Weeks and days are the medical language of pregnancy. Clinicians count pregnancy from the first day of the last menstrual period, not from conception. That's because ovulation and implantation vary, but menstrual cycles give us a consistent starting point. Using weeks allows for precision when it comes to growth, development, testing windows, and clinical decision-making.

Months are less precise and that's where confusion begins. Calendar months don't divide evenly into pregnancy. Some months have four weeks, some have more. That's why "nine months pregnant" can mean different things depending on how you're counting.

So what about being "halfway"? Halfway through pregnancy is around 20 weeks, not five months. This is often when people have anatomy scans and start to feel more connected to the pregnancy, which adds to the emotional weight of that milestone.

Due dates are estimates, not deadlines. Only a small percentage of babies are born on their exact due date. Pregnancy is a range, not a single day, and understanding that can help reduce unnecessary stress.

Got something you want to share or ask? Keep it coming. We love hearing from you. Email us or send a voice memo, and you might just hear it on the next episode.

Don't forget to like, comment, and subscribe your questions could be featured in our next episode.

For additional resources and information, be sure to visit our website at Maternal Resources: https://www.maternalresources.org/

You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement:

• YouTube: youtube.com/maternalresources

• Instagram: @maternalresources

• Facebook: facebook.com/IntegrativeOB

• TikTok: NatureBack Doc on TikTok

Grab Our Book: The NatureBack Method for Birth—your guide to an empowered pregnancy and delivery. Shop now at naturebackbook.myshopify.com

In this episode of True Birth, we explore late preterm birth which are deliveries that occur between 34 and 36 weeks of pregnancy, and why this window matters more than it is often given credit for. Late preterm babies are frequently described as "almost term," yet that framing can obscure the very real physiologic differences that exist in these final weeks of gestation.

We begin by defining what late preterm birth actually means and why it occupies a unique clinical and emotional space. Babies born in this window often look mature and strong, which can make it easy to underestimate the developmental work still happening in the brain, lungs, feeding reflexes, and metabolic systems during the final weeks of pregnancy.

From there, we talk about why late preterm births happen. This includes spontaneous preterm labor, preterm rupture of membranes, and medically indicated deliveries due to maternal or fetal conditions. We discuss how these decisions are made, the balance between continuing a pregnancy and intervening for safety, and why timing can be one of the most nuanced clinical judgments in obstetrics.

A central part of this episode focuses on outcomes, not to create fear, but to offer clarity. We discuss the most common challenges late preterm babies may face, including feeding difficulties, temperature instability, low blood sugar, jaundice, and breathing issues. We also talk about how these risks compare to earlier preterm births and why many late preterm babies do very well with appropriate monitoring and support.

We then shift to the postpartum experience for families. Late preterm birth often comes with unexpected separations, longer hospital stays, or feeding plans that look different than anticipated. We explore the emotional impact of this liminal space when a baby is not critically premature, but not quite ready in the way parents expected and how families can be supported through that adjustment.

Throughout the conversation, we emphasize the importance of preparation and communication. Understanding the possibility of late preterm birth, even in otherwise healthy pregnancies, can help families feel more grounded if plans change. We also discuss how care teams can better frame expectations, provide anticipatory guidance, and avoid minimizing the experience simply because a baby is "close to term."

This episode is about honoring the complexity of late preterm birth: medically, emotionally, and developmentally and recognizing that those last weeks of pregnancy matter, even when outcomes are ultimately positive.

For more episodes and resources, visit truebirthpodcast.com and subscribe wherever you listen to podcasts.

Got something you want to share or ask? Keep it coming. We love hearing from you. Email us or send a voice memo, and you might just hear it on the next episode.

Don't forget to like, comment, and subscribe—your questions could be featured in our next episode.

For additional resources and information, be sure to visit our website at Maternal Resources: https://www.maternalresources.org/

You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement:

• YouTube: youtube.com/maternalresources

• Instagram: @maternalresources

• Facebook: facebook.com/IntegrativeOB

• TikTok: NatureBack Doc on TikTok

Grab Our Book: The NatureBack Method for Birth—your guide to an empowered pregnancy and delivery. Shop now at naturebackbook.myshopify.com

In this episode of True Birth, we take a closer look at pelvic rest in pregnancy, what it actually means, when it is medically indicated, and when it may be unnecessarily prescribed. Pelvic rest is one of the most commonly given recommendations in pregnancy, yet it is often poorly explained and widely misunderstood. This conversation is about bringing clarity, nuance, and context to a topic that can feel confusing and anxiety-provoking for many families.

We begin by unpacking what providers typically mean when they recommend pelvic rest. For many people, the phrase immediately triggers fears of strict limitations or complete inactivity. We explain what pelvic rest usually involves, what it does not, and why the language itself can create more stress than clarity when it is not carefully defined.

From there, we discuss the situations in which pelvic rest is clinically appropriate. This includes conditions such as placenta previa, certain cervical changes, unexplained bleeding, or the presence of a cerclage. We explore the reasoning behind these recommendations and how pelvic rest is used as a precaution in specific, higher-risk scenarios to reduce cervical or placental irritation.

Just as importantly, we talk about when pelvic rest is not routinely necessary. In uncomplicated pregnancies with normal placental placement and no concerning symptoms, pelvic rest has not been shown to improve outcomes. We address how pelvic rest has often been carried forward out of habit rather than evidence, and why many people are advised to restrict sexual activity or vaginal contact without a clear medical reason.

This episode also explores the emotional and relational impact of pelvic rest. Recommendations around intimacy can affect connection, body image, and a person's sense of normalcy during pregnancy. We discuss how couples can navigate these changes with communication and flexibility, and why understanding the "why" behind a recommendation matters just as much as the recommendation itself.

Throughout the conversation, we emphasize the importance of individualized care. Pelvic rest is not a one-size-fits-all prescription, and pregnant people deserve clear explanations, shared decision-making, and the ability to ask questions about risks, benefits, and alternatives.

This episode is an invitation to move away from blanket restrictions and toward thoughtful, evidence-informed guidance, care that respects both physiology and the lived experience of pregnancy.

For more episodes and resources, visit truebirthpodcast.com and subscribe wherever you listen to podcasts.

Got something you want to share or ask? Keep it coming. We love hearing from you. Email us or send a voice memo, and you might just hear it on the next episode.

Don't forget to like, comment, and subscribe—your questions could be featured in our next episode.

For additional resources and information, be sure to visit our website at Maternal Resources: https://www.maternalresources.org/

You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement:

• YouTube: youtube.com/maternalresources

• Instagram: @maternalresources

• Facebook: facebook.com/IntegrativeOB

• TikTok: NatureBack Doc on TikTok

Grab Our Book: The NatureBack Method for Birth—your guide to an empowered pregnancy and delivery. Shop now at naturebackbook.myshopify.com

In this episode of True Birth, we share more birth stories. As always, stories are honest, nuanced, and deeply human. Some are empowering, some are complicated, some are unexpected, and all of them are real.

Birth is often spoken about in extremes. Perfect or traumatic. Natural or medical. Success or failure. But lived experience is far more layered than that. These stories remind us that birth unfolds within bodies, families, systems, and moments we can't always predict and that meaning is often found in how supported, informed, and heard someone feels along the way.

If you are pregnant, postpartum, planning a future birth, or simply holding space for others, this episode is a reminder that your story matters too. There is wisdom in sharing it and healing in being heard.

We want to hear from you. Have a birth story, a question, or something you're still processing? Send us an email or a voice memo. Your message may be featured in an upcoming episode.

If this episode resonated, please like, comment, and subscribe. Your engagement helps us continue these conversations and bring more voices into the space.

For additional resources, education, and support, visit our website at Maternal Resources: https://www.maternalresources.org/

You can also connect with us across our social channels: YouTube: youtube.com/maternalresources Instagram: @maternalresources Facebook: facebook.com/IntegrativeOB TikTok: NatureBack Doc

And if you want to go deeper, explore The NatureBack Method for Birth, our guide to an informed, empowered pregnancy and delivery:

naturebackbook.myshopify.com

In this episode of True Birth, we explore the powerful and often underestimated role partners play in childbirth. Birth is not something that happens only to the person giving birth. It is a shared experience, and the presence, preparation, and emotional steadiness of a partner can profoundly shape how labor unfolds.

This conversation is about moving beyond the idea of the partner as a passive observer and into a role that is grounded, supportive, and intentionally engaged.

We talk about what partners actually do during labor and birth, from providing physical comfort and emotional reassurance to helping maintain focus when things become intense or unpredictable. We discuss how partners can support without trying to fix, manage, or control the experience, and why simply being calm, present, and responsive matters more than doing everything perfectly.

Communication is a central theme of this episode. We cover how couples can talk openly before birth about fears, expectations, and preferences, and how partners can communicate effectively during labor with both the birthing person and the care team. Advocacy is explored in a realistic and balanced way, focusing on how partners can help ensure the birthing person feels heard and supported without creating additional stress.

We also address the emotional side of being a partner at birth. Many partners feel pressure to perform, to say the right thing, or to know exactly what to do. This episode reframes that pressure and offers a more compassionate and realistic view of the partner role, especially when birth does not go according to plan.

We share practical guidance partners can use in real time, including ways to offer comfort, support coping through contractions, and stay connected during the postpartum period as recovery and adjustment begin.

Whether you are preparing for your first birth or reflecting on a previous experience, this episode is an invitation to approach childbirth as a team and to recognize the meaningful role partners play in creating a safe, supported, and connected birth experience.

For more episodes and resources, visit truebirthpodcast.com and subscribe wherever you listen to podcasts.

Got something you want to share or ask? Keep it coming. We love hearing from you. Email us or send a voice memo, and you might just hear it on the next episode.

Don't forget to like, comment, and subscribe—your questions could be featured in our next episode!

For additional resources and information, be sure to visit our website at Maternal Resources: https://www.maternalresources.org/. You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement:

• YouTube: Dive deeper into pregnancy tips and stories atyoutube.com/maternalresources .
• Instagram: Follow us for daily inspiration and updates at @maternalresources .
• Facebook: Join our community at facebook.com/IntegrativeOB
• Tiktok: NatureBack Doc on TikTok

Grab Our Book! Check out The NatureBack Method for Birth—your guide to a empowered pregnancy and delivery. Shop now at naturebackbook.myshopify.com .