True Birth - SoundSage

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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.

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

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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

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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

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]: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

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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

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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

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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

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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

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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 .

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When pregnancy takes an unexpected turn, it can feel disorienting and deeply personal. In this episode, we talk about the curve balls no one plans for: pregnancy loss, placenta previa, emergency cesarean birth, and how to move through them with clarity, compassion, and support. This is a conversation about honoring grief without losing hope, finding steadiness in uncertainty, and reclaiming a sense of agency even when plans change. If your pregnancy story didn't follow the script you imagined, this episode is a reminder that you are not alone, that your experience matters, and that there is still space for healing, strength, and meaning on the other side.

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 .

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Low-dose aspirin, often called baby aspirin, is one of the most commonly recommended medications in pregnancy today. But despite how frequently it's prescribed, many patients still ask the same questions: Why do I need it? Is it safe? When should I start or stop? And who actually benefits?

In this episode, we take a clear, evidence-based look at baby aspirin in pregnancy—cutting through myths, confusion, and mixed messaging.

In this episode, we cover: * What "baby aspirin" actually is (dose, formulation, and how it works) * Why it's recommended in pregnancy, especially for preventing preeclampsia * Who should take it—including high-risk and moderate-risk patients * When to start and when to stop (timing matters) * What the research says about safety for both parent and baby * Common concerns and misconceptions, including bleeding risk * What to do if you're unsure or were told conflicting advice

Why baby aspirin matters: Preeclampsia remains one of the leading causes of pregnancy complications worldwide. Decades of high-quality research now show that low-dose aspirin, started early in pregnancy for the right patients, can significantly reduce risk—with an excellent safety profile.

For many patients, this simple intervention can make a meaningful difference in pregnancy outcomes.

Who this episode is for: * Pregnant patients wondering "Do I really need this?" * Anyone with a history of preeclampsia, hypertension, infertility, IVF, or pregnancy complications * Clinicians counseling patients on aspirin use * Anyone navigating pregnancy advice that feels unclear or contradictory

The takeaway: Baby aspirin isn't about doing more—it's about doing the right thing at the right time, guided by evidence and individualized care.

If you've been prescribed baby aspirin—or think you might benefit—this episode will help you understand why it's recommended and how to take it with confidence.

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 .

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In this episode, we tackle one of the most common questions in pregnancy of late: Is Tylenol safe? It's the medication nearly every pregnant person reaches for at some point, yet the internet is full of conflicting headlines and confusing studies. We break down what the data actually shows, when Tylenol is appropriate, and how to use it safely.

What We Cover • Why Tylenol (acetaminophen) is considered one of the first-lines in pregnancy We explain decades of clinical use, major guideline recommendations, and why it remains the preferred option for fever and pain relief.

• What the research actually says about safety We unpack the difference between correlation and causation, discuss recent observational studies, and highlight what ACOG and SMFM currently recommend.

• When Tylenol is truly needed Fever above 100.4, migraines, musculoskeletal pain, postpartum use, and how untreated fever or pain can create more risk than the medication itself.

• How to use it safely Typical dosing, maximum limits in 24 hours, how to avoid hidden acetaminophen in combination products, and who should be more cautious.

• What to avoid We clarify why NSAIDs (like ibuprofen) are not recommended in most stages of pregnancy and why people often confuse these medications.

Resources Mentioned • ACOG guidance on pain and fever management during pregnancy • SMFM clinical recommendations • FDA medication safety overview (pregnancy and lactation)

Call to Action If you have questions about medication safety in pregnancy or aren't sure what's right for your symptoms, talk with a clinician who understands the nuances of both maternal health and functional medicine. The right guidance can give you confidence and peace of mind.

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 .

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You wrote in, and we listened! In this special listener mail episode, we're answering your questions,reading your stories, and diving into what's been on your minds. From real-life experiences to the big "what ifs," we're here to talk, laugh, and think it through together.

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 .
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This show is about the VBAC Playbook—your complete guide to Vaginal Birth After Cesarean. We bring together everything you need to know in one place: all of our experience, the risks and benefits, the latest evidence, and the practical steps to prepare. Whether you’re weighing your options, looking for reassurance, or wanting to feel fully informed before talking with your provider, this playbook equips you with clear, comprehensive, and empowering information to help you make the best decision for your birth.

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:

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Pregnancy and childbirth are filled with important decisions, and sometimes the advice you receive from your OB/GYN or midwife can feel overwhelming—or incomplete. In this episode of True Birth, we take an honest look at when and why you might consider seeking a second opinion during pregnancy or for birth planning.

A second opinion is not about questioning your provider’s expertise—it’s about ensuring you have the full picture before making decisions that impact your health and your baby’s well-being. We discuss situations where a second opinion can be especially valuable: when facing a major intervention such as induction, cesarean birth, or surgery; when you’re given limited options; or when your instincts tell you something doesn’t feel right.

We’ll explore how different providers approach issues like VBAC (vaginal birth after cesarean), high-risk pregnancy management, and birth preferences, and why those perspectives can vary. Just as importantly, we share practical tips on how to approach the process: how to ask for your records, how to frame the conversation, and how to choose the right expert for a balanced perspective.

Our goal is to empower you to feel confident, informed, and supported in your care. Remember: seeking a second opinion is your right, not a sign of mistrust. It’s one of the best ways to advocate for yourself and ensure you’re making decisions aligned with your values and goals.

Tune in as we unpack real scenarios and offer guidance on making the second-opinion process respectful, productive, and ultimately reassuring—for a healthier pregnancy and a birth experience that feels right for you.

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:

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In this episode of True Birth, we take on one of the most fraught subjects in pregnancy care: substance use. Their conversation goes beyond the obvious admonition that “drugs are bad in pregnancy” to explore the nuance — what counts as a teratogen, which substances alter fetal development directly, and which compromise pregnancy through vascular, placental, or behavioral pathways.

The discussion begins with tobacco, a substance that does not cause specific birth defects but exerts powerful vascular effects that restrict blood flow to the placenta, increasing the risks of low birth weight, preterm birth, and ectopic pregnancy. From there, they move to alcohol, one of the few true teratogens, responsible for fetal alcohol syndrome and its enduring neurodevelopmental and behavioral consequences. The conversation then widens to heroin and opioids, which do not deform fetal anatomy but devastate pregnancy outcomes through miscarriage, placental abruption, and neonatal withdrawal syndromes.

Cocaine emerges as a particularly dangerous agent, not for teratogenicity but for its capacity to cause catastrophic circulatory collapse in both mother and fetus — strokes, abruptions, and even loss of fetal limbs due to infarcted placental tissue. The hosts also explore the gray areas: hallucinogens like LSD, stimulants such as ecstasy, and prescription amphetamines. They note the complexity of studying these substances, given the socioeconomic, dietary, and mental health confounders that often accompany their use.

What makes this episode compelling is not just the catalog of risks but the larger question of how to think about exposure. Mallon and Abdelhak acknowledge the historical shifts — from a time when physicians condoned “a few cigarettes a day” to today’s zero-tolerance policies — and they highlight emerging treatments for addiction, such as Ibogaine, which may offer new hope for patients but remain medically and legally unsettled.

The episode’s takeaway is clear: in pregnancy, no recreational substance is benign. Some, like alcohol, directly alter embryologic development; others, like nicotine and cocaine, impair the very systems that sustain pregnancy. The evidence is complex, but the principle is simple — abstaining is the only truly safe choice.

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 .
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Two Days, Two Docs: Stories from the Delivery Room takes you inside an unfiltered, behind-the-scenes look at 48 hours in Labor & Delivery through the eyes of two physicians: Dr. Yaakov Abdelhak and Dr. Apig Mosses from Maternal Resources. From the adrenaline of middle-of-the-night emergencies to the quiet, awe-filled moments of new life, these stories capture the highs, lows, and everything in between. Whether you’re a fellow clinician, an expectant parent, or simply curious about what really happens beyond those hospital doors, you’ll hear the human side of medicine—raw, real, and unforgettable.

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The American College of Obstetricians and Gynecologists released new clinical guidance on April 17, 2025 that recommends, as they see it, reimagining prenatal care in the U.S. Instead of the traditional 12–14 in‑person visits, ACOG now advocates for individualized prenatal care schedules—especially for average‑ and low‑risk patients—tailored based on medical, social, and structural determinants of health as well as patient preferences The guidance encourages early needs assessments (ideally before 10 weeks), shared decision‑making, coordination of social support resources, telemedicine, and group care modalities to reduce barriers and drive equity Drawing on the PATH framework developed with the University of Michigan, ACOG presents sample visit schedules and monitoring strategies reflecting evidence that fewer visits—with flexible modalities—can maintain quality while improving access and patient experience

As clinicans who have been offering unparalleled care for decades, find out what Dr. Abdelhak and his team at Maternal Resources think of groundbreaking this new update.

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Dr. Mosses comes to Maternal Resources after serving as the Medical Director of the OB/GYN department at Ezra Medical Center in Brooklyn, where he built a thriving obstetric practice from the ground up, now averaging over 50–60 deliveries per month. Prior to that, he was a senior attending physician at NYU Langone in Midwood, Brooklyn, where he maintained a cesarean section rate of under 10%—a testament to his skill in supporting vaginal births, including twin deliveries and VBACs (vaginal birth after cesarean). His approach combines clinical rigor with a strong belief in giving patients safe options for physiologic birth.

Expertise in Vaginal Twins, VBACs, and Minimally Invasive Surgery

Known for his hands-on experience with high-volume deliveries, Dr. Mosses has a deep expertise in managing vaginal twin deliveries and has successfully supported many patients through VBACs. He has performed thousands of deliveries and a wide range of gynecologic surgeries using open, laparoscopic, and vaginal approaches. Whether managing a routine pregnancy or a more complex case, his goal is always the same: to deliver excellent care that respects patient autonomy and promotes healthy outcomes. This commitment perfectly mimmics the core of what Maternal Resources is all about.

Training, Awards, and Teaching Excellence

Dr. Mosses completed his OB/GYN residency as Chief Resident at Richmond University Medical Center, where he received the Society of Laparoendoscopic Surgeons Award and completed advanced training in gynecologic oncology at Sloan Kettering. He has also supervised and trained residents at multiple academic institutions, including NYU Langone and Lutheran Medical Center. His academic background, combined with his leadership and research accolades, reflects his ongoing commitment to advancing women’s health.

Dr. A. Jay Mosses has been recognized for his outstanding contributions to the field of obstetrics and gynecology with several prestigious awards. During his residency at Richmond University Medical Center, he was honored with the Society of Laparoendoscopic Surgeons Award, acknowledging his excellence in minimally invasive surgical techniques. Additionally, his research on the use of double balloon cervical ripening catheters in managing massive hemorrhage in cervical ectopic pregnancies earned him the First Place Award at the 2016 Annual Residents’ and Fellows’ Research Paper Competition. These accolades reflect his commitment to advancing clinical care through both surgical skill and academic research.

We’re honored to have Dr. Mosses on our team and know our patients will benefit from his skill, warmth, and unwavering dedication to their care.

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In this powerful and eye-opening episode, we explore birth stories. Through candid, firsthand birth stories, we highlight how listening to your body, trusting your instincts, and building the right care team can make all the difference.

Whether you're planning a hospital birth, birth center experience, or home delivery, this episode reminds us that not all providers are created equal—and sometimes, your OB just doesn’t know when it comes to birth.

Who This Episode is For: Pregnant people, birth workers, doulas, midwives, and anyone curious about the realities of modern maternity care.

YouTube: Dive deeper into pregnancy tips and stories atyoutube.com/maternalresources .
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Fasting During Pregnancy: What You Need to Know

Pregnancy is a transformative time, full of excitement, anticipation, and, often, many questions about what you should or shouldn't do. One question that occasionally comes up for expectant mothers is: Is it safe to fast during pregnancy? Fasting might be part of a religious practice or lifestyle choice, but when you’re growing a baby, the rules can change. Here’s what you need to know about fasting while pregnant and why it’s crucial to approach this with care.

Why Fasting During Pregnancy Isn’t Generally Recommended Pregnancy is a time when your body requires extra nutrients and energy to support both your health and the development of your baby. Nutrients such as folic acid, iron, calcium, and vitamins are crucial for the growth of your baby’s organs, bones, and overall development. Fasting, whether it's skipping meals, restricting calories, or eliminating certain food groups, can impact the availability of these essential nutrients.

Additionally, regular meals help regulate blood sugar levels. During pregnancy, hormonal changes can already make it more challenging to maintain steady blood sugar, and fasting may lead to dizziness, fatigue, and other health concerns for both mother and baby. This is why many healthcare providers typically advise against fasting during pregnancy, particularly if it involves prolonged periods without food or water.

When Fasting Might Be Acceptable During Pregnancy While routine fasting is not generally recommended during pregnancy, some women may choose to fast for religious reasons, such as Ramadan or other spiritual observances. If you’re considering fasting while pregnant for religious purposes, it’s possible that you can still do so safely with some precautions and guidance.

Here are a few considerations that can help determine if fasting might be okay for you:

Check with Your Healthcare Provider: Before deciding to fast, consult your healthcare provider to discuss your specific health needs and pregnancy status. They can help assess whether fasting is safe for you and your baby, considering factors like your overall health, pregnancy complications (if any), nutritional needs, and the stage of your pregnancy.
Modify the Fast: If your provider agrees that fasting could be acceptable, consider modifying the fast. You might be able to shorten the fasting hours or incorporate light, nutritious foods during breaks to maintain energy levels and nutrient intake. Hydration is crucial, so be mindful of fluid consumption, especially during hot weather or if you're fasting for religious reasons that allow drinking water.
Listen to Your Body: Pay attention to how you feel during the fast. If you experience dizziness, nausea, excessive fatigue, or signs of dehydration, it’s essential to break the fast and consume something nourishing. Remember, the health and safety of you and your baby come first.
Nutrient-Dense Foods: If fasting, plan your meals around nutrient-rich foods that offer protein, healthy fats, fiber, vitamins, and minerals to support your body and your baby’s development. This will help sustain energy and maintain your nutritional needs during the fast.

Tips for Safe Fasting During Pregnancy If you and your healthcare provider decide that fasting is safe for you, consider these tips to make the process easier and safer:

Stay Hydrated: Drink plenty of water during non-fasting hours. Dehydration can be harmful during pregnancy, so make sure to replenish fluids regularly.
Eat Balanced Meals: When breaking the fast, focus on balanced meals that include protein, whole grains, healthy fats, and plenty of fruits and vegetables. Avoid foods that are high in sugar or refined carbs, as they can cause blood sugar spikes and crashes.
Avoid Overexertion: Fasting can reduce energy levels, so it’s important to avoid strenuous physical activity during this time. Light exercises like gentle yoga or walking may be okay, but rest when you need to.
Monitor Your Baby’s Movements: Keep an eye on your baby’s movement patterns. If you notice a decrease in fetal activity, contact your healthcare provider promptly.

The Bottom Line While fasting is generally not recommended during pregnancy due to the increased need for nutrients and energy, it can sometimes be done safely under specific conditions. If you want to fast for religious or spiritual reasons, it’s important to have a detailed discussion with your healthcare provider first. Together, you can make a plan that prioritizes both your health and the well-being of your growing baby.

Always listen to your body and be prepared to modify or end the fast if you experience any adverse effects. Your health and your baby’s development should always come first, and there are often ways to honor your spiritual practices while keeping both of you safe.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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

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The Unexpected Journey: Understanding and Navigating PPROM Life throws curveballs, and sometimes, those curveballs come in the form of these little letters: PPROM. For those unfamiliar, PPROM stands for Preterm Premature Rupture of Membranes, a medical term that sounds as serious as it is. In plain English, it means that the water breaks too early—before 37 weeks of pregnancy and often long before anyone is ready.

What Is PPROM? Preterm Premature Rupture of Membranes, or PPROM, is a condition that affects roughly 3% of pregnancies, yet it accounts for nearly one-third of all preterm births. It occurs when the amniotic sac, which surrounds and protects the baby in the womb, breaks open before 37 weeks of pregnancy and before the onset of labor. This rupture can lead to significant complications, making it a critical condition to recognize and manage promptly.

What Causes PPROM?

The exact cause of PPROM is often unclear, but several factors can increase the risk. Infections of the reproductive tract, such as bacterial vaginosis, are a common cause. Other risk factors include a history of PPROM in a previous pregnancy, cervical insufficiency, multiple pregnancies (such as twins or triplets), and lifestyle factors like smoking. In some cases, the condition may occur without any identifiable risk factors, which makes it all the more important for expectant mothers to be vigilant about their health and prenatal care.

Signs and Symptoms

Recognizing the signs of PPROM is crucial for early intervention. The most common symptom is a sudden gush or a steady leak of fluid from the vagina, indicating that the amniotic sac has ruptured. Other symptoms may include increased vaginal discharge, a sensation of wetness in the underwear that doesn’t dry, or a trickling of fluid that may come and go. Some women may also experience pelvic pressure or mild cramping. If you notice any of these signs, it’s essential to contact your healthcare provider immediately.

Diagnosis and Management

If PPROM is suspected, your healthcare provider will likely perform a physical examination and order tests to confirm the diagnosis. This may include testing the vaginal fluid for amniotic fluid, ultrasound to assess the amount of amniotic fluid around the baby, and checking for signs of infection.

Once diagnosed, the management of PPROM depends on several factors, including the gestational age of the pregnancy, the presence of infection, and the health of the mother and baby. If the pregnancy is near term (after 34 weeks), labor may be induced to reduce the risk of complications. If the pregnancy is earlier, the goal is often to prolong the pregnancy while minimizing risks. This may involve hospitalization, administration of antibiotics to prevent infection, corticosteroids to speed up the baby’s lung development, and careful monitoring of both mother and baby.

Potential Complications

PPROM can lead to several complications, primarily due to preterm birth. Babies born prematurely may face challenges such as respiratory distress syndrome, infections, and developmental delays. Additionally, the longer the membranes remain ruptured, the higher the risk of infection for both the mother and the baby. Chorioamnionitis, an infection of the amniotic sac, is a serious complication that requires immediate medical treatment.

Emotional Impact and Support

The diagnosis of PPROM can be an emotionally challenging experience for expectant mothers and their families. Anxiety about the health of the baby, uncertainty about the outcome, and the potential for an extended hospital stay can all contribute to significant stress. It’s important to seek emotional support, whether through counseling, support groups, or talking with other mothers who have experienced PPROM. Your healthcare team can also provide resources and guidance to help you navigate this difficult time.

Outlook

While PPROM is a serious condition, advances in prenatal and neonatal care have significantly improved outcomes for both mothers and babies. Early recognition and appropriate management are key to minimizing risks and ensuring the best possible outcome. If you’re pregnant and have concerns about PPROM, don’t hesitate to discuss them with your healthcare provider. Being informed and proactive about your health is the best way to safeguard the well-being of both you and your baby.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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

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Thank you for being part of our community, and until next time, let's continue to support, uplift, and celebrate the incredible journey of working moms and parenthood. Together, we can create a more equitable and nurturing world for all.

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The Growing OB/GYN Shortage in the United States: Causes and Implications

The United States is currently facing a significant shortage of obstetricians and gynecologists (OB/GYNs), a crisis that poses serious implications for women’s health care across the nation. This shortage is driven by a combination of factors that are causing many OB/GYNs to leave the field and deterring new doctors from entering it.

High Stress and Burnout

One of the primary reasons for the OB/GYN shortage is the high level of stress and burnout associated with the profession. OB/GYNs often work long hours, are on call frequently, and deal with high-stakes situations such as childbirth complications and emergency surgeries. The intense pressure and demanding schedule can lead to burnout, causing many practitioners to reduce their hours, retire early, or switch to less demanding specialties.

Malpractice Insurance Costs

OB/GYNs face some of the highest malpractice insurance premiums in the medical field due to the risks associated with childbirth and surgical procedures. The fear of litigation and the financial burden of high insurance costs are significant deterrents for both current and prospective OB/GYNs. This financial strain can make it less appealing for medical students to choose OB/GYN as their specialty, exacerbating the shortage.

Decreased Reimbursement Rates

Another contributing factor is the declining reimbursement rates for obstetric and gynecological services. Insurance companies and government programs have reduced the amount they pay for these services, making it financially challenging for OB/GYNs to sustain their practices. This economic pressure has led some doctors to leave the field or limit the number of obstetric services they offer.

Aging Workforce

The OB/GYN workforce is aging, with a large number of practitioners nearing retirement age. As these experienced doctors retire, there are not enough new OB/GYNs entering the field to replace them. The aging population also means that there is an increasing demand for gynecological care, further straining the already limited resources.

Geographical Disparities

The OB/GYN shortage is particularly severe in rural and underserved urban areas. Many OB/GYNs prefer to practice in larger cities where they can access better facilities, support, and lifestyle amenities. This leaves rural communities and economically disadvantaged areas with inadequate access to essential women’s health services, resulting in higher maternal and infant mortality rates in these regions.

Impact on Women’s Health

The shortage of OB/GYNs has serious implications for women’s health. Longer wait times for appointments, reduced access to prenatal and reproductive care, and increased travel distances to see a specialist are some of the immediate consequences. The lack of accessible OB/GYN services can lead to delayed diagnoses and treatments, negatively impacting health outcomes for women and newborns.

Addressing the Shortage

Addressing the OB/GYN shortage requires a multi-faceted approach. Potential solutions include increasing funding for medical education and residency programs to attract more students to the field, implementing loan forgiveness programs for those who choose to work in underserved areas, and advocating for policies that reduce the financial and legal burdens on OB/GYNs. Improving work-life balance through flexible scheduling and better support systems can also help retain current practitioners and reduce burnout.

In conclusion, the OB/GYN shortage in the US is a complex issue with far-reaching effects on women’s health care. By understanding the causes and working towards sustainable solutions, it is possible to ensure that all women have access to the essential reproductive and obstetric care they need.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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

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Thank you for being part of our community, and until next time, let's continue to support, uplift, and celebrate the incredible journey of working moms and parenthood. Together, we can create a more equitable and nurturing world for all.

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NatureBack is the expression of Dr. Yaakov Abdelhak’s obstetrical philosophy after more than 3 decades in the field of high-risk perinatology Maternal-Fetal Medicine. It is a goal-oriented practical method that can mitigate or possibly even eliminate the need for a cesarean delivery.

Now you can read Dr. Abdelhak's first hand experience in his new book The NatureBack Method.

The NatureBack Philosophy starts at the beginning of pregnancy, with recognition of the factors that can lead to cesarean delivery. The risk of cesarean delivery doesn’t arise when a woman goes into labor; it’s set long before any medical intervention. In many pregnancies, a cesarean delivery is initiated during the first trimester, and there are steps that can be taken in each trimester and during birth to reduce the need for surgical intervention.

Most are familiar with the cesarean epidemic where cesareans account for more than 30 percent of all deliveries in the United States. This is a dramatic increase from the mere five percent of babies delivered by cesarean delivery in 1970. Fingers often point at the bias of overworked obstetricians who want to hurry things along, labor induction, and other seemingly counterproductive medical interventions. There is also the widespread use of the external fetal monitor, which is blamed for fueling the anxiety of litigation-weary obstetricians. Some of these usual suspects have earned their dubious reputation, while others are completely innocent—as the NatureBack philosophy details.

NatureBack proports the honest truth about the largest contributing factor to the cesarean wave which is that many babies are just too big. They’re so big, in fact, that many can’t fit through the pelvis.

A very popular, powerful cultural belief is that Mother Nature–the time-tested, proven, physiological, and finely-tuned process–will not let us down. Women have been birthing vaginally for millennia. Is there any reason to believe that a woman would—or even could!—grow a baby so large that it’s physically impossible for the baby to safely pass through her birth canal? That Mother Nature would provide each mom with a baby that fits her body seems like common sense.

The thing is, we no longer live in Mother Nature’s world. Instead, we live in a world very different from the one we adapted to throughout the millennia of human evolution.

The process of vaginal birth has remained the same; it’s our lifestyles that have changed. We have deviated from nature—and mightily so. Our diets, our activity levels, and our expectations have all evolved (some might say devolved). For most of us, modern society means a sedentary lifestyle. It is synonymous with processed food, with the result that we are now consuming carbohydrates on a scale unprecedented in human history.

As a result, babies are growing bigger in gestation than ever before. With the abundance of calories at our disposal, growing babies are turning out to be easier than delivering them.

At Maternal Resources, the team is ready to safely guide you and your family through a healthy pregnancy utilizing the NatureBack method to achieve all your pregnancy goals including Natural Vaginal Delivery, if you so choose.

You can get your copy of the book on Amazon.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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

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Should You Trust Online Reviews? The Pros and Cons of Relying on Online Feedback In our increasingly digital world, online reviews have become a staple for making decisions, especially when it comes to choosing healthcare providers. But with so much information at our fingertips, how do we know if we should trust these reviews? Let's explore the pros and cons of trusting online reviews to help you navigate this critical decision-making tool.

The Pros of Trusting Online Reviews 1. Access to Collective Experiences * Diverse Opinions: Online reviews aggregate the experiences of many patients, providing a broader perspective on a doctor's capabilities and patient care. * Volume of Feedback: A large number of reviews can give a more reliable picture of what to expect, reducing the weight of any single, potentially biased review.

Convenience and Accessibility * Time-Saving: Reading reviews is a quick way to gauge a doctor's reputation without spending hours on individual research.
Ease of Access: With reviews available on multiple platforms, it's easy to compare different providers and make an informed choice from the comfort of your home.
Insight into Patient Satisfaction * Patient-Centric Feedback: Reviews often highlight aspects of care that matter most to patients, such as bedside manner, wait times, and office environment, which might not be evident from professional credentials alone.
Real-World Scenarios: Detailed reviews can provide insights into specific situations, helping you understand how a doctor might handle your particular health concerns.

The Cons of Trusting Online Reviews 1. Risk of Misleading Information * Fake Reviews: Some reviews may be fabricated or incentivized, leading to an inflated positive or negative reputation. * Biased Feedback: People are more likely to leave reviews after particularly good or bad experiences, potentially skewing the overall picture.

Lack of Verification * Anonymous Reviews: The anonymity of online reviews means there is no guarantee of the reviewer’s authenticity or whether they have genuinely experienced the service.
Unverified Claims: Unlike professional evaluations, patient reviews are not typically vetted for accuracy or fairness.
Inconsistent Quality of Reviews * Subjective Opinions: Reviews can be highly subjective, based on personal preferences that may not align with your own priorities.
Variable Detail: Some reviews are vague and lack sufficient detail to be useful, while others may focus on trivial matters unrelated to the quality of medical care.

Finding a Balanced Approach Given these pros and cons, how should you approach online reviews? Here are some strategies to help you make the most of the information available:

Look for Consistency * Pattern Recognition: Identify common themes across multiple reviews. Consistent feedback, whether positive or negative, is more likely to reflect the true nature of the service.
Use Multiple Sources * Cross-Reference Reviews: Check reviews across different platforms to get a comprehensive view. Websites like Healthgrades, Yelp, and Google Reviews can offer varied perspectives.
Professional Opinions: Combine patient reviews with professional ratings and certifications to get a well-rounded picture of a doctor's qualifications and care quality.
Consider the Context * Detailed Accounts: Give more weight to detailed reviews that provide context and specifics about the patient's experience.
Review Dates: Pay attention to the dates of reviews. Recent feedback is more relevant as it reflects the current state of the practice.
Use Reviews as a Starting Point * Initial Screening: Use online reviews to narrow down your options, but don't make your final decision based solely on them.
Personal Experience: Schedule a consultation to get a firsthand experience of the doctor's practice. Your personal comfort and trust in a healthcare provider are invaluable.

While online reviews can be a valuable tool for making informed decisions about healthcare providers, it's essential to approach them with a critical eye. By recognizing their limitations and using them in conjunction with other information, you can make a more informed and confident choice.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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

Twitter: https://twitter.com/integrativeob YouTube: https://www.youtube.com/maternalresources Instagram: https://www.instagram.com/integrativeobgyn/ Facebook: https://www.facebook.com/IntegrativeOB

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Today, we're diving into a fascinating and important topic: what to expect during a twin vaginal delivery. Twin pregnancies come with their own unique set of considerations, and understanding the process can help expectant parents feel more prepared and confident.

In this episode, we'll explore the stages of labor, the role of the medical team, and the potential challenges and joys of delivering twins vaginally. Whether you're expecting twins yourself or simply curious about the intricacies of twin births, we've got you covered. Let's get started on this journey through the remarkable experience of bringing two new lives into the world at the same time.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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

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Welcome to True Birth, where we provide raw, honest insights into pregnancy, childbirth, and the postpartum period. Dr. Yaakov Abdelhak, a Perinatologist, and Certified Nurse Midwife Kristin Mallon are here to share their professional perspectives straight from the trenches of the labor floor.

Episode Overview: In this special episode, we delve into the sensitive topic of coping with perinatal loss. We recognize the profound impact that pregnancy loss can have on individuals and families, and our goal is to offer compassionate guidance and support.

Discussion Points:

Understanding Perinatal Loss:
- Dr. Abdelhak and Kristin provide insights into what perinatal loss entails, discussing its various forms and the emotional toll it can take on parents.
- Navigating Grief and Emotions:
- Coping with the loss of a pregnancy can evoke a range of emotions. Our hosts offer advice on how to navigate grief and provide support for individuals and couples experiencing loss.
- Honoring the Experience:
- We emphasize the importance of validating the grieving process and honoring the memory of the baby lost. Our hosts discuss various ways individuals and families can commemorate their loss and find healing.
- Seeking Support:
- Dr. Abdelhak and Kristin highlight the significance of seeking support from loved ones, support groups, and mental health professionals during this challenging time. They provide resources and strategies for finding the support needed. No path forward is really the wrong path. All feelins are valid

We want to express our deepest empathy for anyone who has experienced perinatal loss. Remember, you are not alone, and it's okay to seek support as you navigate this difficult time. Stay tuned for more honest discussions and support on True Birth.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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

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When expecting a baby, among the flurry of decisions to be made, choosing where to deliver stands out as one of the most significant. It's a choice that goes beyond mere geography or convenience; it's about where you'll welcome your child into the world and the first level of care both of you will receive. It's about safety, support, and a positive birth experience. Today, we're spotlighting Hackensack University Medical Center (HUMC) as an exemplary choice for families looking to ensure the best start for their newborns.

The Importance of the Right Location The location you choose for delivery impacts the medical care quality, emotional support, and the array of services available to you and your baby. A hospital equipped with top-tier facilities, specialized care, and a nurturing environment can make a significant difference in your childbirth experience. It's not just about the immediate moments post-birth but also about the comprehensive care leading up to and following this life-changing event.

Why Hackensack University Medical Center Stands Apart Magnet Hospital Recognition: A Mark of Nursing Excellence HUMC isn't just any hospital; it's recognized as a Magnet hospital. This prestigious designation is the gold standard for nursing excellence and quality patient care. It signals a supportive environment not just for patients but for the medical professionals dedicated to your care, ensuring that you receive the best possible support during this critical time.

Level III NICU: Ready for Every Possibility Babies don't always arrive as expected, and some need a little extra help getting started. HUMC's Level III Neonatal Intensive Care Unit (NICU) is equipped for a high level of neonatal care. This means that even the smallest or sickest of newborns receive top-notch, specialized care, offering peace of mind that, should your baby need it, the best possible support is right there.

All Private Rooms: Comfort, Privacy, and Bonding The benefits of all private rooms cannot be overstated. Privacy during these first moments can significantly impact a mother's stress levels and overall recovery. HUMC offers this serenity, facilitating a peaceful environment where families can bond with their new arrivals without the intrusion of a shared space.

Lactation Consultations 7 Days a Week: Support for Breastfeeding Mothers Breastfeeding, while natural, can come with its set of challenges. HUMC's commitment to lactation consultations seven days a week ensures that mothers receive the support and guidance they need, promoting successful breastfeeding practices and addressing any concerns promptly.

High-Level Experience: A Team You Can Trust At HUMC, you're in good hands. The hospital prides itself on its highly experienced team of obstetricians, pediatricians, nurses, and other healthcare professionals who bring a wealth of knowledge and compassion to their roles. This high level of experience means that expectant parents can relax, knowing they're supported by some of the best in the field.

Choosing where to give birth is a pivotal decision for expecting families. It's about more than just the physical location—it's about the care, the support, and the environment that will surround you and your baby during one of life's most momentous occasions. Hackensack University Medical Center stands out as a beacon of excellence in this regard, offering everything from unparalleled medical care to the peace and privacy families deserve. As you consider your options, remember the difference the right location can make—not just for the birth itself but for the lifelong memories it will help create.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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

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A typical day for an OB/GYN on the labor floor in Labor and Delivery (L&D) is dynamic and multifaceted, blending clinical acumen with compassionate patient care. Their day begins with rounding on patients who are in various stages of labor, assessing their progress, and managing any complications that arise. Throughout the day, the OB/GYN is constantly on the move, alternating between the labor ward, the operating room for cesarean sections, and the antepartum unit for high-risk pregnancies. They collaborate closely with nurses, midwives, and other healthcare professionals to develop care plans, conduct deliveries, and provide postpartum care. The OB/GYN must be prepared to make quick decisions in response to emergent situations, such as fetal distress or pre-eclampsia, ensuring the health and safety of both mother and baby. Amidst the clinical duties, they also find time to counsel and reassure expectant parents, guiding them through one of the most significant moments of their lives. Each day is unpredictable and rewarding, filled with the joy of new beginnings and the satisfaction of overcoming challenges.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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

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Easing Back Pain During Pregnancy: Tips and Insights

Pregnancy is a beautiful journey filled with anticipation and joy, but it can also bring about a less welcomed companion: back pain. Many expectant mothers experience back pain, particularly in the second and third trimesters. This discomfort arises from the natural changes your body undergoes to accommodate the growing baby. However, the good news is there are several strategies to manage and reduce back pain during this special time. Let’s explore some effective ways to find relief and enjoy your pregnancy with more comfort.

Understanding Back Pain in Pregnancy

Back pain during pregnancy can result from a combination of factors. As your baby grows, your center of gravity shifts forward, placing additional strain on your lower back. Hormonal changes also play a role; the body releases a hormone called relaxin, which loosens ligaments and joints in the pelvis but can also lead to instability and pain in the back.

Back pain during pregnancy is a common complaint and can be caused by a variety of factors related to the physical and hormonal changes a woman experiences during this time. Here are the main causes:

Weight Gain: Pregnancy involves significant weight gain within a relatively short period, typically around 25 to 35 pounds (11 to 16 kilograms) for a single pregnancy. The spine has to support this increased weight, which can lead to lower back pain.
Posture Changes: As the uterus expands, a woman's center of gravity shifts forward. To compensate, many women change their posture and the way they move, which can strain the back and result in pain.
Hormonal Changes: During pregnancy, the body produces a hormone called relaxin, which helps prepare the pelvis for childbirth by relaxing ligaments and joints. However, this loosening can also reduce the support for the spine, leading to instability and pain.
Muscle Separation: As the uterus expands, two parallel sheets of muscles (the rectus abdominis muscles) that run from the rib cage to the pubic bone may separate along the center seam. This separation can worsen back pain.
Stress: Emotional stress can cause muscle tension in the back, which may be felt as back pain or back spasms. Pregnant women may experience increased levels of stress, contributing to back pain.
Changes in the Pelvic Area: As the body prepares for labor, the pelvis can begin to move and shift, affecting the balance and alignment, which can lead to pain in the lower back.

Understanding these causes can help in finding appropriate ways to manage and alleviate back pain during pregnancy, such as through exercise, proper posture, and other supportive measures. Always consult a healthcare provider for personalized advice and treatment options suitable for your pregnancy.

Effective Strategies for Relief

Exercise Regularly: Engaging in regular, pregnancy-safe exercise can strengthen your back and reduce discomfort. Prenatal yoga and swimming are excellent for strengthening your muscles without putting too much strain on your back.
Maintain Good Posture: As your belly grows, it's tempting to lean back to compensate, but this can worsen back pain. Try to stand up straight and use a comfortable, supportive chair when sitting. Placing a pillow behind your lower back for support can also help.
Wear Supportive Footwear: Skip the high heels and opt for flat, supportive shoes. The right footwear can prevent additional strain on your back.
Lift Properly: When lifting small objects, bend your knees and squat rather than bending at your waist. This technique helps avoid putting extra stress on your back.
Sleep on Your Side: Sleeping on your side with a pillow between your knees can take pressure off your back. A pregnancy pillow can provide additional support and comfort.
Prenatal Massage: A massage by a therapist trained in prenatal techniques can relieve back pain and provide relaxation.
Heat and Cold Therapy: Applying heat to your back can soothe sore muscles, while cold packs can reduce inflammation. Be sure to wrap heat or cold sources in a towel to protect your skin.
Consult a Professional: If your back pain is severe or persistent, it’s important to consult with your healthcare provider. They may recommend physical therapy or other treatments tailored to your specific needs.

Prevention Tips

Preventing back pain is also crucial. Regular exercise and maintaining a healthy weight can reduce the risk of experiencing severe back pain. Additionally, focusing on posture and avoiding heavy lifting can prevent unnecessary strain on your back.

Although back pain is a common aspect of pregnancy, it doesn’t have to overshadow this incredible journey. By adopting some of these strategies, you can alleviate back pain and focus more on the excitement of welcoming your new baby. Remember, every pregnancy is unique, so it’s essential to consult with your healthcare provider before starting any new exercise regimen or treatment.

As you navigate through your pregnancy, keep in mind that taking care of yourself is also taking care of your baby. Embrace these changes with confidence, knowing there are ways to manage the discomforts that come along

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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

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Navigating the Path toward a Successful VBAC: Essential Questions for Your Healthcare Provider

As strong advocates for informed and empowered childbirth, this episdoe addresses a topic close to the hearts of many expectant parents: Vaginal Birth After Cesarean (VBAC). Choosing a VBAC-friendly provider is a critical step in this journey, not just for the success of the procedure, but for the overall experience of childbirth. Here are key aspects to consider and questions to ask your healthcare provider:

Understanding VBAC Success Rates: The first and perhaps most crucial question to ask is about the provider’s VBAC success rates. This statistic not only reveals their experience with VBACs but also reflects their commitment to supporting them. A provider who believes in the possibility of a successful VBAC and has a track record to prove it is more likely to offer the supportive and positive environment needed.
Gauging Provider’s Attitude towards VBAC: When you bring up the topic of VBAC, observe their reaction. Do they seem supportive and enthusiastic, or hesitant and discouraging? Their immediate response can be very telling about their philosophy and approach towards VBAC. You want a provider who is not just tolerant of VBAC but is genuinely supportive and optimistic about it.
Policies on Inducing VBACs: Induction can be a contentious topic in the context of VBAC. Ask your provider about their policies and views on inducing labor in VBAC cases. Some providers are more conservative and prefer to avoid induction, while others may be open to it under certain circumstances. Understanding their approach helps align your birth plan with their practices.
Coverage and Continuity of Care: It’s essential to know who will cover for your provider if they are unavailable when you go into labor. Ask about the backup plan and the qualifications of the covering providers. Are they equally supportive of VBAC? Will they respect the birth plan you’ve developed with your primary provider? The continuity of care is crucial for a comfortable and confident birthing experience.
VBAC Support Resources: Finally, inquire about additional resources and support for VBAC patients. Does the provider offer educational resources, workshops, or support groups? Are there specific prenatal classes focusing on VBAC preparation? Access to these resources can greatly enhance your understanding and comfort level with the process.
Leveraging Social Networks and the Doula Community for Insights: In the age of digital connectivity, don't underestimate the power of social networks in making an informed decision. Participating in Facebook groups, WhatsApp chats, and reaching out to the doula community can provide invaluable insights. Members of these groups often share their personal experiences with various providers, which can give you a more rounded view of your options. Doulas, in particular, are a treasure trove of information as they work closely with various providers and understand their approaches towards VBAC. Their experiences can help you gauge the provider's true VBAC friendliness beyond what is stated officially. Remember, firsthand accounts from those who have walked the path you're on can be both enlightening and reassuring

Choosing a VBAC-friendly provider is about finding someone who aligns with your values and needs for childbirth. It's not just about their success rates, but also their attitudes, policies, and the support system they offer. As you navigate this journey, remember that your empowerment comes from asking the right questions and making informed choices. Trust in your ability to advocate for the birth experience you desire and deserve.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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

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The No Surprises Act: A Much-Needed Shield in the Healthcare Battlefield In the labyrinth of American healthcare, where the Minotaur of unexpected costs lurks around every corner, the No Surprises Act emerges as a beacon of clarity and protection. Enacted in 2022, this legislation represents a crucial step in untangling the Gordian knot of medical billing, a maze that has perplexed and overwhelmed patients for far too long.

Unmasking the Menace of Surprise Medical Bills

For years, Americans have navigated the perilous waters of healthcare, often finding themselves blindsided by 'surprise bills' - a phenomenon as common as it is financially debilitating. Picture this: You undergo a surgical procedure at an in-network hospital, believing your insurance has you covered, only to receive a staggering bill weeks later because someone on your medical team was out-of-network. It's akin to dining at a restaurant where the menu prices aren't listed, and the final bill is a roll of the dice.

The No Surprises Act: A Shield, Not a Sword

This Act isn't about attacking the healthcare system; it's about defending patients. It effectively outlaws these surprise bills for emergency services, regardless of where they're provided, and for certain non-emergency services at in-network hospitals. The key here is that patients are only responsible for their in-network cost-sharing amounts, turning a potentially ruinous bill into a manageable expense.

Navigating the New Landscape

The implications are profound. Now, in emergency situations, the fear of a financial catastrophe won't loom over patients' heads like the Sword of Damocles. Furthermore, for certain services at in-network facilities, the Act requires providers to obtain patient consent if they intend to bill at out-of-network rates. This is a game-changer, introducing a level of transparency previously unseen in the healthcare arena.

The Caveats and the Road Ahead

As with any monumental legislation, the No Surprises Act isn't a panacea. Issues like ground ambulance services remain unaddressed, and the Act doesn't directly tackle the underlying issue of healthcare costs. However, it's a pivotal first step towards a more equitable system, where patients aren't casualties in a battle between insurance providers and medical facilities.

A Moment of Reflection

This Act isn't just about bills; it's about the ethos of our healthcare system. It's a statement that healthcare should not be a predatory enterprise but a safe harbor. As we move forward, let's hope this marks the beginning of a journey towards a system that prioritizes care over cost, and patients over paperwork.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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

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True Birth discusses new tech in pregnancy. Pregnancy is a time of wonder and anticipation, but it also comes with its share of medical checkups and monitoring. Traditional prenatal care often involves frequent visits to the doctor's office, which can be time-consuming and inconvenient for expectant mothers. However, with advancements in technology, a revolutionary change is underway in obstetrics, ushering in the era of fetal monitoring at home. In this episode, we'll delve into a groundbreaking company that has paved the way for this transformation, offering the first FDA-cleared, remote monitoring system designed to make pregnancy care more accessible and convenient.

Redefining Pregnancy Care

At the forefront of the digital health revolution in obstetrics is new tech that is redefining the way expectant mothers and healthcare providers monitor pregnancies. Their innovative solution is a physician-prescribed, pregnancy monitoring system that empowers women to collect vital data and track their progress comfortably and conveniently from the comfort of home.

The Ease of Frequent Monitoring:

One of the key challenges in traditional prenatal care is the need for frequent monitoring of both the mother's and baby's well-being. This tech makes this process easier and more accessible. The system includes user-friendly devices that allow expectant mothers to perform monitoring sessions in the comfort of their own homes. These sessions are simple, comfortable, and, dare we say, a joy to do.

Data Privacy and Security:

One of the major concerns in remote healthcare is data privacy and security. With this new technology providers and patients can be assured that the data captured during readings is fully compliant with the HIPAA Privacy and Security Regulations. This means that your sensitive health information is protected, giving you peace of mind while you track your pregnancy progress remotely.

Accurate Diagnoses and Predictions:

The data collected throug a remote monitoring system isn't just for show. It plays a crucial role in enhancing the accuracy of diagnoses and predictions related to pregnancy. By continuously monitoring key metrics and trends, healthcare providers can better understand and respond to any potential issues or deviations from the norm in real-time. This proactive approach can lead to better outcomes for both mother and baby.

Empowering Mothers:

Perhaps one of the most significant advantages of this technology is how it empowers expectant mothers. No longer do you need to rely solely on periodic visits to your healthcare provider to understand your pregnancy's progress. With a remote monitoring system, you have access to real-time data that allows you to actively participate in your own care and make informed decisions about your pregnancy journey.

Conclusion:

These new ideas and innovations exemplify how technology can revolutionize healthcare, making it more accessible, convenient, and patient-centric. As we look toward the future of obstetrics, it's clear that innovations like these are poised to transform the way we approach pregnancy care, providing expectant mothers with greater peace of mind and control over their health. The journey to motherhood has never been more empowering.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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

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Bringing a new life into the world is a miraculous and life-changing experience. The 24 hours following childbirth are a crucial time for both mother and baby, as they require specialized care and support. In this episode of True Birth, we will take you through what to expect during this period, from the delivery of the placenta to the early stages of postpartum recovery in the immeidate hours after birth, learning about breastfeeding, receiving help with your newborn, and preparing for discharge. Let's embark on this journey of the first days after giving birth.

The immeidate postpartum hour: After the birth of your baby, the medical team will focus on ensuring that the placenta is safely delivered and that you and the baby are safe. This first hour after birth is usually when there is the highest risk of complications arising in the postpartum period.
Epidural Wearing Off: If you received an epidural for pain relief during labor, you can expect it to gradually wear off after childbirth. Your healthcare provider will monitor your pain levels and provide alternative pain management options if needed, such as oral medications or intravenous pain relief.
Transition to the Postpartum Recovery Room: After delivering your baby, you will typically be transferred to a postpartum recovery room. Here, you'll be closely monitored for any post-birth complications, and your vital signs will be regularly checked. You will also receive information about postpartum care, including how to manage pain, bleeding, and incision care if you had a cesarean section.
Assistance with Breastfeeding: Breastfeeding is an essential aspect of your baby's care, and the hospital staff will provide guidance and support. Lactation consultants and nurses are available to assist with latching, positioning, and addressing any breastfeeding concerns or questions you may have.
Help with Newborn Care: The hospital staff will assist you in caring for your newborn during their first 24 hours of life. This includes monitoring your baby's vital signs, administering any necessary tests or screenings, and teaching you how to change diapers, swaddle, and handle your baby safely.
Pediatric Needs: A pediatrician will conduct a thorough examination of your newborn to ensure they are healthy and meeting developmental milestones. Any necessary vaccinations or screenings will also be administered as per the hospital's protocols.
Discharge Planning: As your 24-hour hospital stay comes to an end, the healthcare team will start the discharge planning process. This involves reviewing postpartum care instructions, discussing any prescribed medications, and scheduling follow-up appointments for both you and your baby.
Learning to Bathe the Baby: Before leaving the hospital, you'll have the opportunity to learn how to bathe your newborn. The nurse will provide step-by-step instructions, ensuring you feel confident in this essential parenting skill.
Installing the Car Seat: Safety is paramount when transporting your baby home, so the hospital staff will guide you in properly installing your infant's car seat. Make sure it is securely fastened and meets all safety standards.

The first two days in the hospital after giving birth are a time of great adjustment and learning for both you and your baby. Hospital staff are there to provide support, guidance, and education to ensure a smooth transition into parenthood. Remember to ask questions, seek assistance when needed, and cherish this precious time with your newborn. Parenthood is a beautiful journey, and with the right resources and support, you can start it off on the right foot.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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

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Respiratory syncytial virus (RSV) is a common virus that can cause respiratory infections in people of all ages, including pregnant women. RSV infections are more prevalent during the fall and winter months. While RSV infections are usually mild and cold-like in healthy adults, they can lead to more severe respiratory symptoms in certain populations, including young infants and individuals with weakened immune systems.

In the context of pregnancy, RSV infections are generally considered a concern primarily because of the potential impact on the health of the mother and the developing fetus. Here are some key points to consider regarding RSV in pregnancy:

Risks to the Pregnant Woman:
- Pregnant women may be at a slightly increased risk of developing severe RSV-related symptoms compared to non-pregnant individuals.
- Symptoms of an RSV infection in adults can include fever, cough, congestion, and shortness of breath. Severe cases may require hospitalization.
- Risks to the Fetus:
- RSV infections in pregnant women do not typically cause direct harm to the fetus, such as birth defects. However, severe respiratory infections in the mother can potentially reduce the oxygen supply to the fetus, which could be problematic in rare cases.
- There is some evidence to suggest that maternal RSV infection may be associated with an increased risk of preterm birth.
- Prevention:
- Pregnant women can take steps to reduce their risk of RSV infection, such as practicing good hand hygiene, avoiding close contact with individuals who are sick, and following respiratory etiquette (covering mouth and nose when coughing or sneezing).
- There is a medication called palivizumab (Synagis) that can be given to certain high-risk infants to help prevent severe RSV disease, but it is not typically recommended for pregnant women.
- Treatment:
- Treatment for RSV infection in pregnant women is generally supportive, focusing on managing symptoms and maintaining adequate hydration.
- Pregnant women with severe symptoms may require hospitalization for oxygen therapy and other interventions.

It's important for pregnant women to consult with their healthcare providers if they develop symptoms of a respiratory infection like RSV, especially if the symptoms are severe or persistent. Healthcare professionals can provide guidance on appropriate management and treatment.

As with any health concern during pregnancy, it's essential to follow the advice and recommendations of your healthcare provider to ensure the health and well-being of both the mother and the developing fetus.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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

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Navigating the healthcare payor system in the United States can be a complex and sometimes overwhelming task. Understanding the intricacies of in-network and out-of-network insurance, as well as co-pays and deductibles, is crucial for making informed decisions about your healthcare. Here's a guide to help you through this labyrinth.

Understanding Your Insurance Plan 1. In-Network vs. Out-of-Network:

In-Network: These are the healthcare providers that have a contract with your insurance company. Visiting these providers generally means lower costs for you because they have agreed to charge negotiated rates.
Out-of-Network: These providers do not have a contract with your insurer. Visiting them often results in higher charges and less coverage from your insurance. In some cases, insurance may not cover these visits at all.
Co-Pays and Co-Insurance:
Co-Pay: This is a fixed amount you pay for a healthcare service, like $30 for a doctor's visit. It's typically paid at the time of the service.
Co-Insurance: This is a percentage of the cost of your healthcare service that you pay after meeting your deductible. For example, if you have 20% co-insurance, you pay 20% of the cost of the service.

Deductibles and Out-of-Pocket Maximums * Deductible: This is the amount you pay for covered healthcare services before your insurance plan starts to pay. For instance, with a $1,000 deductible, you pay the first $1,000 of covered services yourself. * Out-of-Pocket Maximum: This is the most you have to pay for covered services in a plan year. After you spend this amount on deductibles, co-payments, and co-insurance, your health plan pays 100% of the costs of covered benefits.

Tips for Navigating the System 1. Know Your Network: Always check if a provider is in-network before scheduling an appointment. 2. Understand Your Benefits: Familiarize yourself with your plan's details, including co-pays, deductibles, and out-of-pocket maximums. 3. Plan Ahead for Out-of-Network Care: If you must see an out-of-network provider, understand the costs and coverage limitations. 4. Keep Track of Your Expenses: Monitor your out-of-pocket expenses, so you know when you've reached your deductible or out-of-pocket maximum. 5. Appeal Denials When Necessary: If a claim is denied and you believe it should have been covered, don't hesitate to appeal the decision.

Clinical care in private physician offices and hospital-owned practices can differ in several key aspects. Private physician offices are typically owned and operated by individual doctors or small groups of physicians. These settings often provide a more personalized experience, as the physicians may have a smaller patient base and can offer more individualized attention. The administrative processes in private practices are usually more straightforward, potentially leading to a quicker and more efficient patient experience. On the other hand, hospital-owned practices are part of larger healthcare systems. They often have access to more extensive resources, including specialized equipment and a broader range of healthcare professionals. These practices can offer a more integrated approach to care, especially for patients with complex health needs, as they have direct links to the hospital's services and specialists. However, this can sometimes come with a less personal touch and potentially more bureaucratic processes due to the larger system's structure.

Conclusion Navigating the U.S. healthcare payor system requires patience and a good understanding of your insurance plan. By being proactive and informed, you can make choices that suit your healthcare needs while also managing your financial obligations. Remember, when in doubt, reaching out to your insurance provider for clarification can help alleviate confusion and ensure you make the most out of your healthcare plan.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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What are some of the reasons someone would choose to transfer OB/GYN providers later in a pregnancy? Say, perhaps after 20 weeks of gestation?

There are several reasons why someone may choose to transfer to a different healthcare provider late in pregnancy. These reasons may include:

Dissatisfaction with Current Provider: A person may become dissatisfied with their current healthcare provider due to issues such as poor communication, lack of trust, or a feeling that their concerns and preferences are not being adequately addressed.
Changes in Insurance Coverage: Changes in insurance plans or coverage may necessitate a switch to a provider who is in-network or more affordable for the individual or their family.
Relocation: Relocating to a different area or city during pregnancy may require finding a new healthcare provider closer to their new residence.
High-Risk Pregnancy: If a pregnancy is deemed high-risk due to medical conditions or complications that arise late in pregnancy, a person may need to transfer to a specialist or a healthcare facility better equipped to handle their specific needs.
Hospital Preference: Some individuals may have a strong preference for delivering at a particular hospital or birthing center and may need to switch providers to align with their chosen birthing location.
Seeking a Second Opinion: In some cases, individuals may seek a second opinion from another healthcare provider if they have concerns or doubts about the recommended course of treatment or management of their pregnancy.
Provider Availability: Provider availability, especially for obstetricians and midwives, can be limited, and some individuals may need to transfer care if their current provider is unavailable during their expected delivery timeframe.
Personal Preferences: Changing providers may also be driven by personal preferences, such as desiring a different birthing experience, seeking out a specific type of care (e.g., home birth or water birth), or a desire for a different approach to prenatal care.

It's essential for individuals to feel comfortable and confident in their healthcare provider during pregnancy, as this can greatly impact their overall experience. When considering a transfer late in pregnancy, it's advisable to communicate openly with both the current and potential new provider to ensure a smooth transition of care and the best possible outcome for both the expectant person and their baby.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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The landscape of obstetrics is undergoing a profound transformation, characterized by both positive and challenging changes. On the positive side, advancements in medical technology and evidence-based practices are enhancing the safety and well-being of expectant mothers and their babies. Access to prenatal care, maternal education, and support systems is improving, leading to better outcomes. However, this evolution also presents challenges, such as concerns about the medicalization of childbirth and potential disparities in access to care. Striking a balance between embracing innovation and preserving the fundamental principles of compassionate, patient-centered obstetric care will be crucial as the field continues to evolve.

In the future of obstetrics, a transformation is underway that heralds a shift away from the traditional model of solo and private practitioners towards a landscape dominated by doctors employed by hospitals. This evolution carries implications that transcend the clinical realm and touch upon the intricate dynamics of patient care. As the scales tip towards hospital-employed physicians, the alignment of interests between patients and healthcare institutions may become increasingly nuanced. While this transformation may foster greater collaboration and coordination within healthcare systems, it also raises questions about whether the primacy of patients' needs and preferences might be diluted in favor of institutional priorities. Navigating this terrain will require thoughtful consideration of how to maintain patient-centered care amid changing structures, ensuring that the future of obstetrics continues to prioritize the well-being and autonomy of expectant mothers and their newborns.

The future of obstetrics is likely to involve several advancements and changes, driven by advancements in technology, evolving medical practices, and shifting societal needs. While we can't predict the future with certainty, we can provide some insights into potential trends and developments in obstetrics:

Personalized Medicine: The field of obstetrics may increasingly adopt personalized medicine approaches. Genetic testing and genomic profiling may become more routine to assess a mother's and baby's genetic risks for various conditions, allowing for tailored prenatal care and treatment plans.
Telemedicine: Telemedicine has become more prevalent in healthcare, and obstetrics is no exception. Virtual prenatal visits, remote monitoring of vital signs, and online resources for expectant mothers may continue to expand, improving access to care, especially in rural or underserved areas.
Artificial Intelligence (AI): AI and machine learning algorithms can assist in early detection of complications during pregnancy, enhancing the ability to predict and prevent issues such as preterm birth or gestational diabetes. AI can also help improve the accuracy of ultrasound imaging and fetal monitoring.
Remote Monitoring: Wearable devices and sensors can enable continuous monitoring of a pregnant woman's health and the baby's well-being, providing real-time data to healthcare providers and alerting them to potential problems.
3D Printing and Customized Medical Devices: 3D printing technology may be used to create customized medical devices and implants for high-risk pregnancies or complicated deliveries, improving outcomes and reducing complications.
Ethical and Legal Considerations: As technology advances, ethical and legal questions about prenatal genetic testing, gene editing, and other interventions may arise, requiring careful regulation and ethical guidelines.
Maternal Mental Health: Increased attention may be given to maternal mental health, with more comprehensive screening and support services to address issues such as postpartum depression and anxiety.
Global Health Initiatives: Efforts to improve maternal and neonatal health worldwide will likely continue, with a focus on reducing maternal mortality rates and improving access to prenatal care in underserved regions.
Environmental Factors: Climate change and environmental concerns may impact obstetrics as they can affect the health and well-being of pregnant women and infants. Healthcare practices may need to adapt to address these challenges.
Education and Training: Obstetricians, nurses, and other healthcare professionals will need to stay updated with evolving practices and technologies through ongoing education and training.

It's important to note that the future of obstetrics will also be influenced by cultural, social, economic, and political factors, and healthcare systems will need to adapt to address the evolving needs of pregnant individuals and their families. These trends and developments are not exhaustive, but they provide a glimpse into potential directions in which obstetrics may evolve in the coming years.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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

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In the world of obstetrics and labor and delivery, statistics often play a pivotal role in shaping expectations for both parents and healthcare providers. Whether it's the odds of a smooth pregnancy, a complication-free childbirth, or a successful outcome in high-risk scenarios, we're frequently presented with numbers that can either bolster our hope or sow seeds of doubt. However, it's vital to recognize that beyond these statistics, there exists a powerful force capable of transcending expectations: optimism.

The Force of Positive Outlook Optimism is more than just a state of mind; it's a transformative power that can influence outcomes in obstetrics and labor and delivery in ways we may not fully comprehend. Countless stories of families defying daunting predictions and medical odds underscore the extraordinary impact of a positive attitude in the field. Here's why optimism is crucial:

Nurturing the Mind-Body Connection Our minds and bodies share a profound connection. Approaching the childbirth journey with a positive attitude can have a profound impact on physical well-being. Optimism can bolster a mother's resilience, enhance her emotional well-being, and even contribute to smoother labor and quicker recovery.
Resilience in the Face of Obstetric Challenges Medical statistics often provide generalized data, but every pregnancy and labor experience is unique. Optimism equips expecting parents with resilience and adaptability, enabling them to navigate uncertainties and make informed choices. When faced with challenging circumstances, a hopeful outlook can motivate individuals to explore innovative approaches, seek additional medical opinions, and remain committed to the well-being of both mother and child.
Building a Supportive Community Optimism has a contagious quality, creating a ripple effect within the support networks of expectant families. A positive outlook doesn't just uplift the spirits of parents-to-be but also inspires and supports the healthcare providers, family members, and friends who are part of the journey. These strong support systems can play a pivotal role in ensuring a positive obstetric experience and successful delivery.

Tales of Triumph in Obstetrics To illustrate the profound influence of optimism in obstetrics and labor and delivery, let's explore real-life stories of families who defied the odds:

The High-Risk Pregnancy Lisa faced a high-risk pregnancy due to a complex medical condition. Although the odds seemed stacked against her, she and her healthcare team remained optimistic and proactive. They monitored her closely and employed cutting-edge treatments. Against all expectations, Lisa safely delivered a healthy baby, demonstrating the power of hope in obstetrics.
The VBAC Success Sarah had experienced a previous cesarean section and was informed of the risks associated with attempting a vaginal birth after cesarean (VBAC). However, she maintained an optimistic attitude, sought out a supportive healthcare provider, and successfully had a VBAC, proving that determination and positivity can lead to positive outcomes.
The Premature Miracle John and Maria faced the challenge of a premature birth, which carried uncertainties and potential complications. With unwavering optimism and the guidance of a dedicated neonatal team, their premature baby defied the odds and thrived, illustrating the incredible strength that optimism can bring to the neonatal care journey.

Embracing Optimism in Obstetrics While acknowledging and respecting medical statistics is essential in obstetrics, it is equally crucial not to be confined by them. Optimism can serve as a guiding light in the face of obstetric challenges. Here are some ways to cultivate and embrace optimism during your pregnancy and labor journey:

Stay Informed: Educate yourself about your pregnancy, birthing options, and potential challenges. Knowledge empowers optimism. 2. Build a Support System: Surround yourself with a caring network of family, friends, and healthcare professionals who share your optimism and provide emotional support. 3. Prioritize Self-Care: Focus on self-care, including a healthy pregnancy diet, regular exercise, and stress management, to support your physical and emotional well-being. 4. Set Realistic Goals: Establish achievable goals and milestones along your obstetric journey, celebrating each positive step forward. 5. Seek Professional Guidance: Consider consulting with obstetric counselors or joining support groups to help you maintain a positive mindset during pregnancy and childbirth. Medical statistics undoubtedly play a role in obstetrics, but they should not overshadow the transformative power of optimism. Your childbirth journey is a unique and deeply personal experience, and maintaining a positive outlook can have a profound influence on both your physical well-being and emotional resilience. As you embark on this extraordinary journey, remember the stories of those who have defied the odds in obstetrics and let optimism guide you towards a safe and joyful childbirth experience.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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

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While many things have remained the same for millenia, the field of Obstetrics and Gynecology (OB-GYN) has witnessed remarkable advancements over the years, revolutionizing the way healthcare professionals care for pregnant individuals and women's reproductive health. As medical understanding deepens and technology progresses, certain practices that were once considered standard have fallen out of favor. In this epidsode, we will explore techniques that were once commonly used the field of obstetircs but are no longer the go-to methods due to advancements in medical knowledge and technology. Some of the examples on this podcast include fetal scalp sampling, L/S ratios, Quad testing, and Wet preps.

Fetal Scalp Sampling

Fetal scalp sampling, also known as fetal scalp blood sampling (FBS), was a procedure frequently employed to assess the well-being of a fetus during labor. The procedure involved sampling a small amount of blood from the fetal scalp to monitor oxygen levels and acidity (pH) during contractions. It was particularly useful in cases of uncertain fetal well-being. However, the procedure had its limitations, including the potential for infection and fetal injury.

Advancements in electronic fetal monitoring and non-invasive techniques like fetal heart rate monitoring have largely replaced the need for fetal scalp sampling. These modern methods provide real-time information about the fetal heart rate, oxygen levels, and other important parameters, making them safer and more effective alternatives.

LS Ratios

Lecithin-sphingomyelin (LS) ratio testing was a method used to predict fetal lung maturity. The ratio between these two phospholipids in amniotic fluid was believed to indicate the readiness of the fetal lungs for breathing air after birth. An LS ratio greater than 2:1 was considered indicative of fetal lung maturity. However, this method had its limitations, as factors like maternal diabetes could affect the accuracy of the results.

With advancements in medical understanding, it was realized that the LS ratio was not always a reliable predictor of lung maturity. Instead, other tests such as lamellar body counts and phosphatidylglycerol testing have emerged as more accurate indicators of fetal lung development, rendering the LS ratio less relevant in modern OB-GYN practice.

Maternal Serum Alpha-Fetoprotein (MSAFP) Level Checkings

Maternal serum alpha-fetoprotein (MSAFP) level checking was a screening test used to detect potential neural tube defects and chromosomal abnormalities in the fetus. The MSAFP level in the maternal blood was measured, and abnormal levels were associated with an increased risk of conditions like spina bifida and anencephaly. While MSAFP testing provided valuable information, it was a screening tool and not a diagnostic test.

Today, prenatal screening has evolved to include more comprehensive tests like cell-free DNA testing and ultrasound scans. These tests offer greater accuracy in detecting a wider range of fetal abnormalities, including Down syndrome and other chromosomal conditions, reducing the reliance on MSAFP level checking alone.

Wet Preps

Wet preps, a microscopic examination of vaginal secretions, were once used to diagnose vaginal infections and identify the presence of various microorganisms, including yeast and bacteria. This technique involved placing a sample of vaginal discharge on a microscope slide, adding a drop of saline solution, and examining the slide under a microscope. While wet preps could provide valuable information, they had limitations in terms of sensitivity and specificity.

Modern OB-GYN practice now relies on more accurate methods such as nucleic acid amplification tests (NAATs) and cultures to diagnose vaginal infections. These tests offer improved accuracy in identifying specific pathogens and guiding appropriate treatment.

The landscape of OB-GYN has transformed significantly over the years, thanks to advancements in medical science and technology. While techniques like fetal scalp sampling, LS ratios, MSAFP level checking, and wet preps were once instrumental in providing healthcare insights, they have been largely replaced by more accurate, efficient, and less invasive methods. As the field continues to evolve, these changes underscore the importance of staying up-to-date with the latest practices and technologies in providing optimal care to pregnant individuals and women's health.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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

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In the realm of pregnancy complications, vasa previa stands as a rare but potentially life-threatening condition that demands vigilant attention and awareness. Although relatively uncommon, vasa previa requires early diagnosis and appropriate management to ensure the safety of both the mother and the unborn child. In this blog post, we'll delve into the depths of vasa previa, exploring its causes, risk factors, diagnosis, and preventive measures.

Understanding Vasa Previa

Vasa previa is a rare obstetric complication that involves the abnormal placement of fetal blood vessels within the membranes of the placenta. Normally, the umbilical cord connects the fetus to the placenta, providing the essential nutrients and oxygen necessary for the baby's growth. However, in cases of vasa previa, some of these blood vessels run through the cervix and lie close to or even within the birth canal.

Causes and Risk Factors

The exact cause of vasa previa remains unclear, but certain risk factors increase the likelihood of its occurrence. These risk factors include:

Placenta Previa: Women with placenta previa, a condition where the placenta partially or completely covers the cervix, are at a higher risk of developing vasa previa.
Multiple Gestation: Twins, triplets, or other multiple pregnancies can increase the chances of vasa previa due to the complex arrangement of blood vessels.
Assisted Reproductive Technologies: Pregnancies resulting from assisted reproductive technologies, such as in vitro fertilization (IVF), can also elevate the risk.
Previous Uterine Surgery: Women with a history of uterine surgery, including procedures like cesarean sections, may be more susceptible.
Abnormal Placental Placement: Placentas located low in the uterus or close to the cervix can lead to vasa previa.

Diagnosis

Early diagnosis of vasa previa is vital for ensuring a safe outcome. However, due to its rarity and the absence of specific symptoms, it can be challenging to identify. Obstetricians typically employ a combination of methods for diagnosis, including:

Ultrasound: Prenatal ultrasounds are the primary tool for detecting vasa previa. High-resolution ultrasounds can visualize the placental blood vessels and their proximity to the cervix.
Color Doppler Imaging: This technique helps identify blood flow patterns within the vessels, aiding in the differentiation between fetal vessels and maternal vessels.
Digital Vaginal Examination: In certain cases, a digital vaginal examination might reveal bleeding originating from the fetal vessels, which could raise suspicion of vasa previa.

Preventive Measures and Management

While vasa previa cannot be completely prevented, early detection and careful management significantly improve outcomes. The following steps are crucial:

Prenatal Care: Regular prenatal visits and ultrasounds are essential to monitor the baby's growth and detect any potential complications.
Scheduled Cesarean Section: Most cases of vasa previa necessitate a planned cesarean section to avoid the rupture of fetal blood vessels during labor, which can lead to rapid fetal blood loss and endanger the baby's life.
Hospital Birth: Delivering in a hospital with appropriate medical facilities is vital, as immediate medical attention might be required if complications arise.

Vasa previa, though uncommon, is a potentially life-threatening complication that demands awareness and prompt medical attention. With the advancements in prenatal imaging and obstetric care, early diagnosis and proper management can significantly increase the chances of a successful outcome for both mother and child. As expectant parents, maintaining open communication with your healthcare provider, attending regular prenatal check-ups, and understanding your risk factors can contribute to a safer and healthier pregnancy journey.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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Throughout the ages, various misconceptions have surrounded this magical phase of a woman's life, often leading to laughter and disbelief. In this blog, we will delve into some of the funniest pregnancy myths and unravel the truth behind them.

Cravings Indicate Baby's Gender:

One of the most popular and entertaining myths is that a pregnant woman's cravings can predict the gender of her baby. According to the tale, craving salty and savory foods supposedly indicates a boy, while a hankering for sweets signifies a girl. In reality, these cravings are merely due to hormonal changes and the body's nutritional needs during pregnancy, unrelated to the baby's gender. Nevertheless, it's amusing to imagine expectant mothers scrutinizing their cravings for a potential gender reveal!

The Baby Bump's Shape:

People have often claimed that the shape of a pregnant woman's belly can reveal the gender of the baby. A high bump suggests a girl, while a low bump means a boy. In truth, the baby bump's shape is determined by factors such as the mother's body structure, the baby's position, and the number of pregnancies she has had. Yet, the notion of strangers trying to guess the baby's gender by merely looking at a bump remains a comical sight.

Heartburn Equals a Hairy Baby:

According to another pregnancy myth, experiencing heartburn during pregnancy is believed to indicate that the baby will be born with a full head of hair. The association between heartburn and a hairy baby is purely coincidental, as heartburn is caused by the relaxation of the lower esophageal sphincter and hormonal changes during pregnancy. So, the sight of a newborn with a full head of hair leading to tales of heartburn predictions never fails to bring a smile to our faces.

The Moon's Influence on Labor:

Another intriguing pregnancy myth involves the influence of the moon on a woman's labor. Some believe that a full moon can trigger the onset of labor or make it more intense. While this myth may seem strange, it is rooted in folklore and cultural beliefs. Yet, as of now, there is no scientific evidence to support the idea that the moon has any impact on the timing or intensity of labor.

This epsidoe covers several more fun pregnancy myths, busted

Pregnancy myths have been part of human culture for generations, and while they may not hold scientific weight, they continue to entertain and amuse us. From predicting the baby's gender through cravings to the moon's mysterious influence on labor, these myths showcase the fascinating and humorous aspects of pregnancy. Although we celebrate the joyous arrival of a new life with the wonders of science and medicine, we can't help but chuckle at the funny tales that have surrounded pregnancy throughout history. So, as we embrace the beauty of this life-changing journey, let's also enjoy the lighthearted moments and laughter that pregnancy myths bring into our lives.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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In today's fast-paced and dynamic world, the modern woman plays many roles, and none is more profound than that of a working mother. The journey of pregnancy and motherhood is an extraordinary experience, one that transforms a woman in ways that cannot be fully comprehended until lived. As we navigate the complexities of balancing work and family life, it is crucial to recognize the challenges faced by working moms and advocate for policies that support their well-being and success in both realms.

Pregnancy and the Career Woman:

Pregnancy marks a momentous chapter in a woman's life, but for career-driven women, it can also raise concerns about the impact on their professional trajectory. Many working mothers find themselves questioning whether they can maintain their career ambitions while nurturing their growing family. The fear of being overlooked for opportunities or facing discrimination in the workplace due to pregnancy can be very real, and it's essential to address these concerns proactively.

Supportive Work Environments:

Creating supportive work environments for pregnant employees and working mothers should be a top priority for employers and policymakers alike. This includes fostering a culture that values work-life balance, providing flexible work arrangements, and promoting a family-friendly corporate ethos. It is in the best interest of organizations to invest in policies that empower their female workforce, as it not only boosts employee satisfaction but also enhances productivity and retention.

Paid Parental Leave:

One of the most significant challenges faced by working mothers is the lack of comprehensive paid parental leave policies. The United States, for instance, remains one of the few developed countries without a federal paid maternity leave policy. This disparity places undue burdens on working mothers, forcing many to return to work prematurely or make difficult choices between their careers and their families. To create a more equitable society, it is imperative that we advocate for and implement robust paid parental leave policies that benefit both parents and children.

Affordable Childcare:

Access to affordable and high-quality childcare is another pivotal aspect of empowering working moms. The exorbitant costs of childcare services often force women to reconsider their career choices or significantly reduce their working hours. By investing in accessible childcare options, we not only provide essential support for working mothers but also help cultivate a thriving and diverse workforce that benefits society as a whole.

Addressing Unconscious Bias:

Recognizing and addressing unconscious bias is vital to promoting gender equality in the workplace. This bias can manifest in subtle ways, such as assumptions about a woman's commitment to her job after becoming a mother or her ability to take on challenging projects. Employers must undergo training to identify and rectify unconscious biases, ensuring that working mothers are judged on their skills, expertise, and dedication rather than stereotypes.

Remote Work and Flexible Schedules:

The COVID-19 pandemic showed us that remote work and flexible schedules are feasible options that benefit working mothers. Embracing these arrangements not only allows women to balance their professional and personal lives effectively but also opens up new possibilities for women who might otherwise face geographic or logistical barriers to employment.

In an age of progress and innovation, we must strive to create a society that supports and empowers working mothers. Pregnancy and the journey of motherhood should never be perceived as barriers to a successful career. By advocating for policies such as paid parental leave, affordable childcare, and remote work options, we can foster an environment where working mothers can thrive in both their personal and professional lives. Ultimately, supporting working moms is not just an act of compassion; it is an investment in building a more resilient, inclusive, and prosperous society for all.

Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners.

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

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The Positive Side of Forced Deliveries: Embracing Birth with Forceps

Childbirth is a remarkable journey that brings forth new life and creates an everlasting bond between a mother and her baby. While the majority of births occur naturally, there are instances when medical intervention becomes necessary to ensure the well-being of both mother and child. One such intervention is the use of forceps during delivery. In this episode, we explore the positive aspects of assisted vaginal deliveries when forceps are used skillfully, highlighting the immense benefits they can bring to the birthing process.

Understanding Forced Deliveries and Forceps:

A forcep delivery, also known as an operative vaginal delivery, refers to a situation where the use of instruments is required to assist in the birth of a baby. Forceps, a specialized tool consisting of two curved metal blades, are used by medical professionals to gently guide the baby's head through the birth canal during contractions. They are designed to mimic the hands of a skilled practitioner and offer an external aid to help facilitate the birthing process.

Preserving Maternal and Fetal Well-being:

Forceps-assisted deliveries can be a lifesaving measure for both mother and baby. In cases where the baby's heart rate shows signs of distress or the mother's health is at risk, the use of forceps allows for a quicker and safer delivery. By carefully applying forceps, the obstetrician can effectively navigate through complications such as prolonged labor, exhaustion, or fetal distress, ensuring the health and well-being of both mother and child.

Minimizing the Need for Cesarean Sections:

One of the significant advantages of forceps-assisted deliveries is their potential to reduce the need for cesarean sections (C-sections). When used correctly, forceps can help guide the baby's descent, encouraging a vaginal delivery even in challenging circumstances. This is particularly beneficial for mothers who wish to avoid the risks associated with major surgery and recover more quickly postpartum. By opting for forceps-assisted deliveries, the chances of a successful vaginal birth increase, providing a positive birth experience for the mother.

Enhancing Efficiency and Reducing Birth Trauma:

The skillful application of forceps can expedite the birthing process, shortening the duration of labor and reducing the need for interventions such as oxytocin augmentation. This not only saves time but also helps minimize the exhaustion experienced by the mother during prolonged labor. Additionally, by facilitating a quicker delivery, forceps can decrease the potential risks associated with prolonged compression of the baby's head, lowering the likelihood of birth trauma and related complications.

Empowering Obstetricians and Improving Training:

Forceps-assisted deliveries require a high level of skill and expertise from the attending obstetrician. By promoting the utilization of forceps, we encourage the medical community to further refine their techniques and gain proficiency in this valuable tool. This leads to continuous improvement in training programs, fostering a generation of obstetricians who are adept at managing complex deliveries and making informed decisions regarding the use of forceps.

Forcep deliveries, when used skillfully, can be a positive approach to birth, benefiting both mothers and babies alike. By preserving maternal and fetal well-being, minimizing the need for cesarean sections, enhancing efficiency, and empowering obstetricians, forceps-assisted deliveries play a vital role in ensuring safe and successful childbirth. While it is essential to remember that each birthing situation is unique, understanding the potential benefits of forceps helps create a more holistic and informed view of operative vaginal deliveries. Through continued research, education, and collaboration between medical professionals and expectant parents, we can foster an environment that prioritizes the well-being and positive outcomes of both mother and child during childbirth.

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The world of genetics is an intricate and complex field, a web of codes that define every aspect of our being. Occasionally, unexpected changes that occur during the formation of these genetic blueprints, and these can lead to various genetic disorders. Among these disorders are Trisomy 18 and Trisomy 13, also known as Edwards Syndrome and Patau Syndrome, respectively. Although relatively rare, their impact is profound, often leading to serious health challenges for affected individuals.

Trisomy 18 - Edwards Syndrome:

Trisomy 18, commonly known as Edwards Syndrome, is a genetic disorder caused by an error in cell division that results in an extra chromosome 18. The condition is often characterized by severe intellectual and developmental delays, as well as a myriad of physical abnormalities.

Children born with Edwards Syndrome may exhibit a variety of signs, including a small, abnormally shaped head; a small jaw and mouth; and clenched fists with overlapping fingers. They can also have heart defects, kidney problems, and other organ abnormalities. Sadly, due to these severe health issues, many infants with Trisomy 18 do not survive past into birth and the majority to not survive their first year.

Trisomy 13 - Patau Syndrome:

Patau Syndrome, also known as Trisomy 13, is another chromosomal disorder, this time involving an extra copy of chromosome 13. Similar to Trisomy 18, this genetic condition results in severe intellectual and physical challenges.

Infants with Trisomy 13 often have multiple malformations, including heart defects, brain or spinal cord abnormalities, very small or poorly developed eyes (microphthalmia), extra fingers and/or toes (polydactyly), and cleft lip or cleft palate. As with Edwards Syndrome, the prognosis for infants with Patau Syndrome is unfortunately poor, with many not surviving past infancy.

Both Trisomy 18 and Trisomy 13 are incredibly challenging conditions, not just for those directly affected, but also for their families. These disorders highlight the importance of genetic health and the complexity of our chromosomal blueprint. While medical advancements continue to strive for better understanding and treatment options, it's crucial to provide support and understanding for families affected by these conditions.

Early diagnosis, comprehensive care, and a multidisciplinary approach are essential in managing these conditions. But equally important is a supportive and empathetic society that recognizes the unique challenges that individuals with Trisomy 18 or Trisomy 13 and their families face.

Remember, behind every statistic is a person—a life filled with potential and a heart capable of giving and receiving love. In understanding disorders like these, we step toward a more inclusive world where every individual is acknowledged, respected, and celebrated.

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Obstetrical forceps have played a significant role in the history of childbirth assistance, but their use has declined in recent decades. One reason for this decline is the complexity and skill required to effectively and safely use forceps. Mastering the technique of forceps delivery requires extensive training and experience. The risk of complications increases when forceps are not applied correctly. As a result, the medical community has shifted towards alternative methods, such as vacuum extraction and cesarean sections, which are considered safer and more accessible for most healthcare providers. While forceps still have their place in specific situations, their limited use is due to the challenges associated with mastering their application

For centuries, obstetrical forceps were hailed as an essential tool in aiding childbirth. Developed in the 16th century, these spoon-shaped instruments provided a means to safely extract a baby when the mother encountered complications during labor. Skilled practitioners utilized their expertise to maneuver the forceps with precision, ensuring the safe delivery of the infant.

Several factors have contributed to the diminishing use of obstetrical forceps in contemporary childbirth. First and foremost, advances in medical technology have led to the development of alternative methods that provide safer and more controlled delivery options. Vacuum extraction and cesarean sections have become more prevalent, reducing the need for forceps-assisted deliveries.

Obstetrical forceps, once a cornerstone of childbirth assistance, have gradually become a rarity in modern delivery rooms. Advances in medical technology, changing philosophies surrounding childbirth, and the emergence of alternative methods have contributed to their decline. While the art of using obstetrical forceps may be fading into history, it is a testament to the remarkable progress made in ensuring safer and more personalized birthing experiences. As we embrace these advancements, we honor the past and look forward to a future where every birth is a cherished and protected journey.

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As pregnancy progresses, expectant mothers may experience a range of sensations and bodily changes. One common occurrence during the latter stages of pregnancy is Braxton Hicks contractions. These contractions are often misunderstood, leading to confusion and concern. In this blog post, we will explore what Braxton Hicks contractions are and how they differ from real contractions.

Understanding Braxton Hicks Contractions: Braxton Hicks contractions are sporadic, irregular contractions of the uterus that occur during pregnancy, typically starting around the second trimester. They are often described as a tightening or squeezing sensation in the lower abdomen, similar to the feeling of a menstrual cramp. Unlike true labor contractions, Braxton Hicks contractions are generally painless or only mildly uncomfortable.

Differentiating Braxton Hicks from Real Contractions: While Braxton Hicks contractions may feel similar to real contractions, there are several key differences between the two:

Timing: Braxton Hicks contractions are typically irregular and unpredictable, occurring infrequently and without a distinct pattern. Real contractions, on the other hand, become regular, increasing in frequency, duration, and intensity over time.
Effect on the cervix: Braxton Hicks contractions do not cause the cervix to dilate or efface significantly. Real contractions, particularly those associated with labor, cause progressive cervical changes, including dilation and thinning.
Response to activity and rest: Braxton Hicks contractions may subside or decrease in intensity when the mother changes position or rests. Real contractions, however, tend to persist or intensify regardless of the mother's activity level or position.

Braxton Hicks contractions are a natural part of pregnancy and serve as a preparation for labor. Understanding the differences between Braxton Hicks contractions and real contractions can help expectant mothers alleviate unnecessary concerns. Remember, if you have any doubts or experience severe pain, it is always advisable to consult your healthcare provider for guidance and reassurance.

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This episode is a continuation of the episode #104 on "What to Expect When Getting Induced" a step by step guide from getting admitted to delivery of the baby. This episode focuses mainly on how an induction of labor dosen't need to drag on for days when it is actively managed and how Maternal Resources goes about utlizeing an active induction plan of care for their clients.

Pregnancy is a beautiful and transformative time in a woman's life. However, there are situations where labor induction can be a better choice for the health and well-being of both the mother and the baby or for avoiding a cesarean birth. When it comes to labor induction, actively managing the process can lead to a more efficient and safer delivery. In this epsiode, we explore why active management of labor induction is crucial and how it can contribute to a 24-hour timeframe (or less!) for a successful delivery.

Understanding Labor Induction

Labor induction is the process of stimulating contractions to initiate and accelerate the progression of labor. It is typically recommended when there are concerns about the health of the mother or the baby, such as preeclampsia, gestational diabetes, post-term pregnancy, or fetal distress. It can also be performed for medical or personal reasons, including logistical considerations or maternal preference.

Active Management of Labor Induction

Active management of labor induction involves a proactive approach to monitor and encourage progress during the induction process. It incorporates several interventions to ensure an efficient and timely delivery. These interventions may include the administration of medications, such as prostaglandins or oxytocin, rupturing the membranes (breaking the water), and continuous fetal monitoring.

Labor induction is an essential medical intervention that can be necessary for various reasons. However, it is crucial to actively manage the induction process to ensure optimal outcomes for both mother and baby. Active management, involving prompt interventions, close monitoring, and timely decision-making, offers several benefits, including reduced risks, time efficiency, psychological support, and better birth experiences.

Disclaimer: It is important to note that each pregnancy and labor is unique, and the duration of labor can vary significantly based on individual circumstances.

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Childbirth is a miraculous and transformative experience, marking the beginning of a new chapter in a woman's life. While many women choose to opt for pain relief measures like epidurals during labor, there is a growing movement of mothers who seek to embrace the raw intensity of childbirth without medical interventions. In this blog post, we explore the empowering journey of childbirth without an epidural, highlighting its benefits, challenges, and the profound strength it requires.

There are several reasons why women would choose an unmedicated birth over birth with aqn epidrual. Choosing to forego an epidural is a deeply personal decision. Women who opt for unmedicated childbirth often have a strong belief in the body's innate ability to give birth naturally. They embrace the beauty of the physiological process, trusting that their bodies are designed to navigate the journey of labor and delivery.

By choosing a drug-free birth, women often find themselves more connected to their bodies and their babies. Without the numbing effects of an epidural, they remain fully present during the entire experience. This heightened awareness allows them to actively participate in the process, feeling each contraction, and working in harmony with their bodies to bring their little one into the world.

Childbirth without an epidural requires coping mechanisms to manage the intensity of labor. Many women practice mindfulness and breathing techniques, learning to focus their minds and ride the waves of contractions. These techniques help them stay centered, calm, and in control, harnessing the power within themselves to navigate the peaks and valleys of labor.

Unmedicated childbirth triggers the release of hormones such as oxytocin, endorphins, and adrenaline. These natural hormones not only help manage pain but also foster a sense of euphoria, promote bonding with the baby, and facilitate breastfeeding. Mothers who experience childbirth without an epidural often speak of the incredible rush of love and joy that accompanies the unmediated birth experience.

Childbirth without an epidural can present unique challenges. The intensity of the pain requires mental and physical endurance. However, women who choose this path often find immense satisfaction in conquering these challenges. They emerge from the experience with a profound sense of accomplishment, knowing they have tapped into their inner strength and persevered through one of life's most transformative moments.

Creating a supportive birth environment is crucial for women choosing unmedicated childbirth. Surrounding oneself with knowledgeable and empathetic healthcare providers, a loving birth partner, and a supportive birthing team can provide the encouragement and reassurance needed during labor. Birth plans, communication, and a clear understanding of one's options help ensure a positive and empowering birth experience.

Childbirth without an epidural is a personal choice that demands courage, resilience, and a deep trust in the body's abilities. It allows women to tap into their inner power and experience the full spectrum of emotions during the miraculous journey of bringing a new life into the world. While this path is not without its challenges, the rewards are immeasurable. Each unmedicated birth represents a testament to the incredible strength and capabilities of women, leaving an indelible mark on both mother and child, forever cherished and celebrated.

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The placenta, a remarkable organ facilitating the vital exchange of nutrients and waste between mother and fetus, exhibits incredible diversity in its structure and composition. Beyond the conventional placental configurations, such as the discoid shape, several intriguing variations have been discovered. In this blog post, we embark on an enlightening journey to explore and understand four distinctive placental anomalies: circumvallate placenta, balltledore placenta, vasa previa, and accessory lobe placenta. Join us as we delve into these fascinating adaptations and uncover their implications for pregnancy and maternal-fetal health.

Circumvallate Placenta: Unraveling the Ring of Mystique The circumvallate placenta, a captivating anomaly characterized by a raised ring around its periphery, captures our attention first. We delve into the etiology, prevalence, and potential complications associated with this unique placental variant. Additionally, we shed light on the diagnostic methods employed to identify circumvallate placenta and the impact it may have on fetal growth and maternal well-being.

Balltledore Placenta: Peeling Back the Layers of Complexity Intriguing and enigmatic, the balltledore placenta exhibits an unusual lobed appearance, distinct from the typical discoid shape. We embark on an exploration of the developmental mechanisms underlying this fascinating variation. Moreover, we examine the potential ramifications of a balltledore placenta on maternal health, fetal growth, and the overall progress of pregnancy.

Vasa Previa: Navigating the Precarious Pathways Vasa previa, a rare and potentially life-threatening condition, captures our attention next. We delve into the anatomy and pathophysiology of vasa previa, highlighting the presence of fetal blood vessels crossing the cervical os or lying in close proximity to it. Through an in-depth analysis, we emphasize the critical importance of early detection, prenatal monitoring, and timely intervention to mitigate the potential risks associated with vasa previa and safeguard the well-being of both mother and baby.

Accessory Lobe Placenta: The Unseen Intruder Our exploration of placental anomalies concludes with a closer look at the accessory lobe placenta. Often concealed and unnoticed, this variant manifests as an additional lobe attached to the main placental mass. We unravel the diagnostic challenges associated with identifying accessory lobe placenta and shed light on its implications for maternal health and fetal development. Furthermore, we explore the potential obstetric complications and management strategies that healthcare providers employ to ensure optimal outcomes in pregnancies affected by this hidden intruder.

Placental lakes, intriguing pools of blood within the placenta, form an enigmatic feature worthy of exploration. These fluid-filled spaces, ranging in size and distribution, arise from the branching and coalescence of maternal blood vessels within the placental tissue. Placental lakes often appear as dark, irregularly shaped areas on ultrasound scans, and their presence can indicate underlying placental abnormalities or complications. While small placental lakes are usually considered normal and benign, larger or extensive placental lakes may raise concerns regarding impaired placental function and potential risks to fetal health. In-depth monitoring and evaluation are crucial when placental lakes are detected, as they can serve as indicators of underlying conditions that require appropriate management to ensure a successful pregnancy outcome.

Placental anomalies, such as circumvallate placenta, balltledore placenta, vasa previa, and accessory lobe placenta, serve as captivating reminders of the incredible intricacy and adaptability of the human body. As we uncover the mysteries surrounding these unique variations, it becomes evident that each holds profound implications for pregnancy, childbirth, and maternal-fetal health. By increasing awareness and understanding, we empower healthcare professionals and expectant parents to navigate these distinctive scenarios with confidence, ensuring the best possible outcomes for all involved.

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Navigating the complex world of healthcare can be overwhelming, especially when you're faced with the task of advocating for your own needs. However, being an active participant in your healthcare decisions is essential for ensuring that you receive the best possible care. In this blog post, we will explore practical strategies and tips to help you effectively advocate for yourself in healthcare settings.

Educate Yourself: The first step towards advocating for yourself is to become an informed patient. Take the time to research your medical condition or concern, understanding the available treatment options, potential risks, and alternatives. Reliable sources such as reputable medical websites, patient forums, and support groups can provide valuable insights. Armed with knowledge, you'll be better prepared to communicate and make decisions regarding your healthcare.

Build a Strong Relationship with Your Healthcare Provider: Establishing a strong partnership with your healthcare provider is crucial. Actively engage in conversations, ask questions, and share your concerns openly. Remember, your doctor is there to help you, and effective communication is key to a successful healthcare journey. Be honest about your symptoms, medical history, and any lifestyle factors that may affect your health. This information will enable your healthcare provider to develop an accurate diagnosis and tailor a treatment plan specifically for you.

Be Assertive and Clear: When advocating for yourself, it's essential to be assertive and communicate your needs clearly. Don't hesitate to ask for further clarification or request additional tests or referrals if necessary. Describe your symptoms accurately, including their severity, duration, and any triggers or patterns you've noticed. Avoid downplaying your concerns, as this may hinder the understanding of your healthcare provider. By expressing your needs confidently and concisely, you increase the likelihood of receiving appropriate care.

Seek a Second Opinion: If you have doubts about a diagnosis, treatment plan, or surgery, don't hesitate to seek a second opinion. A fresh perspective from another qualified healthcare professional can provide valuable insights and help you make informed decisions. Requesting a second opinion is your right as a patient, and a reputable doctor will respect your choice.

Keep Organized Records: Maintaining organized records is essential for effective self-advocacy. Keep a detailed record of your medical history, including diagnoses, medications, treatments, and any relevant test results. Bring these records to appointments and share them with your healthcare provider. Additionally, document all discussions, recommendations, and decisions made during your healthcare visits. These records will serve as a valuable reference and ensure continuity of care.

Utilize Support Networks: Don't underestimate the power of support networks when advocating for yourself in healthcare. Reach out to family, friends, or patient advocacy organizations that can provide guidance and emotional support. Sometimes, having an advocate accompany you to appointments can help ensure that all your concerns are addressed and that you have a strong support system throughout your healthcare journey.

Advocating for yourself in healthcare can be challenging, but it is essential to take an active role in your well-being. By educating yourself, building a strong relationship with your healthcare provider, being assertive, seeking second opinions, keeping organized records, and utilizing support networks, you can effectively advocate for your healthcare needs. Remember, your voice matters, and with the right strategies in place, you can navigate the healthcare system with confidence and ensure that you receive the care you deserve.

Our practice can be found at www.maternalresources.org Reach out to us at (201) 487-8600

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Extramural delivery is a term used to describe a situation in which a woman gives birth outside of a hospital or birth center setting. This can happen for a variety of reasons, such as a fast labor, lack of transportation, or unexpected complications. While extramural delivery is relatively rare, it can be a stressful and dangerous situation for both the mother and baby.

So, what can you do if you find yourself in this situation? Here are some steps to take:

Stay calm: The most important thing to do in any childbirth situation is to stay as calm as possible. This can help you to focus on the task at hand and make clear decisions.
Call for help: If possible, call for emergency medical services or a midwife to come to your location as soon as possible. Explain the situation clearly and provide your location so that they can find you quickly.
Prepare for delivery: While waiting for help to arrive, prepare for delivery by finding a clean, dry place to lay down, gathering any necessary supplies, and keeping warm.
Follow your body's lead: If you're in active labor, listen to your body and follow its lead. Try to breathe deeply and focus on relaxation techniques to help manage pain.
Keep the baby warm: Once the baby is born, wrap him or her in a warm blanket or clothing to help maintain body temperature.
Seek medical attention: Even if the delivery goes smoothly, it's important to seek medical attention as soon as possible to ensure that both you and the baby are healthy and free from any complications.

Extramural delivery in childbirth can be a stressful and dangerous situation, but by staying calm, calling for help, and preparing for delivery, you can increase the likelihood of a positive outcome. Remember to seek medical attention as soon as possible, even if everything appears to have gone smoothly, to ensure that both you and your baby are healthy and safe.

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Modern Ways of Finding Out Your Baby's Gender: A Sneak Peek into the Womb

Discovering the gender of your baby is an exciting milestone for expectant parents. With advances in technology, there are now several ways to determine the gender of your unborn child with remarkable accuracy. There are several ways not to determine the gender of your baby which differs much more than a few decades ago.

Ultrasound

Ultrasound is the most common and widely used method to find out a baby's gender. Typically performed between 18 and 22 weeks of pregnancy, this non-invasive procedure uses sound waves to produce images of the baby in the womb. A skilled sonographer can identify the baby's gender by analyzing the images. The accuracy of ultrasound in gender determination is quite high, ranging from 95% to 99%, depending on the position of the baby and the expertise of the sonographer.

Non-Invasive Prenatal Testing (NIPT)

Another popular method is Non-Invasive Prenatal Testing (NIPT). This advanced screening test is performed as early as 10 weeks into the pregnancy, and it uses a blood sample from the mother to analyze the baby's DNA. NIPT is primarily used to screen for genetic conditions such as Down syndrome, but it can also determine the baby's gender with over 99% accuracy. Although NIPT is highly accurate, it is not typically performed solely for gender determination due to the higher cost compared to ultrasound.

At-Home Gender Prediction Kits

For parents seeking a more affordable and convenient option, at-home gender prediction kits have gained popularity. These kits use a small sample of the mother's urine to predict the baby's gender based on hormone levels. While the accuracy of these kits varies, most claim to have an accuracy rate of about 80-90%. It's important to note that at-home kits are not as reliable as ultrasound or NIPT, and the results should be taken with a grain of salt.

Gender Reveal Parties

Once parents have discovered the gender of their baby, many choose to share the news with friends and family in a creative way. Gender reveal parties have become a popular trend, with couples using various methods to disclose the big news, such as cutting into a cake with colored filling, popping balloons filled with colored confetti, or setting off colored smoke bombs. These parties not only make for an exciting way to reveal the baby's gender but also create lasting memories for everyone involved.

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The umbilical cord is a vital part of pregnancy, connecting the fetus to the placenta and providing essential nutrients and oxygen to support its growth and development. This cord is formed early in pregnancy and typically measures around 1 feet in length at birth.

During pregnancy, the umbilical cord acts as a lifeline between the fetus and the mother. It contains two arteries and one vein that transport blood, nutrients, and oxygen from the mother to the baby, while carrying away waste products and carbon dioxide from the baby back to the mother's bloodstream. This exchange of vital substances is essential for the healthy growth and development of the fetus.

The umbilical cord also plays a critical role in the delivery process. When the baby is born, the umbilical cord is clamped and cut, separating the baby from the placenta and the mother's bloodstream. The cord is then discarded, and the baby begins to breathe on its own.

In some cases, because the umbilical cord is so vital it can have some kinks or variations that can become more concerning. We all know about the cord can get wrapped around the baby's neck, causing complications during delivery. However, this is rare and can often be detected through routine prenatal care. It can also have differenes in shape, length or characteristics that can be crucial in a developing baby.

The umbilical cord is a crucial part of pregnancy, providing essential nutrients and oxygen to support the healthy growth and development of the fetus. Proper care and monitoring during pregnancy can help ensure a safe and healthy delivery for both mother and baby.

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Acupuncture, Chiropractics, Massage and other complimentary medicine practices are safe in pregnnacy

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The overturning of Roe v. Wade in 2022 was a significant legal decision that has generated strong reactions from various groups and individuals across the United States. Some see it as a positive development, arguing that it aligns with their moral and ethical beliefs regarding the sanctity of life and the rights of the unborn. Others see it as a negative development, believing that it represents an erosion of women's reproductive rights and bodily autonomy.

Regardless of one's perspective, the overturning of Roe v. Wade has implications for women's health and the legal landscape of the country. It could limit access to safe and legal abortion care, potentially putting women's health at risk. It may also lead to legal battles and political debates at the state and federal levels, with different actors seeking to shape the future of reproductive rights.

The impact of the decision on women and society as a whole will depend on how it is implemented and enforced. It remains to be seen how states and the federal government will navigate the complex legal and political terrain of abortion regulation in the aftermath of this ruling.

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For some women, the risk of premature birth or second trimester miscarriages are real and imposing concerns in pregnancy. In some cases, a cerclage may be recommended to help prevent these complications. Here's what you can expect when you get a cerclage during pregnancy:

What is a cerclage? A cerclage is a procedure in which a stitch or band is placed around the cervix to help keep it closed and prevent premature birth or miscarriage. It is typically recommended for women who have a history of premature birth, cervical insufficiency, or a shortened or known weakened cervix. The procedure is usually done around 12-14 weeks of pregnancy and is removed around 36-37 weeks of pregnancy.

Before the cerclage procedure, your OB/GYN will perform a cervical exam and may order an ultrasound to check the length of your cervix. The cerclage procedure is typically done under with local anesthesia and sedation. The OB/GYN will place a stitch or band around the cervix to keep it closed.

After the cerclage procedure, there is some monitoring and rest that ensures, but only for a short period of time. will likely need to There can be cramping and spotting for a few days after the procedure. Often sexual activity and heavy lifting for several days to weeks after the procedure is recommended.

A cerclage can be an effective way to prevent premature birth or miscarriage in certain high-risk pregnancies. If your doctor recommends a cerclage, it is important to understand the procedure, the recovery process, and the potential risks and complications. With proper care and monitoring, you and your baby can have a healthy pregnancy and delivery.

Our practice can be found at www.maternalresources.org Reach out to us at (201) 487-8600

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A scar pregnancy is a rare type of ectopic pregnancy where the fertilized egg implants in the scar tissue of a previous cesarean section or other surgical procedure in the uterus, rather than in the lining of the uterus where a normal pregnancy should occur. This can occur when the scar tissue is not fully healed or is weakened, allowing the fertilized egg to implant and grow in the scar tissue where the uterine muscle can be weakened.

Scar pregnancy can be dangerous, as the scar tissue may not be able to support the growing embryo and can rupture or cause other complications, but it is not always associated with miscarriage or loss of the pregnancy. A scar pregnnacy can actually produce a live. birth.

In addition, scar pregnancy can be difficult to diagnose, as it may not produce typical pregnancy symptoms and may not be visible on a standard ultrasound. A highly trained expert sonographer is generally what is needed for diagnosis. Dr. Ilan Timor is an expert OB/GYN with extensive years in scanning for these types of pregnancies and is world-renown in how to treat and diagnosis these types of pregnancies. Fortunate of us a Maternal Resources, he has recenlty joined our team and can assist us in the diagnosis, treatment and managment of different types of pregnancies.

From Dr. Timor's perspective he doesn't alwasy consider a scar pregnancy an ectopic pregnancy. It is generally accepted in the medical community that a scar pregnancy is a type of ectopic pregnancy, despite the fact that the gestational sac is located within the uterus. This is because the fertilized egg has implanted in scar tissue outside of the normal location in the endometrial lining of the uterus.

In fact, the American College of Obstetricians and Gynecologists (ACOG) defines an ectopic pregnancy as "any gestation that implants outside the endometrial lining of the uterine cavity." This includes implantation in the fallopian tube (the most common location for ectopic pregnancy), as well as other locations outside the uterus, such as the cervix, ovaries, and abdominal cavity.

While scar pregnancy is a relatively rare type of ectopic pregnancy, it can still pose serious health risks and requires prompt medical attention and treatment. Treatment for scar pregnancy typically involves surgical removal of the ectopic pregnancy and the scar tissue, in order to prevent further complications and preserve the health of the uterus.

Maintaining the integrity of the uterus is very important in scar pregnancies. When a fertilized egg implants in the scar tissue of a previous cesarean section or other surgical procedure, it can weaken the scar tissue and put the integrity of the uterus at risk. Scar tissue may be thinner and more prone to tearing, which can lead to bleeding and other complications. If a scar pregnancy is not treated promptly, it can result in further damage to the uterus and potentially require more extensive surgical intervention, such as a hysterectomy.

Therefore, early detection and prompt treatment of scar pregnancy is important to preserve the health and integrity of the uterus. Treatment typically involves the removal of the ectopic pregnancy and scar tissue, which may be done through surgery or medication depending on the severity of the case.

If you suspect you may have a scar pregnancy, it is important to seek medical attention right away. Your healthcare provider can perform an ultrasound and other diagnostic tests to determine the best course of treatment for your individual situation.

Dr. Timor can be found in our practice at www.maternalresources.org He is currently accepting patients and consults in our New York City office to reach us call (201) 487-8600

As always, we'd love to hear from you! Connect with us on our website at www.truebirthpodcast.com or send us an email at info@maternalresources.org

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What would happen if Mother Nature opened a labor and delivery unit? In a world where labor and delivery were left to all things natural, and there were no doctors to guide the process, how would women and babies fair? Before the advent of modern medicine, women relied on Mother Nature to ensure a safe delivery. But without medical intervention, complications were much more common than they are today

As time passed, communities began to realize the importance of medical care during childbirth. They trained midwives and created clinics to provide prenatal and postnatal care. Women no longer had to rely solely on chance for a safe delivery.

Although Mother Nature still plays a role, medical intervention can be a great asset to achieve better outcomes. As a result, childbirth became safer and more women and babies had healthier births.

As always, we'd love to hear from you! Connect with us on our website at www.truebirthpodcast.com or send us an email at info@maternalresources.org

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VBAC stands for Vaginal Birth After Cesarean, which is a delivery method chosen by women who have previously had a c-section but want to deliver vaginally for their next birth. VBAC2, on the other hand, refers to the second or subsequent vaginal birth after a c-section.

VBAC and VBAC2 are two different terms that can be confusing for new parents. Women who have had a previous c-section may be wondering about their options for future deliveries. So, let's break down the difference between these two terms.

VBAC: Vaginal Birth After Cesarean, or VBAC, is a safe and successful option for many women who have previously delivered by c-section. The American College of Obstetricians and Gynecologists (ACOG) states that women who have had one prior low transverse uterine incision are candidates for VBAC.

The success rate for VBAC is high, around 60-80%, and it has several benefits over repeat c-section, including a shorter recovery time, a reduced risk of surgical complications, and a lower risk of infections.

However, VBAC is not recommended for all women, as it carries a small risk of uterine rupture, which can be life-threatening for both mother and baby. Other factors, such as the reason for the previous c-section, may also play a role in determining whether VBAC is a safe option for a woman.

However, just like with VBAC, there are factors to consider when deciding whether VBAC2 is a safe option. Women who have had multiple c-sections or a previous uterine rupture may not be good candidates for VBAC or VBAC2, yet VBAC2 may still be safe and recommended or some women.

VBAC and VBAC2 are both viable options for women who have previously had a c-section and want to deliver vaginally in the future. VBAC is a safe option for most women with one or two prior low transverse uterine incisions.

It is important to discuss your options with your healthcare provider, who can help you make an informed decision based on your medical history and individual circumstances.

As always, we'd love to hear from you! Connect with us on our website at www.truebirthpodcast.com or send us an email at info@maternalresources.org

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Cervical lacerations are cuts or tears that happen to the cervix during labor and delivery. These types of laceratsion are different from the typical 1st and 2nd degree lacerations that occur during labor and delivery normally. Generally they tend to have more blood flow and can be responsible for more blood loss. They also may have an effect in a subsequent pregnancy and labor.

Today’s episode of True Birth is all about cervical lacerations.

A cervical laceration is a cut or tear on the cervix that can happen during delivery. Despite its intimidating name, it’s certainly treatable, and we’re here to explain some helpful information that will let you know what you might be dealing with.

The cervix almost always tears a little during labor, but if the tear reaches the blood vessels in the cervix, it’s called a laceration, and a patient can have significant hemorrhaging.

Previously, the protocol included a check of the cervical angles (3 o'clock and 9 o'clock) in every vaginal delivery. Still, nowadays, a doctor will usually only examine the cervical angles if there’s a complicated delivery or more bleeding than expected. It’s unlikely to be coming from the uterus, and the placenta is already out.

If there’s a significant cervical laceration, it should be sutured - which is usually done with dissolvable stitches. Making sure the cervix is intact after delivery is essential because a cervical laceration that doesn’t heal well can lead to the issue of cervical insufficiency - which can be a cause of miscarriage in future pregnancies.

Recognizing cervical lacerations is the most significant factor in repairing them. And, if anyone has carried pregnancies to term and then begins to lose any, a thorough exam should be carried out to look for possible cervical insufficiency from previously undetected lacerations.

Previous use of a vacuum, forceps or even a history of precipitous (rapid) labor could increase the likelihood of having an issue with the shape of the cervical opening and therefore increase the chances of cervical insufficiency. Dr. Abdelhak proposes the theory that precipitous delivery is likely a mild form of cervical insufficiency.

Dr. Abdelhak also shares a few stories about times when using a cerclage (such as an abdominal or cervical cerclage) led to more success in carrying pregnancies to full term.

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What happends when a cesarean birth is not planned.

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On today’s episode of True Birth, we’re talking about labor coaches, birth coaches, and doulas.

Dr. Yaakov Abdelhak and Certiied Nurse Midwife Kristin Mallon highly recommend having a birth coach during labor. They share some of their positive experiences with the recommended birth coaches and doulas on their site www.maternalresources.org.

It helps to have already a reputation of being practitioners that are C-section averse and always put their patients first because doulas come into the situation less wary.

Some doula certifications are more rigorous than others, and just like any coach or guide, it’s essential to find one with plenty of expertise and high recommendations from trusted sources. Labor coaches and doulas should also have a good relationship with your physician, communicate with them well, and understand their reasoning, instead of having an unnecessarily antagonistic or mistrusting angle.

Coaches and doulas vary in how involved they are pre-labor; some do consultations, going over labor preferences and expectations, and others spend less time with patients until labor unless a question comes up or help is needed. However, once labor starts, they will all be present with the mother to explain what’s going on and provide a familiar point of view about the everyday hospital happenings around them. Some labor coaches and doulas provide lactation and postpartum guidance as well.

What makes a bad labor coach? Someone who’s inactive during labor or who taps out during long labors, increases anxiety in the room, or gives bad advice.

What makes a good labor coach? Someone who can spend hours with a patient during labor, be emotionally present, provide good information, and bring some extra confidence into an often difficult experience. If you’re planning to avoid an epidural, a labor coach or doula is a must.

In this episode, you’ll also hear about the costs of having a doula, the range of rates they usually charge, and even the different styles of some of the recommended doulas on MaternalResources.org.

As always, we'd love to hear from you! Connect with us on our website at www.truebirthpodcast.com or send us an email at info@maternalresources.org

Maternal Resources’ website is:

https://www.maternalresources.org/

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Today’s episode of True Birth is all about circumcision. Circumcision often falls under the category of obstetrics, and many obstetricians are the ones who perform circumcisions at the hospital because it’s considered surgical.

It’s rare to need a suture or have bleeding complications after an infant is circumcised, but having someone familiar with surgery perform the procedure is an added advantage, just in case.

Historically, removing the foreskin of the penis was thought to prevent certain medical complications, but nowadays, many of those beliefs have been debunked. Many people choose to have their male children circumcised because of tradition. For instance, in the U.S., about 71% percent of biological males are circumcised, but in many other countries, that statistic is much lower.

Some medical considerations could delay the timing of the procedure: if the baby is premature or has any homeostasis issues, the procedure should be postponed until it’s safer.

One common instrument used for circumcision is called the Gomco clamp, which lowers the amount of bleeding. Pain medication such as local, non-epi lidocaine is often given. Alternately, a Mogan instrument can be used, but Dr. Abdelhak doesn’t necessarily prefer it because the shape of the cut often doesn’t present as clean-looking initially.

The primary necessity in the procedure is knowing where on the skin to cut. Understand that for a few days before skin regrowth; the area will look quite bare and raw.

Jewish patients often choose to bring their baby back eight days after birth to make it a bris circumcision in accordance with religious tradition. When this is the case, Dr. Abelhak includes a special blessing and respectfully follows the Kosher protocol wherever applicable. We’ll hear some of his accounts of times that Jewish patients came to the office for their child’s bris and why this option might be culturally advantageous for many families.

We hope this episode clarifies some of the details of circumcision for you and adds to your ever-growing knowledge base on pregnancy and birth.

As always, we'd love to hear from you! Connect with us on our website at www.truebirthpodcast.com or send us an email at info@maternalresources.org

Maternal Resources’ website is:

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What is the optimal timing for delivery when a pregnancy goes past the due date? How far past a due date is it recommened to go? Is it safe to go? Why are there different recommendations for each type of pregnancy?

A postterm pregnancy is when the pregnancy goes on beyond beyond 42 weeks (294 days) from the calculated first day of the last menstrual period.

A postdates pregnancy is a pregnancy that goes beyond the due date.

Relevant to this episode is our podcast on how to calcuate a due date, episode #85 linked here

In this episode, Dr. Abdelhak explains his rationale for why he prefers pregancies to end by the 41st week and someones even earlier.

As always, we'd love to hear from you! Connect with us on our website at www.truebirthpodcast.com or send us an email at info@maternalresources.org

Maternal Resources’ website is:

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Cervical cerclage is a fantastic tool used to prevent preterm labor. The placement of a cerclage is a surgical procedure in which a synthetic suture or tape is used to reinforce the cervix. This mechanical enhancement of the tensile strength of the cerclage reinforces the cervix, keeps it closed and is very successful at lengthening many pregnancies.

This podcast covers the different types, why and when each is used.

As always, we'd love to hear from you! Connect with us on our website at www.truebirthpodcast.com or send us an email at info@maternalresources.org

Maternal Resources’ website is:

https://www.maternalresources.org/

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Molar pregnancies, also known as hydatidiform moles, are rare usually unviable pregnancies that develop when trophoblasts (the cells that normally develop into a placenta) grow abnormally. Today’s episode is all about this rare issue in pregnancy, its treatment, and possible complications.

As you may know, human cells should contain 23 pairs of chromosomes; one set from the mother and the other from the father. In a complete molar pregnancy, an empty egg is fertilized by one or two sperm, so all of the chromosomes present are the father’s. In a partial molar pregnancy, the mother’s chromosomes are present but the father’s are double present, meaning the embryo has 69 instead of 46 chromosomes.

Both categories of molar pregnancies require early intervention and care, followed by close monitoring of HCG levels. In cases of complete molar pregnancies, very rarealy, cancer can also be a concern.

Another possible complication is that molar tissue can continue growing even after a D&C procedure, which in very servere cases can prolonged monitoring, further intevention and very rarely chemotherapy.

Symptoms include bleeding, cramping, severe nausea, thyroid issues, and pain. It's hard to diagnose as a normal pregnancy can have all of these symptoms as well. Diagnosis is done by a blood test and ultrasound.

Did we mention these are rare? 1 in 1,000. Risk factors can include extreme ages (very young as well as what we like to call “adult pregnancies” because we don’t use the word geriatric to describe pregnancies), a history of infertility, a previous diagnosis of molar pregnancy, and possibly a history of terminations. If a person has a molar pregnancy, there’s a slightly elevated chance that they’ll have another one, but the chances are still around 1 percent.

Women are strongly encouraged to avoid getting pregnant while they’re watching their hormone levels return to normal (usually around 6 months to a year for complete molar pregnancies).

As always, we'd love to hear from you! Connect with us on our website at www.truebirthpodcast.com or send us an email at info@maternalresources.org

Maternal Resources’ website is:

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Postpartum Depression (PPD) is a depressive period or series of depressive episodes that can happen after the birth of a baby. While there is some debate, most psychological and OB/GYN experts agree that any depression that occurs within the first 12 months after birth may be related to the birth. This type of depression affects 1 in 7 moms and 1 in 10 dads.

Postpartum Depression is not to be confused with postpartum anxiety or perinatal depression and anxiety which can occur shortly before or during pregnancy. These types of anxiety and depression are not covered in this episode.

The suspected incidence is hard to pinpoint and has a large range as some parents are now aware they are experiencing postpartum depression until months or even years later. The symptoms can be confused or confounded with sleep deprivation and new onset sleep disorders that often follow the birth of a baby. The rate of PPD is higher in low and middle income countries. Many studies have landed on the incidence of PPD to be around 10-20% and a parent is 50% more likley to end up in this staistic if they had a history of depression prior. More than 50% of PPD presents by 6 months postpartum.

This epsiode is a from the perspective of the OB/GYN on the first steps in identifying and beginning treatment and connection to resources.

A great resource for everything related to PPD including support groups nationwide can be found on this website
https://www.postpartum.net

As always, we'd love to hear from you!. Please drop us a line on our website at www.truebirthpodcast.com or send us an email at info@maternalresources.org

Our practice website can be found at:

Maternal Resources: https://www.maternalresources.org/

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We've included a list of the most common acronyms and short hand lingo used common in with medical professionals in labor and delivery. This is a great refrence for when you are surronded by new medical lingo and acronyms and you need some help naviating through.

We'd love to hear from you and hear what topics you would like us to cover.

If you are interested in more information about our practice love C/S delivery rate, VBACs, twins or breech deliveries. Our practice website can be found at:

Maternal Resources: https://www.maternalresources.org/

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Obstetrics and Gynecology can be a wonderful beautiful experiene as a place to work but also have its fair share of challenges. In this episode, Dr. Yaakov Abdelhak, Maternal Fetal Medicne Specilaist, and Kristin Mallon, Certified Nurse Midwife, disucss why someone chooses the field of OB/GYN.

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Finding out the gender of the baby in pregnancy. What do most familles decide to do? Find out from the persecptve of the exeprts on how familes approach gender revelation in pregnany.

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Pregnancies affected by pregestational (also called preexisting) diabetes has significantly improved over the past several decades as\ insulin management improved and tighter glycemic control is achieved with glucose monitors.

Diabetes in pregnancy is classifed as followes:

●Type 1 diabetes (autoimmune beta cell destruction, usually leading to absolute insulin deficiency):

a. Without vascular complications

b. With vascular complications (eg, nephropathy, retinopathy, hypertension, atherosclerotic cardiovascular disease, etc)

●Type 2 diabetes (progressive loss of insulin secretion, often in the setting of insulin resistance):

a. Without vascular complications

b. With vascular complications (eg, nephropathy, retinopathy, hypertension, atherosclerotic cardiovascular disease, etc)

●Gestational diabetes (diabetes of during pregnancy and not clearly overt [eg, type 1 or type 2 diabetes])

●Other diabetes (eg, genetic origin, drug- or chemical-induced)

This episode focuses on type 1 and type 2 diabetes in pregnancy and the principles of management.

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Tips for getting pregnany naturally may seem simple enough for some, but navigating fertility and the fertile window can sometimes be confuisng. We have broken it down in an easy to understand way and included some fun tips about how to conceive.

Preconception visits are becoming increasingly more popular as patients educate themselves about how to set themselves up for a health pre-pregnancy period. In this episode, we review some of our very obvious tips for conceiving and not so obvious ones that you may find suprising about how to get pregnant naturally.

We would love to hear from you, make sure to leave a message or comment about topics you'd like us to cover next.

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This episode will cover exaclty what to expect from your labor induction. From addmission to the hospital to delivery of the baby, we've covered everything and the order of events so you can undertand the labor induction process.

There are several reasons why your OB/GYN or midwife may suggest induction of labor and several pregnant patients prefer labor induction, electively. Labor induction has been shown to improve maternal and fetal outcomes for the right situations and conditions. Some condditions that may warrant induction of labor include: high blood pressure, pre-eclampsia, diabetes in pregnancy, low amniotic fluid, and decreased fetal movement after 40 weeks. Traditionally, it was not suggested that prengancy continue after the 42nd week and gestational age was used as a reason for induction of labor.

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What is the difference between midwives, OB/GYNs, and high risk MFM specilaits? What about douals. and labor coaches? Is a midwive like an OB/GYN? Isn't a midwife just a doula? What are the differences between each?

According the the American College of Midwives the definition of midwifery is:

"Midwifery as practiced by certified nurse-midwives (CNMs®) and certified midwives (CMs®) encompasses a full range of primary health care services for women from adolescence beyond menopause. These services include the independent provision of primary care, gynecologic and family planning services, preconception care, care during pregnancy, childbirth and the postpartum period, care of the normal newborn during the first 28 days of life, and treatment of male partners for sexually transmitted infections. Midwives provide initial and ongoing comprehensive assessment, diagnosis and treatment. They conduct physical examinations; prescribe medications including controlled substances and contraceptive methods; admit, manage and discharge patients; order and interpret laboratory and diagnostic tests and order the use of medical devices. Midwifery care also includes health promotion, disease prevention, and individualized wellness education and counseling. These services are provided in partnership with women and families in diverse settings such as ambulatory care clinics, private offices, community and public health systems, homes, hospitals and birth centers."

The definition of an OB/GYN from the American College of Obstetricians and Gynecologist is:

"Ob-gyns are doctors who have special training and education in women’s health care. They are dedicated to the medical and surgical care of women’s health throughout the lifespan.

Ob-gyns who are members of ACOG are called Fellows or Junior Fellows. ACOG Fellows are ob-gyns who are board certified in obstetrics, gynecology, or both. They are identified by the initials FACOG after their name. ACOG Junior Fellows are ob-gyn residents or recent graduates of an approved residency program and not yet board certified.

Some ob-gyns have extra training in a focused area of women’s health care. These areas include:

Female pelvic medicine and reconstructive surgery (focused on pelvic floor disorders, including pelvic organ prolapse, incontinence, and pelvic pain)
Gynecologic oncology (focused on cancers of the cervix, ovaries, uterus, vagina, and vulva)
Maternal-fetal medicine (focused on high-risk pregnancies)
Reproductive endocrinology and infertility (focused on the hormones of the reproductive system and helping women who have problems getting pregnant)"

The defintion of a doula or a labor coach from the Doulas of North America is:

"A [doula] is a trained professional who provides continuous physical, emotional and informationl support to a mother before, during and shortly after childbirth to help her ahieve the healtiest, most satifying expericne possible."

An MFM (Maternal Fetal Medicine) specilaist is:

"Maternal-Fetal Medicine (MFM) physicians are high-risk pregnancy experts, specializing in the un-routine. For moms-to-be with chronic health problems, we work with other specialists in an office or hospital setting to keep mom healthy as her body changes and her baby grows. We also care for moms who face unexpected problems that develop during pregnancy, such as early labor, bleeding, or high blood pressure. We’re the go-to for moms who arrive in the hospital while they are pregnant for any reason, whether after an accident or at the onset of a kidney infection. In other cases, it’s the baby who faces the un-routine. If we find birth defects or growth problems, we can start treatment before birth, providing monitoring, blood transfusions and surgery to support babies with the best possible care until they are ready to arrive in the world.

Training A maternal-fetal medicine sub-specialist is an obstetrician/gynecologist who has completed 4 years of Ob/Gyn training followed by 2-3 years of additional education and clinical experience to develop specialized skills to help both the mom and baby before and during an un-routine pregnancy. Our training includes both medical treatment and complex procedures for moms and babies. We are high-risk pregnancy experts.

Our extra training enables us to conduct and interpret research on new approaches for pregnancy problems. Through educational courses, development of clinical protocols, and research, we share our knowledge of optimal care for complicated pregnancies with others. Our overarching goal is to improve outcomes for moms and babies.

Maternal-Fetal Medicine physicians partner with multiple caregivers to consult, co-manage or care directly for complicated situations, both before, during and after pregnancy. We know it takes a team --starting with the mother and her family--to navigate the un-routine and achieve the best possible outcome.

When should I see an MFM Specialist? MFM specialists treat two patients at the same time. We partner with the mom-to-be, her family, and her medical team to navigate the un-routine and achieve the best possible outcome. We see families who have experienced un-routine pregnancies in the past, mothers with chronic health conditions, and women who develop unexpected problems during their pregnancy. Learn More"

We hope you enjoyed our podcast about how each of these important aspects of childbirth and birthing medicine are uniquley beneficial in the field of reporduction. As alwasys we'd love to get your feedback. Please email us at info@maternalresoures.org or visit our podcast website to leave a comment or feedback regarding this or any episode.

One final comment, Kristin mentions incluidng the Muni Train information fo anyone who wants to check out what part of the San Francisoc train system looks like. You can find it here

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Postpartum hemorrhage (PPH) is heavy or excessive bleeding after giving birth. There are several reasons why PPH may occur following delivery. In this episode, postpartum hemorrhage as a result of uteirne atony is reviewed.

Uterine atony is when the placenta deliveres but the uterus does not cramp down and stop its own bleeding following birth. After birth, there is a natural mechanism where the uterus itself acts as it's own mechanical block of excessive bleedding. When the uterus does not cramp down, uterine atony ensures and excessive bleeding can be the result.

We'll review identificatoin, treatment, and. prevnetion.

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RH factor in pregnancy and RhD alloimmunization in pregnancy. What happends when a patient has RH negative blood during prengnacy and what happends when alloimmunization takes place. RhD-negative patients who deliver an RhD-positive newborn or who are otherwise exposed to RhD-positive red blood cells are at risk of developing antibodies which can leadd to alloimmunization. This primarily affects a subsequent pregnancy if the patient is exposed to RhD positive blood during the pregnancy or labor.

If the next pregnacy has a RhD-positive fetuses, that pregnancy is at risk for developing hemolytic disease of the fetus and newborn (HDFN), which can be associated with serious fetal anemia and fetal hydrops.

This episode reviews the importance of the Rh factor in pregnancy.

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Today is a big anniversary! We have been at podcasting for 1 year and have reached out 100th episode. In this week's podcast we review our most downloaded episodes and our own personal favorites.

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Birth plans have increased in popularity in the last several decades and many templates exist online from popular pregnancy and birthing websites, vlogs and blogs. What really needs to be included in a birth plan?

A birth plan is a great way to have a conversation with your OB/GYN or midwife to be on the same page about the expectations surrounding birth. This episode covers what are key components to include in your birth plan. Our practice website can be found at:

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Radiology and imaging techniques in pregnancy are reviewed such as x-rays, CT scans and MRIs. Find out when it is safe to get imaging done in prengnacy.

The United States Preventive Services Task Force (USPSTF) recommend that routine X-rays and other diagnostic procedures be avoided during pregnancy primarily because if it can be delayed, that is advisable. However, they state that imaging studies are sometimes unavoidable and some may be medically necessary. In this podcast, we explain what imaging in pregnancy is Our practice website can be found at:

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Different types of uterine shapes and sizes are reivewed and how they affect pregnancy and delivery.

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What to do when you can't sleep in pregnancy. There are many reasons as to the source of sleepless nights in pregnancy; and the solutions vary by the cause.

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Bleedding in the first trimester of pregnancy is often more anxiety producing than dangerous in pregnancy. However, it is important to seek the consultation of a medical professional whenever there is bleeding at any point in a pregnancy.

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The AFP screening test in pregnancy is discussed.

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Dr. Yaakov Abdelhak explains the inception of Maternal Resources, what makes it tick and how it's the most special place on the planet to have a baby. Find out why familes come from over 5 different states to deliver with this special team.

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Meconium is brown stained amniotic fluid and represents the passage of stool from the bowels of the baby in utero. We'd love to hear your feedback.

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In pregnancy, thrombophilias or blood clotting disorders can either be inherited or acquired. As you can imagine, blood clotting is not a preferred state in pregnancy a condition laden with micovessels which could clot easily.

Inherited thrombophilias are usually genetic in nature and increase the risk for thromboembolic disease. During pregnancy, the potential for these disorders to be problematic is enhanced because pregnancy is a hypercoagulable state. The most severe sequela is a resulting DVT (deep vein thrombosis) or a blood clot in a deep vein. DVTs can be life threatening and very serious.

Acquired thrombophilias are primarily the result of systemic autoimmune disease resulting in antibodies that predispose the body to clot. A term commonly used for acquired thrombophilias is antiphospholipid syndrome or APS and this condition can occur as a primary condition, or it can occur in the presence of systemic lupus erythematosus (SLE) or other autoimmune conditions.

Thrombophilias in pregnancy are reviewed in detail in this episode as well as how to manage and treat them throughout the pregnancy, labor and postpartum period.

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Everything that's key to know about the immediate postpartum period. You've done all the hard work and delivered a healthy beautiful baby. Now, in this episode, we've reviewed all the essential things that you need to know about what to expect right after giving birth.

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Different types of leg pain in pregnancy are reviewed.

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The fetal echocardiogram is a targeted ultrasound that is used to examine the fetal heart in more detail than a standard anatomy ultrasound. This test is typically performed after the 18th week of gestation by a highly trained sonographer and is do in addition to a routine anatomy ultrasound. This test can be utilized to determine the structure and the function of the fetal heart and gives a better imaging of any inconclusive or insufficient readings on a standard test. This episode explores the benefits of fetal echos and who needs them and why.

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Precipitous labor is labor that is rapid, usually 3 hours or less from start to finish. This episode is a follow up to a previous episode with some new insights.

To some, precipitous labor may sound like a great idea because the labor can be over very quickly, but it can be associated with other complications. In this episode, we review the risk factors, the potential risks and how to spot who may be more susceptible to having a rapid labor.

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All the different ways to date a pregnancy. How to utilize the calender, ovulation and ultrasound to determine when is the best estimated due date. We'd love to hear your feedback.

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Macrosomia refers to a fetus larger than 4000 to 4500 grams (or 9 to 10 pounds) at birth. There are several complications that can occur when a baby is macrosomia and most of them involve labor difficulties or difficulties in the infants transitions to extrauterine life. Find out all you need to know about macrosomia in the latest episdoe of True Birth

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Pubic symphysis pain which is also known as symphysis pubis dysfunction refers to symptoms a patient feels when the joint between the left and right pelvic bones allows for more movement than usual. This is a common discomfort in pregnancy due to the increase in the relaxation and increased mobility of the of the ligaments surrounding the pelvis. Unfortunately, this can cause a lot of pain in the pregnancy. In this episode, the causes and remedies are reviewed for pubic symphysis pain.

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Uterine fibroids, also known as uterine leiomyomas are benign smooth muscle tumors found in or around the uterus. Fibroids are common in women of childbearing age and many women will have no symptoms. Fibroids usually have a minimal effect on the pregnancy, but they can sometimes be associated with fertility concerns and some pregnancy concerns. While many women have no symptoms and may never even know they have a fibroid, pain is usually the most commonly reported symptoms. There is a slightly increased risk of obstetric complications, such as miscarriage, preterm labor and delivery, fetal malpresentation, and placental abruption which are all discussed in this episode of True Birth.

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Guillain-Barré syndrome (GBS) is a very rare, autoimmune disorder in which the immune system damages the nerves, causing muscle weakness, paralysis and pain. The symptoms can last for a few weeks to several years, yet most will make a full recovery. Occasionally, some people with GBS will have permanent nerve damage. In this interesting case, the patient was early in the pregnancy and presented with weakness and numbness that progressed to full paralysis. Dir. Abdelhak explains her progress through the pregnancy and journey from the NJ healthcare system to the MAYO clinic and back. Through it all, the pregnancy was a source of light and hope. Listen in to find out how it all unfolded.

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Gestational diabetes or diabetes in pregnancy diabetes during pregnancy. This podcast will focus primarily on the type of diabetes that develops during pregnancy. Thoses with pregestational diabetes or diabetes that comes before the pregnacy begins result in diffrent management strageties and carry different risks.

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We've compiled all your emails and answered them in this listener mail episode.

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Epidural anesthesia is a type of local anesthetic that is injected into the epidural space. This procedure numbs the spinal nerve roots and provides a block to the lower abdomin, pelvic and lower extremity portion of the body. It is the safest and most effecive method of pharmacologic pain management in labor available.

In this episode, True Birth reviews all the pros and cons of epidurals.

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Varicose veins are a farily common and benign finding in prengnacy. While these types of veins are not harmful, they can be unsightly and uncomfortable. Lower extremity, anorectal, and vulvar varicosities are different types of varicose veins that can be seen and not much can be done to prevent them.

Varicose veins are also very common where as much as 50% of pregnant people experience this type of dilation of the superficial veins. These varicosities can become visible anytime during pregnancy but are most common in the third trimester.

In this episode, Dr. Yaakov Abdelhak & Kristin Mallon review varicose veins and what to do about them.

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Platelets, also called thrombocyotes, are a component of red blood cells. They are fragments of cytoplasm that are derived from the bone marrow and are essential for blood clotting. Blood clotting is exteremly important in pregnancy and labor and delivery to prevent excessive bleeding (hemorrhage).

Should a woman keep an eye on her platelet levels during pregnancy? The resounding answer is yes. Find out how and why platelets matter on this weeks episode of True Birth.

Key Highlights:

[01:54] What are platelets and how are they important to the body?

[05:55] What is the job of platelets in the body?

[06:35] What happens if you don’t have good platelet function?

[07:50] The normal platelet count

[08:40] Causes of low platelets count during pregnancy

[09:37] #1 cause: haemodilution

[12:54] How women get misdiagnosed as having thrombocytopenia

[15:10] Different types of thrombocytopenia

[18:15] Why is it a problem to have platelets levels below 100k/ml?

[21:24] Paralysis during an epidural: why is it rare?

[24:32] Epidural alternatives

[25:30] Why cancer leads to low platelet levels.

[27:49] #2 cause: preeclampsia

[28:58] Some treatments to boost your platelets.

[32:03] Should you worry about DIC when you have low platelets?

[32:21] Can the baby also have low platelets?

[34:46] How to determine the baby’s platelet levels

[38:14] What is alloimmune thrombocytopenia?

[40:49] Thrombocytosis and treatment

[42:43] Summary of the episode

[43:45] Do women on Heparin or Lovenox have to worry about low platelets?

[44:50] Is there anything you can do with your diet to increase your platelets?

[45:46] Why platelets transfusion is not recommended

[47:00] Does it mean you have low platelets if you regularly have nose or gum bleeds?

Notable Quotes * Platelets are one of the most important things in the human body. Their job is to stop bleeding. * Platelets' job is to keep blood where it’s supposed to be and not let it escape when any damage occurs. * 5-10% of women will have platelets under 150,000/ml just because they’re pregnant. * If you have a c-section and your platelets are 50,000/ml, you are in trouble. You might not stop bleeding from the surgery. * The average platelets only last 7-10 days. * Anything that’s going to build your kidneys and bone marrow will build your platelets.

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How long is it necessary to wait to get pregnant after a pregnancy in various circumstances? There is no uniform or immediate answer. In this episode, we explore what is recommend in each circumstance: miscarrarriage, vaginal delivery and cesarean birth. What is the interval between pregnancies that is safe? Tune in this week to find out.

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Put on your Columbo jackets! When a patient tells the story of what happened in their labor and delivery experience, they often leave clues as to what truly happened from a medical perspective. Every clinician understands that patients are not necessarily coming from a medical background when they recount their own experiences with healthcare. The pertinent medical information can be colored by the patient's own perceptions of what was happening we and what they were informed of at the time. A good physician will be able to piece together the puzzle and find the medical facts in the story to crack the case of what really happened in any labor and delivery room. In this creative and interesting episode, Dr. Abdelhak walks us through how he puts on his Sherlock Holmes’ cap and can make accurate deductions from fragments of information in a patients story and medical records. True Birth presents : Forensic Obstetrics

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Group B Strep Bacteria In this episode, we talk about Group B Strep bacteria found on the lower genital tract. The reason why Group B Strep is a problem, how to know the women with Group B Strep, how to treat women with the bacteria and, why women with Group B Strep are not given antibiotics before labor.

Timestamps

[01:38] About Group B Strep bacteria

[03:31] The reason why the bacteria is a problem

[05:30] How to know the women with Group B Strep

[07:12] How to treat women with the bacteria

[09:34] Why women with Group B Strep are not given antibiotics before labor

[12:12] The test for Group B Strep

Notable quotes * Group B Strep is part of the normal vaginal flour. * The main reason why Group B Strep is a problem is that rarely, it can get into the nose and mouth of a newborn that is passing through the birth canal and cause a Neonatal infection. * Women with Group B Strep are given antibiotics in labor, usually ampicillin. * Once the water breaks, the baby might be exposed to the bacteria in the vaginal canal.

Resource links Group B Strep

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What was the c-section rate in 1970 compared to what the c-section rate is now? It's much higher. The c-section rate in the United States has been as high as 35% and even higher for first time moms. Dr. Abdelhak speaks to the 5 main causes of the multifactorial cesarean epidemic .

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This episodes walks through the different types of lacerations and how they are repaired.

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The round ligaments are ligaments that sit near the uterus and, pass near the inguinal canal and end in the labia majora. It is a very common report in pregnancy to experience pain in the round ligament area. The pain is most common in the second trimester and can be on either the right or left side and often described as a pulling sensation. It is thought to be caused by irritation of the nerve fibers along the ligament. In this episode, we discuss treatments and the best course of action in pregnancy.

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What happens in a digital cervical exam done in pregnancy? What is the purpose and what to expect are all reviewed in this podcast. Dilation, effacement, station, position, consistency and all the components of the bishop score are reviewed.

Some charts are included for reference:

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All the categories and classifications of fetal monitoring explained in this thorough episode. What is external fetal monitoring? What is the criteria? What can we do about it? and Is it a good or bad thing?

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Progesterone supplementation in pregnancy and the preconception period has been debated for several years as to its effectiveness. In this episode, Dr. Yaakov Abdelahk gives his take on the use of progesterone for fertility, the prevention of first trimester loss and there prevention of preterm labor.

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Navigating through labor and delivery can be overwhelming enough, especially when it's your first time. In this episode, Dr. Yaakov Abdelhak, high risk perinatologist and Kristin Mallon certified nurse midwife review all the players on the labor and delivery floor.

In this overview, you can understand everyone in the hospital from the president of the hospital to the newest nursing student.

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Anemia is common concern for many women in pregnancy, but less pervasive than you think. The normal iron levels in pregnancy are lower due to a normal dilution effect. In this podcast, we review the different types of anemia, what's normal for pregnancy and how and when to treat it.

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Pitocin is the synthetic version of a natural occurring endogenous hormone called oxytocin. Oxytocin, also called the "love hormone" is produced in the hypothalamus and secreted by the pituitary gland.

Pitocin is a medication most often used to stimulate uterine contractions to induce or augment labor. Because it can be use to stimulate uterine contractions it is also beneficial in preventing postpartum hemorrhage after birth.

Listen in as Dr. Yaakov Abdelhak gives his take on this medication and all the good and bad it has to offer.

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Retained placenta is when the placenta is not delivered within 30 minutes of the delivery of the baby. Some facilities or institutions will consider the placenta to be retained only after 60 minutes or even more, but for the majority of locations, 30 minutes is considered a placenta that is retained (stuck).

There prevalence of retained placenta is about 2-3% of deliverer and can happen in vaginal deliveries or cesarean births. There are several factors that can increase the changes of a retained placenta such as :

Previous retained placenta
Preterm delivery
uterine anomalies
previous uterine scar
preeclampsia
stillbirth
small for gestational age infant
velamentous cord insertion

In the episode, we discuss what to expect in the case of a retained placenta.

We hope you are enjoying this and all of our podcasts. Please share with a friend and tell them about your favorite episode. We greatly appreciate those of you who have written in and told us about what you want to hear about in pregnancy and birth. Please keep these notes coming. You can reach out to us directly on our website on www.truebirthpodcast.com

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Placenta previa is when the placenta (disposable organ of the pregnancy) extends over the cervix and cervical os. When the placenta is completely covering the cervix, this necessitates birth by cesarean, vaginal delivery is not safe or even doable. Even in a practice where there is usually a route to safe vaginal birth, in the case of placenta previa it cannot be done.

There is a different between low lying placenta and placenta previa and this episode explores this topic and why a low lying placenta may not necessitate a need for a cesarean birth and vaginal delivery may still be attempted.

Other great things covered in this podcast include how placenta previa is managed throughout pregnancy and when bleeding and hemorrhaging could be a concern.

We hope you are enjoying this and all of our podcasts. Please share with a friend and tell them about your favorite episode. We greatly appreciate those of you who have written in and told us about what you want to hear about in pregnancy and birth. Please keep these notes coming. You can reach out to us directly on our website on www.truebirthpodcast.com

Our practice website can be found at:

Maternal Resources: https://www.maternalresources.org/

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In this fantastic episode check out all you need to know in that time in between your first positive pregnancy test and getting to your first OB/GYN appointment to confirm your pregnancy. Which prenatal vitamins are important? What foods should you avoid? Can you sleep on your back and more? Everything you wanted to know about those first days and weeks of early pregnancy.

For everything you need about this podcast, check out True Birth: https://www.truebirthpodcast.com/

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Thyroid disease can be tricky to detect in pregnancy because many of the symptoms of thyroid disease can be mild and go undetected or are so similar to the normal side effects of pregnancy they can often be missed. In this episode, Dr. Yaakov Abdelhak, high risk perinatologist and Kristin Mallon certified nurse midwife walk us through everything we need to know about thyroid disease in pregnancy.

What is Thyroid?

[1:08]

The thyroid is an endocrine gland in the neck and produces thyroid hormone. The hormone regulates your metabolism, which is your energy usage, how you absorb, and how you release it into your system. If your thyroid is working well, you wouldn’t know it because you feel fine. But if your thyroid is overactive, called “hyperthyroidism,” you might find yourself releasing too much energy into your system.

Diagnosing Thyroid Disease

[2:47]

Before you start diagnosing schizophrenia or bipolar disease, find out if their thyroid hormones are in the right place because they can be disguised as many psychological issues. With hypothyroidism, you might find yourself cold intolerant where everybody else seems to be comfortable, but you need a sweater or an extra jacket. You have tremendous fatigue, and you’re not active. All of these symptoms are not uncommon, especially in pregnancy. So when a woman is pregnant, it’s tough to diagnose if they have hypothyroidism.

[3:36]

The most common cause of hyperthyroidism is Graves disease, which stimulates your thyroid by outside antibodies that are tricking your thyroid into producing too much hormone, then you get your thyroid is overactive, and you have too much thyroid hormone in your system. The opposite is hypoactive thyroid which we call “Hashimoto’s thyroiditis.” It’s when your thyroid is underactive and is secondary to Graves disease. The thyroid gets overactive, and it turns out you get stimulated too much by the thyroid-stimulating antibodies. Then it produces an excess of thyroid hormone until it burns itself out, and now you have a thyroid that’s not working.

Understanding the Thyroid Glands

[5:04]

To understand the thyroid, you have to understand the most basic thyroid hormone is produced. The thyroid is a gland, but the gland does not decide how much hormone to release to the brain. The pituitary gland releases TSH or thyroid-stimulating hormone. TSH is a messenger hormone to the thyroid, which responds to TSH by generating thyroid hormones in the form of T4 and T3.

[6:25]

The brain or the pituitary, which is a part of the brain, produces TSH. That hormone stimulates the thyroid to produce T3 and T4. There’s another concept that’s important called thyroid-binding globulin. It’s the protein that carries T3 and T4 through the system. If there’s an excess of that binding globulin, you might have higher numbers like in pregnancy.

What happens to your thyroid hormone levels during pregnancy?

[8:13]

Another hormone produced by the pituitary is the Human Chorionic Gonadotropin, which is almost identical to TSH. When a person produces a tremendous amount of HCG early in pregnancy, their TSH gets suppressed.

[12:27]

Because TSH is so affected by HCG, we use different numbers in pregnancy in non-pregnant women. A TSH above 4.5 would indicate that she’s hypothyroid and high TSH, meaning too low thyroid. High TSH means her thyroid is underactive. Think of it as the thyroid is the horse, and the TSH is the jockey whipping the horse. So if the TSH goes up very high, it’s a sign that the horse is not moving fast enough, and if the TSH goes down too low, it’s a sign that the horse is moving fast. So if the TSH is minuscule in pregnancy, we might consider that “subclinical hyperthyroidism.” Otherwise, it’s subclinical hypothyroidism.

The Bottom Line

[18:00]

Hypothyroidism is much more common than hyperthyroidism in the general population. There’s a lot of underactive thyroids, not so much overactive. Even if it is overactive, it’s usually transient until it gets underactive, and then you have the underactive problem.

[18:43]

No matter what disease you have, there’s almost nothing. You just have to take a little Synthroid. If you’ve never had it, there’s no problem. Your body works fine. You just bypass the thyroid, you get Synthroid into your system orally, and you’re perfectly fine. If you have to choose a disease to have, don’t go with liver cancer. Go with hypothyroidism.

Common Medication for Thyroid Disease

[19:15]

Synthroid is the generic form of levothyroxine. Your chronologist titrates the amount of Synthroid or levothyroxine that you need. They give you some, and then they check your thyroid hormones. In pregnancy, your body’s going to metabolize thyroid hormone quicker. So even if you are on Synthroid, you need to check those levels because you might have to adjust your dose.

[21:10]

Methimazole is a contraindication to use in the first trimester. You need to take something because it can lead to miscarriages, preterm delivery, preeclampsia, and all the bad things. Even hypothyroidism can lead to miscarriages or conception issues.

Postpartum thyroiditis

[23:45]

Postpartum thyroiditis is much more common. It is inflammation of the thyroid, which eventually can turn into Hashimoto’s or hypothyroidism. So if a woman is having problems with sleeping, depression, postpartum depression, or weight gain, it’s ideal for screening the thyroid to see if it is underactive or during active thyroiditis. It can be overactive or masquerade as Graves disease or hyperthyroidism and later show up as hypothyroidism.

The Fetal Thyroid

[26:09]

The fetal thyroid doesn’t even come into play in the first trimester. There is no fetal thyroid action in the second. It’s important to have good normal thyroid numbers in the first trimester because you’re supplying thyroid for you and your baby. In the second trimester, the fetal thyroid gland starts to work.

Hormones and Pregnancy

[28:12]

When you look at TSH and other hormones in pregnancy, you look at the reflection of ATG production, especially early in pregnancy. If you grade a baby based on his TSH and T4, you’re saying, “Is HCG production high or low?” Maybe you’re saying, “Was it a great pregnancy from the get-go or not?” That has much more to do with overall performance later in life.

For everything you need about this podcast, check out True Birth: https://www.truebirthpodcast.com/

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As Covid lingers on into the New Year especially with the new Omnicron variant on the loose, the question every pregnant woman wants to know is whether or not to get the Covid Booster vaccine while pregnant.

In this episode, Dr. Yaakov Abdelhak explains why he recommends the covid booster to pregnant women in pregnancy. We'd love to know what you think?

As always we would love to hear from you!

Please support us, but sharing us with a friend or leaving us a review on iTunes.

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Preterm labor is one of the most evasive disease processes we know about in pregnancy and is one of the leading reasons a pregnant woman seeks treatment in a hospital setting. Until now, we have had very little understanding about why preterm labor (PTL) happens.

Most of the therapeutic interventions surrounding PTL involve identifying who is in true preterm labor and appropriating care to delay delivery not stopping preterm labor. Traditional treatments for preterm labor focus on supporting the fetus for extrauterine life including antenatal corticosteroid therapy to support the lungs, group B strep prophylaxis to prevent infection, magnesium sulfate for neuroprotection and assembling the appropriate team for delivery.

Why is there no treatment to stop or better yet prevent preterm labor? Is there something that can be done? Dr. Yaakov Abdelhak believes so and explains his method for the prevention of preterm labor in this podcast.

As always we would love to hear from you!

Please support us, but sharing us with a friend or leaving us a review on iTunes.

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We want to hear from you. What is your biggest fear in childbirth?

Listen is as our two hosts explain what they think a woman's biggest fear is. Also take our instagram poll and let us know what your biggest fear is.

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What's the cause of fetal growth restriction? How can you prevent it? In this episode of True Birth, we will talk about fetal growth restriction/FGR previously termed IUGR or Inner Uterine Growth Restriction.

What is FGR?

[1:36]

It is when the baby falls below the 10th percentile for weight. 10% of babies will be below the 10th percentile, by definition. Hence, 10% of babies will be classified as fetal growth restricted. It's important for you to know that because 10% of babies are not in a pathological situation. They're not in a bad situation. They're not in a situation where they're not growing.

[2:35]

It's important to consider each woman and her partner uniquely in pregnancy. A women that is 5'9 with women and a woman that is 5 feet tall will have different size expectations and patterns when it comes to pregnancy.

Possible reasons that the baby is small

[4:17]

The number one reason that a baby could be on the smaller side is that the mother is small and the father of the baby is maybe not the tallest guy. We use the term FGR/Fetal Growth Restriction when they're in utero, but once they're delivered, we call them SGA/Small for Gestational Age.

[5:06]

When you find the baby's not growing well, this will generally be after 20 weeks Babies are generally the same size until 20 weeks.

[6:08]

Another reason the baby is small is that it's supposed to be small and there's nothing wrong. The number two reason is placental perfusion. It has a problem with the baby getting enough blood flow and nutrients. It is just not getting enough of what it needs to grow well. And there are many reasons why the placenta won't function. So when you see a small baby, especially in the third trimester after 27 weeks, 30 weeks, start thinking, "Oh, how are her blood pressures? She's spilling protein. Is there something going on with this patient that's pointing me towards preeclampsia?"

[8:07]

TORCH is an acronym that stands for toxoplasmosis, rubella cytomegalovirus, herpes simplex, and HIV. Cytomegalovirus is a virus that's very common in the population. Most people have been exposed to cytomegalovirus. T

Ultrasound tools

[12:09]

To understand Dopplers without getting into the physics of what the Doppler effect is, you can take your transducer, you could put it over the cord, and you can turn on the Doppler and you could see the blood flow through the cord.

[13:48]

When you look at a Doppler, and you see the blood flowing the way it should, before the next heartbeat, you measure how fast it's going right before the next heartbeat.

[15:14]

When you talk about fetal growth restriction, you can't just talk about the baby's size because there's only one piece of it. The other piece is what is the placenta telling you? What are the Dopplers telling you?

[15:34]

Biometry is when you measure the femur and the abdomen and measure the head to get the size and weight of the baby and estimated fetal weight.

Guidelines about how to approach Fetal Growth Restriction

[18:12]

If you're below the third percentile, even if everything else is okay, that's the baby you got to deliver at 37 weeks. You can't just sit around and look at that baby for 37 weeks get the baby out. If your baby is above the third percentile and the Dopplers are elevated but not absent, get the baby up. And if there's no flow, the blood stops, that's even more concerning. If you see the reverse flow, you're dealing with a much more ominous situation and you don't want to go past 32 weeks. If you don't think the baby's doing well, you might have to come out even earlier.

Biophysical profile

[22:09]

One of the things that some patients might have to consider in other practices is that they would need to start having biophysical profiles done. A biophysical profile is when you're checking for a series of four different things and looking to ensure that the baby is reassuring overall. What is the baby's movement? What is fetal breathing, which is an exercise the baby does to inhale and exhale fluid? What is his tone? Is the baby flex or the floppy? Or if you feel the baby's not moving, these are things that you have to consider.

[23:51]

One of the things you're looking for when talking about growth restriction is you want to see how the baby is handling the uterine environment? How's the baby doing on the inside? These tests will wish to you to identify a baby that's not doing well or not getting enough blood flow. You need to know if you can wait on it and let the baby stay inside, or is it time to get the baby out? Because then the baby will do better outside of the womb.

Recommendations

[24:20]

The recommendation is that if you recognize growth restriction, you should at least be monitoring weekly, that might be nonstress tests, or that might be a biophysical every week. And if you have a severe growth that restricts a baby under the third percentile or abnormal Dopplers or accident, then twice a week. If you have reversed outside flow, put those patients in the hospital because they need to be monitored around the clock and you got to pull the baby out before it's too late.

[29:08]

The most reliable and consistent way to assess blood flow to the baby is the umbilical artery. Look at the ductus phimosis. When the umbilical cord hits the baby's belly button, a big part of the vein goes up into the heart carrying the birth at heart, and you can see if there's resistance, or even at the umbilical vein.

Here is the photo that we have permission to share.

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One of the most asked questions during an office visit is: "Doc, how do I prevent tearing?" In this episode, we discuss how to prevent perineal tearing during delivery.

Tearing and Contractions

[1:56]

When Kristin was pregnant, her biggest fear wasn’t the tearing but the contractions. Seeing other women with contractions made her feel that it was painful. She says that tearing is more of having an injury that you overlook until it happens.

Infections in Tearing

[2:29]

The body is designed to tear. If a woman has a baby and tears, they should keep their legs together, and it will heal. With thousands of adult women living with tearing, there hasn’t been one infection. Though there are vaginal infections postoperatively, there hasn’t been a repaired tear that got infected.

[3:35]

The Human body is designed for tearing. A human design where a specific area would not be infected, but other areas would be contaminated.

The Fear of Women about Tearing

[4:52]

There are all these things that women make themselves crazy about how to prevent tearing. They make themselves crazy about things like perineal massage. They’re looking it up on the internet and massaging their perineum.

Massaging to Prevent Tears

[5:30]

The skin stretches better when you use mineral oil as a lubricant instead of a surgery loop. Dr. Yaakov is constantly massaging and stretching the skin as much as possible because if the head of a baby comes out slowly, the skin has more time to accommodate and stretch. Those quick deliveries are more common to have a tear.

Using Mineral Oils

[6:36]

Mineral oil is very good. But when the head is coming out, Dr. Yaakov milks the skin on the sides and just pushes it back on the head. With the head coming out and the skin bulging with it, he is trying to milk it back while putting a lot of pressure right on the perineal skin because he is spreading that pressure out across the whole perineal body.

[7:27]

Even with all of Dr. Yaakov’s strategies, 80% of first-time mothers tear. So he thinks that mineral oils and milking the skin over the head are beneficial.

Controlling Tears

[8:07]

The more you control the tear of the bottom, the more likely she’s going to have a tear on the anterior perineum, which is near the urethra, clitoris, and labia. The more you prevent it on the bottom, the more likely it is to go up. The worst thing that can happen is uncontrolled delivery, where the baby's head just pushes and pops out. They head back, and the baby will headbutt you right into the most sensitive part of the body. That will easily cause real trauma. So you have to control that. You have to control the head and not let it extend too quickly control the extension while you’re trying to prevent a tear.

[10:35]

Experienced providers have a better ability to prevent a tear. The more deliveries you’ve done, the more little tricks you have up your sleeve.

Check us out on our website or social media!

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A woman's weight and BMI during and after pregnancy is often discussed and debated. This is especially true in the case of high-weight women, who, as research shows, have a higher risk of complications like cesarean birth.

Today's episode is to discuss high weight women in pregnancy and when we need to concerned and when we don't PLUS, we also discuss some very questionable myths and treatments followed for high-weight women that you need to be aware of. But these in no way imply that people with very low body weight have uncomplicated pregnancies. To prove that, we compare pregnancy risks, body weight gain, and recovery in low-weight, normal weight and high-weight pregnant women and see clearly why a lower than ideal body weight could also pose significant birth complications.

PS. Excessive weight is sometimes associated with ovulation issues. That, in turn, could be caused due to PCOS (PolyCystic Ovarian Syndrome), which is associated with a hormonal imbalance that messes up your ability to metabolize.

Here are a few known complications faced by high-weight women during pregnancy:

Preeclampsia -- Condition associated with high blood pressure and other complications, including retaining fluid and end-organ dysfunction. In extreme cases, it can lead to eclampsia or seizures, a severe form of preeclampsia.

Diabetes (pregestational and gestational) -- Diabetes that's detected during the first trimester or the beginning of the second trimester is called pregestational diabetes. These can lead to abnormalities of development and more chances of miscarriages. Gestational diabetes is a form of diabetes that's developed in women during pregnancy. Women who have this condition wouldn't have had diabetes previously.

Preterm delivery -- A condition that might cause pregnant women to go into labor early.

Macrosomia -- High weight of the baby

     >> Higher weight loss -- High-weight women tend to lose more weight during pregnancy, which is unhealthy. It's healthy to end a pregnancy with a greater weight than what they started with.

High risk of C section -- High-weight women are at a 70 % risk of a C-section -- even after complications like hypertension and diabetes have been neutralized.

Less sensitivity to oxytocin -- Hence an increased need for oxytocin augmentation.

The need to use IPCs (Intrauterine Pressure Catheter) -- a device placed inside the pregnant woman's uterus to monitor uterine contractions during labor.

Pelvic outlet is narrower -- This is alleviated by making positional changes.
Uterine tilt if a woman previously had high weight and lost it abruptly -- This

is alleviated by making positional changes.

Remodelling of bones -- As the bones become more narrow, changes are caused in getting the baby.

Shoulder dystocia and postpartum hemorrhage -- Massage from postpartum hemorrhage is also harder.

Difficult labor -- Caused due to positional issues of internal organs and the baby

A common pregnancy complication seen (especially) in low-weight women: >> Hyphemeresis -- A condition that causes severe metabolic disturbances,

including abnormal amounts of nausea and vomiting.

There’s a ton of other valuable insight offered in this episode. Do not forget to tune in!

RESOURCES MENTIONED:

Episode 042: True Birth Podcast: Uterine Tilt
Episode 029 True Birth Podcast: Preeclampsia
Episode 020 True Birth Podcast: Shoulder Dystocia

Episode 060 True Birth Podcast: Hyperemesis Gravidarium

 To connect with us, Find us on: www.truebirthpodcast.com

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Face presentation is when the baby's face is presenting through the cervix first. Normally, the baby's head is flexed so that the chin tucked. Non-head down positions (including breech, transverse lie, face, brow, and compound presentations) do happen too are account for less than 4% babys at term.

When the baby is coming out face first, the baby's head and neck are hyperextended creating a more difficult and sometimes impossible birth.

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When a c-section birth is done with care and precision it can make all the difference in the healing and recovery for the mother. Operating the right way will also enable a woman to continue to have more pregnancies in a safe and secure way.

In this episode, Dr. Yaakov Abdelhak, a high risk perinatologist MFM specialist, lays out his method for operating in a c-section and includes what can be discussed ahead of time from a woman to her provider. What an opportunity as he reveals his unique method for conducting C sections step by step in this episode of The True Birth Podcast. He explains the best ways to perform the surgery to minimize the risking scarring, post-operative pain and complications.

Planning C-Section

[3:45]

No one thinks they're going to have a C-section until the time comes to have a C-section. Because the heart rate in labor may stop progressing, you won't have time to develop a C-Section when the time comes. It is something that needs planning, like a birth plan. Doctors, on the other hand, dislike being taught how to operate. However, they will tell you things that are entirely feasible and reasonable.

Plan C

[4:43]

When a patient is on the operating table, the personnel in the room, such as the surgeon and nurses, must take a timeout to ensure that everyone is on the same page and help the patient clarify the surgical case.

[5:48]

Before Dr. Abdelhak makes an incision, he uses a marker and draws a line about two inches above the pubic bone. Some people have a natural line that is sometimes faded or darker in pregnancy because of more melanin deposits.

Why Dr. Abdelhak has a marker

[10:31]

If you put a patient back together just a half-centimeter off on the skin, which has the most nerve ending and they're going to feel it, it's important to pay attention and make sure you get them back exactly the way they came apart.

Performing C-Section

[11:51]

Once you open up the skin, the next step is to now get through the subcutaneous fat. Most of the time, you take the electric cautery, and you burn down to the fascia so that you can see the fascia. The fascia is the membranous connective tissue that holds everything together. It's the linings of the muscles that come together in the midline. It's a white, very thick sheet that's holding your abdominal sheet. Cut down to the level of the fascia only in the midline with the electric cautery. Then bluntly separate the rest on the right and left with your fingers because what you're doing is you're pushing the blood vessels laterally instead of cutting them.

[15:06]

When you open the fascia, you have to do it in the same direction as you're doing the skin. Underneath the fascia is a muscle, and now you have to get through the muscle. Doctors learned that it is terrible to cut the abdominal muscles because it's better to pull them to the side. After all, there's a natural kind of separation between the two.

[15:45]

Pull the muscles to the side, stretching before you pull both sides. You have to separate that overlying fascial sheet from the muscles to the side. Then you enter the perineum that is holding all your abdominal content. Now you have exposure to the uterus. At this point, you are making sure that you have enough exposure.

[17:12]

Making a small incision on the skin is very important to have a good recovery. If you have a repeat C-section, you have to go more prominent because you need more exposure. If somebody has a repeat C-section, they might think about opening a larger incision. You have to make no incision on the uterus. Before you go inside the uterus, look at the bottom to make sure the uterus is not tilted to the right or left. It's essential to know that if it's tilted, you can end up cutting some blood vessels.

The Bladder Flap

[19:05]

The bladder runs directly over the uterus, and the perineum joins the bladder to the uterus and becomes the uterus's skin. There is a stage in between where it exits the bladder and forms the uterine skin. You can see on the uterus a potential space. You lift that space, you make a minor incision, you lift it, and when you push the bladder up and away from the uterus, you have more exposure to the lower uterine segment.

Opening the Uterus

[20:36]

When you open up the uterus, you have to be careful not to cut the baby. It would help if you had a "butterfly touch" whenever you are cutting through the uterus. You can use the suction, then use your finger, and you rub it. It will cause the cut to open up more rather than performing another incision.

[24:03]

The thick borders are critical because the uterine wall collected at the lateral edges is protective from extending the incision. So when you pull the baby's head out, if you have a sharp edge there, it's straightforward for the pressure or your hand and the baby's head to cause that sharp edge to elongate. When it elongates, it goes where it wants, usually towards the side and the uterine vessels, and then you get a lot of bleeding. But if you are careful and have thick borders, it's much less common when you pull the baby's head out.

Getting the Baby Out

[26:52]

You're trying to push from the top and shoehorn the baby's head out because you want the baby to come out, not just straight down. When you move on the top, you put your hand in to help guide the head out. You're shoehorning the baby out. Keep as much space as possible for the head and not your hand.

[27:44]

Occasionally, Doctors will produce a vacuum to assist with vaginal deliveries. This suction can also be used for C-sections. The vacuum is very nice as it puts on the head, and you can quickly bring the head out without having your hand in there. You can guide the head, and you don't need to have a big incision.

[28:31]

Once you get the head out, make sure the cord is not around the neck or reduce it, and then you bring the baby out ultimately. Clamping the cord can be done then show the mother her baby. Then give the baby to the nurses so they will dry and clean up the baby.

Closing the Belly

[33:25]

Once you get everything cleaned out, you look at the uterus again and make sure it's dry. If you created a bladder flap, don't repair it as it sits naturally there and heals fine. You don't need to put an extra layer of sutures.

[34:10]

You have to close the perineum because if you don't, you have a much worse adhesion. Failure to close the perineum will lead to many complications and can become messy in the surgery room, so it is imperative to close it properly to prevent that from happening.

[34:53]

If you have a cut edge, it's going to heal whatever is around it. If you put things together with the way they came apart, they heal together. There are areas of the uterine wall, which are still a little raw because you close it, or there are scrapings on the serosa. But just from manipulating the skin, it's going to heal to whatever it's touching.

[37:02]

Do not simply contract the muscle. What you're doing is you're taking sutures, and you're bringing the muscle to the midline, and you're switching the right side to the left side every two or three centimeters. Many women have had C-sections. The muscle was never re-approximated to the midline. Then they have abdominal diastasis, where instead of having a flat belly, you have this pouch right in the middle that bulges out because your muscles are not working to hold everything in nature.

Using Needles

[41:19]

When you use a straight needle, you're holding the needle with your hand just like you're sewing. When you use a curved needle, you're using a needle holder.

Not every C-Section method is the same.

[41:45]

There's not a recipe to do C-sections. Understand that there are many optional steps and different ways to do this. If you understand the difference between a human being and a monkey, it's about 98% the same DNA. That 2% difference is a lot. Somebody else would only consider that 90%. But that 2% makes a huge difference as far as recovery and other factors in the body.

Scarring

[43:32]

Patients hate the scar from C-sections. They would look right at fascial skin incisions as unfavorable. However, there is a way to get rid of the scar, but it takes time. However, you finish up with a cosmetic scar concealed. That is why a Pfannenstiel incision is used in 98 to 99 percent of C-sections since it is considerably more preferable to a woman who does not want a scar.

Things to remember

[46:01]

Minimize the skin incision as small as you like. Then close the perineum. Then bring the muscle to the midline with a suture and get the right side to the left side to avoid being marginalized.

[47:33]

Make sure that you ask them to make a minimal incision on the skin. Ask your surgeon to close the perineum and bring the muscles to the midline. Those are crucial things.

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Going to the dentist in pregnancy is not only allowed but its recommended. Regular dental check ups and good dental hygiene are advisable in pregnancy. This episode also contains a bit about: The Count.

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There are two main types Types of Twins twins when it comes to pregnancy, dizygotic twins and monozygotic twins. In this episode, we review these different types.

Types of Twins

[0:45]

There are two types of twins: Monozygotic and Dizygotic. Each has its own subcategories. (Di) means two; (Mono) means one; Zygote is a fertilized egg. Dizygotic means two fertilized eggs, and Monozygotic means one fertilized egg that split into two. Dizygotic is commonly known as fraternal twins, which means non-identical twins. With Monozygotic, it would be identical twins that split into two.

[1:50]

You can have twins one of two ways. With Dizygotic, you can have a woman ovulate two eggs at the same time, which is uncommon. That means each ovary ovulates an egg, and they both find their way into the uterus and get fertilized, so you have two pregnancies going at the same time. Basically, they’re siblings, but instead of carrying two years apart, your body decided that you’re just going to carry two at the same time, getting a two for one. The other type of twins, which is less common for every two or three cases, is Monozygotic. This is where one egg gets fertilized for whatever reason.

[5:48]

With Monozygotic, there’s one egg that splits itself and turns into “Monozygotic Twins” or identical twins. If that egg splits very early, then each piece of the egg develops a completely separate pregnancy with a completely separate placenta.

Early Conception of Twins

[6:55]

If the egg splits within the first three days, you have two separate placentas and two separate pregnancies. With twins, there are two separate layers called the Chorion and Amnion. These are the two layers of the placenta. The one that is further inside is the Amnion, and the one that is on the outside is the Chorion. With normal pregnancies, both act as a single layer. But with twins that are completely separate, they will have two of both layers.

[8:34]

If the egg separates after the first three days, but not after the first seven days, then each baby will develop its own Amnion even though they will share a placenta. That means each baby has a cord running to the same placenta on different sides of the amniotic separation, which is that wall between them. That wall is a membrane that prevents the twins from entangling their cords. If the baby separates after that seven-day zone, then they not only do share a Chorion, but also an Amnion. This means that both Chorion and Amnion are shared by the twins.

Monochorionic and Dyamniotic Twins

[10:15]

Monochorionic and Diamniotic twins have special considerations and special risks. If it was actually two eggs, and they both get fertilized, then it’s Dizygotic. But if it happens to be a Monozygotic twin that developed early, it will act like a Dichorionic. So how do you know what you are dealing with? You got to look early because early on, it’s very clear on ultrasound if you got two eggs in there that got fertilized or one egg that split in half.

[11:16]

Even if you have one egg and one sperm that got fertilized that split into two, if they split early enough, they are going to have their own two pregnancies. It’s going to be their separate pregnancies. If there had been two eggs that get fertilized, it would act the same way. They will be genetically identical.

[12:12]

7% of Monozygotic twins are Monochorionic or Diamniotic. But the majority of twins are Dizygotic, which means they come from two separate eggs that are fertilized early in pregnancy. With ultrasound, it’s very easy to see early on the two separate sacks that are almost not touching your or very little touching. There’s a sack, and there’s a baby on this side. Those sacks are going to grow, and they’re going to merge. If one placenta isn’t attached to each other or they are within two separate locations, then you are dealing with Diamnitoic twins.

Managing and Identifying Twin Pregnancies

[14:57]

To figure out what type of twin pregnancy a woman has, their placenta is looked at using ultrasound. The points that are looked at are if the twins are sharing a placenta or if the placenta is in the same place. Currently, you cannot tell on ultrasound if it’s one placenta or two that are just against each other. Sometimes, placentas grow to each other, and there won’t be any separation between them. At this point, it’s very important to know if it is Dichorionic or Monochorionic because each is managed differently.

[16:04]

Another way to identify a twin pregnancy is to look at the twin membrane. You then magnify that, and then you measure it. If it’s above point two millimeters, then it’s a sign that it’s a Dichorionic. But if it’s less than .12, then it’s a sign that it is a Mono.

[17:12]

Once you have techniques, you don’t get rid of them. Even if a better technology comes along, you will learn to accept it. But sometimes you can’t see it that well. If the patient’s hard to scan or the memory is not in line well, the best way is to scan the membrane, and you zoom in on it. You count the layers, and if you see two layers, that means that the baby has one outer sac and two inter sac. But if the baby has two outer sacs and two inter sacs.

Twin Transfusion Syndrome

[18:08]

When you have a Monozygotic twin, there is a possibility that one twin can thrive more in the uterine environment than the other twin. With Monochorionic twins, there is a 15% chance of something called Twin Transfusion Syndrome. This is where one baby is getting too much blood back from the placenta, and the other baby is getting too little. The continuous pump where one baby continuously gets more and the other one gets less makes the other baby struggle. One baby cannot keep up with the volume and is overloaded, while the other one is struggling because it’s not getting enough blood.

[20:32]

If the twins are identified as Monozygotic and Monochorionic, then one of them is going to be given more blood. When blood goes to the placenta, it is shared equally between the twins. But if the arterial supply of the placenta is a bit different than the return, then both babies don’t get the same amount of blood. Instead of each baby having the same amount of return channels, both get different supplies of blood. One is automatically going to get less and the other one a little more. Then the sequence of Twin Transfusion begins. One baby’s getting overloaded, the other one’s not getting enough.

[24:05]

The earlier Twin Transfusion happens, the bigger the problem. If it happens late in the game, then you deliver the babies. But if it happens early in the game, you can’t deliver because they’re too premature, and they can’t survive. So if it happens early, you have to stop this vicious cycle from continuing. Most of the time, people will lose a baby because of the twin transfusion sequence if it’s left untreated because the fluid is so great. The excessive fluid will cause pre-term labor, and the patient will just lose the pregnancy because they go into labor early. Even if they carry long enough to get into viability, one baby will get heart failure because it can’t handle all the fluid.

[25:00]

**of note The correct term is reverse in this episode. The correct information is as follows: The fetus with more blood flow is called the recipient twin, and the fetus with less is called the donor twin

Velamentous Cord Insertion

[29:06]

Velamentous Cord Insertion is when the umbilical cord hits the placenta and branches into a spiderweb-like structure, and they drop into the placenta at different points. And that’s how all the blood is getting everywhere. But if that separation happens, then it can become a major problem. It’s a common complication in any pregnancy because you don’t want those vessels exposed, especially if they’re in front of the cervix. With twin pregnancies, Velamentous Cord Insertion is a more common phenomenon where you have that cord insertion. Often, it is tied to a twin transfusion sequence.

Treating Velamentous Cord Insertion

[30:33]

You can go in with a scope, and you can identify the vessels. It mainly involves a lot of ultrasound and targeting. Then you either ablate with a laser or radio waves. Oblate means you are sealing or coagulating them off. You are taking the vessels that run from A to B or B to A, and you are dividing the placenta, so it’s going to function like two separate placentas instead of one. If you overdo it, then you end up with the reverse where the other baby is getting too much. This is because you go in with instruments, and therefore there’s a risk of pre-term labor or amniotic fluid membrane rupture.

Monoamnionic Twins

[35:04

Twin Transfusion doesn’t happen with Mono twins because there’s only one membrane on one side. The problem is that the cords are tangled, which happens early on. As soon as locomotion happens within 12 weeks, babies start swimming. This is the rarest and highest risk type of twin. What happens with those twins is you don’t do anything until 24 weeks because you can’t do anything. You just hope for the best. Once you get viable, you basically put them in a hospital and watch them, and you monitor them several times a day. Once you start seeing fetal heart rate decelerations, you get everything ready and get them delivered. If nothing bad happens, depending on how conservative you are in 34 weeks, just go in by C-Section and deliver them.

Conjoined Twins

[37:21]

The egg doesn’t split until day 11 or 12. If it doesn’t split within that period, you will get conjoined twins. That is a really big deal because now you have a team of surgeons figuring out if you could separate them and depending on where they’re separated. Sometimes they share vital organs, and you can’t separate them. But these conjoined twins happen very rarely.

Managing Risks for Twin Pregnancies

[39:02]

If you have monozygotic twins, but they’re Monochorionic and Diamniotic, then they have two separate rooms. In this case, you just have to monitor them every week. You monitor them every other week because even the simplest, least complicated twins are high risk because there’s growth discordance where one baby grows better than the other. There is a risk of pre-term labor, which is much more common with twins. There’s also the risk of placenta abnormality, where the placenta is in the wrong place. There are all kinds of risks that go up, so you need to get ready for double risks.

Twins with Different Birthdays

[42:23]

Every once in a while, you might find twins that have different birthdays. These types of twin pregnancies are always C-Section. So whenever you encounter twins with different birthdays, it is assured that they were delivered through C-Section.

Least Popular Calendar days to deliver at Hackensack

[46:06]

The first date is September 11, the second is October 31, and the last one is a leap year, which is February 29.

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Placental abruption (aka abruptio placentae) is where there is a partial or complete detachment of the placenta from the uterine wall prior to delivery of the baby. In this episode we discuss how the terminology changes by trimester. A placental abruption is an obstetrical emergency and can cause injury to both the mom and baby.

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Intrahepatic cholestasis of pregnancy (ICP or IHCP) is characterized by itching and an elevation in blood bile acids, that usually develops in the late second and/or third trimester and can be a high risk issue in pregnancy.

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The best time to predict the due date of a pregnancy is at the beginning. Early ultrasound is now routinely performed and exceptionally helpful since it increases the accuracy of predicting a due date over menstrual dating alone. The accuracy of a due date helps to prevent an error when labeling a pregnancy overdue or postterm.

In this episode, we discuss what happens when a pregnancy goes overdue, what the best course of action is and when to intervene.

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Uterine tilt is a term that you won't find in the text books but comes from working day to day in labor and delivery. It refers to the tilt a uterus can have that can obstruct labor. This episode defines uterine tilt and explains what to do about it.

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Recurrent pregnancy loss (RPL) is typically defined as more than one pregnancy loss at any point in the pregnancy, but most often is associated with first trimester loss. It can be extremely emotionally upsetting experience, and many women report that it is similar to women who experience a stillbirth or neonatal death. This episode reviews the evaluation, why and what of RPL.

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The story of a courageous family and their journey to have 4 healthy children despite multiple complications: preterm labor, bleeding, cord prolapse, and uterine rupture.

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This episode outlines a step-by-step process of what happens when a woman undergoes an external cephalic version in a hospital setting.

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Dr. Abdelhak expounds on what makes a patient high risk in pregnancy.

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In this episode, our hosts review how the screening for Down syndrome and other chromosome abnormalities has changed over the last few decades. They go in depth about the latest technology such as SNP*-based technology tests which deliver the most accurate non-invasive prenatal testing available. This is often referred to as (Non-invasive perinatal testing) NIPT or (Non-invasive perinatal screening) NIPS.

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Decreased fetal movement (DFM) is when a woman is perceiving less movement than usual in her pregnancy in the second half of the second trimester or the third trimester. Movement is a sign of fetal well being and a decrease in movement can be associated with sleep cycles but it can also be a first sign of fetal distress. IN this episode, we help a woman distinguish between when a decrease in movement is normal and when it is concerning.

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When the umbilical cord slips out of the cervix before the head or the breech, this is a true obstetrical emergency. The cord is the baby's life supply and when it is out of the uterus it is vulnerable to compression, spasm, occlusion which can compromise the baby's blood and oxygen supply. In the episode, we discuss topic what happens in cord prolapse, how the baby is usually completely fine in acute care settings and why cesarean birth isn't the only solution to cord prolapse. ,

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For many centuries physicians have been trying to understand why some women give birth with relative expediency while other women can have long drawn out labors. In an effort to understand this discrepancy, two physicians (Caldwell & Malloy) studied cadavers and classified the shape of a woman's pelvics.

According to Caldwell & Malloy, there are 4 types of female pelvises all with a distinct shape: Gynecoid, Android, Anthropoid, and Platypelloid (see photo below). It was argued, that the shape of the pelvis was a factor in why a labor could be drawn out. Since this classification came out in 1933, there has been little challenge that these 4 pelvises are not a great representation of the differ shapes of bony structures for women.

In this episode, Dr. Abdelhak elaborates on what parts of the pelvis are important to pay attention to and why they matter.

We've included some photos as this will help with the visualization of what is discussed in this podcast.

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Palpitations in Pregnancy are a common phenomenon due to the increase blood flow and cardiac workload. Dr. Abdlehak reviews when they are normal and when you need to be concerned.

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This episode is all about what happens when you think you are signing up for one type of obstetrical care only to find out you have gotten something completely different. Unfortunately, this is a phenomenon that happens often in the field of OB/GYN. A woman will have her first visit with a physician and review her plan for VBAC or twin vaginal breech, only to find out too late in the third trimester that this was not the the practitioner's true plan all along.

Plenty of true birthisms abound in this great episode.

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This episode is all about what happens when you think you are signing up for one type of obstetrical care only to find out you have gotten something completely different. Unfortunately, this is a phenomenon that happens often in the field of OB/GYN. A woman will have her first visit with a physician and review her plan for VBAC or twin vaginal breech, only to find out too late in the third trimester that this was not the the practitioner's true plan all along.

Plenty of true birthisms abound in this great episode.

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The Case of the Didelphys Uterus and the Vaginal Delivery After Cesarean Breech Delivery.

A uterine didelphys is a type of mullein duct abnormality (class III) where there is an actual duplication of the uterus. The uterus has two horns. Most often there is a duplication of the cervix as well and there is no communication between them ... until now.

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The American College of Obstetricians and Gynecologists (ACOG) recommends ultrasound for all pregnant patients and we too are big fans of ultrasound. If there is one tool that we have that is essential to understanding the well being of a a developing fetus it is an ultrasound.

Listen in as Dr. Abdelahk explains everything you need to know about ultrasound in pregnancy.

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Preeclampsia is a pregnancy complication that affects multiple organs and is progressive. It is generally characterized by new high blood pressure and proteinuria or the new high blood pressure with significant end-organ dysfunction with or without proteinuria in the last half of pregnancy or in the postpartum period. It is important the pre-eclampsia is caught early so it does not progress to eclampsia. Eclampsia is severe pre-eclampsia with seizures.

Pre-eclampsia is caused by placental and maternal vascular factors and the treatment for pre-eclampsia involves delivery and the management of symptoms. Approximately 90 percent of cases present in the late preterm (≥34 to <37 weeks), term (≥37 to <42 weeks), or postpartum (≥42 weeks) period.

Listen in as Dr. Abdelhak walks through this over view of the signs and symptoms of pre-eclampsia each woman needs to self monitor for to avoid this severe complication of pregnancy.

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Uterine rupture is a complication of labor and delivery that is most often associated with women who are undergoing a vaginal birth after cesarean (VBAC) or a trial of labor after cesarean (TOLAC).

The incidence of uterine rupture is approximately 0.3 percent (300 ruptures per 100,000 deliveries) and in a hospital setting are associated with excellent outcomes in which the mother and baby are both unaffected. In this episode, Dr. Abdelhak reviews why concern over uterine rupture (a rare event) should not prevent a woman from attempting a trial of labor after cesarean delivery if she so desires.

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Acid reflux or "gastroesophageal reflux disease (GERD)" pregnancy is when the acid that is normally found in your stomach backs up into your esophagus. The esophagus is the tube that carries food from your mouth to your stomach.

This is a common condition in pregnancy that tends to be found in the second and third trimesters primarily. The good news is it goes away shortly after birth and there are many safe remedies during all trimesters.

The most common non medication recommendations typically include

Avoiding lying down after eating
Avoiding eating near bedtime
Avoid tight fitting bras or clothing
Avoid triggers such as fatty foods, chocolate, spicy and sugars
Sleep with the head raised on a pillow or wedge

The common medications such as antacids surface agents, histamine blockers and proton pump inhibitors are discussed in more detail in this podcast. Enjoy! And may you have a True Birth!

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Induction of labor is safe for women who have had a previous cesarean birth and would like to have a VBAC (vaginal birth after cesarean) and is an options that can be considered. Women who are in need of a induction for medical reasons or because an induction will help facilitate a vaginal birth are not prevented from doing so because they have had a previous cesarean birth. However, there are special considerations for these women.

On average, roughly 60 percent of women who are attempting a TOLAC (trial of labor after cesarean) and are undergoing an induction are successful. Yet Dr. Abdelhak has success rates that are much higher nearing 80-85 percent year over year.

Check out this latest episode to see what the king of VBACs has to say about induction of labor in a VBAC and why his approach is so successful

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There is no known threshold below which the number of repeat cesarean deliveries can be guaranteed to be uncomplicated. In this episode, Dr. Abdelhak discusses having multiple cesarean births.

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Recently, Dr. Abdelhak was interviewed by Elisabeth Sherman for Input Magazine www.inputmag.com about an article relating to the use and addiction of internet chat groups in pregnancy and this got us thinking about the overall use of the internet in pregnancy. What role does the internet play in pregnancy? How useful is it? And, how much should a woman and her family rely on the internet and its information when making decisions about their health and pregnancy?

Btw, you can check out that great article here.

The internet can be overwhelming. We quickly went from a dearth of information in pregnancy to an over abundance (a TMI, if you will) in just under a decade. Anyone can post a blog or a vlog and print has a semblance of authority, making it hard to decern what is correct and what is hogwash. Listen in as these two pregnancy experts weigh in on what the internet has to offer for pregnancy and how to utilize this information effectively.

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Traveling in pregnancy is generally considered to be safe for most women. It is typically recommended to check in with your medical provider before booking your trip and before going away on your trip. The biggest risk the travel itself typically poses is being away from your primary medical provider and not the travel itself, via air, train, ship or car.

There also is the the potentially increased risk of exposure to infectious diseases such as Zika, malaria and SARS-CoV-2 and each of these should be considered with your provider based on your gestational age and destination.

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When there is a loop of umbilical cord around the baby's neck in the womb it called a nuchal cord. This is actually a common ad normal finding during labor and delivery.

Medically speaking the term nuchal cord is define as: an umbilical cord that passes 360 degrees around the fetal neck. They are classified as single or multiple and tight and loose. Single is more common than multiple and loose is more common than tight.

The incidence of nuchal cords is roughly about 25 percent at term and is associated with increased fetal movement and longer umbilical cords.

Listen in as Dr. Abdelhak and Kristin talk about their experience with umbilical cords around the neck with over 10,000 births between them.

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Sweeping the membranes is a great tool that is often used at the end of the 9th month to help stimulate contractions or labor.

It is typically performed during an office visit when and the cervix needs to be partially dilated in order for it to be effective. The OB will typically insert one finger on a vaginal exam beyond the internal cervical os and then rate the finger circumferentially along the lower uterine portion of the uterus/cervix to pull the uterus away from the fetal membranes. This helps to simulate the body into labor and is more effective as a woman approaches her due date and beyond.

Stripping or sweeping the membranes before labor has begun is associated with better outcomes in birth such as lower c-sections and shorter durations of pregnancy (i.e. less chance of going overdue). This is a great tool that many OBs will use to help to stimulate labor and assist a woman

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Shoulder dystocia is when the shoulders fail to delivery easier after the fetal head. If the shoulders do not deliver easily with a few simple maneuvers it is considered an obstetric emergency. Shoulder dystocia is not always easy to anticipate and prevent, and often occurs in the absence of risk factors.

The incidence of shoulder dystocia is 0.2 to 3 percent of births and the calm trained demeanor of an expert birth professional is paramount to navigating these situations with confidence.

In this episode, Dr. Abdelhak walks us through how to approach this labor room situation.

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Dr. Abdelhak answered some weekly questions about pregnancy.

If you have any comments or questions you would like us to answer please connect with us!

We would love to hear from you about your birth experiences or anything you would like us to address about labor, birth pregnancy or postpartum on this podcast. Reach out to us at www.truebirthpodcast.com

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Long gone is the thought of once a cesarean always a cesarean. Women who have had a cesarean delivery in the past have the option of undergoing a trial of labor after cesarean (TOLAC) delivery or planned repeat cesarean delivery (PRCD) in their next pregnancy. Ideally, a planned TOLAC leads vaginal birth after cesarean (VBAC) but may end in an unplanned cesarean delivery.

How to decide if you are a good candidate for a TOLAC, VBAC or PRCD can be a hard choice for women to make. In this episode, we aim to give women some confidence in their choice regarding how they give birth after a cesarean. It is important to take into account personal preferences, as well as medical and pregnancy history

Other factors that influence a women's decision include the chance that a woman will end up with a VBAC based on various factors as well as a woman's chance of uterine rupture.

If you have any comments or questions about VBAC please connect with us!

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How much weight gain in pregnancy is normal? The answer is it's individual and unique for each woman. Excessive weight gain can pose problems in pregnancy and is not typically recommended but in general there are several factors that contribute to what is normal and what is an acceptable amount.

There have been several guidelines outlining the appropriate levels of weight gain in pregnancy and they can vary.

Generally physiologically weight gain is as follows

Fetus – 7 to 8 lb (3.2 to 3.6 kg)
Fat stores – 6 to 8 lb (2.7 to 3.6 kg)
Increased blood volume – 3 to 4 lb (1.4 to 1.8 kg)
Increased extravascular fluid volume – 2 to 3 lb (0.9 to 1.4 kg)
Amniotic fluid – 2 lb (0.9 kg)
Breast enlargement – 1 to 3 lb (0.45 to 1.4 kg)
Uterine hypertrophy – 2 lb (0.9 kg)
Placenta – 1.5 lb (0.7 kg)

Weight loss can also happen and can even be considered normal in the beginning of pregnancy. In this episode, pregnancy (gestational) weight gain is meant to be a personal and individual discussion with a woman an her provider.

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Assisted vaginal delivery (also known as operative vaginal delivery) is when the doctor or midwife assists the woman to delivery using forceps, a vacuum, or other devices to extract the baby from the vagina during the second stage (pushing stage) of labor. There are several factors that go into the decision of when to use an instrument to aid a woman in the delivery of her baby. These factors both maternal and fetal are discussed in this episode. In general, this type of assistance is given in lieu of a cesarean birth.

The prevalence of assisted vaginal delivery with forceps or vacuums is around 3-4.5%. Forceps are utilized much less commonly and account for approximately 0.5 percent of vaginal births, and vacuum deliveries accounted for 2.6-4 percent of vaginal births.

Forceps can be used to delivery the head and or rotate the head to an optimal position for delivery. Different type of forceps can be utilized: outlet forceps, low forceps and mid forceps.

Vacuum deliveries do not have a separate classification system and the rotation of the baby's head is not performed with vacuum deliveries.

We have included a video link here with some explanations of birth forceps and vacuum.

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Cervical insufficiency (previously termed cervical incompetence) is defined as recurrent and painless cervical dilation leading to pregnancy loss typically in the second trimester.

While we addressed the primary cause of unexplained second trimester loss in a previous podcast episode, this is a common explainable reason for pregnancy loss in the second trimester. Cervical weakness or insufficiency may be a result of trauma to the cervix, prior cervical or uterine surgery (eg, LEEP, dilation and curettage, hysteroscopy) or a congenital (birth) abnormality.

Cerclage is a wonderful treatment (both preventative and therapeutic) for cervical insufficiency. In this episode, we review the different types of cerclage and when in a pregnancy they can be placed. A preventative cerclage or a history-indicated cerclage is usually performed at 12 to 14 weeks. Whereas a rescue cerclage and an emergency cerclage are performed later in the second trimester.

The two most common transvaginal techniques for cerclage were described by Shirodkar and McDonald techniques. You can see the video which explains them in more detail.

Dr. Abdelhak explains his rationale for each type of cerclage and when as well as briefly discusses the abdominal cerclage.

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The occiput posterior position otherwise known as the OP position is important to familiarize yourself with because it is the most common fetal malposition in labor. It can be associated with assisted vaginal delivery (aka operative vaginal delivery) and even cesarean delivery.

In this episode, we review the OP position, why it should and should not happen and what can be done about it.

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Dr. Yaakov Abdlehak and Kristin Mallon, CNM discuss listener mail and change their thinking on hyperemesis gravidarum. You can now see the updated show notes for episode 6 about hyperemesis in pregnancy.

True Birth is all about raw honest truths when it comes to labor, delivery, pregnancy and the postpartum period helping women have better births and better birth experiences.

The whole essence of this podcast is we are telling you the way pregnancy and birth really is. We are not sugar coating it and we are not just reading from the book. We are two practicers in the trenches on the labor floor everyday telling you the truth about birth.

We are going to give you the truths as we see them that are not diluted or even mitigated by what the convention of today is. We are giving the truth as the way forward and the way to start thinking about birth. We'll share stories from the labor room from the professional's perspective. We provide an all-about pregnancy and birth through the eyes of Dr. Yaakov Abdelhak, a NYC metro area Perinatologist, Maternal Fetal Medicine Doctor and his trusty side kick Certified Nurse Midwife Kristin Mallon.

We would love to hear from you and you can reach out to us on our podcast page at truebirthpodcast.com

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We're back with the second part of this information and extremely important episode about perinatal loss. We want to remind everyone that while Pregnancy and Infant Loss Remembrance Day is October 15, any day is a good time to reach out and show support to your friends and family who have experienced this type of profound loss. Our perinatal loss support information can be found here The March of Dimes is one of the most well-known and well-established organizations focusing on pregnancy health. March of Dimes has a lot of information on the causes and possible prevention of premature birth, a leading cause of infant death, and it is involved in numerous advocacy efforts to drive research into ways to prevent birth defects and infant death.

As a start, every woman who is pregnant should be aware of the risk factors for premature birth as well as the signs and symptoms of premature labor.

The International Stillbirth Alliance (ISA) is a coalition of stillbirth awareness groups and organizations that work to promote stillbirth research and awareness of stillbirth. The group offers support resources for parents as well as information about ongoing research into stillbirth. The Miscarriage Association is a UK-based support association that offers many resources to help families cope with miscarriage and to spread awareness of miscarriage. They use the general term miscarriage but include support for those who have had an ectopic pregnancy or molar pregnancy as well. The group has a network of support volunteers who can lend a listening ear The miscarriage association also provides information to help people better understand everything from the tests done to look for a miscarriage, to information on "trying again" after your loss.

Sands stands for Stillbirth and Neonatal Death Support. This group is based in the UK, but Sands has chapters in countries around the world. The group offers support to all individuals affected by stillbirth or loss of a newborn infant, and its website includes information on local groups and advocacy opportunities.

Sands also recognizes the importance of bereavement care,2 which has, unfortunately, been addressed to a less degree than the symptoms and treatment of pregnancy loss.

The Compassionate Friends (TCF) is not exclusively focused on pregnancy loss but focuses on providing support for bereaved families who are grieving the death of a child. The group does offer information and support for pregnancy loss of any kind.

The MISS Foundation focuses on crisis support and other aid to families grieving the loss of a child. The group is not exclusively focused on pregnancy loss but is involved in a lot of activities related to miscarriage and stillbirth awareness, such as the MISSing Angels Bills that have been considered or passed in many U.S. states with the idea of granting parents the right to receive a state-issued certificate of stillbirth recognizing the loss of a baby to stillbirth.

The Center for Loss in Multiple Birth (CLIMB) offers support to parents who have lost babies in multiple pregnancies, including those who have lost all babies in the pregnancy as well as those who have lost one twin.

The site offers fact sheets aimed at dads, grandparents, siblings, and survivors as well as information about research into this type of pregnancy loss.

Helping After Neonatal Death (HAND) is a California support group for late pregnancy loss and neonatal loss. Its website features fact sheets and information about local groups in northern California. The group also offers two in-person support groups as well as phone support for grieving parents.

Even if you are not a California native, the HAND website provides support, including letters addressed to parents, friends , and family, and even health care professionals who are facing the grief which accompanies stillbirth and neonatal death.

The Ectopic Pregnancy Trust is a group sponsored by London's King College Hospital. The website has information on the causes and treatment of ectopic pregnancy, as well as support forums. The group supports research into early diagnosis of ectopic pregnancy and means of prevention.

The website (of course, easily accessible to those outside the UK) has abundant resources with information on a number of topics surrounding ectopic pregnancy. It even has information for dad's and ectopic pregnancy, recognizing the difficulties faced by those who are "so close but yet so far."

Tommy's functions as something of a UK-based March of Dimes equivalent. The group has information on how to have a healthy pregnancy and prevent any preventable stillbirths or preterm births. The group also supports research on miscarriage prevention and causes

Western New York Perinatal Loss Center https://wnypbn.org In order to get on our email subscription list and never miss a book update, sign up at www.truebirthpodcast.com

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Perinatal loss is a profound experience for women and her family. Examples of perinatal loss include miscarriage, ectopic pregnancy, stillbirth, neonatal death, and other losses. In this episode. Dr. Abdelhak specifically examines unexplained loss which most often will happen in the second trimester at 13 weeks to 28 weeks, but in rare occasions this type of loss will happen in the third trimester as well. We tread lightly. We share our same true-birth-ism that are part of each episode and we honor and support those in our families and communities who have experiences such sorrow. These truths are keeping the conversation going, sharing new information as we think differently about this heartbreaking experience. We hope to this knowledge can bring a sliver of peace to a mourning family. Our perinatal loss support information can be found here The March of Dimes is one of the most well-known and well-established organizations focusing on pregnancy health. March of Dimes has a lot of information on the causes and possible prevention of premature birth, a leading cause of infant death, and it is involved in numerous advocacy efforts to drive research into ways to prevent birth defects and infant death.