We sit down with Joshua Oommen to get nerdy about clinical reasoning, FDA standards, and why “good evidence” is harder to define than most of us admit. We challenge the reflex to trust p-values and meta-analyses, then test our instincts against real OBGYN examples where the literature has whiplashed practice.
• why the podcast is called Thinking About OBGYN and how clinical reasoning shapes our work
• the NEJM proposal to make one pivotal trial the FDA default and what “confirmatory evidence” might mean
• medical reversal, surrogate endpoints, and how trust erodes when practice changes late
• why Bayesian thinking fits how clinicians interpret tests, trials, and prior beliefs
• how meta-analyses fail through small study effects, publication bias, p-hacking, and heterogeneity
• the amnioinfusion comeback as a case study in applicability and overconfident conclusions
Be sure to check out thinking about obgyn.com for more information and be sure to follow us on Instagram.

0:00 Welcome And Today’s Big Question

3:48 Why “Thinking About OBGYN” Exists

11:54 The NEJM Push For One Trial

16:38 Medical Reversal And Trust Problems

24:43 AI Proteins And CRISPR Pressure Tests

32:33 Bayes Thinking Beyond P Values

36:43 Why Meta-Analyses Often Mislead

41:08 Bias And Heterogeneity Red Flags

46:24 Amnioinfusion And A Meta-Analysis Comeback

1:02:29 Final Warnings And How To Learn

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We bring back the biggest takeaways from the ACOG ACSM, then move fast through the newest guidance and the newest hype shaping real OBGYN care. We focus on what the evidence actually supports, where practice still lags behind, and how “labels” can quietly push patients toward harm.

• conference highlights including rural OBGYN access and what gets attention on the exhibit floor
• vitamin K shot refusal trends and why late bleeding still matters weeks after birth
• 2026 ACOG cervical cancer screening changes with primary HPV testing preferred for ages 30 to 65
• self-collected HPV screening and the systems needed to keep follow-up safe
• why annual Pap testing and cytology-only strategies increase overdiagnosis and can miss HPV risk
• postmenopausal bleeding workup shifting toward ultrasound plus endometrial biopsy up front
• large baby induction data and why outcomes can worsen without neonatal benefit
• third-trimester ultrasound screening performance and the real-world labeling effect
• early proof-of-concept therapy for preeclampsia targeting sFlt1 removal to prolong pregnancy
• hysterectomy duration and route as drivers of venous thromboembolism risk
• laboring down claims from retrospective reports versus randomized trial findings
• debunking physiologic third stage claims and reaffirming active management to prevent hemorrhage

Be sure to check out thinkingaboutobgyn.com for more information, and be sure to follow us on Instagram.

0:00 ACOG Meeting Takeaways And Rural Access

3:58 Vitamin K Refusal And Newborn Bleeding

6:37 Cervical Screening Moves Toward HPV

14:48 Postmenopausal Bleeding Now Needs Biopsy

20:00 Tylenol Data And Macrosomia Induction

28:34 Ultrasound Labeling Effect And Liability Fears

37:29 Removing sFlt1 To Buy Time

40:14 Longer Hysterectomy Surgeries Raise VTE Risk

42:14 Laboring Down Claims Versus RCT Reality

49:59 Counseling Fatigue Without Ignoring Risk

54:21 Third Stage Myths And Hemorrhage Prevention

58:42 Evidence Literacy And Closing Notes

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We answer vaccine questions head-on, using real numbers to separate online fear from how vaccines, immunity, and public health actually work. We break down why diseases feel “gone,” what the modern schedule really exposes babies to, and how to spot misleading claims around ingredients, autism, and VAERS. Featuring Kate Moloney and our vaccine-hesitant friend Anah.

• why vaccine success makes diseases look eradicated while risk returns when coverage drops
• Stanford modeling estimates for measles, diphtheria, polio, and rubella without vaccination
• meningococcal meningitis basics, who is most at risk, and why outcomes can be catastrophic
• why clean water and sanitation do not explain protection from droplet-spread viruses
• what antigens are and why antigen exposure is far lower than decades ago
• downsides of delaying vaccines including longer vulnerability and more office visits
• aluminum, formaldehyde, and mercury claims explained with real-world comparisons
• “natural immunity” tradeoffs including measles pneumonia, immune amnesia, and SSPE
• long flu and post-viral inflammatory syndromes as quality-of-life consequences
• how vaccine schedules change, why the autism claim is debunked, and what profit incentives really look like
• what VAERS can and cannot tell you, plus how bias and viral claims distort reports
• why newborn hepatitis B vaccination exists, screening gaps, and true serious side effects
• rubella history and why vaccination primarily protects fetuses

1:05 Do We Vaccinate Too Much

3:32 Modeling A World Without Vaccines

6:20 Meningitis And Fast Catastrophes

8:28 Clean Water Is Not A Vaccine

11:02 Antigens And The Modern Schedule

15:44 Why Spacing Shots Can Backfire

16:53 Aluminum Formaldehyde Mercury Facts

22:00 Natural Immunity And Measles Damage

26:16 Long Flu And Post Viral Illness

28:26 Profit Fears And Autism Claims

31:26 VAERS Limits And Bad Math

38:39 Why Newborns Get Hepatitis B

45:09 Real Side Effects And Detox Scams

48:37 Rubella And Protecting Fetuses

51:57 Final Takeaways And Next Steps

Be sure to check out thinkingaoutobgyn.com for more information and be sure to follow us on Instagram.

Follow us on Instagram @thinkingaboutobgyn.