True Birth

Helping women have better births and better birth experiences. Our experts share their perspectives on pregnancy, childbirth and the postpartum period. These are raw, honest stories about the experience of labor from the professional's point of view. Listen and get inside your OB/GYN or midwife's head. Our goal is to share the truth about pregnancy and birth with the listener and to explain our thought process. We see our role as one in which we guide and inform, presenting facts so that the laboring mother can make the best decisions for her. If there are concerns during pregnancy or issues that need to be addressed before the birth, we present them, opening a dialogue and encouraging conversation; we give the options, but we can not and will not decide for the patient. We leave it up to her and her family. We are here to be as straightforward and transparent as possible and help a birthing woman have the optimal pregnancy, labor and birth experience. We serve the truth straight up in common English and steer clear of medical jargon. Our goal is to make medicine, obstetrics, and all relevant information as easily digestible as possible for the listener to enjoy, share and learn from. Each episode covers birth and prenatal topics through the eyes of Dr. Yaakov Abdelhak, a NYC metro area Perinatologist and Maternal Fetal Medicine Doctor, and his trusty side kick, Certified Nurse Midwife Kristin Mallon.

Re-Release: Epidurals in Labor & Delivery: Episode #78 06/09/2025

Re-Release: Epidurals in Labor & Delivery: Episode #78 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. When it comes to managing labor pain, epidurals are one of the most commonly requested and effective options. But despite their widespread use, many expecting parents still have questions or concerns. Here’s what you need to know. An epidural is a type of regional anesthesia that blocks pain in a specific part of the body—most commonly from the waist down. It’s administered through a small catheter placed in the lower back and can significantly reduce the intensity of contractions without making you drowsy or disconnected from the birth experience. One of the biggest benefits of an epidural is flexibility. It can be adjusted throughout labor depending on your needs and comfort. Some people feel enough relief to rest, while others maintain enough sensation to push effectively during delivery. Contrary to popular myth, an epidural does not usually slow labor or increase the risk of cesarean delivery in most healthy pregnancies. Like all medical interventions, epidurals do carry some risks—such as a drop in blood pressure, headache, or in rare cases, complications related to placement. However, for many, the benefits far outweigh the risks, especially when monitored by an experienced anesthesiologist. Choosing pain relief is a deeply personal decision. Whether you plan to get an epidural, go unmedicated, or keep your options open, the most important thing is that you feel supported, respected, and informed. Remember, there’s no one “right” way to give birth. Empowered birth is about making choices that align with your values, goals, and comfort. An epidural doesn’t take away your strength—it supports your journey. Our practice website can be found at: Maternal Resources: Remember to subscribe wherever you get your podcasts. Please consider leaving us a review on iTunes Our Social Channels are as follows Twitter: YouTube: IG: Facebook: /episode/index/show/truebirth/id/22120916

Fetal Head Size in Pregnancy: Episode #182 05/27/2025

Unicornuate Uterus: Episode #181 05/20/2025

Unicornuate Uterus: Episode #181 Understanding Unicornuate Uterus: What It Is, Prevalence, Risks, and a Positive Outlook A unicornuate uterus is a rare congenital condition where the uterus develops with only one half, or "horn," instead of the typical two-horned shape of a normal uterus. This happens during fetal development when one of the Müllerian ducts, which form the uterus, fails to develop fully. As a result, the uterus is smaller, has only one functioning fallopian tube, and may or may not have a rudimentary horn (a small, underdeveloped second horn). This condition falls under the category of Müllerian duct anomalies, which affect the female reproductive tract. For those diagnosed, understanding the condition, its implications, and the potential for a healthy pregnancy can provide reassurance and hope. What Is a Unicornuate Uterus? The uterus typically forms as a pear-shaped organ with two symmetrical halves that fuse during fetal development. In a unicornuate uterus, only one half develops fully, creating a smaller-than-average uterine cavity. This anomaly can occur with or without a rudimentary horn, which may or may not be connected to the main uterine cavity. If a rudimentary horn is present, it might cause complications like pain if it accumulates menstrual blood, as it often lacks a connection to the cervix or vagina. The condition is often diagnosed during routine imaging, such as an ultrasound, MRI, or hysterosalpingogram (HSG), typically when a woman seeks medical advice for fertility issues, pelvic pain, or irregular menstruation. In some cases, it’s discovered incidentally during pregnancy or unrelated medical evaluations. How Prevalent Is It? Unicornuate uterus is one of the rarest Müllerian duct anomalies, occurring in approximately 0.1% to 0.4% of women in the general population. Among women with Müllerian anomalies, it accounts for about 2% to 13% of cases. The condition is congenital, meaning it’s present at birth, but it often goes undiagnosed until adulthood because many women experience no symptoms. Its rarity can make it feel isolating for those diagnosed, but awareness and medical advancements have made it easier to manage and understand. Risks Associated with Unicornuate Uterus While many women with a unicornuate uterus lead healthy lives, the condition can pose challenges, particularly related to fertility and pregnancy. The smaller uterine cavity and reduced endometrial surface area can increase the risk of certain complications, though these are not inevitable. Below are some potential risks: Fertility Challenges: The smaller uterus and single fallopian tube may slightly reduce the chances of conception, especially if the rudimentary horn or other structural issues interfere with ovulation or implantation. However, many women with a unicornuate uterus conceive naturally without intervention. Miscarriage: The limited space in the uterine cavity can increase the risk of miscarriage, particularly in the first trimester. Studies suggest miscarriage rates may be higher (around 20-30%) compared to women with a typical uterus, though exact figures vary. Preterm Birth: The smaller uterus may not accommodate a growing fetus as easily, potentially leading to preterm labor or delivery before 37 weeks. Research indicates preterm birth rates in women with a unicornuate uterus range from 10-20%. Fetal Growth Restriction: The restricted uterine space can sometimes limit fetal growth, leading to low birth weight or intrauterine growth restriction (IUGR). Malpresentation: Babies in a unicornuate uterus may be more likely to position themselves in a breech or transverse position due to the confined space, which could complicate delivery. Cesarean Section: While not mandatory, a cesarean may be recommended in cases of malpresentation, preterm labor, or other complications. However, this is not a universal requirement. Other Complications: Women with a unicornuate uterus may have a higher risk of endometriosis or painful periods, especially if a non-communicating rudimentary horn is present. Kidney abnormalities are also associated with Müllerian anomalies, as the kidneys and reproductive tract develop simultaneously in the fetus. Despite these risks, it’s critical to note that not every woman with a unicornuate uterus will experience these complications. With proper medical care, many achieve successful pregnancies and deliveries. A Positive Outlook: Normal Vaginal Delivery Is Probable The diagnosis of a unicornuate uterus can feel daunting, but it’s important to emphasize that a healthy, full-term pregnancy and a normal vaginal delivery are entirely possible. Advances in obstetrics and prenatal care have significantly improved outcomes for women with this condition. Here’s why you can remain optimistic: Personalized Care: Working with an experienced obstetrician or maternal-fetal medicine specialist ensures close monitoring throughout pregnancy. Regular ultrasounds can track fetal growth, position, and amniotic fluid levels, allowing for timely interventions if needed. Not Doomed to Cesarean: While some women may need a cesarean due to specific complications, many with a unicornuate uterus deliver vaginally without issue. The decision depends on factors like fetal position, labor progression, and overall health, not the uterine anomaly alone. Full-Term Pregnancies Are Achievable: With careful monitoring, many women carry their pregnancies to term (37-40 weeks). Preterm birth is a risk, but it’s not a certainty, and modern neonatal care can support babies born slightly early if needed. Healthy Babies: Countless women with a unicornuate uterus give birth to healthy, thriving babies. The condition does not inherently affect the baby’s development or genetic health. Support and Advocacy: Connecting with others who have similar experiences, whether through online communities or support groups, can provide emotional strength and practical advice. Knowing you’re not alone can make all the difference. A unicornuate uterus is a rare but manageable condition that requires awareness and, in some cases, specialized care. While there are risks to consider, they are not insurmountable, and many women with this anomaly experience successful pregnancies and vaginal deliveries without complications. With the right support, you can embrace your unique journey, knowing that a unicornuate uterus does not mean you’re destined for preterm birth, cesarean delivery, or pregnancy complications. Instead, it’s a testament to your resilience and the incredible capabilities of modern medicine to support you every step of the way. Connect With Us: YouTube: Dive deeper into pregnancy tips and stories at . Instagram: Follow us for daily inspiration and updates at . Facebook: Join our community at Tiktok: Grab Our Book! Check out The NatureBack Method for Birth—your guide to a empowered pregnancy and delivery. Shop now at . /episode/index/show/truebirth/id/36640040

Re-Release: C-Section Delivery Done Right: Dr. Abdelhak's Cesarean Birth Guide. Episode #50 05/12/2025

Re-Release: C-Section Delivery Done Right: Dr. Abdelhak's Cesarean Birth Guide. Episode #50 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. To connect with us, Find us on: Maternal Resources Social Facebook: |nstagram: Subscribe to the podcast on and leave a review! /episode/index/show/truebirth/id/21081290

The Bad and the Ugly: RARE Life Complicating OB Conditions 05/05/2025

First Pregnancy vs Second: Episode #178 04/28/2025

First Pregnancy vs Second: Episode #178 First vs. Second Pregnancy: What to Expect According to Birth Experts Having attended over 10,000 births together, experienced Dr. Yaakov Abdlehak OB/GYN and certified nurse midwife Kristin Mallon consistently observe differences between first and second pregnancies — both in the body’s physical response and in the way care is personalized. 1. Labor tends to be faster in the second: In a first pregnancy ("primip"), the cervix, uterus, and pelvic floor are going through this process for the first time. Labor (especially early labor) is usually longer because the body is “learning” how to stretch and open. In a second pregnancy ("multip"), the cervix and uterus often respond more quickly. Labor tends to be shorter and more efficient — sometimes dramatically so. 2. Physical symptoms show up earlier in the second: Many women “show” earlier during the second pregnancy because the abdominal muscles and ligaments are already stretched from the first. Common symptoms like back pain, round ligament pain, and pelvic pressure may also appear sooner. 3. Confidence and mental preparation are different: First-time mothers often seek more reassurance, detailed explanations, and frequent check-ins because everything is new. Second-time mothers are often more tuned into their bodies, more trusting of the process, and ask for more autonomy. They typically want care that respects their previous experiences — whether that means avoiding past mistakes or replicating positive memories. Tune in and listen as these two experts dive into these and other topics, sharing real-world insights, practical advice, and what every mother should know for her first, second, and beyond. Connect With Us: YouTube: Dive deeper into pregnancy tips and stories at. Instagram: Follow us for daily inspiration and updates at . Facebook: Join our community at Tiktok: Grab Our Book! Check out The NatureBack Method for Birth—your guide to a empowered pregnancy and delivery. Shop now at . /episode/index/show/truebirth/id/36360810

Maternal Resources: How I Built This #177 04/21/2025

Manual Removal of the Placenta: Episode #176 04/15/2025

Swelling in Pregnancy: Edema Episode #175 04/07/2025

Swelling in Pregnancy: Edema Episode #175 In this episode, we dive into a common yet often confusing part of pregnancy: edema and swelling. From puffy ankles to swollen hands, many expectant parents experience some degree of swelling—but how do you know what’s normal and when it’s time to call your doctor? We break it all down for you with expert insights, practical tips, and clear guidance. What You’ll Learn: What is Edema? A quick look at why swelling happens during pregnancy, including the role of increased blood volume and pressure on veins. Normal vs. Concerning: How much swelling is typical, and what signs (like sudden swelling or headaches) might signal something more serious, such as preeclampsia. Real-Life Scenarios: Common areas of swelling (feet, ankles, hands) and when it’s just discomfort versus a red flag. Tips for Relief: Simple, safe ways to manage swelling—like elevating your legs, staying hydrated, and wearing compression socks. When to Seek Help: Clear advice on when to contact your healthcare provider and why it’s better to be cautious. Highlights: The surprising connection between salt intake and swelling—myth or fact? Why the third trimester often brings the most puffiness. A listener Q&A: “My rings don’t fit anymore—is this normal?” Whether you’re a first-time parent or a seasoned pro, this episode will help you navigate the ups and downs (and swells!) of pregnancy with confidence. Tune in for a mix of science, stories, and actionable advice! Connect With Us: YouTube: Dive deeper into pregnancy tips and stories at . Instagram: Follow us for daily inspiration and updates at . Facebook: Join our community at Tiktok: A Big Thank You: We’re so grateful you’re part of this journey! Let’s keep supporting, uplifting, and celebrating working moms and parenthood—together, we’re building a more nurturing, equitable world for everyone. Grab Our Book! Check out The NatureBack Method for Birth—your guide to a empowered pregnancy and delivery. Shop now at . /episode/index/show/truebirth/id/36036450

How to Be the Patient Docs Actually Look Forward to Seeing: Episode #174 03/31/2025

Attempting a VBAC after two Cesarean Births: Episode #173 03/24/2025

Prodromal Labor: Episode #172 03/17/2025

Bowel Movements in the Labor room 03/11/2025

Boarding Pass Blues: Finding Humor in Flying Headaches (and a Bit about Pregnancy) 03/03/2025

Natural Breech Delivery: Step by Step - Episode #169 02/24/2025

Exercise in Pregnancy: Episode #168 02/18/2025

Listener Mail: Episode #167 02/11/2025

Prenatal Lab Tests in Pregnancy. Episode #166 02/04/2025

Prenatal Lab Tests in Pregnancy. Episode #166 During pregnancy, lab tests play a crucial role in monitoring both maternal and fetal health, ensuring early detection of potential complications. Routine blood tests in early pregnancy include a complete blood count (CBC) to check for anemia or infections, blood type and Rh factor screening to prevent incompatibility issues, and tests for infectious diseases such as HIV, syphilis, and hepatitis B. Additionally, rubella immunity testing is done to assess whether the mother is protected against the virus, which can cause severe birth defects if contracted during pregnancy. Urinalysis is also standard to screen for infections, protein levels (which could indicate preeclampsia), and glucose levels, which may suggest gestational diabetes risk. Genetic screenings, such as non-invasive prenatal testing (NIPT) or carrier screening for conditions like cystic fibrosis and sickle cell disease, may also be recommended based on risk factors or family history. As pregnancy progresses, further lab tests are conducted to monitor emerging conditions and ensure fetal well-being. Between 24 and 28 weeks, the glucose challenge test (GCT) is typically performed to screen for gestational diabetes, a condition that can impact both mother and baby if left untreated. A repeat CBC may be ordered in the third trimester to reassess anemia, and Group B Streptococcus (GBS) testing is done around 36 weeks to determine whether antibiotics are needed during labor to prevent newborn infection. Additional testing, such as thyroid function tests, liver function tests, or expanded genetic screening, may be recommended based on the individual's health status and risk factors. These lab tests, combined with regular prenatal care, help guide clinical decisions, ensuring a safe pregnancy and a healthy birth outcome. 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 . 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: . You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement: Twitter: YouTube: Instagram: Facebook: 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. /episode/index/show/truebirth/id/35140545

Placenta Location: Does it Matter? Episode #165 01/27/2025

Placenta Location: Does it Matter? Episode #165 The location of the placenta plays a significant role in pregnancy and birth, but its impact can vary depending on specific circumstances. Placenta positioning is important for several reasons, particularly when it affects the path of delivery, but in many cases, it doesn’t interfere with the general progress of pregnancy or fetal movement. One of the key factors in the placenta’s location is whether it is positioned low in the uterus, a condition known as a low-lying placenta or placenta previa. This occurs when the placenta attaches near or over the cervix, the lower part of the uterus. When this happens, it can lead to complications, especially if the placenta partially or completely blocks the cervix (a condition known as placenta previa). In such cases, a vaginal delivery might be dangerous due to the risk of bleeding, and a cesarean section is usually recommended. Therefore, the location of the placenta in relation to the cervix is crucial for determining the safest mode of delivery. However, while the placement of the placenta can influence the type of delivery, it often doesn’t affect other aspects of the pregnancy, such as fetal movement. The baby’s ability to move inside the uterus is primarily determined by factors like amniotic fluid levels, the baby’s size, and the integrity of the uterine wall, rather than the exact position of the placenta. In fact, many pregnancies with low-lying placentas do not lead to significant movement restrictions, and fetal kicks and rolls are still felt in the usual manner. It’s also important to note that the placenta’s position can change over the course of the pregnancy. As the uterus grows, the placenta may shift, especially if it was initially low-lying. In many cases, what appears to be a low-lying placenta early in pregnancy will resolve by the time of delivery, with the placenta moving upward and away from the cervix, allowing for a vaginal birth. In summary, while the location of the placenta is crucial for determining the safest method of delivery, it does not generally interfere with other aspects of pregnancy like fetal movement. Conditions such as placenta previa or low-lying placentas are primarily concerning in terms of the risk they pose to the delivery process, but they are often not a barrier to a healthy pregnancy overall. 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 . 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: . You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement: Twitter: YouTube: Instagram: Facebook: 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. /episode/index/show/truebirth/id/35036945

The NatureBack Book: Episode #164 01/20/2025

The NatureBack Book: Episode #164 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 T. 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. 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 . 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: . You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement: /episode/index/show/truebirth/id/34906945

Amniotic Fluid: What's normal? Episode #163 01/14/2025

Amniotic Fluid: What's normal? Episode #163 Understanding Amniotic Fluid: What's Normal and What's Not Amniotic fluid is the protective liquid contained within the amniotic sac that surrounds a baby during pregnancy. This vital fluid plays a critical role in fetal development, providing cushioning, regulating temperature, and enabling the baby to move and grow within the uterus. It also facilitates the development of essential systems like the lungs, digestive tract, and musculoskeletal system. What Is Amniotic Fluid Made Of? Amniotic fluid begins to form around the 12th day of pregnancy and is initially composed of water from the mother. As the pregnancy progresses, it includes fetal urine, nutrients, hormones, and antibodies, creating a nutrient-rich environment for the growing baby. What's Normal? The amount of amniotic fluid changes throughout pregnancy, peaking around 34 weeks and then gradually decreasing. Here’s what’s considered normal: Volume: Typically, the amount of amniotic fluid ranges from 500 to 1,000 milliliters at term. Clear or Slightly Tinted Fluid: Normal amniotic fluid is clear or slightly yellow-tinted. Healthy Fetal Movement: Adequate fluid allows the baby to move freely, which promotes muscle and bone development. Doctors assess amniotic fluid levels using ultrasound and measure the Amniotic Fluid Index (AFI) or the Deepest Vertical Pocket (DVP) to ensure levels are within a healthy range. What's Not Normal? Abnormalities in amniotic fluid levels can indicate potential complications: Low Amniotic Fluid (Oligohydramnios): This condition occurs when fluid levels are too low and can lead to: Restricted fetal growth. Increased risk of umbilical cord compression. Complications during labor, such as reduced cushioning for the baby. Excess Amniotic Fluid (Polyhydramnios): Excess fluid can result from issues such as gestational diabetes, fetal anomalies, or infections. It may cause: Preterm labor. Difficulty breathing for the mother due to uterine overdistension. Increased risk of placental abruption or cord prolapse. Discolored Fluid: Green or Brown (Meconium-Stained Fluid): This indicates that the baby has passed its first stool in utero, which could signal fetal distress. Bloody Fluid: This may suggest complications like placental abruption or injury. Monitoring Amniotic Fluid Routine prenatal care includes monitoring amniotic fluid levels. If abnormalities are detected, your healthcare provider may recommend additional tests, interventions, or close monitoring to ensure the safety of both mother and 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 . 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: . You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement: Twitter: YouTube: Instagram: Facebook: 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 /episode/index/show/truebirth/id/34845120

Forensic Obstetrics Part 2: Episode #162 01/06/2025

Forensic Obstetrics Part 2: Episode #162 In obstetrics and medicine, uncovering the right diagnosis or understanding a patient’s medical history often involves piecing together subtle clues, much like solving a puzzle. While patients are typically reliable historians, there are moments when they may not recall specific events, procedures, or reasons for past medical decisions, especially during high-stress situations like childbirth or complex treatments. This can leave gaps in the story that require careful investigation and interpretation by the ob/gyn or midwife. In these moments, healthcare providers must rely on a combination of patient accounts, medical records, and clinical intuition to reconstruct the sequence of events. By asking targeted questions, reviewing past notes, or identifying patterns in a patient’s symptoms, clinicians can often uncover the critical details needed to make informed decisions. This detective work is essential not only for understanding what happened in the past but also for shaping the best course of action for the future, ensuring safe and personalized care. In this episode, we’ll explore compelling examples from our practice where connecting the dots and uncovering hidden clues led to key insights about a patient’s past. These stories highlight the art of medical investigation and the critical thinking required to provide exceptional care. Amniocentesis, once a hallmark of prenatal diagnostics, has become a relic of an earlier era in reproductive healthcare. The procedure, which involves extracting amniotic fluid with a needle to screen for genetic conditions, was groundbreaking in its time. But advances in non-invasive prenatal testing (NIPT) have rendered it largely unnecessary. NIPT, which analyzes fetal DNA from a simple maternal blood draw, provides highly accurate results for common chromosomal abnormalities without the risks of miscarriage associated with amniocentesis. The shift away from invasive procedures reflects a broader trend in medicine: the prioritization of safer, less disruptive technologies that yield similar or superior outcomes. While amniocentesis may still have a role in certain rare cases, its decline underscores how innovation can relegate once-essential tools to the margins of clinical practice, reshaping the landscape of prenatal care. 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 . 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: . You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement: Twitter: YouTube: Instagram: Facebook: 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. /episode/index/show/truebirth/id/34735655

External Cephalic Version (ECV) Step-by-Step Guide Episdoe #40 - Rerelease 01/01/2025

Amniocentesis - Do you need it? Episode #161 12/30/2024

Patient Feedback - Reading Client Reviews: Episode #160 12/23/2024

What to Expect at Your OB's doctor's office visits: Episode #159 12/09/2024

Spontaneous Labor vs. Induction of Labor: Episode #158 12/02/2024

Spontaneous Labor vs. Induction of Labor: Episode #158 When it comes to childbirth, many expectant parents envision waiting for labor to begin naturally. However, recent research, including the groundbreaking ARRIVE Trial (A Randomized Trial of Induction Versus Expectant Management), has reshaped how medical professionals approach labor and delivery, particularly for first-time moms. The ARRIVE Trial studied over 6,000 first-time mothers with low-risk pregnancies. It compared outcomes for those induced at 39 weeks of pregnancy with those who waited for labor to begin spontaneously. The results challenged traditional assumptions about induction, revealing several compelling reasons why induction of labor might be recommended: 1. Lower Cesarean Delivery Rates Contrary to concerns that induction might increase the likelihood of cesarean delivery, the ARRIVE Trial found the opposite. Women induced at 39 weeks had a significantly lower rate of cesarean births (18.6%) compared to those who waited for spontaneous labor (22.2%). This finding is critical, as cesarean delivery carries higher risks of complications and a longer recovery period for the mother. 2. Improved Outcomes for Babies Inducing labor at 39 weeks was associated with better neonatal outcomes. Babies born to mothers in the induction group were less likely to require respiratory support or experience other complications. This is significant because it underscores the potential for induction to enhance both maternal and neonatal health. 3. Reduced Risks Associated with Post-Term Pregnancies While 39 weeks is considered full term, waiting for spontaneous labor can sometimes lead to pregnancies extending beyond 40 weeks. Post-term pregnancies carry increased risks of complications, including stillbirth and meconium aspiration. By opting for induction at 39 weeks, providers aim to mitigate these risks while ensuring the baby is delivered at an optimal time. 4. Enhanced Predictability for Families For many first-time parents, induction offers a level of predictability. Knowing when labor will begin can help families plan for childcare, work leave, and support during delivery. This logistical benefit is often a practical consideration in recommending induction. 5. Alignment with Modern Maternal-Fetal Care The ARRIVE Trial highlights a shift in how healthcare providers view induction. Rather than considering it only when medically necessary, induction at 39 weeks for first-time moms is increasingly seen as a proactive approach to optimize outcomes. Importantly, this recommendation is tailored to women with low-risk pregnancies who meet specific criteria, ensuring that induction is not overused. Things to Keep in Mind While the ARRIVE Trial has influenced many obstetric practices, it’s essential to remember that each pregnancy is unique. The decision to induce labor should be based on a thorough evaluation of the mother’s health, the baby’s condition, and the preferences of the birthing person. Other Episodes that related to this topic: - NatureBack Philopsphy - Why Induction takes 24 hours or less 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 . 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: . You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement: Twitter: YouTube: Instagram: Facebook: 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. /episode/index/show/truebirth/id/34262620

Fasting in Pregnancy: Episode #157 09/30/2024

Fasting in Pregnancy: Episode #157 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 . 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: . You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement: Twitter: YouTube: Instagram: Facebook: 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. /episode/index/show/truebirth/id/33270362

PPROM (Preterm Premature Rupture of Membranes): Episode #156 09/03/2024

PPROM (Preterm Premature Rupture of Membranes): Episode #156 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 . 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: . You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement: Twitter: YouTube: Instagram: Facebook: 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. /episode/index/show/truebirth/id/32875910

The OB/GYN Shortage in the US: Episode 155 07/29/2024

The OB/GYN Shortage in the US: Episode 155 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 . 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: . You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement: Twitter: YouTube: Instagram: Facebook: 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. /episode/index/show/truebirth/id/32368187

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