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

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

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

00:00:00 Opening Banter & Autism Claims

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

00:09:54 Why Speed in Surgery Matters

00:15:35 Surgeon Variability and Outcomes

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

00:27:20 Less Bleeding Through Minimal Dissection

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

00:35:05 Confidence vs Arrogance in the OR

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

00:45:05 Visualization, Assisting, and Debriefing

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

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

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We push back on claims that Tylenol or vaccines cause autism and explain how weak methods, conflicts of interest, and cherry-picked data fuel public panic. We also unpack why diagnoses have risen—broad criteria, screening, and access—not because of a new environmental villain.

• Summary of claims made at the press event and why they fail
• What the cited acetaminophen paper did and didn’t show
• Conflicts of interest, pay-to-publish venues, and bias
• Why correlation isn’t causation; confounding by indication
• Bradford Hill criteria applied to acetaminophen and autism
• Sibling-controlled studies as the strongest current evidence
• Amish and Cuba myths; diagnosis versus true prevalence
• DSM-5 changes driving higher autism diagnoses
• State-by-state variation explained by services and funding
• Vaccine safety evidence contrasted with myths
• Practical counseling: treat fever; use clear, strong evidence

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

0:00 Setting The Record Straight

2:30 The Press Conference Claims

5:30 Tylenol, Vaccines, And Autism

9:30 The Study Behind The Hype

14:30 Conflicts, Bias, And Bad Methods

19:30 Correlation Isn’t Causation

23:00 Bradford Hill 101

28:30 Amish, Cuba, And Diagnosis Rates

33:30 Screening Tools And Subjectivity

37:30 Sibling Studies: The Strongest Signal

42:00 Why Meta-Analyses Can Mislead

46:00 What The “Navigation Guide” Misses

51:00 Vaccine Myths In Perspective

54:00 Why Autism Diagnoses Rise

59:00 DSM-5 And Access To Services

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Dr. Howard Harrell explores common questions about birth alternatives posed by Anna, a mom-to-be with questions, examining scientific evidence behind claims often found online that challenge evidence-based obstetric practices. The discussion separates facts from philosophy by analyzing actual research data on interventions like epidurals, oxytocin, and birthing positions.

• Maternal mortality has decreased 173-fold since 1850, coinciding with the rise of modern obstetrics
• The "cascade of interventions" theory isn't supported by scientific evidence
• Studies show epidurals don't increase cesarean delivery rates, contrary to popular belief
• Oxytocin augmentation, when properly used, can decrease cesarean rates rather than increase them
• Upright birthing positions don't show improved outcomes compared to lying on back
• Hospital/provider cesarean rates matter more than specific interventions in predicting your risk
• For low-risk pregnancies, intermittent rather than continuous fetal monitoring may reduce unnecessary interventions
• Best approach combines respecting physiologic birth while using appropriate medical tools when needed

Visit thinkingaboutobgyn.com for more information and follow us on Instagram. We'll be back in two weeks.

00:00:02 Introduction to Natural Birth Questions

00:02:09 Historical Maternal Mortality Statistics

00:05:54 Nutrition Myths and Modern Food Safety

00:11:34 Debunking the Cascade of Interventions Theory

00:21:32 Epidurals: Facts vs. Misconceptions

00:35:59 Birth Positions and Perineum Protection

00:44:20 Avoiding Unnecessary Cesareans

00:48:56 Continuous vs. Intermittent Fetal Monitoring

00:56:24 Artificial Rupture of Membranes Discussion

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