ObGyn Intelligence: The Evidence of Women’s Health

ObGyn Intelligence: The Evidence of Women’s Health

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The Evidence-to-Practice Gap: Why It Takes 20 Years to Stop Doing Harm
The average lag between definitive evidence and guideline change was 10 to 20 years. For some practices, it was longer. The reasons haven’t changed.
 • Amos Grünebaum, MD
The Tests That Told Us Nothing: Estriol, L/S Ratios, X-Ray Pelvimetry, and Weekly Herpes Cultures
We spent millions on tests that didn’t predict what we needed to know. The evidence said so. We kept ordering them.
 • Amos Grünebaum, MD
Separated at Birth: How We Undermined Breastfeeding for Decades
Nursery separation, formula supplementation, immediate cord clamping, and 100% oxygen. Every one harmed the babies we were trying to protect.
 • Amos Grünebaum, MD
The Annual Exam Myth: How We Screened Too Often, Too Early, and for the Wrong Things
Annual Pap smears. Annual pelvic exams. CA-125 for ovarian cancer screening. We ordered them for decades. The evidence said they didn’t work. We ordered…
 • Amos Grünebaum, MD
Diazepam, Alcohol (Ethanol), and the Drugs We Used to Stop Seizures and Labor
The Collaborative Eclampsia Trial changed everything. So did the realization that IV alcohol doesn’t stop contractions.
 • Amos Grünebaum, MD
From Overtreatment to Precision: The Overtreated Cervix, the Morcellation Crisis, and the SHAPE Trial
We conized mild dysplasia that would have resolved on its own. We froze lesions we should have excised. We morcellated uteri containing cancers we…
 • Amos Grünebaum, MD
Tests and Treatments That Never Worked: The Infertility Edition
We scraped the uterus to help women conceive. We blew air through their tubes. We gave them clomiphene without watching what happened. We transferred…
 • Amos Grünebaum, MD
The Labor Curves That Weren’t: How Friedman’s Clock Led to Unnecessary Cesareans
Strict time limits in labor were based on a 1950s study of a highly selected population. We used them for 60 years.
 • Amos Grünebaum, MD
40 Years of Evidence, Zero Change in Practice: The EFM Problem
The Dublin trial showed continuous monitoring increased cesareans without improving outcomes. That was 1985. We are still doing it.
 • Amos Grünebaum, MD
The Hysterectomy Default: When Removing the Uterus Was the Answer to Everything
Fibroids? Hysterectomy. Bleeding? Hysterectomy. Pelvic pain? Hysterectomy. The United States performed more hysterectomies per capita than any other…
 • Amos Grünebaum, MD
Everything Worse: How Routine Episiotomy Persisted for Decades`
We were taught that a clean surgical incision done routinely healed better than a tear. We were wrong, and 90% of women got one anyway.
 • Amos Grünebaum, MD
Access Barriers Disguised as Safety: Norplant, Bone Warnings, and the Emergency Contraception Delay
We made contraception harder to get, harder to use, and harder to access in emergencies. We called it safety. It was paternalism.
 • Amos Grünebaum, MD
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