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She joined the MJH Life Sciences team in December 2019. She graduated from Youngstown State University in 2019 with a bachelor's degree in journalism and a minor in political science. Prior to graduating, Morgan worked as the editor-in-chief of her college newspaper. She went on to work as an assignment editor at a broadcast news station in Youngstown, Ohio, before joining 

 You can reach her at mebert@mjhlifesciences.com.

A new meta-analysis found no significant difference in wound complications between metal staples and subcuticular sutures for post-cesarean skin closure in obese patients.

No clear advantage of staples vs sutures found for cesarean closure in obese patients

A new study finds that patient-reported screening methods are highly effective for determining medication abortion eligibility.

History-based screening accurately identifies eligibility for medication abortion

A new ACOG clinical guidance offers updated recommendations on umbilical cord management for preterm births based on recent evidence and analysis.

ACOG updates clinical guidance on delayed umbilical cord clamping in preterm neonates

Stephanie Pearson, MD, FACOG, is a board-certified obstetrician-gynecologist, educator, and advocate for physician well-being based in the Philadelphia, Pennsylvania, area. After a shoulder injury during a critical delivery ended her medical practice, Pearson redirected her passion toward helping fellow physicians. Recognizing the critical importance of disability and life insurance, Pearson cofounded PearsonRavitz, an insurance brokerage and advisory firm serving all 50 states.

Stephanie Pearson, MD, provides some tips for ergonomics within obstetrics and gynecology.

Stephanie Pearson, MD, on ergonomics in ob-gyn: Beyond just standing straight 

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A Psychedelic to Treat Postpartum Depression?

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Challenge your diagnostic skills: What's your diagnosis based on these images from a 14-week fetus?

Image IQ: Fetal Abdomen in Early Second Trimester

The odds of never breastfeeding and of breastfeeding cessation are increased among women with hypertensive disorders of pregnancy (HDPs), according to a recent study published in 

HDPs have been reported as the leading cause of maternal and infant morbidity and mortality in the United States.

 However, these risks may be reduced through breastfeeding, based on data from previous studies.

 Breastfeeding is performed by 83% of US women at delivery, but only 25% exclusively through 6 months.

“Though other maternal comorbidities, including gestational diabetes, have been seen to negatively influence breastfeeding outcomes, little is known about breastfeeding outcomes for the 16% of US pregnant women with HDP compared with women without HDP,” wrote investigators.

Assessing breastfeeding duration and HDP diagnosis

The cross-sectional study was conducted to determine the impact of HDP exposure on never breastfeeding and breastfeeding cessation among US women. Data was obtained from the Centers for Disease Control and Prevention Pregnancy Risk Assessment Monitoring System.

Women with complete HDP data and a live infant at survey completion, alongside noninitiation or cessation of breastfeeding, were included in the analysis. Deliveries between 2016 and 2021 were eligible, with never breastfeeding and time to breastfeeding cessation in weeks reported as dependent variables.

Breastfeeding less than 1 week was categorized as cessation at 0.5 weeks. Other responses for breastfeeding included the exact breastfeeding duration in weeks and a response of “still breastfeeding.” HDP was defined as self-reported high blood pressure or hypertension, preeclampsia, or eclampsia before or during pregnancy.

Maternal age, insurance, race and ethnicity, household income, enrollment in the Women, Infants and Children program, educational level, and marital status were reported as covariates. Health-related covariates included preterm birth, singleton live birth, cesarean delivery, smoking in pregnancy, body mass index over 30, and gestational diabetes.

There were 205,247 women across 43 US states included in the final analysis, 0.8% of whom were American Indian, 5.3% Asian, 15% Black, 18% Hispanic, 50.8% White, 2.3% multiracial, and 0.7% other. Ninety-nine percent of samples were from first-time mothers, with 54% having private insurance and 91% delivering at term.

An HDP diagnosis was reported in 17% of participants, with women aged under 18 years or at least 35 years more likely to be diagnosed. Additional groups with an increased HDP prevalence included American Indian or Black women, not married, insured by Medicaid, and with a household income of $40,000 or less.

Women with HDP were also more likely to have a body mass index of 30 or higher, gestational diabetes, and to smoke. Infants of these women were more often born preterm, had a low birth weight, and were admitted to a hospital for over 5 days after delivery.

Breastfeeding initiation was reported in 85% of women with HDP vs 88% without. When adjusted for covariates, an odds ratio of 1.11 was reported for never breastfeeding among women with HDP. Race and ethnicity did not significantly influence this link.

The odds of breastfeeding cessation were also increased among women with HDP, with an adjusted HR of 1.17. The median time to breastfeeding cessation was 17 weeks among this population, vs 34 weeks among women without HDP. Since over 25% of the population was still breastfeeding at the last observation, an upper quartile was not obtained.

Race and ethnicity influenced the association between HDP and breastfeeding cessation. Asian, non-Hispanic Black, and American Indian patients had increased risks, with HRs of 1.34, 1.19, and 1.18, respectively. Overall, the data highlighted increased risks of never breastfeeding and breastfeeding cessation among women with HDP.

“Further analyses could inform tailored approaches to promote breastfeeding for dyads experiencing higher cardiometabolic risk and promote health equity for US women and infants,” wrote investigators.

Nardella D, Canavan ME, Taylor SN, Sharifi M. Hypertensive disorders of pregnancy and breastfeeding among US women. 

. 2025;8(7):e2521902. doi:10.1001/jamanetworkopen.2025.21902

Ford ND, Cox S, Ko JY, et al. Hypertensive disorders in pregnancy and mortality at delivery hospitalization - United States, 2017-2019. 

 2022;71(17):585-591. doi:10.15585/mmwr.mm7117a1

Women with hypertensive disorders of pregnancy are more likely to never start or stop breastfeeding early, according to a recent study.

Clinical

Hypertensive disorders in pregnancy linked to lower breastfeeding rates

Depression significantly worsens mothers’ ability to provide quality care across multiple parenting domains, according to a recent study published in the July issue of 

This provides a significant update to previously established data, which only included English-language reports published up to 2013. In the past decade, 97% of published studies reported a link between maternal depression and negative parenting practices.

"Understanding this relationship is crucial for developing effective psychological methods and interventions," said Tiago N. Munhoz, PhD, a psychologist at Federal University of Pelotas.

Articles published from November 2013 through 2023 were identified through searches of the PubMed, SciELO, BVS, LILACS, Web of Science, Embase, and PsychInfo databases. These included observational studies with participating mothers receiving a major depressive disorder (MDD) diagnosis or undergoing postpartum depression screening during postpartum or child youth.

Investigators screened 11,305 studies, with 166 undergoing full review by 2 independent reviewers.

 Gray literature was not included in the analysis.

Studies assessing parenting styles such as authoritarian, permissive, or neglectful were excluded from the analysis, leading to data being extracted in 29 articles.

 These included 10 conducted in Europe or Central Asia, 6 in East Asia or the Pacific, 6 in Latin America or the Caribbean, 5 in North America, and 2 in the Middle East or Africa.

Of countries where the studies were conducted, 8 were middle-income countries and 1 was low-income. English was the language of publication for 27 studies and Portuguese for 2. In some studies, interactions between mothers and children were videotaped.

All 14 studies assessing mother-baby bonding found this bond was impaired among patients with maternal depression, with a correlation found between higher Edinburgh Postnatal Depression Scale scores and a weakened bond measured using the Postpartum Bonding Questionnaire.

Additionally, an increased bond was reported with their children among mothers without depressive symptoms when compared with those reporting symptoms throughout their lives. Low sensitivity, defined as recognizing and responding to a child’s needs, was also noted among mothers with MDD.

Other parenting behaviors negatively affected

Additional domains of parenting worsened among mothers with MDD included involvement, commitment, pleasure in interacting with the child, and smiling at, touching, or interacting with the baby. Mothers with MDD also had increased negative emotions and hostility, while displaying relaxed discipline and inconsistent punishment.

A lack of correlation between maternal depression and sensitivity or positive regard for the child was found in a single study conducted in the United States. This trial included 36 low-income mother-child dyads.

Strong associations were found in the remaining 28 studies.

 The review was limited by a predominant representation of high-income countries, not including broader parenting constructs, and the lack of a meta-analysis.

Call for culturally diverse research and interventions

Investigators recommended further research to assess these associations in diverse sociocultural contexts.

“Existing literature suggests that depression-alleviating interventions based on cognitive behavioral therapy and mindfulness improve parent–child relationships and reduce negative parenting behaviors," wrote investigators.

 “Such tactics benefit maternal well-being and the overall family dynamic."

Maternal depression substantially compromises parenting quality. Wolters Kluwer Health. July 11, 2025. Accessed July 21, 2025. https://www.eurekalert.org/news-releases/1090978

Lages ED, da Silva MA, Soares FC, Munhoz TN. The impact of maternal depression on early parenting: a systematic review. 

2025;33(4):179-190. doi:10.1097/HRP.0000000000000434

A new review reveals that maternal depression significantly impairs bonding, sensitivity, and emotional engagement among mothers.

Maternal depression linked to poor parenting outcomes

Additional research is needed to expand on placenta accreta spectrum (PAS) guidelines, according to a recent study published in 

A comprehensive multidisciplinary approach is needed to manage PAS. This involves multiple specialties such as obstetrics and maternal-fetal medicine, urology, surgical oncology, and advanced gynecologic surgery.

 Therefore, standardized clinical practice guidelines (CPGs) are used to ensure the best possible outcomes.

“Although previous reviews have provided some comparisons between the main guidelines on PAS, a gap remains in systematically evaluating discrepancies and evidence across all CPGs, particularly concerning variations between high-income countries and low- to middle-income countries (LMICs),” wrote investigators.

The systematic review was conducted to provide a comprehensive analysis of PAS guidelines. All CPGs published from January 1, 2014, to January 31, 2024, focusing on PAS or including recommendations related to cesarean delivery (CD) were included in the analysis.

Guidelines were identified through professional societies’ websites, medical databases, and cited references from relevant CPGs. Data was extracted by 2 independent reviewers, with conflicts resolved by cross-checking the original articles.

The extracted information was reviewed by a panel of 15 to 18 experts through 2 SurveyMonkey rounds. During the review, experts commented and revised recommendations and highlighted areas of disagreement.

There were 18 articles included in the final analysis, 14 of which primarily addressed PAS and 4 mainly focused on the management of CD or postpartum hemorrhage. Recommendations specific to LMICs were reported in only 1 article.

An agreement rate of 75% was reported across the guidelines’ epidemiology sections. CD was recognized as a significant risk factor of PAS in all guidelines, with additional CD further increasing risk. Notably, a referenced source highlighted an odds ratio of 1.96 for PAS in patients with a prior CD vs no CD.

Additional risk factors discussed in the guidelines include prior myomectomy, minor uterine operations, and placenta previa or low-lying. However, these associations were supported by moderate to low evidence.

Inconsistent reports were noted for multiparity, multiple pregnancies, smoking, cocaine use, anemia, and other factors. For prenatal screening, an overall agreement rate of 76.9% was reported vs a 7.7% disagreement rate and 15.4% insufficient evidence. Ultrasonography was unanimously recommended as the first-line method of PAS screening.

Second-trimester screening was most often recommended, though 3 guidelines recommended first-trimester initiation. Priority candidates included patients with known risk factors, but less agreement was reported for anterior low-lying placenta cases.

A 2013 meta-analysis was frequently cited. In the study, ultrasonographic sensitivity and specificity of 90.7% and 96.9%, respectively, were reported. Less agreement was found for magnetic resonance imaging, with some guidelines reporting value in certain scenarios but highlighting conflicting evidence.

An agreement rate of 88.9% and insufficient evidence of 11.1% were reported for antenatal management across guidelines. No consensus has been reached about the optimal surveillance timeframe in patients suspected to have PAS. Variations were also noted in the recommended gestational age for inpatient admission.

The need to manage suspected PAS disorders and specialized disorders had unanimous agreement across the guidelines. Comprehensive counseling was also strongly recommended for patients considering fertility preservation in all guidelines. This is needed to ensure patients understand the risks associated with fertility preservation.

Evidence to definitively provide future pregnancy rates and whether to mention risks about intensive care unit admission and death remains insufficient in patients considering conservative management. However, all guidelines recommended the decision to receive conservative management should only be made after thorough counseling.

The review highlighted discrepancies and evidence gaps in vital areas of PAS identification and management. Investigators concluded there is a need for context-specific recommendations made with these resource limitations in mind.

“With PAS incidence increasing worldwide, prioritizing these research areas and developing comprehensive, globally applicable guidelines are essential steps toward improving outcomes for all patients affected by this life-threatening condition,” wrote investigators.

Bonanni G, Lopez-Giron MC, Allen L, et al. Guidelines on placenta accreta spectrum disorders: a systematic review. 

. 2025;8(7):e2521909. doi:10.1001/jamanetworkopen.2025.21909

Shamshirsaz AA, Fox KA, Salmanian B, et al. Maternal morbidity in patients with morbidly adherent placenta treated with and without a standardized multidisciplinary approach. 

. 2015;212(2):218.e1-9. doi:10.1016/j.ajog.2014.08.019

A new study highlights the urgent need for standardized, globally applicable guidelines to improve the diagnosis and management of placenta accreta spectrum.

Global review reveals gaps in PAS guidelines

The US Food and Drug Administration (FDA) convened a public expert panel to discuss the use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy, highlighting a contentious and complex issue that affects millions of women in the United States. The panel brought together perinatal psychiatrists, developmental biologists, epidemiologists, obstetricians, and mental health experts to assess the current evidence on SSRIs, including their risks, benefits, and regulatory implications.

FDA Commissioner Marty Makary, MD, MPH, opened the session by acknowledging that “nearly 1 in 4 middle-aged women are on an antidepressant, and up to 5% of women in pregnancy are on an antidepressant.” While recognizing the potential benefit of SSRIs, he cautioned that the broader picture of mental health in the United States has not improved despite increasing prescriptions. “The more antidepressants we prescribe, the more depression there is,” he said. “We have to start talking about root causes.”

Anick Bérard, PhD, professor of Perinatal Epidemiology, University of Montreal, faculty of Pharmacy, and CHU Ste-Justine in Montreal, and adjunct professor at the Faculty of Medicine, Université Claude Bernard, stated that depression and anxiety in pregnancy are prevalent and require treatment. “Untreated depression and anxiety during pregnancy have been shown to be associated with an increased risk of postpartum depression,” she said. She emphasized the complexity of risk-benefit analysis for antidepressant use in pregnancy and noted that the absolute risk of outcomes such as miscarriage or autism remains low, even if relative risk appears elevated in some studies.

Jay Gingrich, MD, PhD, director, Institute for Developmental Sciences, and professor of Developmental Psychology (in Psychiatry), Columbia University Irving Medical Center, presented findings from large-scale studies linking in utero SSRI exposure to increased rates of adolescent depression. “Until recently, there's really never been any attempt to study whether this treatment of the mother actually improves outcomes in the offspring,” he noted. Gingrich also emphasized that serotonin plays a different developmental role in utero than in adults, acting as a neuromodulator that influences organ and neural development.

Adam Urato, MD, chief of Maternal-Fetal Medicine at MetroWest Medical Center, called for stronger FDA warnings. “Patients regularly tell me that essentially the only counseling they received is that SSRIs don't affect the baby or cause complications. This is simply not accurate,” he said. He cited data from animal studies and human imaging studies to assert that SSRIs alter fetal brain development. “The SSRIs can be very difficult to get off of, so the time to think about these things is long before pregnancy,” he added.

Some panelists, such as Kay Roussos-Ross, MD, took a different position. “One in 5 women will have a perinatal mood disorder,” she said. “Psychotherapy and SSRIs are tools that we have… Treating mental illness in pregnancy is not a luxury. It's a necessity.” Roussos-Ross cited guidelines from multiple professional societies and argued that the risks of untreated mental illness often outweigh those of SSRI exposure, especially when factoring in increased rates of preterm birth, poor prenatal care, and maternal suicide.

Roussos-Ross is a professor and chief in the Division of Academic Specialists in General Obstetrics and Gynecology, and director of the Perinatal Mood Disorders Program in the Department of Obstetrics and Gynecology and Psychiatry at the University of Florida College of Medicine.

However, several participants questioned the foundational premise of SSRI efficacy. Joanna Moncrieff, MD, professor of Critical and Social Psychiatry at University College London and practicing psychiatrist, stated, “There is very little evidence that antidepressants have actual benefits in depression.” She argued that perceived improvements may stem from nonspecific psychoactive effects rather than the correction of a biochemical imbalance.

Multiple speakers also criticized the prevailing “chemical imbalance” narrative. Jeffrey Lacasse,

PhD, MSW, associate professor, College of Social Work, Florida State University, noted, “88% of Americans believe that antidepressants correct chemical imbalances, despite no conclusive scientific basis.” He suggested this belief contributes to overprescribing, including among women of reproductive age.

Michael Levin, PhD, distinguished professor, Department of Biology and director of the Allen Discovery Center at Tufts University, provided evidence that serotonin signaling plays a critical role in early embryonic patterning and organ asymmetry. “Manipulating its use by cells with SSRIs is very, very likely to cause certain kinds of defects,” he said, referencing experiments in frogs and chicks.

In addressing regulatory implications, a psychiatrist at TaperClinic and former FDA medical officer Josef Witt-Doerring, MD, highlighted that even known risks such as neonatal withdrawal and cardiac malformations are inconsistently addressed across SSRI drug labels. He proposed more accessible patient education, such as QR codes on prescription bottles linking to FDA-approved risk summaries.

The panel did not reach consensus on new regulatory action, but many agreed that greater transparency, improved labeling, and expanded access to nonpharmacologic interventions are needed. “The key is information,” said Urato. “Never before in human history have we chemically altered developing babies like this…without any real public warning.”

The FDA has not announced whether it will revise current SSRI labeling or issue new guidance. However, the agency indicated it would consider the panel’s input in evaluating potential policy updates.

FDA expert panel on selective serotonin reuptake inhibitors (SSRIs) and pregnancy. US Food and Drug Administration. July 21, 2025. Accessed July 21, 2025. https://www.youtube.com/watch?v=2Nha1Zh63SA

Experts debate the risks and benefits of SSRIs during pregnancy, emphasizing the need for better education and transparency in treatment options.

FDA panel convenes on SSRIs and pregnancy amid ongoing debate over risk, efficacy

Saying "obstetrician-gynecologist" is a mouthful for most people, and it's probably the most abbreviated specialty in medicine, both spoken and written. However, there doesn't seem to be a consensus on how to pronounce OB-GYN. First, is it the two-syllable "O-B" or the monosyllabic "Ob"? Second, is it "gin" or "gyne" (like "Lyme")? I wonder if you have a preference. I know I do.

Almost nobody says "obstetrician-gynecologist" when speaking about these specialist physicians. But what's the "correct" way to pronounce OB/GYN?

Is It Ob-Gin or Ob-Gyne?

What is your diagnosis based on these images of the ovary?

Challenge your diagnostic skills with this image quiz: Is this ovarian lesion cystic in nature or something else?

Joe Antony

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