Episode 9.10 Pit Breaks, Cannabis, and IUDs for Endometrial Protection

Howard and Antonia explore the evidence behind pit breaks in labor, cannabis use in pregnancy, and IUD options for hormone replacement therapy.• Pit breaks in labor lack substantial evidence of benefit when used in active labor• Current research suggests stopping oxytocin during active labor may slightly increase cesarean rates rather than decrease them• Long pit breaks (up to 8 hours) in latent labor may be beneficial by allowing rest and promoting patience• Recent systematic review shows prenatal cannabis use increases risk of low birth weight by 75%, preterm birth by 50%, and perinatal mortality by 29%• Cannabis use during pregnancy (7.2% of pregnant women) now exceeds tobacco use• Retrospective studies on doula care show association with better outcomes, but can't establish causation due to inherent differences in patients who seek doulas• 52mg levonorgestrel IUDs (Mirena/Liletta) are suitable for endometrial protection during HRT, but evidence only supports use up to 5 years• Most systematic reviews combine heterogeneous studies and shouldn't be considered level 1 evidenceWe'd love to hear your questions! Send them to us through our Instagram or website thinkingaboutobgyn.com.00:04:52 Pit Breaks in Labor00:15:32 Examining Evidence on Oxytocin Discontinuation00:26:08 Prenatal Cannabis Use and Adverse Outcomes00:36:07 Doula Care Study Analysis00:57:22 Levonorgestrel IUD Use in HRTFollow us on Instagram @thinkingaboutobgyn.