When you’re a woman, you basically have Grey’s Anatomy-level lexicon thrown at you on the regular. And while no one expects you to become a walking encyclopedia of medical knowledge, it is helpful to recognize and understand certain key terms as they pertain to your reproductive health. One of them? Obstetrics.
If you’re pregnant, trying to get conceive, or even just think there’s a remote possibility in the near future, you’ll want to have at least a cursory grasp of what obstetricians do and what falls under their purview and experience. So, here’s a closer look at the field and what it means for you.
What is an obstetrician?
To address the role of an obstetrician, we must first look at their field of expertise: obstetrics. Merriam-Webster defines obstetrics as a branch of medical science that deals with pregnancy, childbirth, and the postpartum period.
An obstetrician, then, is a doctor who is trained to deliver babies and provide pregnancy and postnatal care (after the baby is born). You may also hear the term maternal-fetal medicine or MFM. Obstetricians who specialize in this branch of obstetrics often work with pregnant women who are considered high risk due to chronic health issues or problems that present during the pregnancy.
How does one become an obstetrician?
Of all the things you can stress over while pregnant (we know — there are a lot), wondering whether your obstetrician received enough training and education shouldn’t be one of them. Most students who choose to pursue the obstetrics track devote around 12 years of their lives to learning their trade.
This includes earning a bachelor’s degree (typically in a science-based major), passing the Medical College Admissions Test (MCAT), going to medical school, and expanding their obstetrics knowledge during a four-year residency program. And to receive that MFM designation, an obstetrician has to tack on another two to three years of training. Once all of that is complete, they must pass a certification exam through the American Board of Obstetrics and Gynecology. Whew!
What is the difference between an obstetrician and a gynecologist?
Obstetrics and gynecology are actually considered to be one branch of medicine. However, it does comprise two different specialties or fields. Per Virginia Beach Obstetrics & Gynecology, obstetrics deals with “the care of pregnant women, the unborn baby, labor and delivery, and the immediate period following childbirth.” Gynecology deals with anything related to the reproductive organs: the uterus, fallopian tubes, cervix, ovaries, and vagina.
Wondering why so many doctors are referred to as OB-GYNs? Since the specialties are so closely related, doctors usually receive training and education for both during school and their residency. As such, many will go on to specialize in both areas.
What does an obstetrician do during pregnancy?
Once you find out you’ve got a little bun in the oven, you’ll be seeing your obstetrician or OB-GYN for routine prenatal care. Expect the first appointment to be full of questions and tests (urinalysis, blood panels, etc.) as your doctor tries to determine any risks to your pregnancy. This typically wouldn’t take place until around eight weeks after your last period, although some doctors schedule first pregnancy appointments slightly earlier.
As your pregnancy progresses, you’ll continue to see your obstetrician on a regular basis — usually once a month until you near the end of your pregnancy, at which point you’ll likely move to once a week. These check-ups generally consist of checking your baby’s growth and position, answering any questions you may have, and performing routine tests. Some obstetricians do ultrasounds in their rooms as well.
What are some obstetric conditions?
Throughout your pregnancy and into labor and delivery, certain conditions may present. But don’t worry! Your obstetrician will manage and/or treat those, too.
These include ectopic pregnancy, shoulder dystocia (when baby’s shoulders get stuck during delivery), preeclampsia, fetal distress, placental abruption, placenta previa, uterine rupture, prolapsed cord (when the umbilical cord gets stuck during delivery), obstetrical hemorrhage, sepsis (a life-threatening illness caused by your body’s response to infection), and more.
Your obstetrician may also treat you for postpartum conditions related to birth and delivery like postpartum preeclampsia, any issues that may arise with a C-section incision, experience more than the expected natural bleeding, and they may often be the first contact if you’re experiencing postpartum depression, in which case they will refer you to an expert who can help.
What procedures do obstetricians perform?
If you have a non-complicated pregnancy, you may not see your doctor much during labor and delivery. They’ll probably pop in periodically to gauge your condition but, for the most part, you’ll be tended to by nurses or midwives. When it comes time for the big show, though, your obstetrician will oversee the induction, if necessary, and return to perform a vaginal or cesarean delivery. They may also need to perform a forceps and vacuum delivery and/or episiotomy (a cut at the opening of the vagina) to facilitate vaginal delivery.
Sometimes, complications arrive prior to labor and delivery that require an obstetrician to perform cervical cerclage (procedures which reinforce the cervix) or even dilation and curettage (also known as a D&C, a surgical procedure performed after a miscarriage or to remove cysts or tumors). If your pregnancy is high-risk, your obstetrician may offer more ultrasounds throughout your pregnancy, an amniocentesis to identify certain genetic abnormalities, lab testing to identify and/or rule out certain conditions, a biophysical profile, or cordocentesis (umbilical blood sampling).
If you give birth to a male and so request it, your obstetrician may perform your child’s circumcision. In general, your obstetrician will check in with you after childbirth to make sure you and baby are doing well. At that point, they’ll most likely remind you to schedule a follow-up appointment for six weeks after baby’s birth — or sooner, if you had any complications during delivery.
What is the difference between an obstetrician and a perinatologist?
Perinatologists, often referred to as maternal-fetal medicine specialists are OB-GYNs who specialize in treating women with high risk pregnancies. Women with a history of complicated pregnancies, pregnant with multiples, in need of a C-section, or with a pre-existing medical issue will probably need to see a perinatologist during their pregnancy and for the labor and birth.
When should you visit an obstetrician?
As soon as you suspect you’re pregnant, you should schedule an appointment to see your obstetrician. In fact, you don’t even have to wait until you’re expecting! If you’re thinking about growing your family, your obstetrician can be an invaluable resource in helping you prepare for pregnancy.
Once you’re officially knocked up (congrats, Mama!), you’ll meet with your obstetrician regularly throughout the course of the pregnancy. After your little cutie — or cuties, ayyy — arrives, you’ll meet with your obstetrician six weeks later to address any issues. This is also a prime time to ask if you can be cleared for sex if that’s even something on your radar at this point. If not, that’s totally normal and, hell, understandable. On that note, you may also want to go ahead and discuss birth control options.
How do you choose an obstetrician?
Because you’ll be trusting your obstetrician to see you through some of the biggest moments of your entire adult life, you may feel anxiety over choosing the right one. If you already feel comfortable with the OB-GYN who performs your annual exams, it makes sense to stick with them. Still, it’s never a bad idea to do your due diligence and explore all of the options available to you. This is especially true if your pregnancy is considered high risk, as you’ll likely want an obstetrician with an MFM sub-specialty.
Here are some questions Natural Birth and Baby Care recommends asking as you meet a prospective obstetrician when you’re looking for a new practice or early in your pregnancy (we’ve added a few additional ones from our own experience):
- What prenatal tests do they or the practice require? What do they recommend?
- What is their view on labor and birth?
- Will they stay with you during pushing?
- Can you eat or drink during labor?
- Will they stay with you throughout your labor and birth, or could someone else in the practice take over?
- How often will they be checking on the baby during labor?
- What positions can you birth in?
- What prenatal tests do they recommend vs. what tests do they require?
- Will they attend the birth, or does that depend on who is on call?
- What is the practice’s cesarean section rate? VBAC rate?
- What are their views on episiotomy vs natural tears
- What procedures does they perform immediately on the newborn? What can wait? Will they wait if you request it?
- Will they wipe down the vernix caseosa after birth or will they leave it for longer?
- How many babies do they deliver per month?
- What’s their stance on skin to skin immediately after a C-section?
- What kind of postpartum follow-up do they or the practice give?
- When is the first followup after birth, is it two weeks or six week?
- What do they do in the event of a long labor? A “stalled” labor?
- What are their fees and what do they include?
- How long are typical wait times at scheduled appointments?
- What do they consider a high risk pregnancy?
In deciding who to choose for your obstetrician, you may ultimately decide to forgo one in favor of a doula or midwife. Per the American Pregnancy Association, approximately 60 to 80 percent of women experience a low-risk pregnancy. So, if you prefer a more natural, hands-off approach to pregnancy and childbirth, an alternative route may seem like a better fit.
Having said that, it’s important to note that obstetricians have specialized training to manage life-threatening complications and access to advanced medical technology.