Obstetrics vs. Gynecology
Obstetricians are also gynecologists, which involves delivering care for all women’s health issues. Collectively, the two fields make up the OB/GYN title, which is considered one specialty. The OB/GYN branch of medicine requires the completion of medical school and a residency program. Some OB/GYNs will acquire further knowledge in fields like maternal-fetal medicine, gynecologic oncology, reproductive endocrinology and infertility, and female pelvic medicine and reconstructive surgery. To become board-certified, you must take and pass the American Board of Obstetrics and Gynecology certification exam. A doctor can choose only to practice one part of the OB/GYN specialty. For example, they can focus on obstetrics and only see patients related to preconception, pregnancy, childbirth, and postpartum. Doctors who specialize in obstetrics can deliver babies. Obstetricians can also specialize in maternal-fetal medicine (MFM). Doctors with MFM specialty focuses on chronic health conditions or abnormal issues during pregnancy. If your pregnancy is high-risk, you may see an MFM. Some doctors will practice both fields and provide services for obstetrics and gynecology. Likewise, some OB/GYNs specialize in medical genetics and genomics (MGG). These clinical geneticists, as they are sometimes called, provide diagnostic, management, and genetic counseling services for parents who have or are at risk for genetically-related health problems. To become certified in MGG, physicians complete a two-year training program after completing the OB/GYN residency. Some OB/GYNs focus primarily on critical care (CC) by providing care to critically ill patients primarily in the intensive care unit (ICU) setting of a hospital. These physicians have received additional training, which allows them to work in partnership with other doctors on the ICU team. Another type of OB/GYN found in the hospital setting are laborists, who work strictly in the hospital setting to assist women with pregnancy challenges as well as labor and delivery. These physicians can admit patients and provide emergency services as well as manage labor and deliver babies. Overall, OB/GYNs can perform both major and minor surgical procedures. According to the American Medical Association, examples of major surgical procedures include hysterectomy, laparoscopic surgery (sometimes with robotic assistance), hysteroscopic procedures, or laparotomy with surgery on the pelvic organs. In-office procedures include amniocentesis, umbilical vein sampling, colposcopy, abortion, conization of the cervix, hysteroscopy, and saline-infused sonograms.
How Obstetricians Differ From Other Physicians
An obstetrician can be your primary care physician. But more than likely, you will only use them as a primary provider if they offer services beyond preconception, pregnancy, childbirth, and postpartum. They have specific knowledge and skills in the medical and surgical care of the female reproductive system, which sets them apart from other physicians. This allows them to serve as consultants to other physicians and as a primary physician for women. Many patients choose to use an obstetrician for pregnancy-related issues in addition to their primary care doctor. If you are having medical concerns beyond preconception and pregnancy, you may want to consider seeing a family practice or other type of doctor that can provide comprehensive health care. One study found that primary care physicians are more likely to address concurrent medical problems during preventive gynecologic visits compared with obstetrician-gynecologists.
Finding an Obstetrician
Talk to your primary care provider: The doctor you might already be seeing currently can help you find an obstetrician in your area. Check your insurance plan to see what is covered: Talk with your insurance company to get recommendations. They may only provide benefits for doctors in-network. If that’s the case, you will want to work from that list or ask about out-of-network coverage if you find an obstetrician that is not part of their plan. Ask for recommendations from friends or family: You can always turn to people you trust to help give you suggestions.Search online: You can go online to research provider bios, credentials, patient reviews, board-certifications, and hospital recommendations.
What to Look For
Before you decide on an obstetrician to deliver care, refer back to the provider list from your insurance company. You may want to start your search from the list of obstetricians they refer to as in-network providers. The second step to looking for an obstetrician pertains to your health history. If you have any pre-existing health conditions that may impact your pregnancy, you will want to consider an obstetrician with additional training in high-risk pregnancies, such as a maternal-fetal medicine specialist. Another consideration is the hospital or birthing center the obstetrician will use. Is it in-network for your insurance benefits, or will you be required to pay additional out-of-pocket expenses, which can run high for childbirth? Also, consider the level of NICU care the facility provides. Other things to consider are the percentage of cesarean births they perform, the type of pain management they prefer, will they allow a doula during the birth, are they open to a VBAC (vaginal birth after cesarean), and their availability is for questions during non-routine visits. Other questions to ask or skills to look for in an obstetrician include experience with complications like preeclampsia, placental abruption, ectopic pregnancy, uterine rupture, prolapsed cord, and fetal distress. Even though you may never experience these conditions or complications, you may want to find an obstetrician who has extensive training and experience with these high-risk issues and conditions.
How Obstetricians Are Involved in Your Pregnancy
An obstetrician plays a critical role in your pregnancy. If you are trying to conceive, you may already be seeing an obstetrician; otherwise, you will likely make an appointment after you confirm pregnancy.
Prenatal Visits
During the preconception period, an obstetrician can see you for a pre-pregnancy care checkup. According to the American College of Obstetricians and Gynecologists, the goal of this appointment is to identify anything that could impact your pregnancy. You can expect to discuss your medical history, diet and lifestyle, medications, past pregnancies, and other health-related conditions like diabetes, hypertension, and thyroid disease that may affect your pregnancy. Once a home pregnancy test comes back positive, it’s time to make an appointment with an obstetrician. In general, they recommend making an appointment approximately eight weeks after your last menstrual period. This initial appointment will allow your obstetrician will confirm pregnancy and set a schedule for your prenatal visits. During the routine prenatal visits, you can expect your doctor to track your progress, measure your weight gain, check blood pressure, measure your abdomen to monitor baby’s growth, check the baby’s heart rate, and answer any questions you may have. Obstetricians are also trained to screen for antenatal depression and anxiety. These appointments typically take place once a month throughout your pregnancy.
Routine Checks
Your obstetrician can perform ultrasounds and lab tests as needed. If you need an amniocentesis for a high-risk pregnancy, they will be involved. When it comes time for childbirth, an obstetrician can perform a vaginal delivery, cesarean section, episiotomy, cervical cerclage, forceps and vacuum deliveries, and dilation and curettage, among other procedures.
Postpartum Care
Their role in your pregnancy does not stop at childbirth. You will see an obstetrician at least one more time during the postpartum period. This is typically a follow-up appointment at six weeks to assess healing, address any issues you had during pregnancy or childbirth, explore postpartum mental health issues like anxiety or depression, and to answer any questions about birth control options like the intrauterine device or the pill.
A Word From Verywell
Choosing an obstetrician to oversee your pregnancy and childbirth is a big decision. Take your time, ask a lot of questions, and seek input from trusted friends and family. Make sure they fit your criteria and specific needs, especially if you have a high-risk pregnancy. And remember, you can always change providers if you don’t feel comfortable.
