Obstetrics is the “field of medicine that deals with the care of women during their pregnancy, childbirth and the postpartum period (the time after the childbirth)”. Simply stating, obstetrical care is the “management and treatment that is given to the women prior and during their pregnancy and the postpartum period”. As a medical specialty, obstetrics is combined with gynecology and falls under the discipline, known as obstetrics and gynecology (abbreviated as OB/GYN or OB-GYN). The term OB/GYN refers to both the practices obstetrics and gynecology or to the doctor who practices both these fields. Some of the doctors practice only one of these specialties. For example, obstetricians only practice obstetrics that focuses on pregnancy and childbirth while gynecologists only practice gynecology that focuses on the reproductive health of women. In simple words, obstetricians provide care to pregnant women and gynecologists treat those women who are not pregnant.
In today’s article, we focus on the following main areas related to obstetrical care:
- What is an obstetrician,
- Education/training of obstetrician,
- Conditions that obstetrician treat,
- Procedures that obstetrician perform,
- How the obstetrician works with pregnancy team and,
- Why should a woman see an obstetrician
What is an obstetrician?
An obstetrician is the doctor who specializes in the field of obstetrics and provides surgical care to women who are pregnant. Obstetricians provide comprehensive care consisting of managing and treating the women before, during and after their pregnancy and childbirth. They provide prenatal care services throughout the pregnancy that includes regular checkups, physical exams, and lab tests as well as the postnatal care (postpartum period) that is given to the mother after the childbirth.
Those obstetricians who practice both OB/GYN receive gynecological training as well and provide care to the women who are not pregnant, in order to maintain the health of the reproductive system and treat all the related disorders and conditions.
Although, other doctors can also deliver the babies most of the women see an obstetrician because he/she can fully take care of the pregnancy including the prenatal and postnatal care.
Some obstetricians specialize in maternal-fetal medicine (MFM), “a branch of obstetrics that deals with those pregnant women who have chronic health conditions or serious complications/abnormal issues that develop during the pregnancy”. As MFM doctors handle the high-risk pregnancies so they are considered as high-risk experts. Those women who have any chronic health condition choose the MFM doctors before conceiving so that a plan can be devised for pregnancy.
What education and training are required for an obstetrician?
Below steps are required to become an obstetrician:
- Earn a bachelor’s degree
- Attend medical school
- Obtain medical license
- Participate in residency program
- Board certification
Here’re the details of each step:
Step 1: Earn a bachelor’s degree
The process of becoming an obstetrician starts with earning an undergraduate degree. As there is no specialized degree in obstetrics so most of the medical schools require that the educational background of applicants should be strongly science-based. So, the individuals should choose science majors in their bachelor’s degree.
Step 2: Attend medical school
The next step in this process is attending the medical school. During or after the junior year in the college, the students should need to pass “Medical College Admissions Test (MCAT)” to get admission to the medical school. Students can get admission in the medical school of their choice with the passing scores of MCAT. Every medical college or university has different requirements and prerequisites as well as different course outlines, but generally, the first 2 years are needed for the academic studies that mainly include anatomy, laboratory science, and general healthcare procedures while the second 2 years are needed for getting practical experience through the clinical and hands-on work in hospitals and clinics.
Step 3: Obtain medical license
Before beginning the residency program, the medical school graduates are qualified to take the “United States Medical Licensing Examination (USMLE)”. As with all other physicians, the obstetricians must successfully pass the USMLE to become licensed for practicing as a doctor in the USA.
Step 4: Participate in residency program
After the completion of medical school, prospective obstetricians are required to take part in the four-year residency program under the supervision of a licensed obstetrician. During the residency, the students can expand their medical knowledge with much more focus on obstetrics. They also get hands-on training in monitoring the pregnancies and childbirths, handling the conditions related to infertility, reproductive endocrinology, gynecology, gynecologic oncology, and urology. During the residency, the students also receive training in managing and treating the high-risk pregnant women (maternal-fetal medicine).
With the experience and knowledge that the students receive during the residency program on daily basis, by the end of the residency, they will become enough capable to effectively, efficiently, and confidently treat the patients.
At this point, for those students who want to specialize in maternal-fetal medicine (MFM), must complete an additional 2-3 years of training. For those who don’t want to specialize can decide to go into the public or private sector.
Step 5: Board certification
Once the training is completed, the “American Board of Obstetrics and Gynecology” certification is required through certification exam.
What are the conditions that obstetrician treat?
At first, the initial appointment with the obstetrician usually occurs approx. eight weeks after the last menstrual cycle. After that, routine prenatal care begins that lasts throughout the pregnancy. During the prenatal care, the obstetrician conducts regular physical exams and lab tests that are important to look out for any complication during the pregnancy.
Obstetricians who specialize in MFM also treat high-risk pregnant women during and after the pregnancy. A woman may have a high-risk pregnancy if she:
- Has a chronic health condition during the pregnancy
- Is over the age of 35
- Is carrying multiple babies
- Has history of miscarriage, cesarean delivery or preterm labor (premature delivery)
- Is engaging in smoking and/or drinking
- Develops certain complications during pregnancy that affect her or the baby
Some other conditions that obstetricians treat include:
- Ectopic pregnancy: It is a complication of pregnancy that occurs when the fertilized egg attaches itself in any place other than inside the uterus and commonly it implants in fallopian tubes.
- Fetal distress: It is an uncommon complication in which the fetus doesn’t receive enough oxygen that can cause a rise in the fetal heart rate. Prolonged labor increases the risk of fetal distress.
- Preeclampsia: A pregnancy disorder, characterized by high blood pressure and signs of damaging the other organs, most commonly the liver and kidneys.
- Placental abruption: It is a serious condition in which the placenta partially or completely separates itself from the uterus before the childbirth.
- Shoulder dystocia: It occurs after the normal delivery of the baby’s head when the baby’s shoulders get stuck during the childbirth.
- Uterine rupture: It is serious though very rare labor complication that occurs in women who have uterine scars from their previous cesarean delivery. The uterine scar causes the uterus to tear/rupture during the vaginal childbirth.
- Prolapsed cord: It is a complication that occurs when the umbilical cord becomes trapped against the body of the baby during the delivery.
- Obstetrical bleeding: This complication also known as maternal hemorrhage or obstetrical hemorrhage in which heavy bleeding occurs during pregnancy, childbirth or postpartum period. Most often, the bleeding is vaginal or rarely but dangerously it may be internal, into the abdominal
- Sepsis: It is a life-threatening condition in which the body’s response to an infection causes the injury to its own tissues and organs. It can damage the organ systems causing them to fail.
What are the procedures that obstetrician perform?
Apart from the routine deliveries and labor services, obstetricians also perform various procedures that include:
- Vaginal delivery: It is a natural method of childbirth in which delivery occurs through the vagina.
- Cesarean delivery: It is also known as cesarean section or C-section in which a surgical incision is made in the abdomen or uterus of the mother to deliver the baby. C-section is performed when the vaginal delivery put mother or baby at risk.
- Cervical cerclage: It is also known as a cervical stitch. When a woman’s cervix is weak (a condition refers to cervical incompetency), she gets high chances of premature delivery because the cervix shortens and opens too early during pregnancy. Obstetrician performs a treatment called cervical cerclage for cervical incompetence. During the procedure, stitches are placed in the cervix that holds it closed.
- Dilation and curettage (D&C): It is a surgical procedure in which obstetrician dilates (expands) the cervix and removes a part (tissue) of the lining of the uterus and/or contents inside the uterus. It is used for diagnosing and treating uterine conditions or to clear the uterus after abortion or miscarriage.
- Episiotomy: This procedure is performed during vaginal delivery in which surgical cut is made at the opening of the vagina for the baby to easily pass through.
- Forceps and vacuum deliveries: During childbirth, when the baby couldn’t be delivered through pushing stage, the obstetrician uses certain instruments such as forceps or a vacuum extractor (kind of a suction cup) to help easily deliver the baby.
Obstetrician also performs certain tests when a woman has a high-risk pregnancy, these tests include:
- Amniocentesis: This test is used to determine the sex of the baby and identify certain genetic abnormalities in the developing fetus.
- Cordocentesis: A diagnostic test, also known as percutaneous umbilical blood sampling (PUBS) in which fetal umbilical cord blood is taken to detect congenital conditions, certain infections, fetal abnormalities or blood disorders.
- Measurement of the cervical length is used to assess the risk of premature delivery.
- Various lab tests are performed for different conditions and for measuring the fetal fibronectin for assessing the risk of premature delivery.
- A biophysical profile (BPP): It is a simple test that is performed during pregnancy to assess the well-being of the baby through ultrasound and heart rate monitoring.
How does the obstetrician work with the pregnancy team?
Obstetrician plays a central role before, during and after the pregnancy.
Obstetrician works with nurses, midwives, physician assistant and other medical professionals to provide complete obstetrical care to the women. Obstetrician works with these team members during the prenatal visits.
Obstetrician recommends that parents-to-be should attend the childbirth classes, prenatal classes or pregnancy education from childbirth educators or nurses.
On the delivery day, the team of nurses and labor coaches helps the women through the whole labor process but obstetrician monitors the progress and finally delivers the baby when the time comes.
Some obstetricians work in a group practice where various doctors share the call on duties and so another obstetrician may deliver the baby. Make sure to ask about this while choosing your obstetrician.
Why should a woman see an obstetrician?
Although, family doctors and midwives help a woman in giving the pregnancy care there are certain circumstances where it is vital for the expecting mother to see an obstetrician.
If an expecting mother is over the age of 35 or has a high-risk pregnancy, she should see an obstetrician for prenatal care. For those women who have high-risk pregnancies should see maternal-fetal medicine specialist because he/she is able to effectively handle the complicated pregnancies. Family doctor or midwife who is providing the pregnancy care, consult an obstetrician or refer the expecting mother to an obstetrician if complications occur.
If the expecting mothers are healthy and they anticipate a normal, healthy pregnancy, it is still better to get their pregnancy care from an obstetrician.
If you’re deciding for choosing an obstetrician, you can consult Eman Al-Janabi M.D who is a board-certified obstetrician and gynecologist and offers comprehensive OB/GYN services at Women Caring For Women in Staten Island, NY. Women Caring For Women is one of the reliable and trusted women healthcare centers that offer customized treatments for every patient with personalized care and comfortable environment. We provide the best obstetrical care in Staten Island, NY ensuring the well-being of the expecting mother and unborn baby.
For booking an online appointment, visit our website or call (718) 630-1300 for an immediate help.