Gynecology and Obstetrics are two different medical specialties that focus on the female reproductive system. Obstetrics focuses on the care of pregnant women, the delivery, labor, the unborn child, and the period immediately following the birth of the child. An obstetrician will make sure both the mother and child get the best prenatal care possible, and that the delivery is completed without complications, but should problems arise, they are available to intervene.
A certified obstetrician will have undergone a minimum of four years of residency training after they have received a general medical degree. Gynecology and obstetrics are closely related, and most specialists in these fields can provide care in both areas. This close relationship is why you often see OB/GYN on most office doors for these types of doctors.
What is Obstetrics
The field of obstetrics deals with the care of pregnant women and their babies. Several complications can occur while a woman is carrying her child such as ectopic pregnancy, fetal distress, issues with the placenta or high blood pressure, or a severe illness called pre-eclampsia.
- Ectopic Pregnancy
A fertilized egg attaching somewhere other than the inside of the uterus, it is called an ectopic pregnancy. This type of pregnancy most commonly occurs in the fallopian tube, and is then referred to as a ‘tubal pregnancy.’ A fertilized egg cannot develop inside these tubes as they are not designed to hold a growing embryo. When this type of pregnancy occurs, it has to be treated by an obstetrician.
An ectopic pregnancy can occur for several reasons including inflammation in the fallopian tubes or tubes that have become entirely or partially blocked. It can also be the result of scar tissue from a previous surgical procedure or infection on the tube which will interfere with the egg’s movement. Other conditions that can result in an ectopic pregnancy can be abnormal growths from a congenital disability which have caused the tube to be abnormally formed or adhesions on the tube from previous surgeries.
- Fetal Distress
The term fetal distress is not well defined. It was at one point used to describe a fetus not receiving adequate amounts of oxygen while the mother was carrying or during labor. This condition often appears when an abnormal heartbeat is detected on the fetus. Because the term is hard to define, it is also difficult to make an accurate diagnosis and give the proper treatment.
Fetal distress is often confused with birth asphyxia which happens when a baby does not have enough oxygen before, during, or after labor. This condition can be caused by multiple reasons including reduced blood flow when the umbilical cord becomes compressed or low oxygen levels in the mother’s blood.
- Placenta Issues
The placenta develops as an organ in your uterus during pregnancy. It will provide oxygen and nutrients to your unborn child as it grows and removes waste products from your baby’s blood. This organ attaches to the wall of your uterus, and the baby’s umbilical cord develops from it. The placenta can connect to the back, front, side, or top of your uterus. During your pregnancy several problems can occur with your placenta:
Placenta previa happens when your placenta totally or partially covers the outlet for the uterus (cervix). This condition can cause severe vaginal bleeding during delivery or while still pregnant.
Placental abruption occurs when your placenta separates from the inner wall of the uterus before you deliver. This condition can take away your baby’s oxygen supply and could result in having to deliver early.
Retained placenta happens when you do not deliver the placenta within thirty minutes after giving birth. The placenta may have become trapped behind the cervix or didn’t detach from the uterus wall. You will need to be treated for this as if left; you risk severe infection or life-threatening blood loss.
Placenta accreta is a condition when your blood vessels and other parts of the placenta attach to deeply into your uterine wall. This condition will result in the placenta firmly remaining attached after you’ve given birth. Most obstetricians will recommend you have a C-section to remove the placenta surgically.
- High Blood Pressure
If you experience high blood pressure while you are pregnant, you will have to be monitored closely. There are several serious risks that can develop from high blood pressure when you are carrying your child. These risks include:
Placental abruption or preeclampsia risks are increased. This condition is where your placenta separates from the inner wall of your uterus and can cause heavy bleeding. It can become life-threatening to both you and your unborn baby.
Decreased blood flow can occur where your placenta does not receive the proper amount of blood, and your baby’s oxygen levels are compromised. This condition can result in low birth weights, premature birth, breathing problems or increased risk of infection to your baby along with other complications.
Injury to your organs can happen with poorly controlled blood pressure. These injuries can affect your heart, lungs, brain, kidneys, liver and other major organs. It can become a life-threatening issue for you if your blood pressure is not gotten under control.
Intrauterine growth restriction is another concern when blood pressure is too high during pregnancy. This condition can result in your baby’s growth decreasing.
Future cardiovascular disease is increased if you suffer from preeclampsia while giving birth. The risk for future cardiovascular disease is much higher if you’ve had preeclampsia more than once or if you have had a premature birth caused by high blood pressure. Premature delivery is often necessary when life-threatening conditions arise from high blood pressure during your pregnancy.
Preeclampsia is a complication that rises out of pregnancy when high blood pressure becomes an issue in the mother. This condition usually becomes an issue after twenty weeks of pregnancy in a woman who otherwise has had normal blood pressure. If left untreated there are serious risks for both the mother and the baby which can include death.
What an Obstetrician Does
A board-certified obstetrician has completed rigorous oral and written exams along with residency training and medical school. To become an obstetrician, one must complete specific premedical education along with attaining a bachelor’s degree. Once this is achieved, it is necessary to take and pass the Medical College Admissions Test. This test is required in order to enroll in medical school.
Once medical school is completed, it is necessary to complete a residency program to further one's experience. Residents are required to spend a lot of hours at a hospital or office to help with emergencies, births, and other related pregnancy procedures. If you are considering to specialize in MFM, an additional two to three years will be needed.
After these two to three years are completed, a certification exam is needed. If you pass the exam given by the American Board of Obstetrics and Gynecology, you are granted a certificate to practice.
Monitor both you and your unborn child for health conditions that could put either of you at risk during your pregnancy or during the birth. They will watch your blood pressure, look for signs of diabetes developing, infections, or any genetic disorders.
The obstetrician will check your health and that of the developing baby by performing tests such as ultrasounds, taking your measurements along the way and other routine tests that allow them to keep track of both your health and that of your unborn baby.
You will be advised how to diet, exercise, which medications are safe to take and other ‘stay healthy’ information will be provided from your obstetrician to ensure your safe health and that of your baby’s.
Your obstetrician can answer any questions you have regarding your pregnancy and the baby growing inside. Any feelings you may be experiencing that you cannot explain can be discussed with your obstetrician, and they will help you through any situation to explain what you can expect while being pregnant.
An obstetrician can help you handle morning sickness, heartburn, leg pain or any other of the common complaints pregnant women are known to suffer through.
Your obstetrician will be there for you to explain what happens during labor and what you can expect during delivery.
Sometime around the 24th week of pregnancy, many women develop gestational diabetes. A diagnosis of this condition does not indicate you had diabetes before you became pregnant, or that you will continue to have this condition after you give birth. You will have to follow your physician’s advice closely though regarding blood glucose levels while you are pregnant.
Exercising during pregnancy can alleviate a lot of common problems that can occur. It can help you improve your circulation, prevent you from becoming constipated, reduce your risk of hemorrhoids, varicose veins, leg cramps and prevent your ankles from swelling. Exercise can also help strengthen your back and prevent back pain which is another common problem during pregnancy. Talk to your physician at All Women’s Care about an exercise plan to help you through these next few months.
You be able to continue taking certain drugs or prescriptions as there are some which are safe to continue while you are pregnant, and some can cause serious effects on the health of your baby. The Centers for Disease Control reports more than two-thirds of women who are pregnant in the United States take one or more prescription drugs while they are pregnant. The first trimester is the most critical stage for the development of your baby; you should talk to your obstetrician at All Women's Care and discuss any medications you plan on using before taking any drugs during this stage or any other.
- Morning Sickness
Vomiting and nausea may be the first sign you are pregnant. This sickness usually begins around the sixth week of pregnancy and can occur at any time of the day, but most women suffer from it in the morning. You can expect this sick feeling to continue through the 12th week of pregnancy. This sickness is not harmful to either you or your unborn child unless it develops into a hyperemesis gravidarum.
- Hyperemesis Gravidarum
Hyperemesis gravidarum happens when during the morning sickness period you are unable to keep food down and experience excessive vomiting. This condition is harmful to both your unborn baby and you if left untreated. You should discuss these symptoms immediately with your obstetrician at All Women’s Care if they develop so they can create a treatment plan for you.
- Leg Pain
The most common form of leg pain during pregnancy is Sciatia. This pain is a result of the weight from your growing uterus pushing down on your sciatic nerve. Leg pain generally runs down the back of your leg. You should talk to your obstetrician about these pains if you are experiencing them as they could turn into more severe conditions such as uterine fibroids or deep vein thrombosis.
Almost half of all pregnant women report they experience severe heartburn usually during the second and third trimester of their pregnancy. This condition is also known as acid indigestion and is a result of your stomach contents that are coming back up (reflux). You will experience irritation or a burning sensation in your esophagus when this happens.
During pregnancy, heartburn may occur due to the changing levels of your hormones. This change can affect the muscles in your digestive tract and how you can tolerate foods.
Labor is the process of giving birth and delivering your placenta, umbilical cord and membranes from your uterus to your vagina. The beginning stage of labor is called dilation and is when your cervix dilates to a full diameter of approximately 10cm.
During the first stage of your labor known as the latent phase, your contractions become progressively coordinated, and your cervix dilates to about 4cm. It will vary between women how much time these contractions will last. During the second stage or active phase, your cervix becomes fully dilated, and the baby begins to descend into your pelvis area. The time on this phase also varies between women and results with your baby moving through your cervix and out your vagina into the world.
Delivery is the expulsion of your baby into the world. Delivery is the extraction of your child’s fetal membranes and your baby. Due to possible complications during delivery, your obstetrician will be available should they need to intervene.
When an Obstetrician is a High-Risk Expert
Obstetricians provide care throughout the entire pregnancy and also handle postnatal care. Some obstetricians prefer to specialize in what is known as MFM (maternal-fetal medicine). MFM is a branch of obstetrics and focuses on women who are pregnant and suffer from abnormal issues or health problems. Obstetricians who practice MFM are considered to be high-risk experts.
- Maternal-Fetal Medicine
Maternal-fetal medicine or MFM specialist is a physician who helps to care for women with high-risk or complicated pregnancies. Having twins is considered to be a high-risk, so it is likely an MFM specialist will be asked to be part of your medical team. To qualify as an MFM specialist, an obstetrician must complete an additional three years of training specifically for high-risk pregnancies. These doctors can also be called perinatologists.
An MFM specialist or perinatologist provides care to women considered to be in a high-risk pregnancy. Through their care, they help the mother manage her health issues such as high blood pressure and diabetes. They are also there for women who develop complications during childbirth or any other part of their pregnancy. An MFM specialist will perform procedures such as an ultrasound to monitor your baby’s development and look for birth defects or genetic disorders through tests such as amniocentesis, umbilical cord sampling, or CVS (chorionic villus sampling).
Special care an MFM specialist provides is to monitor and diagnose congenital disabilities, blood disorders, heart problems and will provide surgical procedures if needed. These doctors will also identify and provide recommendations to mothers if they plan future pregnancies.
Your Obstetrician and Your Pregnancy Team
Your obstetrician plays a vital role before, during, and after your pregnancy. They will work with the nurses or midwives, PAs (physician assistants) and other healthcare professionals to make sure you are provided the best care throughout your pregnancy. You may see several of these team members during your routine prenatal visits.
Your obstetrician might ask that you and the dad-to-be or your partner to attend childbirth classes or pregnancy education that is presented by childbirth educators or nurses. These classes prepare you and your spouse or partner for when the big day arrives.
On the big day, the day your baby is born, labor coaches and nurses will assist you through the hard work of labor. Your obstetrician will watch your progress, and when it is time, they will deliver your baby. If you are working with an obstetrician in a group practice, another doctor may deliver your child. If this makes you uncomfortable, make sure you discuss it with your physician ahead of time.
Why an Obstetrician is Necessary
Family doctors or midwives can coordinate your care during your pregnancy, but certain situations can occur where it might be essential to seek the attention of a doctor of obstetrics. One of those situations is if you are over the age of 35 or considered to be having a high-risk pregnancy. These situations are vital to have your prenatal care through a licensed obstetrics physician.
When you hear the term high-risk pregnancy, it suggests you will require extra care during your pregnancy to have a successful and healthy delivery. This condition often occurs if you have suffered from a chronic illness or have other factors that place you in a high-risk category.
It is possible to begin a pregnancy under normal conditions and develop symptoms that will place you in a high-risk category. It doesn’t matter when your condition develops; it is most likely your status will remain throughout the rest of your pregnancy and even into delivery.
The symptoms of a high-risk pregnancy can be minor or life-threatening for both you and your unborn child. This risk requires you to receive additional monitoring and care from your obstetrician.
A high-risk pregnancy is a stressful time and creates a mix of emotions in you. These emotions may impact how you feel through your pregnancy and take some of the joy out of your time being pregnant. The constant worry about yourself and your unborn child can become confusing, so it is essential to speak with your obstetrician and discuss all your feelings whether physical or emotional.
If you have had previous health conditions that could impact a pregnancy, you should discuss them with your obstetrician so they can help you navigate your pregnancy process safely and in a healthy manner. These are some of the conditions that could put you in danger of experiencing a high-risk pregnancy:
- Chronic kidney disease such as preeclampsia
- High blood pressure and when untreated can cause a delay in your baby’s growth leading to placental abruption
- Obesity which can lead to needing a cesarean delivery
- Diabetes 1 or 2 which can result in fetal macrosomia or the birthing of a large baby
- Sickle cell disease or other blood disorder
- Anxiety or depression or both
- AIDS or HIV which can be passed on to your baby
- Thyroid disease can result in having your baby early
If you suspect your pregnancy will be high-risk, it is a good idea to work with an obstetrician who has advanced training dealing with complicated pregnancies. It is still suggested you work with an obstetrician even if you feel your pregnancy will be healthy as there are always situations that can occur even with a healthy mother.
Is There an Obstetrics Physician Near Me?
When planning to become pregnant, or if are already pregnant, you should call All Women’s Care 213-250-9461. We serve the Los Angeles area and help women throughout their pregnancy to ensure both the mother and the child remain healthy.