What is an Obstetrician?

Table of contents:

1. Introduction 

2. What does an Obstetrician do?

3. What happens at the first appointment with an Obstetrician?

4. Difference between an Obstetrician and Gynaecologist  

5. Role of Obstetrician during labour and after birth 

6. How to become an Obstetrician

7. Take-Home points 

8. FAQ on What is an Obstetrician

Introduction 

If you're planning to get pregnant or Expect a baby shortly, an obstetrician is the one Speciality doctor which you will encounter the most till delivery of the baby, but what is an Obstetrician, what does an obstetrician do? What conditions do obstetricians treat? In this blog, we’ll be unravelling each of these questions in detail.

What is an Obstetrician?

An obstetrician is a medical doctor who has specialised in the field of Obstetrics and Gynaecology. Obstetricians have undergone medical training and have been certified to deal with pregnancy and its related conditions.

Obstetricians are trained in managing high-risk pregnancies like Pregnancy-induced hypertension, Pre-eclampsia, Gestational diabetes, anaemia, and Intrauterine growth restrictions. Obstetricians also perform C-sections and provide medication to treat these pregnancy-related conditions. 

During birth and after birth they work closely with paediatricians to monitor foetal well-being and to provide after-birth (post-natal) care to the mother.

In India, Most obstetricians also deal with gynaecology meaning apart from pregnancy and its related medical conditions they also deal with female reproductive conditions like infertility, irregular menses, vaginal discharge etc.

It is important to consult an obstetrician as soon as you find you're pregnant, based on symptoms of pregnancy, or after testing with a pregnancy kit. We’ll discuss what does an obstetrician do and Why it is so important to consult an obstetrician during pregnancy.

What does an Obstetrician do?

After learning What is an obstetrician? Let's have a look at What does an Obstetrician do? Obstetricians are involved in Prenatal(before birth), natal(birth) and postnatal(after birth) care of both mother and baby. They make sure that the foetus and mother remain healthy, and if the mother is suffering from some disease like hypertension or diabetes associated with pregnancy, complications due to these can be reduced. 

The following points summarise what does an Obstetricians do:

1. Confirms pregnancy: An obstetrician confirms pregnancy on your first visit by using ultrasonography, because the Urine pregnancy kit is not a confirmatory test of pregnancy.

2. Diagnosing Ectopic pregnancy: Ectopic pregnancy happens when the embryo is implanted somewhere else apart from the uterus endometrium. First USG, is done to confirm pregnancy, An obstetrician also rules out ectopic pregnancy.

3. Screening and treatment for pregnancy-related diseases: An obstetrician orders several investigations on your first visit and subsequent visit to screen and diagnose pregnancy-related diseases like gestational diabetes, pregnancy-induced hypertension, gestational trophoblastic disease, anaemia etc.

4. Monitor maternal well-being: At every antenatal visit, an obstetrician records the mother's weight and haemoglobin status to assess maternal well-being.

5. Screens for congenital malformations of baby: An obstetrician performs an anomaly scan(2nd-trimester USG scan) and other scans to rule out any congenital anomaly in the baby. This is usually done in the second trimester of pregnancy.

6. Identifies and treats recurrent Pregnancy loss: An obstetrician is involved in diagnosing recurrent pregnancy losses, and also in treating it. Recurrent pregnancy loss can be due to underlying conditions like APLA syndrome or Cervical incompetence.

7. Monitor foetal well-being and labour contractions: Regular monitoring of foetal well-being, like foetal heart rate and its variations is recorded by an obstetrician. Apart from this, just before labour continuous monitoring of foetal heart rate and maternal uterine contraction is recorded to know if there is foetal distress or not.

8. Assists Normal delivery: An obstetrician assists normal vaginal delivery in different steps of labour. If labour doesn't progress obstetricians are also involved in Induction of labour.

9. Performs Caesarean section: If there is foetal distress or maternal complication for which vaginal delivery cannot be performed, C-sec is done by an obstetrician.

10. Performs Instrumental delivery: Instrument deliveries like forceps delivery, and episiotomy are also performed by an obstetrician.

11. Manages after-birth complications: Obstetricians are involved in managing after-birth complications like subinvolution of the uterus, in which the uterus doesn't return to normal before pregnancy size or sepsis, postpartum haemorrhage, uterine prolapse etc.

12. Performs abortion: If the mother opts not to carry forward pregnancy either due to her reasons(like accidental pregnancy) or Congenital anomaly of the foetus. Obstetricians also Dilation and Curettage in case of abortion.

13. Provides Contraceptive methods after the birth of a baby: An obstetrician also provides contraceptive options which can be given immediately after delivery like a Copper T device or tubectomy if the family is complete. Other contraceptive options are also given by obstetricians like Condoms, oral contraceptive pills, permanent contraceptive methods etc.

What happens at the first appointment with an Obstetrician?

While visiting for the first time to an Obstetrician, you may feel nervous about what's going to happen. Let’s understand what happens at first appointment with an Obstetrician?:

1. Most people visit an obstetrician for the first time when they get their urine pregnancy kit test positive.

2. Obstetricians may order a UPT(urine pregnancy test) again or can move forward to confirmation of pregnancy using USG after noting complaints of patients.

3. Dates of Last menses are recorded by an Obstetrician to calculate the expected date of delivery and Gestational age of foetal.

4. If a female doesn’t Remember her Last menses date, USG is used to calculate the expected date of delivery. At the same time, Obstetricians rule out ectopic pregnancy and gestational trophoblastic disease.

5. After this basic investigation is done like haemoglobin levels, Blood pressure, weight, urine culture and sensitivity, Hepatitis and HIV markers, VDRL(for syphilis), blood sugar levels etc.

6. These basic investigations are done to ensure both maternal and foetal complications can be assessed and necessary measures can be taken for prevention or treatment.

7. A pregnant mother is then advised for a 2nd visit to the Obstetrician with these basic investigations done.

Difference between an Obstetrician and Gynaecologist 

Obstetricians are concerned with pregnancy and childbirth. Obstetricians deal with conditions related to pregnancy and assist delivery, perform C-sec etc.

On the other hand, a Gynaecologist is concerned with the Female reproductive system and the conditions associated with it:

1. Fibroid

2. Endometriosis 

3. PCOS/PCOD

4. Infertility

5. Menopause

6. Irregular menses

7. Cancers related to female genitals like Ca Cervix(cervical cancer), Ca ovary(ovarian cancer) etc.

8. Infections concerning female reproductive tracts 

In India, Obstetricians and gynaecologists are not two different people usually. A person is trained in Obstetrics and Gynaecology in the same course.

Role of Obstetrician during labour and after birth 

Obstetricians have different roles during labour and after birth. Here are the role of obstetricians during labour:

1. Assisting normal vaginal delivery 

2. Induction of labour

3. Augmentation of labour

4. Managing complications of labour like obstructed labour

5. Performing C-sec

6. Instrumental delivery

Obstetricians’ role after birth:

1. Assessment and treatment of after-birth complications like subinvolution of the uterus.

2. Postpartum haemorrhage

3. Uterine rupture

4. Treatment of perineal muscle tear

5. Contraception to couples

6. If there are foetal or maternal complications during pregnancy, an obstetrician also discusses the fate of that complication in future pregnancy 

How to become an Obstetrician

To become an Obstetrician in India, You need to complete MBBS and register yourself with the state medical council. Afterwards, you need a Diploma in Gynaecology and Obstetrics degree or You can choose a Postgraduate course in Obstetrics and Gynaecology.

After all these, you can establish yourself as a Practising Obstetrician.

Take-Home Points 

1. What is an obstetrician? An obstetrician is a medical doctor who has specialised in the field of Obstetrics and Gynaecology.

2. Obstetricians have undergone medical training and have been certified to deal with pregnancy and its related conditions.

3. In India, Most obstetricians also deal with gynaecology meaning apart from pregnancy and its related medical conditions they also deal with female reproductive conditions 

4. The job of obstetricians is to confirm pregnancy, deal with complications of pregnancy, Diseases related to pregnancy like anaemia, gestational diabetes, pregnancy-induced hypertension, perform C-sec, assist normal vaginal delivery etc.

5. The difference between Obstetricians and gynaecologists is that Obstetricians are concerned with pregnancy and childbirth while gynaecologists are concerned with the Female reproductive system and conditions associated with fibroid, endometriosis, infertility, irregular menses etc.

6. To become an Obstetrician you need an MBBS degree then a postgraduate diploma degree or an MD/MS in Ob Gyn.