Obstetricians usually work as part of an antenatal team, which includes midwives, family nurses, GPs, anesthetists, and pediatricians. They all care for you throughout pregnancy and help you deliver a child.
What Does an Obstetrician Do?
Obstetrician’s main task is providing prenatal care such as:
- Physical exams
- Ultrasounds
- Blood tests
- Urine tests
- Prenatal genetic screening tests
- Making sure that the medications you take are safe for the baby
- Providing information about recommended diet and physical activity during pregnancy
- Answering your questions about delivery or the pregnancy itself
An obstetrician monitors you and your baby during pregnancy and helps during labor and delivery by managing complications or inducing labor.
What Happens During a Visit to the Obstetrician’s Office?
During your first visit, your doctor will ask you questions about your medical history, focusing mainly on obstetrics history. They will ask questions about:
- A number of your previous pregnancies
- Pregnancy complications history (such as high blood pressure during pregnancy, gestational diabetes, preterm labor, stillbirth) and outcomes
- What medications and supplements do you use
- Infectious disease history (especially diseases that can be dangerous for the fetus when contracted during pregnancy, like rubella or toxoplasmosis).
They will also ask about your current well-being, any disturbing symptoms like bloody or increased vaginal discharge or abdominal pain, and the frequency and intensity of fetal movements. After asking you those questions, the doctor will perform a physical examination to see how far along you are, check the baby’s development rate, look for any worrying symptoms, and measure your pelvis to see if your baby can fit through your birth canal.
Obstetricians also use ultrasounds during the examination to confirm the presence of a living fetus and assess fetal growth and well-being. At the end of your visit, you will most likely be prescribed some routine lab tests to check your overall health, immunity to certain infections that can interfere with your child’s development, and exposure to any diseases that can be transferred to your newborn during delivery.
Physical Exam
During your visits to the obstetrician’s office, your OB-GYN may recommend a physical examination. You will be asked to undress below the waist and to lay down on an examination table with your legs resting on leg supports.
First, your doctor will look at your vulva, checking for cysts, genital warts, abnormal discharge, or irritation. Then they will insert a speculum (an instrument that holds open walls of the vagina) into your vagina to check your cervix and vaginal walls for any abnormalities. During this step, a PAP smear test might also be done to check the chances of getting cervix cancer.
Afterward, an obstetrician may use specialized instruments to check a few things. They could look at how stretchy a small skin area between your genitals and bottom is. They might also see where a part of your uterus called the cervix is located and how easily it can move around. The doctor might even take measurements concerning different parts of your hips to determine if there’s enough room for the baby’s head to pass through when it’s time for birth. Your OB-GYN will need those parameters during the later stages of your pregnancy to determine, using the Bishop score, how well prepared your cervix is for labor.
When you are a few months along, the doctor may also use Leopold’s maneuvers to determine your child’s position (if it lies in your womb longitudinal or sideways in relation to you), its presentation (which part of your baby is facing the vaginal canal, either it’s head or legs) and position of your child’s head (the position of baby’s head as it enters the birth canal). It is performed by touching your abdomen in various places to determine the exact position of the baby.
The last part of the physical examination is external pelvimetry. Using an instrument called pelvimeter, an obstetrician measures the exact dimensions of your pelvis to determine the risk of a condition in which a baby’s head is too big to fit through the mother’s pelvis and becomes stuck during labor.
Blood Test
The first lab test that your obstetrician will most likely prescribe you is a blood test to determine your blood type and what kind of antibodies your body produces.
An Rh factor is a protein found in red blood cells. Some people have it, which makes their blood Rh-positive, while others don’t, making them Rh-negative. When an Rh-negative woman becomes pregnant with an Rh-positive fetus, her body’s immune system antibodies may start attacking the fetus.
If you produce anti-Rh antibodies and your child inherits its father’s Rh-positive blood, those antibodies might cross through the placenta and damage your baby’s blood cells, causing a condition called hemolytic disease of the fetus and newborn. If you are Rh-negative and your partner is Rh-positive, don’t worry. Your doctor will prescribe shots to prevent any harm to your baby.
Blood tests will also tell your obstetrician if you have any mineral deficiencies and measure your hemoglobin level. Hemoglobin is a protein found in blood cells that carries oxygen, distributing it throughout your body. During pregnancy, your blood also provides oxygen for your baby, so keeping your hemoglobin level in the normal range is essential.
Urine Test
The urine test is another important test that is routinely performed during pregnancy. Some doctors may order a urine sample each visit to ensure your urinary tract is in good shape.
When collecting urine, following some rules for the test to be reliable is crucial. For best results, start with washing your hands and cleaning your genitals using an antiseptic wipe with front-to-back movement. After cleaning your genitals, start urinating in the toilet for a few seconds to wash away any leftover bacteria and slip the sterile container to catch “mid-stream” urine into it. After collecting the urine samples, close the cup with a lid, but be careful not to touch the inside of the container as you might contaminate it with bacteria that live on your skin. Remember to label the container with your name, date, and time of collection before handing it over to the laboratory or your doctor.
This sample will be tested for glucose (sugar), protein, blood cells, and bacteria. While small amounts of glucose can be found in a healthy person’s urine, an elevated level suggests that your blood sugar is too high, which may be caused by gestational diabetes. Protein is usually found in the urine of people with kidney damage; if it’s accompanied by high blood pressure, it may suggest preeclampsia. Blood cells and bacteria are signs of urinary tract infection. They should be treated as soon as possible because it can progress to kidney infection, which can even get you hospitalized.
Obstetric Ultrasound
During an obstetric ultrasound, an obstetrician uses a probe that sends sound waves that bounce off of your and your child’s tissues to produce an image of a baby, your uterus, and your ovaries. This test needs no special preparation; you only need to lie down and expose your lower abdominal area so the sound-emitting probe can touch your skin.
Obstetric ultrasound is used to:
- Establishing the age of pregnancy (if you are not sure when your baby was exactly conceived)
- Monitoring your baby’s development rate
- Detecting some genetic disorders
- Determining the number of fetuses in multiple pregnancies
- Visualizing a child’s position inside your womb and its size
- Evaluating the amount of amniotic fluid around your baby
- Checking the state of your cervix (it can detect its shortening or opening, which usually happens when your organism is preparing for labor)
What Kind of Surgeries Do Obstetricians Perform?
Outside of guiding you through your pregnancy, obstetricians can perform a variety of surgical procedures related to a woman’s reproductive system.
Hysterectomy
Hysterectomy is either partial or entire removal of the uterus, usually done when a woman develops an otherwise incurable condition like cervical cancer.
Myomectomy
Myomectomy is the procedure of removing usually not cancerous growths that develop in or on the wall of the uterus, causing pain and bleeding from the uterine wall, and can reduce women’s fertility or even cause miscarriage.
Dilation and curettage
Dilation and curettage (D&C) is an outpatient procedure during which the cervix is first dilated so that a special instrument can be inserted into the uterine wall. It is used to clear uterine wall lining from fetal tissues after miscarriage or abortion or to treat abnormal vaginal bleeding of unknown cause.
Tubal ligation
Tubal ligation, or, as it is often called, “tying the tubes,” is performed by either cauterizing (burning) a woman’s fallopian tubes shut or by clamping them using special clips or bands. If successful, it makes a woman infertile until she undergoes tubal ligation reversal surgery.
Cervical cerclage
Cervical cerclage is a procedure that attempts to prolong pregnancy in women who are at risk of preterm labor—usually performed when your obstetrician notices that your cervix started to shorten or dilate too early and might not be able to hold your baby’s weight long enough, putting you at risk of miscarriage or preterm labor. It is performed by sewing a strong suture into and around the cervix to strengthen it. The suture is removed later after the highest risk of ending the pregnancy prematurely has passed.
Assisted delivery
Assisted delivery is used in 1 in 8 deliveries. It utilizes either forceps or a vacuum suction cap to help the mother deliver a baby when labor is not progressing or due to an underlying health condition that prevents a woman from pushing during delivery, like very high blood pressure. Other reasons that call for assisted delivery are:
- Incorrect baby’s position
- Premature delivery (forceps can help protect an immature baby’s head from getting pressed against the mother’s pelvis)
- Concerns about the baby’s heart rate
Caesarian section
C-section is a method of delivery that bypasses the natural birth canal. Used when there are concerns about either child’s or mother’s health. In this method, the baby is delivered through an incision made by an obstetrician in the woman’s abdomen and uterus. The most common reasons for c-sections are:
- Lack of labor progression
- Unusual baby’s position
- Multiple pregnancies
- Gestational diabetes
- Prolapsed umbilical cord
Sources
- National Health Service (NHS) Infections in pregnancy that may affect your baby (2024)
https://www.nhs.uk/pregnancy/keeping-well/infections-that-may-affect-your-baby/ - National Cancer Institute (NIH) Cervical Cancer Screening (2024)
https://www.cancer.gov/types/cervical/screening - National Library of Medicine (NIH) Kelly C. Wormer; Amelia Bauer; Ann E. Williford. Bishop Score (2023)
https://www.ncbi.nlm.nih.gov/books/NBK470368/ - National Library of Medicine (NIH) Shervonne S. Superville; Marco A. Siccardi. Leopold Maneuvers (2023)
https://www.ncbi.nlm.nih.gov/books/NBK560814/ - Conner SN, Longman RE, Cahill AG. The role of ultrasound in the diagnosis of fetal genetic syndromes. Best Pract Res Clin Obstet Gynaecol. 2014 Apr;28(3):417-28. doi: 10.1016/j.bpobgyn.2014.01.005. Epub 2014 Jan 28. PMID: 24534428; PMCID: PMC4079588.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4079588/ - Hartmann KE, Velez Edwards DR, Savitz DA, Jonsson-Funk ML, Wu P, Sundermann AC, Baird DD. Prospective Cohort Study of Uterine Fibroids and Miscarriage Risk. Am J Epidemiol. 2017 Nov 15;186(10):1140-1148. doi: 10.1093/aje/kwx062. PMID: 28591761; PMCID: PMC5860279.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5860279/ - National Health Service (NHS) Forceps or vacuum delivery (2023)
https://www.nhs.uk/pregnancy/labour-and-birth/what-happens/forceps-or-vacuum-delivery/
