Obstetrics, branch of medicine that specializes in caring for women during pregnancy, labor, and immediately following childbirth. The term derives from the Latin obstare, meaning to stand by, or opstare, meaning to render aid, and obstetrix, meaning the woman who stands by. Until the early 18th century, childbirth assistants were usually midwives, women who provide care to other women during pregnancy and childbirth. During the 19th century, obstetrics evolved as a medical specialty. Physicians who specialize in obstetrics are called obstetricians.
Obstetricians are commonly also certified in
gynecology, to provide care for a wide range of problems involving the reproductive system. Obstetricians with special training in high-risk pregnancy are referred to as maternal-fetal medicine specialists or perinatologists. Many physicians in family practice include obstetrics and some gynecologic surgery in their practices. In addition,
midwifery is practiced in many parts of the United States, as well as throughout the world. Women may choose midwives in areas where physicians are unavailable or unaffordable, or because they believe in a less medicalized approach to childbirth.
Obstetrical care ideally begins with the counseling of a woman who is either planning a pregnancy or at risk for an unplanned pregnancy. Preconception counseling may include assessment of lifestyle, including issues such as diet, exercise, consumption of alcohol or tobacco, and ways of dealing with stress; recommendation of vitamins; administration of necessary vaccinations; and general advice about maintaining healthy habits. Throughout a pregnancy a woman may schedule eight to ten or more visits to her obstetrician, during which tests are performed, such as blood typing—in preparation for possible blood transfusion, and to determine if there are incompatibilities between the mother’s and baby’s blood—and screening for infectious diseases. Specialized tests to monitor the health of the fetus may be recommended, including
ultrasound to visualize the fetus, and genetic testing to learn the risk for genetic diseases such as
Down syndrome.
An obstetrician attends the woman during labor and delivery and is trained to handle any complications that would endanger the mother and fetus. Complications may include premature rupture of the membranes, in which the water bag ruptures but labor does not begin spontaneously; failure to progress, in which labor has begun but the woman’s cervix—the small organ that connects the uterus to the vagina—fails to widen or dilate properly; or breech presentation, in which the fetus is oriented feet first down the birth canal instead of head first. Obstetricians perform
cesarean sections, in which the fetus is removed through an abdominal incision, and they also surgically repair injuries to the birth canal that may occur during delivery. Immediate care of the mother for several weeks after delivery is generally considered part of obstetrical practice. Once a baby is delivered, its care may be assumed by a pediatrician (see
Pediatrics), a specialist in the care of children.
Obstetricians complete four years of medical school, followed by four or more years of primary care training and training in obstetrics and gynecology. After completing an approved training course and a period of practice, obstetricians may take an examination for board certification, a nationally recognized acknowledgment of expertise in a specialty. In addition, physicians planning to specialize in gynecologic cancer,
infertility, or reconstructive surgery may complete two to three years of additional training to receive board certification in their particular subspecialty.
