The OB/GYN and the Maternal Fetal Medicine Specialist: What’s the Difference?

Both obstetrician-gynecologists (OB/GYN) and maternal-fetal medicine (MFM) subspecialists are clinicians dedicated to addressing similar but slightly different aspects of reproductive needs of the female patient. A traditional OB/GYN often takes care of women through pre-pregnancy, antepartum, delivery and postpartum periods, when such patients are considered low risk. However, once patients meet a certain threshold and are considered to have high risk pregnancies, they are co-managed by maternal-fetal medicine (MFM) subspecialists.  A vast majority of pregnancies are low risk hence, an OB/GYN is the default physician most patients would see once pregnant.

An MFM is essentially an OB/GYN with three additional years or more of training/education in managing high-risk pregnancies. An MFM is often an integral part of a medical team, that often comprises an OB/GYN and a midwife, working together to ensure you get comprehensive care throughout your pregnancy.

High-risk pregnancies are those pregnancies that potentially put the health or life of the pregnant patient and or the developing fetus in jeopardy. Underlying conditions for such pregnancies could be chronic, such as seen in patients with pregestational diabetes, hypertension or other heart-related conditions, autoimmune and neurologic conditions. Other high-risk conditions can be relatively more acute as in instances of preterm labor, premature rupture of membranes, viral infections in pregnancy and antepartum bleeding.

Other high risk pregnancy conditions pertain to those involving twin pregnancies or higher order pregnancies, as well as those involving birth defects or genetic conditions that may affect the fetus, the newborn and the affected couple’s future reproductivity. MFM subspecialists work to reduce the likelihood these and similar pregnancy complications will compromise the health or life of their patients and optimize perinatal outcomes.

Given select concerns about your pregnancy, your OB/GYN will refer you to an MFM subspecialist, who would work with your primary OB/GYN to coordinate and perform ultrasounds, blood work, antenatal surveillance and recommend best practice management for a safe and healthy pregnancy towards optimal outcomes.

Obstetrician and Gynecologist (OB-GYN) Practice and Focuses:

• General women's health:
  • Reproductive health
  • Pregnancy
  • Childbirth
  • Postpartum care
• Gynecological care:
  • Menstrual issues
  • Contraception
  • Menopause
  • Surgery for conditions like fibroids or ovarian cysts
• Provide routine prenatal care and manage normal pregnancies
• Perform deliveries 
• Address general gynecological health concerns

Maternal Fetal Medicine (MFM) Practice and Focuses:

• Focus on high-risk pregnancies and complications related to pregnancy:
  • Multiple pregnancies
  • Preterm labor
  • Fetal anomalies
  • Placental issues
  • Perinatal infections
• Provide advanced prenatal testing, genetic counseling, and fetal monitoring
• Manage pregnancies with pre-existing conditions such as diabetes, hypertension, or heart disease
• Perform procedures like amniocentesis, chorionic villus sampling (CVS), and fetal surgeries
• Offer specialized care and interventions to optimize outcomes for both the mother and the fetus

Each year, approximately 20% of all pregnancies are considered “high risk.” Although all OB/GYNs can effectively care for pregnancies of risk, it is always recommended to add an MFM doctor to your standard care. Having both doctors ensures that anything of risk is addressed carefully and cautiously alongside your regular check-ups. One thing to note is that MFM care can begin before conception, during pregnancy or after delivery.