Gynecology and obstetrics are medical disciplines that deal exclusively with women’s healthcare. What confuses most people is that doctors called OB-GYNs can specialize in both obstetrics and gynecology. So, what are the differences between obstetricians gynecologists and OB/GYNs? Which one should a woman go to for health issues?
The professional team of medical providers at Tidewater Physicians for Women specializes in women’s health. If you, or someone you know, has questions about their health, call Tidewater Physicians for Women today at (757) 461-3890 to schedule a check-up, mammogram, or Pap smear with an OB/GYN.
Obstetricians and Obstetrics
Obstetrics is a branch of medicine focusing solely on women’s health during pregnancy, childbirth, and post-partum concerns. An obstetrician practicing in the U.S. must complete the following educational and licensing requirements:
- Earn a bachelor of science (B.S) degree in a science-based discipline (biology, chemistry, etc.)
- Pass the Medical College Admission Test (MCAT) to gain entry into a medical school
- Earn an M.D. degree following four years at medical school (includes practical experience and internships)
- Pass the U.S. Medical Licensing Examination (USMLE) to obtain a medical license
- Work four years in residency training under the guidance of a licensed obstetrician
- Pass a written and oral exam provided by the American Board of Physician Specialties to become board certified
- Take continuing education courses to be able to renew certification and licensing
Fetal Testing and Monitoring
Obstetricians take care of all the health needs of pregnant women from conception to the birth of their child and postpartum. In addition to delivering babies, obstetricians perform the following tests to monitor the health of mother and baby:
Ultrasonography
Ultrasounds help obstetricians ensure the fetus is developing normally. Ultrasounds are also used to determine if more than one fetus is in the womb or outside of the womb.. Congenital abnormalities and placental numbers can be detected with an ultrasonography.
Blood tests
Blood tests to check Rh compatibility are given during the first three or four months of pregnancy. If the test detects Rh incompatibility between the mother and fetus, the obstetrician will give their patient an injection of Rh-immune globulin when they are 28 weeks pregnant. Another injection is then given a few days after birth.
A genetic disease screening called a fetal karyotype is another genetic disease test done by obstetricians that requires taking a sample of amniotic fluid from the woman’s uterus. Fetal karyotypes are often performed on older mothers who are more likely to give birth to a child with Down’s Syndrome. Additional genetic testing may be offered. Insurance carrier coverage of genetic testing varies.
Fetal nonstress test
If an obstetrician is concerned about the health of a baby during the last trimester, they may order a nonstress test to monitor the baby’s heart rate. This test evaluates how a baby’s heart reacts when they are moving in the womb.
In addition to specializing in maternal-fetal medicine, obstetricians also provide advice regarding a pregnant woman’s diet, exercise, and choice of birth control.
Disease Detection and Treatment During Pregnancy
Pregnancy initiates dramatic physical and hormonal changes in women that can cause certain diseases. Some of the more common diseases experienced by pregnant women that obstetricians diagnose and treat include:
Gestational diabetes: some pregnant women who are not diabetic develop gestational diabetes while pregnant. A combination of increased hormone levels and weight gain is thought to cause gestational diabetes. Obstetricians routinely test a patient’s blood for signs of insulin resistance and possible gestational diabetes after the first trimester.
Thyroid disorder: during pregnancy, a woman’s body requires more thyroid hormones to maintain metabolic stability. A dysfunctional thyroid can negatively impact the health of the fetus and the mother. Obstetricians may screen pregnant women they identify as high-risk (over 30, diabetic, history of infertility) for hyperthyroidism or hypothyroidism, especially those with a pre-existing thyroid disorder.
Preeclampsia: after pregnancy has passed the 20-week mark, an obstetrician will closely monitor a patient for signs of preeclampsia. Preeclampsia is a serious condition affecting about five to eight percent of pregnant women. Preeclampsia poses the most risk for women with a family history of preeclampsia, to women carrying multiple babies, and to those who are over 40 years old. Assessments performed by obstetricians to detect preeclampsia involve high blood pressure monitoring, urine testing for high levels of protein, and Doppler scans to measure blood flowing to the placenta.
Other pregnancy-related conditions treated by obstetricians include:
- Placental abruption (separation of the placenta from the uterine wall before delivery)
- Prolapsed umbilical cord (cord is trapped or tangled during childbirth)
- Uterine rupture (a division, or rupture, of all three uterine layers)
- Dilation and curettage
- Vaginal or cesarean delivery
- Episiotomy (incisions made between the anus and vaginal opening to facilitate childbirth)
- Vacuum and forceps deliveries
After giving birth, women may continue visiting their doctor for post-partum follow-ups if they have a Cesarean section or other delivery problems. Once conditions are resolved, mothers will see a gynecologist for diagnosis and treatment of various health concerns associated with female reproductive anatomy.
Gynecology and Gynecologists
Gynecology is a specialized branch of medical care that focuses on the reproductive health of women who are not pregnant. A gynecologist treats girls as young as 16 and women in their 90s for reasons ranging from delayed puberty and vaginal infections to abnormal vaginal bleeding and ovarian cancer.
Like obstetricians, these doctors must earn a B.S degree in a field associated with medicine before applying for medical school. After graduating medical school, a gynecologist needs to finish a four-year residency program and work under the supervision of a licensed gynecologist. Finally, they must pass the U.S. Medical Licensing Examination to become a licensed physician.
Why Women See a Gynecologist
Two tests vital to a woman’s health provided by a gynecologist are the pelvic exam and Pap test. Pelvic exams involve evaluating the vagina, cervix, uterus, ovaries, and pelvic area for signs of abnormalities.
Pap smears taken during pelvic exams involve collecting cervical cells for detection of precancerous or cancerous cells. A pap smear remains the best method for detecting polyps, cysts, and early-stage cervical cancer.
Gynecologists diagnose and treat diseases and disorders of the female reproductive system. This system consists of the vagina, vulva, cervix, uterus, ovaries, and Fallopian tubes. Common conditions affecting this system that gynecologists specialize in diagnosing and treating include:
- Cancer of the reproductive organs
- Symptoms of perimenopause and menopause
- Amenorrhea (absence of menstruation)
- Menorrhagia (abnormally heavy menstrual periods or lengthy menstruation)
- Dysmenorrhea (painful periods)
- Bacterial, viral, or fungal infections of the vagina, uterus, or cervix
- Pelvic inflammatory disease (PID)
- Urinary tract infection (UTI)
- Pelvic organs weakening and dropping below the pelvis (prolapse)
While gynecologists can diagnose cancer of the cervix, they often refer patients to an oncologist or other medical specialty physician for treatment. Gynecologists can treat infections, PIDs, UTIs, STDs, and menstrual issues but will likely refer patients with more complex conditions to a specialist. For example, women who are having difficulty getting pregnant due to hormonal imbalances may be treated by their gynecologist with hormone-stabilizing drugs. However, if treatment is not successful, the gynecologist will refer the patient to a fertility doctor.
Gynecologists also perform a variety of minimally invasive and full surgical procedures:
- Tubal ligations
- Cervical biopsies (extraction of tissue samples for evaluation)
- Dilation and curettage
- Partial or full hysterectomy
- Removal of fallopian tubes (salpingectomy)
- Removal of the ovaries (oophorectomy)
- Colposcopy (closer examination of the cervix following an abnormal Pap test result)
- Endometrial ablation (eradicates the lining of the uterus to reduce or eliminate heavy or lengthy periods)
- Removal of the cervix (trachelectomy)
- Diagnostic and exploratory laparotomy (for diagnosing abdominal or pelvic pain, uterine fibroids, ovarian cysts)
- Pelvic organ prolapse surgery
Gynecologists do not diagnose or treat conditions affecting pregnant women. Likewise, obstetricians do not diagnose or treat conditions affecting women who are not pregnant.
What are Some Subspecialties of Obstetrics and Gynecology Care?
An OB/GYN is a doctor who has advanced education and training in both the obstetric and gynecological fields of medicine.
An OB/GYN diagnoses and treats health problems affecting the female reproductive system of both pregnant and nonpregnant women of all ages. Women visit OB/GYNs for a wide variety of diseases and disorders that are exclusive to women. For example, an OB/GYN can provide fertility treatments, recommend contraception methods, treat endometriosis and STDs, and remove ovarian cysts. Reproductive endocrinology is another medical specialty practiced by OB/GYNs that deals with infertility associated with disorders of the endocrinology system.
Obstetricians, gynecologists, and OB/GYNs regularly collaborate to ensure patients receive the best, most informed health care possible. With female reproductive health and general female health so closely linked, many women choose to schedule examinations, tests, and treatments with an OB/GYN.
The doctors and staff at Tidewater genuinely care about women’s health issues. Call Tidewater Physicians for Women today at (757) 461-3890 to schedule a check-up, mammogram, or Pap smear with an OB/GYN.
