All you need to know about OB-GYNs
An obstetrician-gynecologist, or OB-GYN, specializes in women's health. Skilled in both obstetrics and gynecology, OB-GYNs are often the first point of contact for all problems related to the female reproductive system and care during and after pregnancy.
Most people think that an OB-GYN is the same as a gynecologist. This is a misconception because gynecologists specialize only in one discipline – gynecology. They deal with non-pregnancy issues and focus on your overall reproductive health. Gynecologists train in performing hysterectomies, tubal litigations, and screening tests for reproductive-related disorders. They can also advise on sexual matters, including contraceptives, sexual practices, and sexually transmitted infections (STIs).
OB-GYNs, unlike gynecologists, are qualified to handle all stages of pregnancy, right from the prenatal period to postnatal care, including any pregnancy-related complications, besides treating disorders related to female reproductive health. If you have questions about family planning, birth control, pregnancy, or infertility, find and visit the best OB-GYN near you.
After completing medical school, OB-GYNs must complete a four-year residency in obstetrics and gynecology. They then qualify for board certification by the American Board of Obstetrics and Gynecology (ABOG). OB-GYNs can subspecialize by enrolling in fellowship training.
Subspecialties in OB-GYN
OB-GYNs may specialize in fields that require additional training and certification, such as:
- Specialists in maternal-fetal medicine (MFM) perform ultrasounds to monitor the fetus' growth and development and provide high-risk pregnant women with prenatal care. They also assist the patient in controlling underlying health conditions like high blood pressure or diabetes. Additionally, they use techniques like chorionic villus sampling (CVS) and umbilical cord sampling to look for genetic abnormalities. They identify and treat congenital problems in growing newborns, perform necessary procedures, and care for the mother's postpartum health problems.
- Reproductive endocrinologists (RE): They deal with complex reproductive endocrinology and infertility difficulties. Infertility can affect men or women at any age. If a patient who has had unprotected sex for a year fails to conceive, they can see an OB-GYN. Reproductive endocrinologists use diagnostic procedures such as X-rays of the uterus or fallopian tubes, testing of the semen, or an ovarian reserve fertility test to identify the problem. Depending on the examination results, they may suggest procedures like laparoscopy, hysteroscopy, or abdominal myomectomy. They also support IUI (intrauterine insemination) and IVF (in vitro fertilization).
- Gynecologic oncologists diagnose and treat reproductive system cancers using chemotherapy, surgery, and palliative care.
- Complex family planning specialists: Patients with complicated medical conditions can receive care from these professionals for abortion and contraception care. They also help the patients with family planning by instructing and advising them.
- Female pelvic medicine and reconstructive surgeons: They treat genitourinary problems such as recurrent fecal and urinary incontinence, defecatory disorders, and sexual dysfunction. To identify these issues, they conduct physical examinations and use diagnostic methods such as office cystoscopy, endoanal sonography analysis, and urodynamic testing. They also perform abdominal sacrocolpopexy, sacrospinous fixation, uterosacral ligament suspension, and mid-urethral sling.
- Critical care medicine specialists: They look after critically ill and injured patients.
- Hospice and palliative medicine specialists: These specialists care for patients with terminal illnesses or those needing end-of-life care. People nearing the end of their lives may feel depressed and lonely and are more susceptible to medication's adverse side effects. They aim to enhance patients' quality of life by offering comprehensive treatment. They might collaborate with groups of nurses, pharmacists, and social workers.
Some conditions treated by OB-GYNs
OB-GYNs can diagnose and treat different types of diseases and conditions. They include:
- Endometriosis occurs when the endometrium, the tissue lining the uterus, grows outside the uterus. About 10% of women of reproductive age suffer from this painful disorder. An OB-GYN might use procedures such as laparoscopy and biopsy to diagnose the condition. Treatment comprises medication and, in some instances, surgery.
- Uterine fibroids: Fibroids comprising smooth muscle cells and fibrous connective tissue are tumors found in the uterus. Fibroids are common in women nearing menopause. Most of the time, fibroids are benign or non-cancerous and can grow at different rates. Ultrasounds and MRIs can help diagnose fibroids.
- Polycystic ovary syndrome (PCOS): A result of hormone abnormalities, PCOS is common in women of reproductive age. Irregular menstruation, excessive production of the hormone androgen, and insulin resistance are some symptoms. If neglected, it can result in infertility, diabetes, and cardiovascular disease.
- Recurrent pregnancy loss: This refers to two or more consecutive pregnancy losses or pregnancies that end involuntarily before 20 weeks. Recurrent pregnancy loss can happen for different reasons; an OB-GYN can diagnose the cause with tests such as karyotype analysis and evaluation of the uterine cavity.
- Cervical cancer: One of the common causes of cervical cancer is the human papillomavirus (HPV). An OB-GYN can diagnose this disease through screening checks like HPV testing. They might then refer you to a gynecologic oncologist for specialized treatment.
Can OB-GYNs perform surgery?
Other than assisting women during labor and childbirth, OB-GYNs receive training to perform non-pregnancy-related procedures that concern the female reproductive system. These include minor diagnostic procedures that may be performed in an office or clinical setting and complex surgeries. Examples of some outpatient and inpatient procedures include laser surgery, laparoscopic ovarian cystectomy, hysterectomies (done laparoscopically, vaginally, or abdominally), and tubal ligation.
OB-GYNs are qualified to perform the following diagnostic and surgical procedures:
- Dilation and Curettage (D&C): Obgyns typically perform this procedure to diagnose and treat a uterine condition. D&C may be done to treat concerns like heavy bleeding or clear the uterine lining after a miscarriage or abortion. During the procedure, an OB-GYN dilates the cervix, which is the lower and narrow part of the uterus, using either a medication or a small instrument. This is followed by using a surgical instrument called a sharp instrument called a "curette" or suction device to remove uterine tissue. A D&C involves removing contents from the uterus, not just a small tissue sample. This may be done to prevent infection, stop heavy bleeding, remove a pregnancy tumor, remove cervical or uterine polyps, or clear out that remains in the uterus post heavy bleeding due to childbirth.
- Colposcopy: This diagnostic procedure may be used to examine the vulva, cervix, and vagina for disease and is the usual recommendation after a pap test or pelvic exam reveals some abnormalities. A colposcopy can help diagnose conditions such as genital warts, precancerous changes in the tissues of the cervix, vagina, or vulva, and cervicitis (inflammation of the cervix). The procedure involves using a colposcope which is a unique magnifying instrument to check the cervix and vagina. A typical colposcopy may take anywhere from 10 to 20 minutes to complete.
- Myomectomy: This procedure is performed to remove leiomyomas, known as uterine fibroids, which are non-cancerous growths that may appear in the uterus during childbearing years or even after. Many individuals with uterine fibroids may not show any symptoms. However, a myomectomy may be necessary if the uterine fibroids are causing symptoms such as heavy or painful periods, pelvic pain, frequent urination, and longer periods that interfere with daily activities. The procedure involves removing fibroids and reconstructing the uterus, unlike a hysterectomy, where the uterus is removed. Depending on the size of the fibroids, your OB-GYN may choose one of the following surgical approaches: abdominal, laparoscopic, robotic, or hysteroscopic myomectomy.
What to expect at an OB-GYN appointment?
Girls and women go in for OB-GYN appointments at various stages of their lives, and their healthcare needs differ from phase to phase. Experts recommend that girls have their first OB-GYN appointment around 15. These appointments help teenagers get comfortable talking to a doctor specializing in female reproductive issues.
The doctor may discuss topics such as birth control and sexually transmitted diseases, irrespective of whether the patient is sexually active. They do not conduct pelvic exams unless there is some problem or unusual symptoms. HPV vaccines and home breast exams are other topics. From age 21, you might need to see an OB-GYN for regular pap smears.
From age 22 to about 44, you can expect the OB-GYN to recommend annual breast, abdomen, and pelvic examinations. They will also assess your vitals, such as blood pressure, blood sugar levels, and cholesterol. Contraception, fertility, and genetic counseling are some issues you should discuss, depending on your lifestyle and preferences.
After age 45, hormonal changes occur as a precursor to menopause, usually between ages 50 and 52. OB-GYN appointments during this phase of life are likely to focus on tests like mammograms, colonoscopies, and bone density screenings. For women over 55, OB-GYN appointments might tackle issues such as decreased libido, vaginal dryness, and skin changes caused by reduced estrogen levels.
How to choose between an OB-GYN and a midwife?
After learning about your pregnancy, you must prioritize finding a specialized prenatal care provider. You can typically choose between an OB-GYN (obstetrician and gynecologist) or a midwife. It is best to explore your options before selecting your pregnancy caregiver.
Midwives offer comprehensive women's health services, similar to OB-GYNs. In addition to pregnancy and childbirth care, they can handle annual checkups, help with birth control, and support women through menopause. However, they are primarily known for their expertise in pregnancy, delivery, and postpartum care.
Your midwife will collaborate with your healthcare team throughout your pregnancy, including your OB-GYN or family doctor. Many women maintain their relationship with their midwife even after giving birth.
You can choose from three types of certified midwives:
- Certified nurse-midwives (CNMs) combine nursing expertise with advanced midwifery training. These registered nurses hold master's or doctorate degrees and certification from the American Midwifery Certification Board.
- Certified midwives (CMs) enter the field by taking a different path. Though not nurses, they earn post-graduate midwifery degrees and secure certification from the American Midwifery Certification Board.
- Certified professional midwives (CPMs) focus specifically on midwifery services. The North American Registry of Midwives certifies them based on their demonstrated skills and knowledge.
Understanding the specialties of midwives versus OB-GYNs can help you make the right choice for your care. Consider these key differences:
- Pregnancy risk levels: Choose an OB-GYN for high-risk situations like multiple births or if you have existing medical conditions. Midwives excel in low-risk pregnancies but can coordinate with specialists when needed.
- Water births: While hospitals and OB-GYNs increasingly accommodate water births, midwives typically offer extensive experience with this delivery method.
- C-sections: Only OB-GYNs can perform C-sections, whether planned or emergency. Their surgical training enables them to handle these and other complicated deliveries, making them essential for high-risk pregnancies.
Find the best OB-GYNs near you in Silver Spring, MD
A good OB-GYN must be qualified, experienced, and someone you can be comfortable discussing personal health issues with. Here is where Zocdoc can be of assistance. Our easy-to-use platform gives you access to an extensive database of medical practitioners nationwide and a hassle-free experience.
Create a free account on Zocdoc and use the convenient filters to refine your search to match specific criteria. Look for OB-GYNs that meet your preferences of gender, location, and educational qualifications. You can also look for doctors by insurance coverage, hospital affiliations, and symptoms. Find out more about the best OB-GYNs near you by clicking on their profile. You can see their education and experience, the languages they speak, licensure, accreditation, affiliations, and awards, among other details.
You can have multiple insurance plans linked to your Zocdoc account, but you must select one to use for each appointment booking. You can provide information about any additional insurance you have during the booking process or on the provider's intake forms. If you have any questions about your health insurance, reach out to Zocdoc's patient help center.
Check the verified patient reviews and ratings to gauge whether the doctor fits your requirements. Depending on availability, you can also find doctors outside of regular business hours and on weekends. Another convenient feature of Zocdoc is setting up a virtual appointment to get to know your doctor before an in-person consultation.
All bookings made on Zocdoc are free, simple, and secure!
Statistics on STIs in Maryland and Montgomery County
Unsafe sexual practices and poor hygiene can lead to STIs such as syphilis, gonorrhea, and chlamydia. According to the 'Sexually Transmitted Disease Surveillance 2022' report by the CDC (Centers for Disease Control and Prevention), about 2.5 million of these diseases were reported nationally, even during the COVID-19 pandemic. The report also stated that in 2022, cases of syphilis have risen by 80% in the past five years, chlamydia cases have been at the same level, and gonorrhea cases have decreased by approximately 9%.
The same report shows that the rate of chlamydia in Maryland was around 506.7 per 100,000. The rate of gonorrhea was roughly 181.1, and syphilis (primary and secondary) was almost 12.7 per 100,000.
The 'Sexually Transmitted Infections 2019 Annual Report' by the Maryland Department of Health Center for STI Prevention indicates that the rate of chlamydia in Montgomery County was approximately 447.2 per 100,000. For gonorrhea, it was at around 79.4; for syphilis (primary and secondary), it was about 8.9 per 100,000.
Sources
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