Being pregnant is an exciting, amazing thing, and you want nothing more than the best for this growing life inside of you.
Most of us understand a healthy lifestyle is important to ensure a healthy pregnancy, but it also takes regularly scheduled appointments with excellent prenatal care.
That’s why the first of many decisions you’ll make as a new mom is to find the best doctor that’s right for you. Whether you have a high- or low-risk pregnancy, your provider will continually monitor and watch your baby grow and develop to ensure her health and safety.
But many women are left wondering how do they know if a pregnancy is high risk? Should they start with an obstetrician/gynecologist (Ob/Gyn) or maternal-fetal medicine (MFM) specialist?
Dr. Melissa Mancuso, chair of Akron Children’s Hospital’s Maternal-Fetal Medicine Department, answers these questions and more about high-risk pregnancy and the roles these providers play in keeping you and your baby safe throughout pregnancy.
What is a high-risk pregnancy?
A high-risk pregnancy occurs when there are potential complications that could affect the mother, her baby or both. These conditions may be preexisting or develop during pregnancy.
A pregnancy could be considered high risk for the mother if she has a pre-existing medical condition, such as diabetes, obesity, high blood pressure or an autoimmune or kidney disease. In addition, problems may develop during pregnancy, such as early labor, bleeding or pre-eclampsia, that could denote high risk.
A history of miscarriage, problems with previous pregnancies or genetic disorders, such as cystic fibrosis, also can cause a high-risk pregnancy.
A pregnancy could be designated high-risk for the baby if there’s an abnormal finding during an ultrasound, such as a birth defect, growth problems, multiples or low amounts of amniotic fluid.
A high-risk pregnancy doesn’t necessarily mean it will be more challenging than a low-risk one, but it could mean additional appointments and ultrasounds with an MFM specialist.
What’s the difference between an Ob/Gyn and MFM specialist?
An Ob/Gyn is a doctor who specializes in women’s reproductive health. They care for women during and just after their pregnancy, deliver babies and consult on other important women’s health issues, including birth control and menopause. In addition, they treat infections, screen for cancer and perform surgeries for pelvic organ or urinary tract problems.
MFM specialists, or perinatologists, subspecialize within the field of obstetrics. They strictly focus on the health concerns of the mother and fetus prior to, during and shortly after a complicated pregnancy. They have extensive training in assessment and treatment of fetal problems. If a birth defect or other problem is found, they can begin treatment before birth, if possible.
“An Ob/Gyn may deal with abnormal uterine bleeding and other gynecologic issues that have nothing to do with pregnancy,” said Dr. Mancuso. “They take care of women across the entire life span with regard to reproductive organs. We can do that as well, but we spend our entire day strictly focusing on minimizing complications arising from high-risk pregnancy.”
Dr. Melissa Mancuso
How does their training differ?
MFM specialists receive the same traditional obstetrics and gynecology training as an Ob/Gyn provider, but they are required to complete an additional 3 years of education and training in high-risk pregnancy.
MFM specialists are not only board-certified in Ob/Gyn, but they are also board-certified in maternal-fetal medicine.
“The expertise of a maternal-fetal medicine physician comes into play when reading ultrasounds or performing invasive in utero procedures, such as an amniocentesis, shunt placements or in utero medication,” said Dr. Mancuso.
What if I don’t know whether I’m high risk?
Once pregnant, many women start with their Ob/Gyn. If the provider discovers that a woman is high risk, she can refer her to an MFM specialist.
“If you’re unsure, talk to your doctor about any potential risks or schedule an appointment with an MFM specialist,” said Dr. Mancuso. “We don’t turn away any patients. We will assess your risk and if it’s considered a normal pregnancy, we will refer you back to an Ob/Gyn.”
However, if you know you have a preexisting condition or genetic risk, start with an MFM specialist. She will coordinate you and your baby’s care during pregnancy and at delivery with the help of a pediatric care team.
In addition, the MFM team can provide your family with genetic counseling and other education to help alleviate anxiety and consider how it might impact future pregnancies.
How do Ob/Gyns and MFM specialists work together?
An MFM specialist and Ob/Gyn are usually part of a medical team who all work together to ensure you receive comprehensive care during pregnancy.
While an Ob/Gyn may oversee your prenatal care, an MFM may offer care recommendations, monitor your condition or oversee any testing or treatment during pregnancy.
Some women with complicated pregnancies continue to see their Ob/Gyn for regularly scheduled appointments with periodic visits to an MFM. Others may see an MFM for all of their appointments. How frequently you see an MFM depends on you and your baby’s condition.
“We complement each other,” said Dr. Mancuso. “If something abnormal is found, we will work alongside the Ob/Gyn to give families the best outcome. Together, we have the expertise required to keep you and your baby safe before, during and after pregnancy.”
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