I remember a young woman, let’s call her Priya, sitting in my office. Her eyes were wide with worry. She’d just found out her pregnancy was considered ‘high-risk,’ and her obstetrician mentioned a referral to someone called a perinatologist. The unknown can be so scary, can’t it? Especially when it involves your precious little one on the way. She asked me, “Doctor, what does this mean? Is my baby going to be okay?” It’s a question I hear often, and it’s completely natural to feel a bit overwhelmed. So, let’s talk about what a perinatologist is and how they can be an amazing source of support during certain pregnancies.
So, what exactly is a perinatologist? Think of them as a super-specialized doctor for pregnancies that need a little extra TLC. They’re actually obstetrician-gynecologists (you probably know them as OBGYNs) who’ve gone on to do extra training, usually two or three more years, specifically in high-risk pregnancies. You might also hear them called maternal-fetal medicine (MFM) specialists – it’s the same thing, just a different name. Their main job is to look after both you and your baby when there are health complications, or a higher chance of them, during pregnancy, labor, or delivery. This could be a health issue you already had before getting pregnant, or something that pops up during the pregnancy itself. They also help if there’s a concern that your baby might have a congenital disorder (that’s a health problem present at birth) or some other birth abnormality.
When Might You Meet a Perinatologist?
It’s natural to wonder, “Why me? Why do I need to see a perinatologist?” Well, your regular OBGYN is fantastic for most pregnancies. But sometimes, certain situations call for that extra layer of expertise.
Your OBGYN might suggest you see a perinatologist if your pregnancy is labeled high-risk. Now, that term ‘high-risk’ can sound pretty alarming, I know. But it doesn’t automatically mean something is wrong or that your pregnancy is in danger. It simply means your pregnancy will benefit from closer monitoring because there’s a slightly increased chance of a complication for you or your baby.
Here are some common reasons a pregnancy might be considered high-risk, and why a perinatologist might join your care team:
- Your age: Especially if you’re over 40.
- Expecting multiples: Carrying twins, triplets, or more is amazing, but it does come with unique needs.
- Past pregnancy experiences: Things like previous miscarriages, stillbirths, or complications like preeclampsia (a serious blood pressure condition during pregnancy), preterm labor, or gestational diabetes (diabetes that develops during pregnancy).
- A family history: If certain genetic conditions run in your family.
- Your own health: If you have an ongoing health condition, such as:
- Heart disease
- Diabetes (pre-existing)
- High blood pressure (pre-existing)
- Inflammatory bowel disease (like Crohn’s or colitis)
- An autoimmune disorder (like lupus or rheumatoid arthritis)
- Kidney problems
- A history of seizures
- Bleeding or clotting disorders
- Genetic conditions like cystic fibrosis or sickle cell disease.
Sometimes, you might even chat with a perinatologist before you conceive if you already know your pregnancy will likely be high-risk due to an existing condition. Other times, a concern might pop up unexpectedly during your pregnancy, maybe from an abnormal prenatal screening test, or if the baby isn’t growing as expected (fetal growth restriction). They can also be involved if there are concerns about the placenta, like placental abruption (where it separates from the uterine wall too early) or placenta previa (where it covers the cervix).
A perinatologist doesn’t usually replace your regular OBGYN. Think of it more like teamwork. Your OBGYN might consult them for a second opinion, or you might see the perinatologist a few times, or they might be more involved, depending on what’s going on. They’re experts in:
- Preconception counseling: Helping you plan if you have health issues.
- Advanced prenatal testing and care for high-risk situations.
- Managing your health conditions during pregnancy.
- Using tools like detailed ultrasounds to check on the baby and diagnose any potential issues.
- Assisting during labor and delivery if needed.
- Managing any complications that might arise after birth, like excessive bleeding or an infection.
Your OBGYN and Your Perinatologist: A Team Effort
So, how is a perinatologist different from your regular obstetrician? It’s a great question. As I mentioned, a perinatologist is an obstetrician. They’ve done all the standard OBGYN training and then decided to go even further, completing an extra two to three years of fellowship. This special fellowship focuses on the really complex medical and even surgical issues that can happen during pregnancy, for both mom and baby. They become experts in diagnosing and managing fetal conditions, too.
It’s important to know that seeing a perinatologist usually doesn’t mean you stop seeing your trusted OBGYN. Most of the time, they work together. Your OBGYN will guide how often you see the perinatologist. Sometimes it’s just for a consultation or two; other times, the perinatologist might be more hands-on with your care, especially if things are particularly complex.
And just to clear up any confusion with terms – if you hear ‘maternal-fetal medicine specialist’ or ‘MFM specialist,’ they’re talking about a perinatologist. Same expert, different label!
Becoming a perinatologist is quite a journey of dedication. After their initial college degree, they go through:
- Medical school (usually 4 years).
- A residency in obstetrics and gynecology (another 4 years).
- And then, a fellowship in perinatology or maternal-fetal medicine (an additional 2 to 3 years).
That’s a lot of learning to make sure they’re equipped to handle those extra-challenging situations!
Your First Visit: What to Expect
Heading to a new specialist can bring on some nerves. So, what might that first visit with a perinatologist look like? Well, it really depends on why you’re there.
Mostly, that first appointment is about getting to know you and your pregnancy story. They’ll want to:
- Go over your health history in detail.
- Discuss your specific condition and how it might affect your pregnancy and your baby.
- If there’s a concern about your baby, they’ll counsel you on any genetic or congenital conditions found or suspected, and what kind of medical care your little one might need after birth.
Sometimes, they might perform tests during that first visit, or schedule them. These could include:
- Detailed ultrasounds (they often have very advanced ultrasound equipment).
- Specific blood tests.
- Prenatal screening discussions.
- More specialized tests if needed, like an amniocentesis (where a small sample of amniotic fluid is taken) or chorionic villus sampling (CVS) (taking a tiny sample of placental tissue). These tests can help diagnose genetic or chromosomal conditions.
The key thing is they’ll work closely with your OBGYN and any other doctors on your team. They might also coordinate with a neonatologist (a doctor specializing in newborn intensive care) or your baby’s future pediatrician if specialized care is anticipated after birth. Open communication is so important, and they’re there to answer your questions. We’ll discuss all options for you.
Do Perinatologists Deliver Babies or Perform Surgeries?
This is a common question! Sometimes, yes, a perinatologist might be the one to deliver your baby, especially if a very complex delivery is anticipated or if a specific fetal intervention is needed during birth. However, in many cases, your regular OBGYN will still deliver your baby, with the perinatologist having provided expert consultation and a care plan.
And yes, perinatologists are trained to perform specialized surgeries when necessary. This could include:
- More complicated C-sections.
- A cervical cerclage, which is a procedure to stitch the cervix closed if it’s at risk of opening too early.
- In rare, life-saving situations, an emergency hysterectomy (removal of the uterus) if there’s severe bleeding after delivery.
Again, it all depends on your unique situation. They are there to provide the specific expertise your pregnancy needs.
Key Things to Remember About Your Perinatologist
This is a lot of information, I know! If your head is spinning a little, that’s okay. Here are the main things I’d love for you to take away about seeing a perinatologist:
- A perinatologist (or maternal-fetal medicine specialist) is an OBGYN with extra training in high-risk pregnancies.
- Being referred to one doesn’t automatically mean something is terribly wrong; it means you and your baby will get specialized, focused care.
- They manage health conditions in the pregnant person and can diagnose and manage issues in the fetus.
- They work with your regular OBGYN as part of a team.
- They can offer advanced testing, counseling, and help plan for complex deliveries or postnatal care if needed.
- Their goal is the healthiest possible outcome for both you and your baby. When you meet with a perinatologist, remember they are there to support you.
Hearing you need to see a specialist during pregnancy can be unsettling, but please know that a perinatologist is there to be your ally, offering an extra layer of skill and support. You’re putting an expert team in place for you and your little one. You’re not alone in this journey.
