What Is a Perinatologist?

A perinatologist, sometimes also referred to as a maternal-fetal medicine (MFM) specialist, is a an obstetrician-gynecologist who specializes in high-risk pregnancy. This means that in addition to their ob/gyn residency, they have completed an additional three-year fellowship focusing on complications of pregnancy (medical, fetal, genetic, and more) and their effects on the mother as well as the fetus.

MFM training also involves training in assessment and treatment of fetal complications or conditions. They often work with a general ob/gyn or midwife in the care of a patient, providing supplementary and complementary care. Perinatologists are also typically the go-to doctors for women who go to the hospital when in an accident, or coming in with any problems.

When to See a Perinatologist

While many women might see a perinatologist during a pregnancy, some women might see a perinatologist before they get pregnant. If you have a pre-existing medical condition like diabetes or lupus, or if you have a history of miscarriage or a previous high-risk pregnancy, or if you are obese, seeing a perinatologist prior to becoming pregnant might be beneficial.

A perinatologist can provide assistance with altering medications to help minimize adverse effects to your baby in the womb, review weight loss or healthy eating plans, or review any risks to becoming pregnant. If you are concerned about genetic factors or conditions like Tay-Sachs or sickle cell disease, or have a family history of cystic fibrosis, preconception genetic screening at a perinatologist’s office can be helpful.

What Is a High-Risk Pregnancy?

A high-risk pregnancy, in its broadest terms, is a pregnancy that is potentially threatening to the life of the woman or the fetus. Some pregnancies start off as high-risk, and some become high-risk as the pregnancy progresses. Some women are high-risk before they even conceive. If your pregnancy is considered high risk, you will need specialized care and extra monitoring during. Being high-risk doesn’t necessarily mean that your pregnancy or birth will be difficult, but the label notes that there are some factors that can complicate things.

Risk Factors for a High-Risk Pregnancy

  • Age: teen pregnancies and pregnancies in women aged 35 and older are considered high-risk due to increased risk of preeclampsia.
  • Certain health conditions like diabetes, lupus, or depression
  • Being overweight or obese—this can increase the risk for preeclampsia, gestational diabetes, stillbirth, and more
  • Being pregnant with multiples

Sometimes pregnancies don’t start off high-risk, but become high-risk. Reasons for this can include:

  • The discovery of birth defects in the fetus
  • Diagnosis of gestational diabetes
  • Diagnosis of preeclampsia
  • Problems with fetal growth

You might also be referred to a perinatologist during pregnancy if you have a history of eating disorders, if you’ve had pregnancy losses in the past, if you’ve had cervical surgery, or have blood or endocrine issues. Each woman is different and brings a unique history to pregnancy, and your obstetrician will be able to take a thorough medical history and talk with you about what supplemental care might be necessary for you and your baby, and whether a perinatologist is warranted.

What to Expect at the Perinatologist

Depending on the reasons for your referral to a perinatologist, the specific elements of your visit can vary. Perinatologists and their teams do a variety of things, including genetic screening, ultrasound, blood tests, fetal monitoring, and various procedures like amniocentesis and chorionic villus sampling. They can also check in with you and see how you’re feeling, physically and emotionally, monitor your medication levels and any chronic conditions you have, and work with surgeons who specialize in fetal surgery, if necessary.

A Word From Verywell

If your obstetrician has referred you to a perinatologist, don’t panic! This doesn’t necessarily mean there is something “wrong.” Your obstetrician might want an expert opinion about a concern or question they have, or might want specialized attention to a health condition you may be dealing with. A perinatologist can be a valuable addition to your obstetrical care team, even before you become pregnant.

If you’re worried about seeing a specialist, or unsure as to why a referral was given, it’s important to ask your obstetrician. Talk to your team about your questions and concerns, so that everyone is on the same page and you can be an active participant in your prenatal care.

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