What Is a Perinatologist?

A perinatologist, which is also called a maternal-fetal medicine (MFM) specialist, is an obstetrician-gynecologist (OB/GYN) who specializes in high-risk pregnancy. In addition to their OB/GYN residency, a perinatologist also completes a three-year fellowship that focuses on complications of pregnancy (medical, fetal, genetic, and more) and their effects on the pregnant person as well as the fetus.

MFM training also involves the assessment and treatment of fetal complications or conditions. These specialists often work with a general OB/GYN or midwife to provide care to patients, which can include supplementary and complementary care. Perinatologists are typically the go-to doctors for pregnant people who go to the hospital after an accident or other emergencies.

When to See a Perinatologist

Many women see a perinatologist during pregnancy, but some women might see a perinatologist before they get pregnant. You might benefit from seeing a perinatologist before becoming pregnant if:

• You have a pre-existing medical condition (such as diabetes or lupus)
• You have a history of miscarriage
• You have had a previous high-risk pregnancy
• You are obese

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

What Is a High-Risk Pregnancy?

In its broadest terms, a high-risk pregnancy is a pregnancy that is potentially threatening to the life of the woman or the fetus. A pregnancy can start off as high-risk or 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. Being high-risk doesn’t necessarily mean that your pregnancy or birth will be difficult, but the label provides a note to your healthcare team that there are factors that they need to be aware of when planning your treatment.

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

• The discovery of potential birth defects in the fetus or growth restriction
• The discovery of potential complications with maternal health
• Common conditions such as preeclampsia or gestational diabetes

Other conditions that can make a pregnancy high-risk are a history of eating disorders, recurrent pregnancy loss, cervical surgeries/procedures (such as a LEEP), or maternal health issues such as high blood pressure, pre-existing diabetes, or clotting disorders.

Each woman is different and brings a unique history to each pregnancy. Your obstetrician will take a thorough medical history and talk with you about what supplemental care might be necessary for you and your baby. This will include a discussion of whether you should see a perinatologist.

What to Expect at the Perinatologist

Depending on the reasons for your referral to a perinatologist, the specific elements of your visit will vary. Perinatologists and the teams that work with them provide a variety of health care services, including genetic screening, ultrasound, blood tests, fetal monitoring, as well as diagnostic procedures including amniocentesis and chorionic villus sampling.

As with your other doctors, your perinatologist will also check in with you and see how you’re feeling (physically and emotionally), monitor your medications or any chronic conditions you have, as well as work with surgeons who specialize in fetal surgery, if necessary.

A Word From Verywell

If you are referred to a perinatologist, don’t panic. It does not necessarily mean there is something “wrong” with you, your baby, or your pregnancy. A perinatologist can be a valuable addition to your obstetrical care team—even before you become pregnant.

Your obstetrician might refer you because they want an expert opinion about a concern or question they have regarding your care. For example, they might feel that a condition or risk factor you are dealing with should have specialized care.

If you’re worried about seeing a specialist, or unsure as to why a referral was given, ask your obstetrician. Don't be afraid to speak up and talk to your team about your questions and concerns. That way, everyone is on the same page and you can be an active participant in your prenatal care.