I was recently asked the question: “What is an obstetrician’s role during pregnancy and childbirth?”
Before answering that question, I should mention what an obstetrician is. This topic is covered in my website article ‘What is an obstetrician?’
An obstetrician is a specialist medical doctor. An obstetrician is a doctor who has had successfully undertaken, after university graduation as a doctor, training in the management of women during pregnancy, childbirth, and the postnatal period through a recognised training program. In Australia, this speciality training is done through the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (R.A.N.Z.C.O.G). I attended the University of Sydney to become a doctor. This university course (Bachelor of Medicine and Bachelor of Surgery (M.B. B.S.) was over six years. After graduating from the university as a doctor it took me another six years of extra training and examinations that need to be passed in obstetrics and gynaecology before qualifying as specialist obstetrician doctor.
The role of an obstetrician in a pregnant woman’s care will depend on whether she is a public or private patient. As a public patient, she will attend a public hospital and her care will usually be given by midwives supported by trainee obstetricians. There will be a specialist obstetrician who can be consulted by the junior hospital staff, if the junior hospital staff considers there is a need. While a specialist obstetrician may personally manage some high-risk public patients most public pregnant women will have minimal or no contact with a specialist obstetrician doctor during their pregnancy, childbirth, or postnatal period.
This contrasts with the care received by a pregnant woman who decides to be managed as a private patient. A private patent will be managed by the specialist fully qualified obstetrician to whom she has been referred by her GP doctor. In my case I see my patients personally for each antenatal visit, personally manage any pregnancy problems during their pregnancy, plan the delivery with the patient, manage their labour, (with the support of a hospital appointed midwife), deliver their baby (both vaginal and Caesarean section deliveries), supervise their postnatal care in hospital, and see them personally for their 6-week postnatal visit.
Some obstetricians employ a midwife in their rooms to help with their private patients’ antenatal care. I decided not to do this as I want to give personal care and have a personal relationship with my patients. Some obstetricians work in a group practice of obstetricians so they can share the ‘out of hours’ workload and have time off. I, and many of my colleagues, have a solo obstetric practice and I am available 24 hours per day 7 days per week for my patients. If I am not available (e.g. as I am away) then I will arrange a colleague obstetrician to cover for me.
The main advantages of being a private obstetric patient is the personal relationship with a specialist fully trained obstetrician, being able to tailor your care so personal requests can usually be accommodated, and you having a fully trained and experienced specialist doctor looking after you (which increases safety for both mother and baby). I have personally managed over 10,000 pregnant women.
Most pregnancies and births are uneventful. But pregnancy and childbirth can have a considerable range of complications, some of which are life-threatening to mother and/or her unborn baby and some of which can result in trauma that will adversely affect the life of the mother and/or her child forever. These complications can occur without any warning. A specialist obstetrician with a ‘hands-on’ approach to your care is more likely to be able to anticipate a complication and to take measures that prevent it or minimise its impact on your wellbeing and your baby’s wellbeing. But some complications will happen without any warning. As well unexpected life-threatening complications can happen even in a very low risk pregnancy and childbirth. If they do happen, it is a fully trained highly experienced obstetrician who is the best person to deal successfully with the adverse developments.
While an obstetrician has a hectic, highly stressed, and totally unpredictable lifestyle there is incredible job satisfaction. As an obstetrician, I am supporting a woman at one of the most important and most dangerous times of her life (because of the life-threatening crises that can occur even without any warning). I share with a patient and her husband/partner the joy of the birth of their precious baby. It also results in a very special bond with patients and so often an ongoing wonderful relationship that lasts for decades.