Obstetricians and gynecologists (OB/GYNs) embark on a rigorous educational journey, beginning with a bachelor’s degree followed by a medical degree (MD or DO) from an accredited institution. Upon completing medical school, they immerse themselves in a four-year residency program specifically focused on obstetrics and gynecology (American Medical Association, n.d.). This extensive training culminates in the requirement to pass either the United States Medical Licensing Examination or the Comprehensive Osteopathic Medical Licensing Examination, which qualifies them to practice medicine. Many practitioners additionally pursue board certification from the American Board of Obstetrics and Gynecology (ABOG) (American Board of Obstetrics and Gynecology, n.d.).
As specialists in women’s health, OB/GYNs deliver comprehensive medical care that spans both obstetric and gynecological services. Their responsibilities encompass the entire spectrum of reproductive health, from managing pregnancies and childbirth—beginning with preconception counseling and extending through postnatal follow-up—to treating a range of gynecological conditions such as abnormal uterine bleeding, menopausal symptoms, vaginitis, and pelvic pain (University of Medicine and Health Sciences, n.d.). In clinical settings, they perform essential procedures, including IUD insertions, Pap smears, breast examinations, biopsy sampling, and ultrasound evaluations. Moreover, many OB/GYNs delve into specialized fields such as gynecologic oncology, maternal-fetal medicine, and reproductive endocrinology (University of Medicine and Health Sciences, n.d.).
Trained as pelvic surgeons, OB/GYNs skillfully conduct surgeries like cesarean sections, hysterectomies, and endometrial ablation. Recent innovations in the field highlight the dynamic nature of their practice, including the development of vacuum-induced tamponade devices for managing postpartum hemorrhage and fetal therapies for conditions such as twin-twin transfusion syndrome (University of Medicine and Health Sciences, n.d.). Through their holistic approach and advanced treatment options, OB/GYNs play a crucial role in promoting women’s health, though the current legal landscape may prevent some from providing abortion services in states with restrictive laws (Guttmacher Institute, 2017). In such scenarios, they are responsible for counseling patients on their pregnancy options and offering necessary referrals.
The ethical framework guiding OB/GYN practice is rooted in principles such as respect for autonomy, beneficence, nonmaleficence, and justice (American College of Obstetricians and Gynecologists, 2007). These principles inform actionable guidelines, such as those surrounding voluntary informed consent and confidentiality (American College of Obstetricians and Gynecologists, 2007). The American College of Obstetricians and Gynecologists (ACOG), a prominent professional organization with over 26,000 members, strives to maintain high standards in women’s healthcare through continuing education and the establishment of patient care protocols (American College of Obstetricians and Gynecologists, n.d.). ACOG operates under an Executive Board composed of seven officers and ten district representatives, and it oversees various programs, including the Committee Opinions initiative (American College of Obstetricians and Gynecologists, n.d.).
When comparing OB/GYNs with certified nurse-midwives (CNMs), both share a commitment to women’s health during pregnancy and childbirth, emphasizing patient-centered care and often collaborating within healthcare settings. However, their educational pathways diverge: CNMs typically complete a nursing degree followed by a master’s degree in midwifery (Yu, 2021) and are primarily trained to manage low-risk pregnancies (National Institutes of Health, 2021), often advocating for natural childbirth (National Institutes of Health, 2021). In contrast, OB/GYNs possess the training and expertise to address more complex medical scenarios and perform a wider range of surgical interventions.
The availability of diverse care options for women presents both opportunities and challenges. On one hand, it empowers women to select providers that resonate with their values, fostering personalized care. On the other hand, this multitude of choices can be overwhelming, particularly for those lacking clear information on the distinctions among providers. Personally, I lean towards holistic and patient-centered approaches to healthcare, which align more closely with the philosophy of CNMs. This perspective may introduce tensions during collaborative endeavors with OB/GYNs, especially concerning interventionist practices in childbirth, such as cesarean sections and the use of pharmaceuticals, which I believe should be minimized unless medically warranted.