Why can't Obstetrics be by its self since Gynecology is already by its self

[jessicaabruno]

It should because it would be better. Thank you.

[Lousli]

If you mean as a specialty for a doctor, I'd guess because a doc probably couldn't make a living on gynecology visits alone. Usually, unless someone is having a problem, they visit a GYN once a year for a checkup, at most. There are some gynelogical problems, like cancers (usually referred to an oncologist for care if you are diagnosed with cancer), fibriods, STD's, etc. but I would think that even with these things a GYN wouldn't have a very full schedule.

[jessicaabruno]

lousli,

Thank you for your reply and now I understand why both of them are put together.

[applejuice]

If you mean as a specialty for a doctor, I'd guess because a doc probably couldn't make a living on gynecology visits alone.

That is correct. :wink

An ob needs to do enough damage to birthing mothers to be sure he has enough patients coming to him for the rest of their lives for checkups and for repairs for the damage he inflicted on each of them during their birthing process to support his gyn part of his practice.

;)

IMHO, all women should go to midwives, and then referred to obstetricians only if there are complications; after all, obstetricians are surgical specialists trained for abnormalities in the birthing process.

They know nothing of a normal birth and should stay far away from normal births.

[NYCVeg]

I definitely agree with applejuice that the midwifery model is far preferable to the medical model for birth care.

But, that being said...I know that many women (who would be going to OBs anyway) really like the continuity of being able to have the same doc for their care, particularly b/c for many women being checked out "down there" is difficult and requires a certain amount of trust. A friend of mine, for instance, had a gyn she loved--and when she ended up having a very complicated pregnancy (months of bed rest, other stuff), she was VERY glad to have someone with whom she already had a good relationship--I think it would have been really psychologically difficult for her to have to shop around once she was pregnant.

[Slabobbin]

I agree with the above post.

[applejuice]

OMG!?

I thought someone would burn me at the stake for that!

Thank you.

That has been my own personal observation.

I am not young!

I know that the doctor who does the caesarean is the one who does the hysterectomy years later...and women keep going back to the same guy, or someone they recommend.

[wannabe]

Well, I for one have a highly trained gynaecologist to deal with my female bits (I have endo, and something wrong with my ovaries), then a highly trained midwife for normal pregnancy/birthing.

I think the original question was why don't obstetricians practice simply in obstetrics, and no gyn, just like many gyns practice in ust gyn.

[PerennialMom]

That is correct. :wink

An ob needs to do enough damage to birthing mothers to be sure he has enough patients coming to him for the rest of their lives for checkups and for repairs for the damage he inflicted on each of them during their birthing process to support his gyn part of his practice.

;)

IMHO, all women should go to midwives, and then referred to obstetricians only if there are complications; after all, obstetricians are surgical specialists trained for abnormalities in the birthing process.

They know nothing of a normal birth and should stay far away from normal births.


YES YES YES!!!!!!! I couldn't agree with you more! :thumb

[eminer]

But, that being said...I know that many women (who would be going to OBs anyway) really like the continuity of being able to have the same doc for their care

Why not a midwife for both? :)

[jessicaabruno]

IMHO, all women should go to midwives, and then referred to obstetricians only if there are complications; after all, obstetricians are surgical specialists trained for abnormalities in the birthing process.

applejuice,

Same here or go to family physicans or internal medicine.

Thank you.

[cam&kat's_mom]

What about those that have had terrible experiences with midwives? Should everyone dislike them? Some areas do not have midwives readily available for births. making a broad statement that OB Dr's know nothign about normal pregnancies/briths is just wrong. Have you bee to EVERY OB Dr out there? And NOT ONE knew anything aboutu normal birth? Interesting. I went to an OB (looked for a midwife that could practice where I am without traveling 45 miles each way and could not find one) and I had a normal pregnancy and birth, and they didn't damage me or my children in any way shape or form. So apparently an over generalization has been made. I'm not trygin to heat a debate, I simple came to learn from others. I really wish people that just want to throw out comments that they know will start a debate would just start a thread that says "I feel like debatign adn arguing adn slamming people today.. if you wnat to join me check out thuis thread" That would really save those of us that are reading for factual information the haslse of reading through statements that overgeneralize and are not beneficial to the topic posted...
Probably shouldn't have even written this in here as i am just feeding the fire. But oh well. And sorry for feeding the fire, i wil try to avoid it in the future, it just seems that tere are always people jumping in to throw digs, rather than imput real info.
And to the OP, I think that they are a combined practice so that there could be continuity for a patient. The gyn may know their history and then can follow them through the pregnancy and birth, also the follow up after the birth for those that go. Also it is comforting to know that you have a familiar person to join you on the journey to birth. Just my thought on it.

[Dreaming]

I like my OB. :thumb
My homebirth MW... don't like her so much (if I did I wouldn't have an OB this time...).
I believe it comes down to people not profession.
Everyone is different.

OP- I agree with the above that a doctor wouldn't have enough to do. I also think it makes things more convenient for *most* women since they don't have to seek out a new provider. I prefer to keep the number of people who are looking at/ putting tools or hands into my nether regions in this lifetime to a BARE minimum. :thumb

[NYCVeg]

Why not a midwife for both? :)

While I agree this is certainly ideal for ME, there ARE women who are more comfortable with doctors (see the above posts), as well as women who actually NEED doctors for certain conditions. And, many/most women who get regular gynecological care DO see a gynecologist, so I can understand why, if you have a gyn you loved and trusted, that you would to continue in her care when pregnant. And insurance, unfortunately, also plays a role in this. For the many women who have no insurance or insurance that does not cover midwifery, I think sticking with a provider that you already know/like/trust is preferable to shopping around for someone else for prenatal and birth care.

[NYCVeg]

I agree with the above that a doctor wouldn't have enough to do.

I don't know that this is true. There are many gyns who do not do obstetrics (although I don't know that are obstetricians who don't do gynecology).

[applejuice]

Well, I for one have a highly trained gynaecologist to deal with my female bits (I have endo, and something wrong with my ovaries), then a highly trained midwife for normal pregnancy/birthing.

Ask your mom if she was a DES daughter or mother; ask her if the doctor ever gave her "special vitamins" for her pregnancy - often DES was given this way.

Abnormalities of the reproductive tract in women was and is very common in those poor women who had nothing to say about getting that treatment.

[Ruthla]

I think it's because GYN care is more easily schedualed (for the dr) than OB care. I've heard of quite a few OB/GYNs who retire from OB but continue to practice as a GYN.

Besides, when you include post-partum visits, there's nothing that a GYN does that an OB doesn't also do. It's no more work, or investment in equipment, to add GYN to an OB practice. The inverse isn't true.

[wannabe]

Applejuice, actually DES causes structural abnormalities like a T-shaped uterus. The first clue is generally multiple miscarriages. it has no association with endo.

I have no uterine issues whatsoever. But it is good advice for women in their late 30s (the DES daughter cohort is around that age) with miscarriage issues, or any woman with miscarriage issues to have an HSG and hysteroscopy to check their uterus.

[wannabe]

Originally Posted by eminer
Why not a midwife for both?

Midwifes don't do surgery, infertility treatment, drug management, etc. When you need a doctor, you need a doctor.

[Lousli]

:yeah: Midwives often are unable to treat patients considered high risk for any number of reasons. My mom is a CNM and can't see patients with GD, twins, and other risk factors. She wouldn't be able to see me, if I came to her practice, because I have a history of two preterm births.

[eminer]

Hey all, not questioning the need for doctors. Just pointing out that midwives also do well woman care.

So lay off. :p

[applejuice]

Applejuice, actually DES causes structural abnormalities like a T-shaped uterus. The first clue is generally multiple miscarriages. it has no association with endo.

I have no uterine issues whatsoever. But it is good advice for women in their late 30s (the DES daughter cohort is around that age) with miscarriage issues, or any woman with miscarriage issues to have an HSG and hysteroscopy to check their uterus.
I know, but I have many suspicions that many of the newer reproductive tract problems that have come to the attention of medical experts are associated with DES, and that doctors have simply stopped researching it and connecting anything new with DES. It was prescribed from 1938 to 1971 as an anti-miscarriage "vitamin" and used in our meat products until 1979.

The person who alerted me to this was Dr. Robert Mendelsohn, who was himself working at the University of Chicago when the double blind study was going on in the late 1940s and early 1950s.

JMHO

[*guest]

My GYN has a solo practice, and she specializes in gyn surgery and infertility. She is always fully booked, so I don't think it's possible to make the blanket statement that no GYN could survive on only non-OB work. I see her for my well visits and the management of my endo. And to someone else's point above, no, I'm not a DES daughter either. There are theories that endo is linked to environmental toxins, but that's another story...

I love my GYN (she's the first doctor who ever asked me if I planned to breastfeed as she was doing a routine breast exam, and then she went on to tell me how great her experience nursing twins was), but I see a midwife for pregnancy care and homebirth. I'd never seek out on OB on purpose for normal pregnancy and delivery. I do like the separation of care and that I don't have to "fire" her for my pregnancy since she doesn't even do delivery. I wish more people did not automatically think "OB" for pregnancy. I'll return to her for care after the pregnancy if my pelvic pain comes out of the remission it's in now. I see nothing inconvenient about having different providers for different specialties. Add it to the list, just like eye doctors, chiropractors, dentists, whatever.

[mwherbs]

on the subject there are sub-specialities like
perinatologist -- this person doesn't do gyn care- maternal/fetal medicine

midwives do to an extent infertility care, rx , minor surgeries and can do most screening and dx tests- referral up the line to a specialist

in a sense midwives are the more focused in OB care -- with some adjunctive skills for gyn-- if you can do a pap, breast exam and screen for stds in pregnancy you can do the same for non-pregnant women

[luvmy3boys]

To answer the OP, I think some GYNs only have GYN patients because they can keep regular hours and do not necessarily have to be on call or come in all hours of the day/night.
Gynaecology is the study of women, so it makes since to go hand and hand with Obstetrics. However, I do know doctors who are OBGYNs, who only have pregnant patients.

[PerennialMom]

I know my midwife (a CPM) does regular paps exams. I just see my DO, but am considering switching to her for everything. I've never seen an OB/GYN for anything and I hope I never have to (but if I do, I'll be thankful the profession is there as an option)!