A lot of people can help you along your journey from conception to taking care of your newborn: OB/GYNs, reproductive endocrinologists, midwives, doulas and lactation consultants, just to name a few. While you don't need to see all those providers, if you have what’s considered a high-risk pregnancy, you might get a  referral to a maternal fetal medicine doctor, or a perinatologist. 

Women with high-risk pregnancies, meaning they have certain pregnancy complications and conditions, typically see this type of OB/GYN at least once while they're carrying their babies. Here's everything you need to know if your general practitioner refers you to one while you’re expecting.

What is a perinatologist?

A perinatologist, also known as a maternal fetal medicine specialist (MFM), is an OB/GYN who specializes in high-risk pregnancies and pregnancy complications. 

After completing four years of residency training, OB/GYNs who decide to become perinatologists spend an additional three years in a fellowship learning how to care for pregnant women with certain conditions or complications.

When should you see a perinatologist?

Any woman with a high-risk pregnancy may wind up going to a maternal fetal medicine specialist. Some factors that up your odds for potential pregnancy complications include:

  • Being younger than 18 or older than 35
  • Being under- or overweight prior to conception
  • Having an in vitro fertilization (IVF) pregnancy
  • Previous pregnancy complications or fertility problems
  • Diabetes 
  • High blood pressure
  • Heart disease
  • Uncontrolled asthma 
  • Cancer
  • Autoimmune diseases (such as lupus)
  • Blood disorders
  • Kidney problems

Sometimes, conditions arise during pregnancy that may make it higher risk. These include:

If any of these conditions apply to you, a perinatologist can help monitor you and your baby's health. The doctor may also coordinate your care with other specialists, such as an endocrinologist or a rheumatologist. 

What to expect during a perinatology appointment

You may see a perinatologist periodically throughout your pregnancy, or just once if your MFM then writes a plan for your general OB/GYN to follow and use.

Either way, expect the perinatologist to ask about your medical history and possibly do a physical exam. Based on your particular circumstances, your MFM specialist may perform one or more of these prenatal tests:

  • Targeted ultrasound, which checks how your baby’s organs are growing
  • Fetal echocardiography, which produces photos of your baby's heart
  • Amniocentesis, when a sample of amniotic fluid is extracted from the uterus to rule out genetic and chromosomal conditions
  • Chorionic villus sampling (CVS), which is similar to amniocentesis except it uses a small sample of placental cells instead of amniotic fluid

Your doctor will discuss any tests with you ahead of time so you know why they’re done and what to expect before, during and after.

What is the difference between a perinatologist and an obstetrician?

When you compare a perinatologist to an obstetrician, the biggest difference is those three extra years of training. During that time, maternal fetal medicine specialists learn even more about:

  • Ultrasounds and prenatal diagnosis
  • Maternal critical care
  • Genetics
  • Obstetric surgery
  • Obstetrical anesthesia
  • Fetal evaluation and intervention

Does a perinatologist deliver babies? 

It depends. Some perinatologists will deliver babies for high-risk and regular pregnancies. Others provide only prenatal care and have obstetricians handle labor and delivery.

Perinatologists are specifically trained to handle high-risk pregnancies. So if your doctor refers you to one of these maternal fetal medicine specialists for extra monitoring, know that both your health and your baby's are in good hands.