Obstetrics and gynecology (OB-GYN) is a medical specialty focused on the female reproductive system, covering everything from pregnancy and childbirth to preventive screenings and conditions like endometriosis or infertility. It’s actually two disciplines combined into one: obstetrics handles pregnancy and delivery, while gynecology covers reproductive health outside of pregnancy. Most doctors in this field practice both, which is why you’ll see them referred to simply as OB-GYNs.
What Obstetrics Covers
The obstetrics side focuses on caring for you before, during, and after pregnancy. Prenatal care starts early, with regular visits to monitor both your health and the baby’s development. Your OB-GYN will track things like blood pressure, weight gain, fetal heart rate, and screen for conditions such as gestational diabetes or preeclampsia. They also help you develop a birth plan, counsel on nutrition, and flag any risk factors that could complicate delivery.
During labor and delivery, OB-GYNs manage every stage of the process. They determine whether labor is progressing normally, assist with vaginal delivery, and perform cesarean sections when needed. They also handle emergencies like heavy bleeding or complications with the placenta. After the baby is born, postpartum care continues for up to six weeks, addressing recovery, breastfeeding support, mood changes, and family planning.
Postpartum depression is one condition that OB-GYNs actively screen for. Trying to get pregnant, being pregnant, and the birth of a baby can all increase the risk of depression, and losing a pregnancy or struggling with infertility can as well.
What Gynecology Covers
Gynecology addresses reproductive health across your entire life, not just during pregnancy. This includes managing menstrual problems, pelvic pain, hormonal imbalances, sexually transmitted infections, and conditions like polycystic ovary syndrome or uterine fibroids. It also covers contraception: your gynecologist can help you choose from intrauterine devices, hormonal methods, barrier methods, or permanent options like tubal ligation.
Infertility falls under this umbrella too. The clinical definition is not being able to get pregnant after one year of trying, or six months if you’re 35 or older. Your OB-GYN can run initial evaluations and, if needed, refer you to a fertility subspecialist.
Preventive care is a major part of gynecology. Cervical cancer screening follows specific age-based guidelines. From age 21 to 29, a Pap test every three years is the standard recommendation. Starting at 30 through 65, you have more options: an HPV test every five years, a combined HPV and Pap test every five years, or a Pap test alone every three years. The American Cancer Society now recommends starting screening at age 25 with an HPV test repeated every five years.
When to Start Seeing an OB-GYN
The American College of Obstetricians and Gynecologists recommends that the first reproductive health visit happen between ages 13 and 15. This initial visit doesn’t necessarily include a pelvic exam. It’s more of an introduction: a chance to discuss menstrual health, answer questions about puberty, and establish a relationship with a provider before more involved care is needed later.
Common Surgical Procedures
OB-GYNs are trained surgeons, and a significant portion of their work involves procedures ranging from minor to major. Some of the most common include:
- Cesarean section (C-section): surgical delivery of a baby through the abdomen
- Hysterectomy: removal of the uterus, performed through open surgery, laparoscopy, or robotic-assisted techniques
- Myomectomy: removal of uterine fibroids while preserving the uterus
- Dilation and curettage (D&C): a procedure to remove tissue from the uterus, often after a miscarriage or to diagnose abnormal bleeding
- LEEP: removal of abnormal cells from the cervix, typically after an abnormal Pap result
- Endometrial ablation: destruction of the uterine lining to reduce heavy menstrual bleeding
- Tubal ligation: permanent contraception by closing or blocking the fallopian tubes
- Laparoscopy: minimally invasive surgery using small incisions, used to diagnose and treat conditions like endometriosis or ovarian cysts
Training and Certification
Becoming an OB-GYN requires four years of medical school followed by 48 months (four years) of residency training in an accredited obstetrics and gynecology program. Board certification comes from the American Board of Obstetrics and Gynecology, which requires completing residency and passing qualifying exams.
OB-GYN Subspecialties
After completing residency and board certification, some OB-GYNs pursue fellowship training to specialize further. The five recognized subspecialties are:
- Maternal-fetal medicine: focuses on high-risk pregnancies, including complications like preterm labor, multiple gestations, or preexisting conditions in the mother
- Reproductive endocrinology and infertility: treats hormonal disorders and helps patients conceive through techniques like IVF
- Gynecologic oncology: manages cancers of the reproductive system, including ovarian, uterine, and cervical cancer
- Urogynecology and reconstructive pelvic surgery: treats pelvic floor disorders like urinary incontinence and organ prolapse
- Complex family planning: specializes in contraception management and pregnancy termination, particularly in medically complicated cases
Most people will never need a subspecialist. A general OB-GYN handles the vast majority of reproductive healthcare, from your first visit as a teenager through menopause and beyond.