In the U.S., most generalist women’s health physicians are obstetrician-gynecologists with training in both obstetrics and gynecology (OB/GYN). Many moms-to-be already have an established relationship with a particular women’s health provider, and come in for their first pregnancy visit prepared.
However, for patients who have not yet decided, the decision is made during the first visit, which usually happens between 8-12 weeks of pregnancy.
Find someone who clicks with you
“I believe that the biggest challenge a patient faces in finding a perfect provider is to find someone that has a good personality match for them,” said Dr. David Hirsch, OB/GYN physician at Marshfield Clinic Health System.
He said some patients prefer a brief, to-the-point interaction, while some prefer a scientific discussion of physiology, and others prefer a more natural chatty interaction.
“In my experience, each provider tends to be stronger in a particular kind of interaction,” Hirsch said. “And, when there’s a good match, it can kind of ‘click.’ That’s the most productive kind of provider-patient relationship.”
The initial pregnancy visit in Women’s Health at Marshfield Clinic Health System could be with the provider you will see throughout your pregnancy. The visit also could be with a nurse practitioner or certified nurse midwife who would complete the initial pregnancy intake. They would then help you choose which provider to see throughout the rest of pregnancy, depending on your philosophy and style of care, goals and birth plans, medical history and prior birth experiences.
Within the Health System, the process has some variables by location, but ultimately, the choice of provider is yours.
Care options for women
Women’s health care also has various options for your care before, during and after pregnancy.
Certified nurse midwives have a master’s in nursing-midwifery, and provide many of the same services as an OB/GYN provider like managing contraception, menstrual problems, prenatal care and deliveries. Midwives do not perform surgery.
“In Wisconsin, midwives often care for their low-risk patients without any physician involvement,” Hirsch said. “However, their OB/GYN colleagues are always available should higher-risk situations arise and for emergencies.”
In some cases, pregnant women have medical conditions that preclude them from selecting a midwife, but that is uncommon. Women’s Health subspecialties like maternal-fetal medicine and gynecologic oncology are specialties selected for you based on your health needs.
Maternal-fetal medicine subspecialists have additional training in how maternal disease affects pregnancy, how pregnancy affects maternal disease, and on high-risk fetal conditions. Gynecologic oncologists subspecialize in cancer of the pelvic organs like uterus, ovaries and cervix.
“OB/GYNs and midwives also work collaboratively with other specialties and subspecialties for conditions not within their training or capability of handing,” Hirsch said. “For example, if an OB/GYN patient has gall bladder disease, she is referred to general surgery.”
For gynecologic conditions like problem periods, many primary care providers refer to women’s health, and the patient is scheduled with whomever is available.
Although women’s health providers provide primary care through the reproductive years and beyond, many prefer women seek an internal medicine or family medicine practitioner as she ages or develops medical conditions such as hypertension.