OB/GYN, according to Wikipedia, is "the abbreviation for obstetrics and gynecology, which are two surgical-medical specialties dealing with the female reproductive organs in their pregnant and non-pregnant state, respectively, and as such are often combined to form a single medical specialty and postgraduate training program. This combined training prepares the practicing OB/GYN to be adept at the surgical management of the entire scope of clinical pathology involving female reproductive organs, and to provide care for both pregnant and non-pregnant patients."

With this definition in mind, we can say that obstetrics focuses on childbirth, from prenatal care, including fetal care, through postpartum care and gynecology is more devoted to women's healthcare with special attention to the reproductive organs. A specialist in obstetrics is called an obstetrician and a gynecologist specializes in gynecology. All obstetricians are trained gynecologists, however, the opposite is not necessarily true.

Education and Training for Obstetricians

OB/GYN doctors have a very long training period. In the United States, OB/GYN schooling requires four years of tertiary education from an accredited university or college, then four years of medical school, and four years in residency. Afterward, an OB/GYN may decide to specialize, which entails additional education in the form of fellowships, taken after residency. Fellowships can take from one to four additional years. However, all of that education pays off in the end. According to Payscale, an online site giving information on various careers, an OB/GYN (as of November 2010) will earn between $131,863 - $235,544 per year. We need to remember that those amounts of money don't magically appear at the end of residency. Any doctor has to establish their career and that can take considerable time.

Obstetrical Nursing

Just as doctors choose to specialize in pregnancy and birth, nurses do as well. OB/GYN nursing focuses on the care of pregnant women and their babies. They are capable of, and expected to independently assess, implement, and evaluate health care during the various stages of giving birth. If an obstetrics nurse decides to take on an additional specialty, she may put her attention on perinatal nursing or becoming a labor and delivery nurse. During labor and delivery, and obstetrics nurse will, among other things, administer pain medication if it is being used or provide alternate methods of pain management for labor. As a rule, unless there are serious problems with the delivery, an OB/GYN nurse will manage the labor and delivery until the time the baby is actually being born, when the doctor will handle the birth.

Obstetrics and Midwifery - Can They Work Together?

Obstetrics and midwifery, while distinct and different, actually overlap in terms of medical knowledge and practice - both focusing on the care of the pregnant and laboring woman. Obstetrics is geared toward problems and difficulties during pregnancy and labor, and midwifery focuses on the normalcy of pregnancy and the birthing process while acknowledging the vulnerability of childbearing. As time has gone on and medicine has become more technological, obstetrics is more oriented toward pathology while midwifery continues to maintain its steady pace toward the normalcy of pregnancy and the need to give a woman both emotional and practical support.

As obstetrics moved through the 20th century, it became the preferable way to deliver a baby, using anesthesia, forceps delivery, administering an enema and allowing nothing by mouth prior to labor. An episiotomy was common practice and drugs to induce and control labor were introduced. By the end of the 20th century, fetal monitoring, scanning, and IV infusions as well as cesarean deliveries had become the norm.

Midwifery in the 21st Century

The identity of midwifery was challenged by all of the changes to childbirth in the 20th century. As the shortage of obstetricians became an issue, along with falling birth rates and economic conditions, midwives began to come to the fore again in Europe. However, in the US, they were unable to defend themselves against the medical profession and the prevailing attitude that pregnancy and childbirth is pathological (an illness) and dangerous, continues to have some effect upon midwifery in the US. However, women began to take issue with the over-medication and interference with the natural function of giving birth and that had led to a resurgence of interest in midwifery. Certified nurse-midwives are now more accepted than ever - but apprentice-trained midwives for home births, called direct-entry midwives, are still trying to get in the door.

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