Gynaecologist or obstetrician: who to consult and when

You probably know that gynaecologists and obstetricians both deal with women’s reproductive organs and health, but what’s the difference?

Clarifying the roles

At Mediclinic hospitals, the roles of gynaecologist and obstetrician are usually combined, explains Dr Kasturi Moodley, a gynaecologist and obstetrician from Mediclinic Pietermaritzburg, from where she runs the Midlands Fertility Health Centre. Gynaecologists, she explains, are medical doctors who specialise in women’s sexual health issues from adolescence to menopause, while obstetricians treat pregnant women from conception to six weeks after the delivery of the baby.

“When we specialise as gynaecologists, we’re able to practise as obstetricians as well, because the training encompasses gynaecological treatment as well as pregnancy care. The overlap occurs when a young woman, who has been consulting a gynaecologist annually to ensure her health and wellbeing, decides to start a family. She then visits her gynaecologist, who switches to the role of obstetrician. The obstetric component of the specialty deals with the care of both mom and baby throughout the pregnancy, labour, and delivery.”

Seeing a gynaecologist in adolescence

Gynaecologists see a young woman from the time she begins menstruating. They advise her on her development, as well as what she can expect in the years to come. “We can help to demystify the menstrual cycle for their patients and outline everything that accompanies a cycle through the different phases of a woman's life,” says Dr Moodley.

Patients will also be offered options for managing periods and the accompanying symptoms, some of which can be debilitating at times. Ultrasound examinations may be done to confirm the uterus and ovaries look normal and healthy.

“We recommend that patients have this conversation annually with their gynaecologist so as to keep track of changes in their bodies and not to become overwhelmed with all the information out there, some of which may be incorrect or assumed.”

Becoming sexually active

Once a woman becomes sexually active, she should see a gynaecologist annually for an examination. Your gynaecologist will also take your medical history and advise on any treatment or interventions that could improve your quality of life and help you stay safe and healthy. A gynaecologist is concerned with the wellbeing of the gynaecological organs, which include your uterus, ovaries, fallopian tubes, cervix, vulva, and vagina.

“These organs are all controlled and directed by hormones in the brain and in the ovaries,” explains Dr Moodley. “As gynaecologists, we can also advise our patients on the different contraceptive methods available and determine which is most suitable for each individual.”

A routine test that gynaecologists conduct on sexually active women is a Pap smear, which is a screening test for cervical cancer. Dr Moodley encourages women to have this test annually, as it could literally save your life. “A Pap smear is one of the few screening tests that we have for women to prevent cancer, and yet cervical cancer is still the number one cause of death among South African women,” she says.

“Gynaecology is the one specialty where we would like to see a patient every year when they’re well, so we can help them maintain their wellness.”

Obstetrics and babies

When women become pregnant or are planning a pregnancy, the crossover occurs between gynaecology and obstetrics. “Once a woman is pregnant, she and her partner should consult their gynae, then in the role of an obstetrician, for the duration of her pregnancy,” says Dr Moodley. “As obstetricians, we ensure the safety and wellbeing of mom and baby, with consultations every six weeks. These comprise tests, such as ultrasound scans and blood tests.”

An obstetrician will also advise patients on their birth choices, in other words, whether to have a normal delivery versus a caesarean section, and their pain relief options. They’ll also inform the parent/s about what will happen during the delivery and after the baby is born. 

Perimenopause and the changes ahead

During perimenopause, which usually occurs between the ages of 35-45 years, you should maintain your annual gynaecological check-ups. This helps ensure your continued health and wellbeing, and guides you on the inevitable changes, and the options available for a smoother transition.

Menopause and beyond

Annual check-ups with a gynaecologist become even more important for women aged 45-52 years and beyond to help them stay informed about and manage menopausal symptoms. “Too many women struggle unnecessarily during menopause, because of false information or assumptions pertaining to this change. This is where a gynaecologist can assist,” says Dr Moodley.

She recommends that all girls and women visit their gynaecologist as early as possible for guidance, accurate information, and confirmation of their gynaecological health and wellbeing.

To find a gynaecologist/obstetrician at a Mediclinic near you, visit www.mediclinic.co.za