What to Expect from Maternal-Fetal Care

If you’re a mother-to-be whose pregnancy isn’t routine—perhaps you’re expecting twins, or you or your baby has developed an unexpected medical condition—your doctor or midwife may refer you to a maternal-fetal medicine specialist (MFM) for extra care.

These high-risk pregnancy experts, also called perinatologists, are OB-GYNs with two to three additional years of advanced education and training in diagnosing, monitoring, and treating pregnancy complications in women and their unborn children. Their focus: keeping both of you healthy before, during, and after you give birth. 

Here’s what you should know about MFMs and the benefits of working with one.

When to See an MFM

A woman may consult with an MFM before conception, at any time in her pregnancy, and after giving birth. Here are some of the most common reasons women see these specialists:

Before pregnancy:

  • Planning a healthy pregnancy: Meeting with an MFM before you conceive can help you plan a healthy pregnancy. Ongoing health issues, such as asthma, diabetes, a heart condition, high blood pressure, and obesity, can worsen during your pregnancy. This can affect you and, sometimes, your developing baby. This specialist can also monitor how your pregnancy is affecting chronic health conditions that involve your heart, blood vessels, lungs, kidneys, immune system, digestive system, and more. She or he can advise you about safe medications and other treatments and how to stay healthy after delivery.

  •  Helping if you’ve had pregnancy problems in the past: A maternal-fetal medicine specialist can look for the reasons for multiple miscarriages or early labor and delivery and find solutions.   

During pregnancy:

  • Screening for genetic abnormalities, birth defects, growth restrictions, and more: In addition to blood tests, MFMs use advanced ultrasound techniques, fetal echocardiograms, and other tests to identify genetic problems and birth defects. This allows parents to prepare for the birth of a child with special needs. It also helps other doctors such as pediatric surgeons make plans for treating babies with birth defects after—and sometimes even before—birth. If tests show that a baby’s growth is restricted, an MFM can decide whether an early birth is best.  

  • Checking the health of multiples: Twins, triplets, and other multiples face a wide variety of risks and higher odds for early delivery. These specialists can track the growth of multiples and use advanced imaging techniques to look for causes of medical issues that multiples can face, such as slow growth or circulation problems. In some cases, they can even perform procedures to correct issues before birth.     

  • Treating your health: You may also be treated by an MFM if you’re injured during pregnancy.

  • Assessing other problems and risks: An MFM can assess and recommend treatment for pregnancy problems such as too much or too little amniotic fluid, conditions in which the mother’s immune system attacks the child’s tissue, and diabetes or high blood pressure that develop during pregnancy.   

After labor and delivery: Women who have complications after birth, such as heavy bleeding or infections, may receive care from a maternal-fetal medicine specialist along with an intensive care team.

What to Expect

You may consult once with an MFM or frequently, depending on your needs and your baby’s needs.The specialist usually works with the obstetrician, family doctor, or nurse-midwife caring for you during your pregnancy to create a care plan for you and for your baby. If needed, he or she will also work with other specialists who are taking care of you, and with neonatologists and other doctors ready to care for your newborn after birth.

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