Do I Need to See a Maternal Fetal Medicine (MFM) Doctor?

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If your obstetrician has suggested that you see an MFM, meaning a maternal fetal medicine doctor, you might wonder why. When you’re pregnant, you’re already juggling appointments with your ob-gyn or midwife. Adding another provider to the lineup can feel daunting.

But rest assured: Consulting with a maternal fetal medicine doctor is well worth your time. Let’s discuss the role of an MFM doctor and how they can help you have a healthy pregnancy and delivery.

What Does a Maternal Fetal Medicine Doctor Do?

MFM doctors, also known as perinatologists, specialize in managing high-risk pregnancies and complications that may occur during pregnancy and after childbirth.

Unlike your local ob-gyn, an MFM specialist typically doesn’t deliver babies. Instead, they consult with obstetricians and other birthing professionals. They help them manage people with complex or high-risk pregnancies.

Perinatologists-in-training must first complete medical school, then an ob-gyn residency, and finally undergo more training to specialize in maternal-fetal medicine. In the United States, most MFM doctors complete three years of fellowship training after their four years of residency.

During their fellowship, these specialists become experts in procedures for managing complex pregnancies.

MFM specialists often:

• Perform genetic tests to check the fetus for certain inherited conditions. These tests can include amniocentesis or chorionic villus sampling.
• Assist in complex deliveries to ensure both baby and birthing parent are healthy.
• Manage a pregnant person’s pre-existing health conditions.
• Perform advanced ultrasound imaging to detect fetal health problems.

How Do I Know if I Need to See a Maternal Fetal Medicine Doctor?

Two main categories of people see an MFM in addition to their ob-gyn. These are people who have a high-risk pregnancy because of an existing health issue outside of pregnancy and people who develop a pregnancy complication, either due to their own health or the health of the fetus.

High-risk pregnancy

If your doctor has told you that your pregnancy is “high-risk,” feeling concerned is normal. However, it doesn’t necessarily mean your pregnancy or your baby are in danger.

Medical professionals label a pregnancy “high-risk” if it increases the odds of certain health problems. These risks may affect the pregnant person, the fetus, or both.

Your doctor may classify your pregnancy as high-risk if:

• You had certain medical conditions before becoming pregnant. Examples include high blood pressure, diabetes, thyroid problems, and autoimmune disease.
• You’re very young (in your teens) or pregnant for the first time after age 35.
• You drink alcohol or use tobacco or other substances, including some prescription medications.
• You are pregnant with more than one fetus (twins, triplets, etc.).
• You’ve experienced preterm birth, late miscarriage, or other complications during previous pregnancies.
• You developed certain health conditions during a previous pregnancy. Examples include gestational diabetes and blood pressure issues.
• Your fetus has one or more inherited health condition(s) that require medical treatment before or right after birth.

Maternal fetal medicine doctors specialize in helping pregnant people manage risk factors. They can prescribe medications, monitor your condition, and perform procedures to reduce your risk.

They’ll also consult with other providers involved in your care. Bringing in additional care providers helps ensure you’re getting the right care.

Complications that develop during pregnancy

Some people don’t have existing risk factors for a complicated pregnancy. However, they can still develop problems along the way. If this happens to you, your ob-gyn may recommend that you see a perinatologist.

Here are some conditions for which your ob-gyn or midwife may refer you to an MFM:

• Vaginal bleeding.
• Problems with the placenta, including placenta previa and placenta accreta.
• A prematurely thinning cervix (cervical insufficiency).
• Signs of possible preterm birth.
• Conditions that are identified with your baby on ultrasound, including growth problems or developmental concerns.
• A previous C-section or other abdominal surgery.

Why else might I consult with an MFM doctor?

Maternal fetal medicine doctors specialize in complex pregnancies, but that isn’t all they can do. Even if your health care team hasn’t labeled your pregnancy high-risk, you may still benefit from an MFM visit.

If your ob-gyn or midwife suspects any complications they can’t address, they may refer you to MFM. The MFM doctor can help confirm or deny your provider’s suspicions.

For example, an MFM ultrasound may “catch” a fetal health condition that’s difficult to detect during regular checkups. Perinatologists spend hours practicing advanced fetal imaging techniques during their fellowships. As a result, they’re experts at identifying concerns that routine ultrasounds miss.

MFM specialists can also run other tests to identify fetal health problems. They can run these tests during or even before pregnancy.

Common procedures include:

• Amniocentesis — This test happens later in pregnancy (15 to 20 weeks). The doctor takes a sample of the amniotic fluid. It can also officially diagnose genetic conditions.
• Chorionic villus sampling (CVS) — This is an early test (run between 10 and 13 weeks). The doctor takes a sample of the placenta. It can officially diagnose genetic conditions.
• Cervical cerclage – This procedure is a stitch in the cervix that can help prevent preterm labor if you have had a history of early preterm labor or your cervix is identified as being short on ultrasound.
• Prenatal genetic screening — This helps estimate the chances your fetus has certain inherited conditions.

What Are the Benefits of Seeing a Maternal Fetal Medicine Doctor?

Perinatologists are uniquely capable of managing complex problems related to pregnancy. During their training, they become experts in many advanced procedures, both for the developing fetus and the mother. This in-depth experience can make them an invaluable addition to your care team.

Maternal fetal medicine doctors typically practice at higher-level maternal care centers. This lets them access the advanced equipment and facilities they may need to manage complex pregnancies.

The name “maternal fetal medicine” also highlights a critical element of this specialty. MFM doctors focus on the welfare of both mother and baby. To combat rising maternal mortality rates, medical organizations are highlighting the importance of advanced maternal care.

In 2012, the Society for Maternal-Fetal Medicine began promoting specific training in maternal health. They recommend that MFM fellows complete longer rotations in labor and delivery and critical care units. The newest generation of MFM doctors will prepare to ensure the best outcomes for babies and birthing people.

How Do I Know if It’s Time to See a Maternal Fetal Medicine Doctor?

Your ob-gyn, midwife, or another health care professional may refer you to a maternal fetal medicine doctor. However, a referral isn’t the only way to see an MFM specialist.

You know your health history better than anyone. If you know you have any of the risk factors discussed above, you can ask your pregnancy provider for an MFM referral.

It’s perfectly acceptable to ask them, “Do you think it would be appropriate for me to see maternal fetal medicine?”

You can help your health care team provide the care you need by advocating for your health and expressing your concerns.