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Obstetrician-Gynecologist

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An Ob-Gyn getting ready for a procedure.

Obstetrician-Gynecologists (Ob-Gyn) assist women during pregnancy, wanting to become pregnant, identifying and treating diseases in the uterus and pelvis area of women, along with many other things. It is a job that has been around since in the 17th century but also in ancient Greek times as well. Dr. James Marion Sims has been credited with the name "Father of Modern Gynecology" due to the inventions of tools and procedures still used to this day.[1]

Job Description and Subspecialties

An Ob-Gyn giving an ultrasound to a pregnant mother.

Ob-Gyn's specialize in caring for a woman from the beginning of pregnancy to birth. They also diagnose and treat diseases in the female reproductive tract. People seek out an Ob-Gyn when they are either wanting to get pregnant or already pregnant. People also reach out to Ob-Gyn's when needing reproductive or prenatal care for a woman. As part of the job description of an Ob-Gyn, they must also preform annual exams for their patients compiling a portfolio of the patients medical history. And using their medical history, Ob-Gyn's also will provide counseling on diets, hygiene, sexual health, and the prevention of diseases.[2]

In the field of Obstetrics and Gynecology, there are four recognized sub-specialties; Gynecologic Oncology, Maternal/Fetal Medicine, Reproductive Endocrinology, Infertility, and Urogyneology/Reconstructive Pelvic Surgery. [3]

Gynecologic Oncology

Gynecologic Oncology is the diagnosis and treatment of ovarian cancer. Ovarian Cancer is a nonspecific term for all different kinds of cancers in the ovaries. There are many different kinds of treatment for ovarian cancers. In some cases, surgery can be curative but only in the early stages and the cancer has to be localized to one specific area, if the cancer has spread to other parts of the body or the lymph nodes then surgery is usually not an option. Radiation therapy is another option, the most common form of radiation therapy is external radiation therapy, the treatment takes only a few minutes and is repeated each day for twenty to twenty-five treatments. Other treatment options included chemotherapy, Immunotherapy, Investigational treatment, and alternative treatment. Each investigational and alternative treatment is case specific. In some they involve surgery, or experimental drugs. In most cases experimental drugs are not approved by the FDA, and are in the trail stages. These trials are almost always a last resort to give the patient more time with their families, it is very unlikely that these treatments are curative.[4]

Maternal/fetal Medicine

In order to specialize in maternal/fetal medicine, the OB/GYN must complete and additional two-three year fellowship program with the American Board of Obstetrics and Gynecology. All OB/GYN’s specialize in the health of both mother and child during pregnancy, but the subspecialty maternal and fetal medicine, is specific to when there are complications during pregnancy. They diagnose and treat the condition, whether it is a pre-existing medical condition, or a condition that affects the pregnancy itself. The maternal/fetal subspecialty has a very broad field, they deal with medical issues, genetic and surgical complications and much more.[5]

Abortions

Graph of who is more likely to preform an abortion.

As a part of their job some Ob-Gyn's preform abortions, which is the termination of a pregnancy. A survey was conducted with a total of 1,800 Ob-Gyn's, both male and female. When asked if any of them have been asked to preform an abortion 97% of the candidates replied by saying yes, but only 14% of the 97 actually preformed an abortion. Through this survey facts about abortion and an Ob-Gyn's view or shown. After the survey it revealed that more women are willingly to preform an abortion than men, and most Ob-Gyn's who do preform abortions are with the ages of 26 and 35. [6] However Ob-Gyn's are not required to preform an abortion if they are not comfortable with the idea. However, the process of preforming an abortion is similar to that of a miscarriage. Kevin Keith, MA in Philosophy, reveals what he thinks of doctors refusing to preform an abortion "[the] are distorting [their] professional practice out of personal whim, to the detriment of patients who need the care comprehended by that profession."[7]

Education

new born being examined.

Becoming an Ob-Gyn a person is required to have their bachelor's degree along with four years of medical training. Once they have graduated from college they complete four years of a residency on Ob-Gyn. In this time the resident will learn about diagnosing, treatments, management, and prevention. To specialize their title after four years of residency they must go through three years of training in the specific field. Once all the training has been completed the wanna be Ob-Gyn must take a board test to earn their certification, The American Board of Obstetrics and Gynecology. Once they have passed the test the former student is now an Ob-Gyn but must retake the board test every six years to be able to keep their license to practice their medicine.[8]

The education to become an OB/GYN is extensive and very competitive. It requires a minimum of three years of undergraduate school, but most applicants have a bachelor degree, four years of medical school, and three to eight years of internship and residency. Undergraduate premedical students must complete classes in physics, biology, pathology, medical ethics, laws governing medicine, physiology, pharmacology, microbiology, anatomy, mathematics, English, inorganic, and organic chemistry, biochemistry humanities, social sciences. Also, some students volunteer at hospitals and clinics to gain experience in the health profession.

During the first two years of medical school, med students spend most of their time in laboratories and classrooms, learning how to take medical histories, examine patients, and diagnose illnesses. During the last two years of medical school, med students work at hospitals and clinics under supervision, learning acute,chronic, preventives and rehabilitative care, doing rotations in many different specialties including Obstetrics and Gynecology, gaining experience in diagnosis and treatment of illness [9]

History

Photo of James Marion Sims, father of modern gynecology.

The history of Ob-Gyn's dates back to midwives, when only women would help other women in need. However the realization that all women needed a midwife, of some sort, led to European doctors attending deliveries of the higher class in the 17th century. From that the job of being an Ob-Gyn spread to also the middle class. During the 17th and 19th century's the invention of the forceps (which are used during childbirth) occurred as well as the beginning of anesthesia. In this time period cesarean section (C-section) was born. This procedure, c-section, allows a mother to give through an incision in her uterus and abdominal wall. Nearing the end of the 19th century the job of an Ob-Gyn was mainly located in Europe and the United States. Once the 20th century came around Ob-Gyn's began to widen their job description to fertility control and natural births. In this century the ultrasound was invented (see image at right) and aided Ob-Gyn's to detect any birth defects or any unknown facts about the fetus. Not only did Ob-Gyn's help fertile women they also helped those that were infertile but creating a solution, artificially implanting fertilized embryos. This is when a partner in a relationship could not have a child and so their Ob-Gyn would fertilize an egg and then place within the uterus of a woman.[10]

Ultrasound

The father of modern gynecology has been named Dr. James Marion Sims. Due to Sims' creative tools and surgical processes, relating to women's health, he has been called "The Father of Modern Gynecology." An invention of Sims was the vaginal speculum, which allowed doctors to examine their patients dilation. And one of his new surgical techniques was used in repairing vesicovaginal fistulas, which was a tear between the uterus and the bladder, a common issue in the 19th century. However Sims experimented with these and many other techniques on his black slaves. Sims preformed surgeries on women, who may not have consented. Without any anesthesia, the pain the women felt was excruciating but that did not stop Sims there. After he had worked on his slaves he later began working on black children. Sims would use shoe tools during his "surgeries" to loosen their skull and pry apart their bones. While Sims may have helped in the history of Og-Gyn's his methods were wrong and harmed many innocent African-Americans.[11]

Video

This video takes you into a day in the life of an Ob-Gyn.

References

  1. What to Expect From a Ob-Gyn Visit Webmd. Web. Last accessed February 13, 2018. Author unknown.
  2. OBGYN Learn.org. Web. Last accessed February 13, 2018. Author unknown.
  3. Ob/gyn.Obstetrics and Gynecology care associates, S.C. web. Last update 9/18/13 Unknown Author
  4. How cancers are treated Obstetrics and Gynecology care associates, S.C.web. Last updated 9/18/13 Unknown Author
  5. Maternal-Fetal Medicine.SMFM .Web. accessed 11/6/13 Unknown Author
  6. Carmon, Irin. Ob-Gyn's who preform abortions Jezebel. Web. Published August 23, 2011.
  7. Carmon, Irin. Ob-Gyn refusing abortions Quora. Web. Published February 18, 2015.
  8. Walsh, Kellie. What's an Ob-Gyn Healthline. Web. Published May 27, 2016.
  9. Obstetrician and Gynecologist Career information Obestetrics.com .web. last updated. 5/20/10 Unknown Author
  10. Obstetricsandgynecology Encyclopaedia Britannica. Web. Last accessed February 13, 2018. Author unknown.
  11. Holland, Brynn. History of Sims History. Web. Published August 29, 2017.