A lot of people may help you along your journey from conception to those early newborn weeks: OB/GYNs, reproductive endocrinologists, midwives, doulas, and lactation consultants, to name a few. While you don't need to see all of them, if your pregnancy is considered high-risk, your provider may refer you to a maternal fetal medicine (MFM) specialist, also known as a perinatologist.

Women with certain medical conditions or pregnancy complications often see an MFM at least once during pregnancy. Here’s what these specialists do, why you might be referred, and what to expect at your appointment.

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Key Takeaways
  • A perinatologist is a high-risk pregnancy specialist. These maternal fetal medicine doctors are OB/GYNs with three extra years of training in caring for pregnancies with complications — so if you’re referred to one, it simply means you’re getting an extra layer of expert support.
  • You might see one if you have certain health conditions or pregnancy complications. Anything from being pregnant with multiples to having diabetes, high blood pressure, or a history of pregnancy issues can prompt a visit. Sometimes you’ll see an MFM once, other times throughout your pregnancy.
  • Your appointment may include advanced ultrasounds or diagnostic tests. Depending on your situation, a perinatologist may perform specialized scans or procedures to check on your baby’s development — and they’ll walk you through exactly what to expect every step of the way.

What is a perinatologist?

A perinatologist, also known as a maternal fetal medicine specialist (MFM), is an OB/GYN with advanced expertise in high-risk pregnancies.

After completing four years of OB/GYN residency, perinatologists spend an additional three years in a fellowship focused on caring for pregnant women with medical conditions, complications, or other factors that may need closer monitoring.

“Having a perinatologist on your team is a good thing,” says What to Expect Community mom KristininBigD. “It’s very reassuring to know I’m being watched over so closely.”

When should you see a perinatologist?

Your provider might refer you to a perinatologist if your pregnancy is considered high-risk, meaning there’s something in your health history or current pregnancy that could benefit from extra monitoring.

Preexisting factors may include:

Complications that arise during pregnancy may also prompt a referral, such as:

If any of these conditions apply to you, a perinatologist can keep a close eye on both you and your baby. They may also coordinate your care with other specialists, such as an endocrinologist or a rheumatologist, to ensure you have the most comprehensive care team.

“All 3 of my pregnancies have been monitored by an MFM!” says What to Expect Community mom bbmm2025xx. “My first was for FGR and gestational diabetes — and now it’s just because of my history and being older, but I love the extra monitoring.”

Keep track of your prenatal appointments, weight, medications, and more in the My Journal feature of the What to Expect app.

What to expect during a perinatology appointment

You may see a perinatologist once or several times throughout pregnancy. Sometimes they’ll create a care plan your regular OB/GYN will follow, and other times they’ll stay involved from start to finish.

“Because everything was looking great the MFM doctor just met with us once and graduated us back to my regular OB for the rest of my pregnancy,” says What to Expect Community member Nom-de-Mere.

At your visit, the perinatologist will review your medical history and possibly do a physical exam. Based on your needs, your MFM specialist may perform one or more of these prenatal tests:

  • Anatomy scan: A detailed ultrasound that checks how your baby’s organs are developing
  • Fetal echocardiography: A closer look at your baby’s heart
  • Amniocentesis: A testing of amniotic fluid to check for genetic or chromosomal conditions
  • Chorionic villus sampling (CVS),: A sampling of placental cells to screen for genetic or chromosomal conditions

Your doctor will explain each test beforehand, so you know why it’s being done and what to expect before, during, and after.

“Honestly I love the mfm they are always great and you get to see baby a lot more and probably more tailored care imo,” says What to Expect Community mom rchlcx2.

How is a perinatologist different from an obstetrician?

The biggest difference between a perinatologist and an obstetrician is those three years of extra hands-on training in areas such as:

Do perinatologists deliver babies?

It depends. Some perinatologists deliver babies, especially those involving high-risk situations, while others focus on prenatal care and partner with OB/GYNS for labor and birth. 

Perinatologists are specially trained to support high-risk pregnancies. If you’re referred to one, rest assured: You and your baby are getting specialized, expert care. If you're not sure what type of pregnancy doctor is right for you, don't hesitate to ask your current provider for guidance.