What Is Obstetrics and Gynecology? Research Areas, Funding, and Career Paths

Obstetrics and gynecology, usually shortened to OB-GYN, is the branch of medicine and biomedical science concerned with pregnancy, childbirth and the postpartum period (obstetrics) and with the health of the female reproductive system across the lifespan (gynecology). It is both a clinical specialty, in which physicians called obstetrician-gynecologists provide medical and surgical care, and a research discipline that draws on endocrinology, genetics, epidemiology, pharmacology, developmental biology and clinical trial science. This guide explains what the field covers and how its subspecialties divide up, then adds the research-administration layer that generic overviews leave out: who funds the work, how pregnant and lactating people are (and are not) included in research, which societies and journals shape the field, and what training looks like. It is educational, not medical advice.

What Is Obstetrics and Gynecology?

The two halves of the name describe two overlapping areas of practice. Obstetrics deals with pregnancy, labor and delivery, and the weeks after birth, and with the health of both the pregnant person and the fetus. Gynecology deals with the reproductive organs and related conditions outside of pregnancy, including menstrual disorders, contraception, infertility, pelvic pain, menopause, and cancers of the reproductive tract. In the United States the two are combined in a single residency and a single primary board certification, which is why most practitioners work in both areas, although some limit their practice to one or to a subspecialty.

“Women’s health” is a broader and looser term than OB-GYN. It often includes conditions that are not reproductive at all, such as cardiovascular disease, osteoporosis or autoimmune disease as they present differently in women, and it is practiced by internists, family physicians, nurse practitioners and midwives as well as obstetrician-gynecologists. Research in women’s health therefore overlaps with, but is not identical to, research in obstetrics and gynecology. Language in this area is also evolving: many researchers now say “pregnant people” or “birthing people” to recognize that not everyone who is pregnant identifies as a woman, and this guide uses both forms.

Scope: What Does the Discipline Cover?

Illustrative areas of clinical and research activity include:

• Prenatal and antenatal care — screening and monitoring across pregnancy, including genetic screening, ultrasound, and management of conditions such as hypertensive disorders of pregnancy and gestational diabetes.
• Labor, delivery and the postpartum period — induction and augmentation of labor, cesarean delivery, hemorrhage, and recovery after birth. Two widely used clinical assessment tools from this setting are the Bishop score, used to assess cervical readiness for labor induction, and the Apgar score, used to describe a newborn’s condition shortly after birth.
• Fetal and neonatal outcomes — preterm birth, fetal growth restriction, stillbirth and congenital conditions, studied jointly with neonatology and pediatrics.
• Reproductive endocrinology and fertility — ovulation, hormonal regulation, assisted reproductive technology, and conditions such as polycystic ovary syndrome. See What Is Endocrinology? for the hormone-science foundation.
• Gynecologic conditions — endometriosis, fibroids, abnormal uterine bleeding, pelvic floor disorders, and menopause.
• Gynecologic oncology — cancers of the cervix, uterus, ovary, vulva and vagina.
• Family planning and contraception — contraceptive methods, pregnancy-related decision making, and related public-health research.

Subspecialties

In the United States, the American Board of Obstetrics and Gynecology (ABOG) certifies obstetrician-gynecologists and administers subspecialty certification beyond the primary certificate. The established subspecialties are:

• Maternal-fetal medicine (MFM) — care and research for high-risk pregnancy, including chronic maternal disease, multiple gestation and fetal conditions. MFM physicians are the group most closely tied to clinical trial networks in obstetrics.
• Reproductive endocrinology and infertility (REI) — hormonal disorders of reproduction and fertility treatment.
• Gynecologic oncology — surgical and medical management of reproductive-tract cancers; these physicians often lead cancer trials in cooperative groups.
• Female pelvic medicine and reconstructive surgery (urogynecology) — pelvic floor disorders such as prolapse and incontinence.

Adjacent fields with their own training and research traditions include midwifery, perinatal epidemiology and neonatology. Where a research question crosses these boundaries, such as how a medication taken in pregnancy affects a child’s development, it also draws on developmental biology, pharmacology and genomics.

Research Methods in Obstetrics and Gynecology

The field uses the full range of clinical research designs, but several features are particular to it.

• Randomized trials of care strategies. Many obstetric questions are about timing and approach rather than drugs, for example when to induce labor or how to manage a particular complication. Large pragmatic trials are common. The ARRIVE trial, which compared induction of labor at 39 weeks with expectant management in low-risk first-time mothers, was run through the NICHD Maternal-Fetal Medicine Units Network and published in the New England Journal of Medicine in 2018.
• Observational and population research. Because pregnancy is often excluded from drug trials, much of what is known about medication safety in pregnancy comes from registries, pregnancy exposure cohorts and large health-record studies. This is where epidemiology and pharmacovigilance methods carry most of the weight, with their usual risks of confounding and bias.
• Surveillance. Public-health systems such as the CDC’s Pregnancy Risk Assessment Monitoring System (PRAMS) collect population data on maternal experiences and outcomes, and maternal mortality review committees examine individual deaths.
• Dual-patient outcome design. A pregnancy trial usually has to account for two patients at once, the pregnant person and the fetus or newborn. Trial protocols therefore define maternal, fetal and neonatal outcomes separately, and often a composite outcome, which complicates sample size and safety monitoring. See Designing a Clinical Trial Protocol.
• Basic and translational science. Laboratory work on placental biology, parturition (the onset of labor), uterine physiology and the reproductive endocrine axis feeds clinical questions on preterm birth and preeclampsia.

A Short History

Obstetrics was one of the earliest organized branches of medicine, with a long history of midwifery preceding the profession. The modern United States specialty took institutional form in the twentieth century: the American Board of Obstetrics and Gynecology was founded in 1927 and incorporated in 1930, the American College of Obstetricians and Gynecologists (ACOG) was founded in 1951, and the Society for Maternal-Fetal Medicine was established in 1977. On the research side, the National Institute of Child Health and Human Development (NICHD) was created in 1962, and in 1986 it created the Maternal-Fetal Medicine Units (MFMU) Network, a standing consortium of clinical centers for multicenter obstetric trials. The regulatory side of pregnancy research has developed in parallel and is covered below.

Who Funds Obstetrics and Gynecology Research?

• NICHD. The Eunice Kennedy Shriver National Institute of Child Health and Human Development is the National Institutes of Health institute most closely identified with pregnancy, birth and reproductive health research, and it supports the MFMU Network. Its programs also cover pelvic floor disorders, gynecologic health and infertility.
• Other NIH institutes. The National Cancer Institute funds gynecologic oncology; other institutes fund placental, cardiovascular, mental-health and substance-use work in pregnancy. The NIH Office of Research on Women’s Health coordinates women’s health research across institutes. Institute-level award rates vary; see NIH Paylines FY2026.
• CDC and other federal agencies. The CDC supports surveillance and maternal-health programs; the FDA regulates the drugs and devices studied.
• Foundations and industry. Private foundations, disease charities and pharmaceutical and device companies fund clinical studies, though commercial investment in pregnancy-specific products has historically been limited by the liability and regulatory concerns described below.
• Population-scale programs. Cohort programs such as the All of Us Research Program create large data resources that can include reproductive-health information.

Grant applications in this field need the same administrative infrastructure as any NIH-funded clinical research: an approved protocol, informed consent, and a justified inclusion plan for participants by sex, age and, where relevant, pregnancy status.

Including Pregnant and Lactating People in Research

The history of pregnancy and research is one of protective exclusion that came to be seen as a problem in its own right. After the thalidomide tragedy of the early 1960s, researchers and regulators became very cautious about exposing the fetus to experimental agents, and pregnant people were routinely excluded from trials. The consequence was that many medications reached the market with little or no pregnancy-specific data, so clinicians and patients had to decide about treatment during pregnancy without direct evidence. The 1993 NIH Revitalization Act required the inclusion of women and minorities in NIH-funded clinical research, but pregnancy remained a common exclusion criterion in practice.

Several developments have tried to correct this:

• Federal task force. The 21st Century Cures Act established the Task Force on Research Specific to Pregnant Women and Lactating Women (PRGLAC), convened in 2017. Its 2018 report to the HHS Secretary and Congress made 15 recommendations, including designing studies to include pregnant and lactating women unless there is scientific justification not to, and removing regulatory barriers to research in pregnant women.
• NIH inclusion policy. NIH policy requires that individuals of all ages be included in human subjects research unless there are scientific or ethical reasons not to, and NIH strongly encourages including pregnant women in clinical research whenever inclusion is scientifically valid and ethically permissible (Notice NOT-OD-18-116).
• FDA labeling. The FDA’s Pregnancy and Lactation Labeling Rule, effective June 30, 2015, removed the old pregnancy letter categories (A, B, C, D and X) from prescription drug labeling and replaced them with narrative summaries of the available data on pregnancy, lactation, and females and males of reproductive potential.

Regulatory protections for research with pregnant participants sit in Subpart B of the Common Rule, which adds requirements for research involving pregnant women, human fetuses and neonates. See 45 CFR 46 Subpart B, the overview of what each subpart of 45 CFR 46 covers, and the dictionary entry on vulnerable populations in research. Research that uses human fetal tissue has its own policy framework, described in Human Fetal Tissue Research. Pregnancy also raises distinct questions for vulnerable-population categories under the Common Rule and for informed consent, because decisions can affect another person who cannot consent. Whether a given study may enroll pregnant participants, and under what conditions, is determined by the institution’s IRB under the applicable regulations; see The IRB Application and the IRB entry. Eligibility rules should be written deliberately, since a blanket exclusion of pregnancy needs a stated justification; see Inclusion and Exclusion Criteria.

Societies, Journals and Credentialing Bodies

• ACOG is the main professional membership organization of obstetrician-gynecologists in the United States. It publishes clinical guidance documents (practice bulletins and committee opinions) and the journal Obstetrics & Gynecology, often called the Green Journal.
• Society for Maternal-Fetal Medicine (SMFM) represents maternal-fetal medicine specialists and holds an annual Pregnancy Meeting.
• ABOG certifies physicians in the specialty and its subspecialties.
• Journals. Beyond the Green Journal, widely read titles include the American Journal of Obstetrics and Gynecology, BJOG: An International Journal of Obstetrics and Gynaecology, Human Reproduction and Fertility and Sterility.

Clinical guidelines from these bodies are themselves a research-administration topic, since authorship and panel rules matter for how they are trusted; see Clinical Practice Guideline Authorship.

Training and Career Paths

In the United States, obstetrician-gynecologists complete medical school followed by a four-year residency in obstetrics and gynecology and then board certification through ABOG. Those seeking a subspecialty complete an additional fellowship, typically three years for maternal-fetal medicine, reproductive endocrinology and infertility, gynecologic oncology and female pelvic medicine. Physician-scientists may add research training through an NIH career development award, a PhD or a master’s in clinical research, and some programs offer dedicated research tracks within fellowship. Non-physician researchers in the field come from epidemiology, nursing, public health, biostatistics and basic science, and nurse-midwives and perinatal nurses lead a significant share of care and of nursing research (see What Is Nursing Science?). Training and certification pathways differ in other countries, so readers outside the United States should check their national college or board.

Where the Discipline Meets Research Administration

• IRB review and consent. Pregnancy studies often involve additional IRB scrutiny and special rules for research involving neonates.
• Data and safety monitoring. Because one trial can affect two patients, data and safety monitoring boards for obstetric trials need maternal-fetal expertise.
• Long follow-up. Outcomes in children can appear years later, so budgets and retention plans for infant and child follow-up need to be built into the grant.
• Clinical operations. Delivery units run around the clock, so consent and enrollment may need to happen in labor, which raises timing questions covered in When Should Informed Consent Be Obtained? Practical supplies for facilities that serve this population are covered in the Birthing Center Supply Checklist.
• Related disciplines. Neighboring discipline guides on this site include anesthesiology, rheumatology (many autoimmune conditions peak in reproductive years and complicate pregnancy) and endocrinology.

Frequently Asked Questions

What is the difference between obstetrics and gynecology?

Obstetrics concerns pregnancy, childbirth and the postpartum period. Gynecology concerns the health of the female reproductive system outside pregnancy. In the United States both are covered by one residency and one primary board certification, so most OB-GYNs practice both.

What does an OB-GYN do?

An obstetrician-gynecologist provides prenatal care, delivers babies, performs gynecologic surgery and provides preventive and reproductive health care. Many also take part in clinical research, particularly at academic medical centers.

What is maternal-fetal medicine research?

Maternal-fetal medicine research studies high-risk pregnancy and the health of the pregnant person and fetus together. In the United States, the NICHD MFMU Network, created in 1986, conducts large multicenter obstetric trials.

What does NICHD fund in obstetrics and gynecology?

NICHD, established in 1962, funds research on pregnancy, birth, fertility, and gynecologic and pelvic health, along with child development. It supports the MFMU Network and investigator-initiated grants. Other NIH institutes fund related work, such as the National Cancer Institute for gynecologic cancers.

What is ACOG?

The American College of Obstetricians and Gynecologists, founded in 1951, is the main US professional organization for obstetrician-gynecologists. It issues clinical guidance and publishes Obstetrics & Gynecology.

Why have pregnant people been excluded from clinical trials?

Mostly out of caution about fetal harm, a caution reinforced by the thalidomide experience, along with liability and regulatory concerns. This left gaps in evidence about medications used in pregnancy. Federal policy now encourages inclusion where scientifically valid and ethically permissible, and a blanket exclusion should be justified.

Can pregnant women be enrolled in research?

Often yes, subject to IRB review and the additional protections in Subpart B of the Common Rule where it applies. Whether a specific study may enroll pregnant participants depends on its risks, potential benefits and the governing regulations, so confirm with your IRB.

What is the difference between OB-GYN and women’s health?

OB-GYN is a defined medical specialty. Women’s health is a wider field that includes reproductive care but also conditions like heart disease and osteoporosis, and is practiced by many kinds of clinicians.

How long does it take to become an OB-GYN?

In the United States, a four-year residency follows medical school, with an additional fellowship of typically three years for subspecialties such as maternal-fetal medicine.