How Can a Maternal-Fetal Specialist Help with my High-Risk Pregnancy?
Benjamin Byers, DO, FACOG, of the Center for Maternal & Fetal Care, part of the Bryan Physician Network, answers your questions.
Q: What is a maternal-fetal medicine specialist?
This physician completes medical school, as well as a 4-year residency in obstetrics/gynecology and a 3-year maternal-fetal medicine fellowship, which is dedicated only to high-risk pregnancy care.
Maternal-fetal medicine specialists are referred to as MFMs or perinatologists. MFM physicians typically work with your primary obstetrician to co-manage a high-risk pregnancy.
I would estimate that 90 percent of my patients fall into this category. This typically means seeing a patient at routine intervals during her pregnancy, and usually an obstetrical ultrasound is performed. Thus, I am part of the patient’s health care team. Some patients, based on the primary obstetrician’s decision, are only seen by an MFM physician during their entire pregnancy, including the delivery.
Procedures that I perform include cesarean delivery, vaginal delivery, cervical cerclage, high-risk OB ultrasound, fetal echocardiogram, amniocentesis, and dilation and curettage.
Q: What brought you to a career in this field?
I have always found pregnancy care and obstetrics fascinating, from the physiology of the developing baby and placenta, to the excitement of the delivery, and all stages in between. My wife, Debra, manages her type 1 diabetes with an insulin pump; an MFM cared for her during her pregnancy, and the expertise that this doctor provided made a big impression on me.
Obstetrics is a unique field that encompasses primary care, continuity, surgery and sometimes emergency situations. I wanted to be able to take care of all women, regardless of the complexity of their pregnancy, and that’s why I chose to become a maternal-fetal medicine physician.
Q: How did you prepare for this career? What do the FACOG initials behind your name mean?
I grew up in rural eastern Iowa and attended Central College in Pella. I was granted early acceptance into Des Moines University for medical school.
Part of this early acceptance program was that I was to become a rural family practice physician in Iowa. I was fine with this plan until I did my obstetrics/gynecology clinical rotation — from that point on, I knew that OB/GYN (and then subsequently MFM) was the career for me. I did an OB/GYN residency at Brooke Army Medical Center in San Antonio and completed an MFM fellowship at the University of Texas Medical Branch in Galveston.
FACOG means Fellow of the American College of Obstetricians and Gynecologists. This signifies the doctor is board certified and has gone through the application process.
Q: Do you have a family of your own? Where were you raised? Are other family members in health care careers?
Debra and I were married in 2000, and we have three children: an 11th grader, a 9th grader and a 7th grader. They all attend Lincoln Christian School. My dad was a teacher — he was my teacher in 7th grade! — and my mom was a teacher’s associate. I was raised in Monticello, Iowa (near Cedar Rapids), population 3,500. My brother is a veterinarian, and my sister is an assistant at an optometrist’s office. Before moving to Lincoln in 2014, I was an officer and physician in the U.S. Army for 13 years. I achieved the rank of lieutenant colonel and was deployed to Iraq as a battalion surgeon in 2011.
Q: What do you find most rewarding about your career?
I enjoy helping manage high-risk pregnancies, which can involve maternal conditions such as diabetes, hypertension and lupus; fetal conditions such as birth defects and genetic problems; and pregnancy issues such as cervical insufficiency, preeclampsia and preterm labor.
Q: Can you share a special experience with us from your practice?
Cervical insufficiency means the cervix prematurely dilates, which typically means losing the pregnancy at a very early gestational age. If this is caught early in the process, then a stitch in the cervix (called a cerclage) can save the pregnancy. It is very rewarding to be able to save a pregnancy so that the mom can take home a healthy baby.
Q: How valuable is a prenatal diagnosis?
Prenatal diagnosis means diagnosing birth defects or genetic problems prior to delivery. A pre-delivery diagnosis, in most cases, leads to a better outcome for the baby, especially in the situation of a congenital cardiac problem.
Of course, the majority of the time, I provide positive news for the patients (meaning that there is no problem with their baby), which is also rewarding. Some maternal diseases such as type 1 diabetes can carry a high risk for birth defects.
Q: Do I need a referral from my primary care physician to see a maternal-fetal doctor?
Yes, in most cases, a referral from the primary obstetrician is required. Some patients, if they were seen by me or another MFM in a prior pregnancy, can enter care directly without a referral.
Q: What is the role of my primary care doctor?
The primary obstetrician is responsible for routine OB care. I take care of the high-risk problems.
Q: Where can I find out more about maternal-fetal medicine?
The Society for Maternal Fetal Medicine website — www.smfm.org — has more information.
Q: What impresses you about being in Bryan’s network?
I really enjoy working for Bryan Physician Network because the administrators actually care about my well-being as a person. They know me on a personal level and are very approachable.
Q: What is the most important thing you’d like people to know?
Even though I was raised in Iowa, I’m a Cornhuskers fan!
To learn more about maternal-fetal medicine and high-risk pregnancies, contact the Center for Maternal & Fetal Care at Bryan East Campus at 402-483-8485, or ask your primary care physician. See a video about Dr. Benjamin Byers at bryanhealth.org/DrByers.