What Is a Maternal Fetal Medicine Doctor?
A maternal fetal medicine (MFM) doctor is an obstetrician with an additional layer of training in high-risk pregnancy. Dr. Macedonia compares it to the difference between a family physician and a cardiologist. After medical school, an MFM completes a four-year OB/GYN residency and both written and oral board exams, then a three-year fellowship focused on intensive care, specialized surgery, advanced ultrasound, fetal echocardiography, and genomics. That’s roughly the same training time it takes to become a neurosurgeon.
The specialty covers both sides of a pregnancy:
- Maternal: moms with conditions like diabetes, hypertension, lupus, kidney disease, or cancer
- Fetal: diagnosing birth defects, chromosomal and genetic conditions, and managing risks like preterm birth and placental abruption
Dr. Larkin, who practiced general obstetrics for five years before his fellowship, sums up the mindset shift simply. A general OB assumes a patient is normal until proven otherwise. An MFM assumes there may be a risk factor until it’s ruled out.
Why It’s Called "The Pregnancy Consult"
An MFM doesn’t replace your OB or midwife. In most cases, your OB or midwife still delivers your baby. LMFM’s role is consultation: advanced ultrasound, genetics, and a clear plan that gets sent back to your delivering provider so the birth is as safe and smooth as possible. As Dr. Macedonia puts it, "We help our colleagues help you."
That often means coordinating with cardiology, endocrinology, rheumatology, and hematology. Because LMFM is independent and credentialed at four regional hospitals, the team can coordinate care across different health systems. You don’t have to give up a cardiologist or endocrinologist you trust just to keep everything under one brand.
MFM Ultrasound vs. a Standard Ultrasound
One of the biggest differences patients notice is the ultrasound itself.
|
Typical radiology ultrasound |
Ultrasound at LMFM |
| Anatomy exam |
Level 1 (basic) |
Level 2 detailed anatomy survey for every patient |
| Fetal heart |
Standard views |
Fetal echocardiography available in-office |
| Preterm birth screening |
Cervical length not routinely offered |
Cervical length screening offered |
| Your results |
Usually sent later by portal or phone |
Reviewed with a provider in person before you leave |
LMFM also performs routine first trimester dating scans and GYN ultrasounds, including evaluation of uterine shape abnormalities. You don’t have to be high risk to be seen.
Not sure if you’re high risk? You don’t need a referral to reach out. LMFM accepts self-referrals and offers early first trimester appointments. Request an appointment or call the office to find out if a visit makes sense for you.
What to Expect at Your First Visit
The LMFM office is designed to feel more like a spa than a sterile clinic, and the doctors dress casually on purpose. Here’s how a typical first visit goes:
- Check-in: basic paperwork, just like most medical offices.
- Vital signs: if you’d rather not be weighed, just say so. If automatic blood pressure cuffs stress you out, the team can take a manual reading after your exam once you’ve settled in.
- Ultrasound: a specially trained sonographer performs a painless exam, and large screens let you watch your baby in real time.
- Results conversation: a doctor or advanced practice provider reviews your results face to face. There’s no stopwatch. Every patient leaves with their questions answered.
The guiding principle, both doctors say, is the Golden Rule. Every decision gets weighed by asking what they’d want if the patient were their own daughter or family member.
Why Early Care Matters
First prenatal visits traditionally happened around 7 to 9 weeks. Today, access problems push many first appointments to 12 to 15 weeks, and a lot happens in the first trimester. LMFM sees patients early, which allows timely first trimester screening and earlier intervention when something needs attention.
The practice also wishes more people knew about preconception counseling. If you have a complicated medical history or a difficult previous pregnancy, an MFM can walk you through the risks and what a pregnancy might look like before you conceive.
High Touch, High Tech
LMFM invests in top-tier ultrasound equipment and uses AI behind the scenes for insurance appeals, dictation, and complex genomic interpretation. (If insurance denies a claim, LMFM does not balance bill patients.) But the doctors are firm that technology belongs behind them, never between doctor and patient. When they walk into the exam room, there’s no keyboard in the way.
High-Risk Pregnancy Care in Lancaster County
LMFM is a team of about two dozen people heading into its tenth year, serving families in Lancaster, Lititz, Belleville, and the greater Reading area. Patients come through OB and midwife referrals, including direct-entry midwives, as well as self-referrals. Whether you’re managing diabetes, carrying twins or multiples, worried about preterm birth, or need genetic counseling, the team is here for Central Pennsylvania families.
Listen to the Full Episode
This first episode also covers how each doctor found medicine (fish eyes at the grocery store for Dr. Larkin, the Army and M*A*S*H reruns for Dr. Macedonia) and what’s ahead for the show, including future guests like doulas, direct-entry midwives, and nutrition experts. Subscribe on YouTube and send in your questions.
Frequently Asked Questions
What is a maternal fetal medicine doctor? A maternal fetal medicine doctor is an OB/GYN who completed an extra three-year fellowship in high-risk pregnancy. MFMs care for moms with medical conditions and diagnose and manage fetal concerns like birth defects, genetic conditions, and preterm birth risk.
Do I need a referral to see Lancaster Maternal Fetal Medicine? No. LMFM accepts self-referrals in addition to referrals from OBs, midwives, and primary care doctors. If you’re unsure whether you’re high risk, you can contact the office directly.
Will a maternal fetal medicine doctor deliver my baby? Usually not. In most cases your OB or midwife still delivers. The MFM acts as a consultant, providing ultrasound, genetics, and a care plan that’s shared with your delivering provider.
What’s the difference between a level 1 and level 2 ultrasound? A level 1 ultrasound is a basic exam. A level 2 ultrasound is a detailed anatomy survey with specialized views of the baby’s heart, brain, and other structures. LMFM performs a level 2 equivalent exam on every patient.
When should I have my first prenatal visit? Traditionally, first visits happen around 7 to 9 weeks of pregnancy. Being seen early in the first trimester allows for timely screening and earlier intervention if anything needs attention.
