Clinical medicine rotations
Obstetrics & gynaecology
Obstetrics and gynaecology (O&G) covers pregnancy, childbirth and women's reproductive health. For a psychiatrist it is the foundation of perinatal psychiatry: depression and psychosis around childbirth, and the safety of psychiatric medicines in pregnancy and breastfeeding.
Depth by stage, Pre-U → Consultant (details)
What is it?
Obstetrics is the care of women during pregnancy, labour and after birth; gynaecology is the care of the female reproductive system outside pregnancy. Students learn antenatal care, how to conduct a normal delivery, the main obstetric emergencies, and common gynaecological conditions such as abnormal bleeding, infertility and cancers.
In Malaysia, students spend time in labour rooms, antenatal clinics and gynaecology wards of busy public hospitals, and often must log a number of deliveries they have observed or assisted.
Pregnancy and the months after birth are a time of high risk for mental illness. What a student learns here about the body in pregnancy becomes essential when, years later, the same doctor manages a mother with postpartum psychosis or decides whether a mother can continue lithium.
Why does a psychiatrist need it?
Perinatal mental illness is common and can be dangerous for mother and baby. Psychiatrists must understand normal pregnancy, obstetric complications, the timeline of the postnatal period, and how drugs cross the placenta and enter breast milk. They also see women with pregnancy loss, infertility, menopause-related symptoms and premenstrual mood disorders.
What level is expected at each stage?
Scale: 1. Aware → 2. Understands → 3. Applies → 4. Masters / Teaches. What the levels mean.
- Pre-UNot expected
- Pre-clinicalAwareLearns reproductive anatomy, physiology and embryology.
- ClinicalUnderstandsTakes obstetric histories, performs antenatal examinations and observes deliveries.
- HousemanshipAppliesManages labour ward and gynaecology patients under supervision, including obstetric emergencies.
- Medical officerUnderstandsRetains enough to recognise pregnancy-related problems and refer safely.
- Psych traineeUnderstandsApplies O&G knowledge to perinatal psychiatry: prescribing in pregnancy and postpartum risk.
- Specialist / consultantUnderstandsWorks jointly with obstetric teams on high-risk mothers; perinatal subspecialists reach a higher level.
What are the key topics?
Obstetrics
- Antenatal care and screening
- Normal labour and delivery
- Obstetric emergencies: haemorrhage, eclampsia, shoulder dystocia
- Gestational diabetes and hypertension in pregnancy
- Puerperium: the six weeks after birth
- Breastfeeding basics
Gynaecology
- Menstrual disorders and premenstrual symptoms
- Contraception and family planning
- Infertility and its emotional burden
- Menopause and hormone changes
- Gynaecological cancers and screening (cervical screening)
Perinatal mental health links
- Baby blues versus postnatal depression
- Postpartum psychosis as a psychiatric emergency
- Anxiety and OCD in pregnancy and after birth
- Pregnancy loss, stillbirth and grief
- Hyperemesis and its psychological impact
- Domestic violence screening in antenatal care
Medicines in pregnancy
- Teratogenic risk by trimester
- Valproate risk and the need for pregnancy prevention in women who can conceive
- Basic principles of prescribing in breastfeeding
- Weighing the risk of untreated illness against drug risk
How is it learned and assessed?
- Labour ward and antenatal clinic attachments
- Delivery logbook and case write-ups
- OSCE stations and case-based assessments at end of posting
- O&G component of the final professional examination
Typical textbooks and resources
- Ten Teachers: Obstetrics and Ten Teachers: Gynaecology — classic student texts
- Oxford Handbook of Obstetrics and Gynaecology — practical reference
- MOH Malaysia obstetric and perinatal clinical guidelines
- Royal College of Obstetricians and Gynaecologists guidance (UK) — widely referenced
Titles are widely used examples; editions change. Use university libraries or legitimate purchases.
Common questions
Is postnatal depression the same as the baby blues?
No. The baby blues are brief, mild mood changes in the first days after birth and settle on their own. Postnatal depression lasts longer, affects daily functioning and needs assessment and treatment.
Why does O&G matter for psychiatry?
Because pregnancy and the year after birth carry a high risk of mental illness, and psychiatric medicines must be chosen carefully. Psychiatrists rely on what they learned in O&G to work safely with obstetric teams.