A laborist is a board-certified or board-eligible obstetrician-gynecologist (OB/GYN) focused exclusively on caring for patients within the hospital setting, specifically the labor and delivery unit. This physician works as an inpatient specialist, similar to a hospitalist in general medicine, dedicating their time solely to women hospitalized for obstetric or gynecologic conditions. The laborist model provides continuous, specialized care and enhances patient safety in the maternity ward. The primary purpose of this role is to ensure an experienced physician is physically present and immediately available to manage all inpatient issues.
The Clinical Responsibilities of a Laborist
The laborist’s role involves hands-on clinical tasks for patients requiring immediate or acute care. One primary duty is managing unassigned patients, including those who present without a private obstetrician or who are uninsured. They also operate the obstetric triage unit—the labor and delivery emergency department—evaluating all incoming patients for labor status or potential complications.
They are responsible for performing deliveries, including routine vaginal births and complex cesarean sections, for patients under their direct care. A significant part of their job is responding instantly to obstetric emergencies, as they are already in the hospital when minutes matter. These time-sensitive situations include managing complications such as postpartum hemorrhage, shoulder dystocia, or abnormal fetal heart rate tracings.
The laborist also provides consultation services to other hospital departments, such as the emergency department, when a patient presents with a gynecologic or early pregnancy concern. Their expertise is utilized for any patient admitted to the antepartum (before birth) or postpartum (after birth) units who develops a complication. This focus on immediate, inpatient care differentiates their clinical work from the scheduled prenatal care provided in an outpatient office.
How the Laborist Staffing Model Functions
The laborist staffing model provides 24/7 in-house coverage on the labor and delivery unit. These physicians typically work scheduled shifts, often 12 or 24 hours long, ensuring a well-rested, board-certified physician is always on the premises. This continuous physical presence dramatically improves response times for unexpected medical events.
When an obstetric emergency occurs, such as a placental abruption or cord prolapse, the laborist can be at the bedside performing necessary procedures, like an emergency cesarean delivery, in moments. This immediate availability is supported by the American College of Obstetricians and Gynecologists to enhance patient safety and improve outcomes for both mother and baby. Their employment structure is generally as a salaried hospital employee or through a contract group, rather than a private practitioner.
This model allows private OB/GYNs to manage their outpatient clinics without the disruption of being called away for deliveries or emergencies. The laborist acts as the hospital’s dedicated inpatient physician, stabilizing the private physician’s work-life balance and reducing schedule unpredictability. Separating the office practice from inpatient coverage benefits the entire system through better physician rest and more organized care.
Laborist Versus Your Primary OB/GYN
The relationship between a laborist and a patient’s primary OB/GYN is one of coordinated care, not replacement. The primary physician provides all scheduled prenatal care and maintains the established patient-physician relationship. When the patient arrives at the hospital, the laborist may initially manage care, especially if the primary OB/GYN is not yet present or is managing office hours.
Clear handoff protocols and documentation transfer are necessary for this model to work, ensuring the laborist is fully aware of the patient’s medical history and birth plan. In many cases, the laborist acts as a backup, providing continuous monitoring and progressing labor until the primary physician arrives to perform the delivery. The laborist can also manage the patient completely, including the delivery, if the patient’s own doctor is unavailable or requests the laborist to take over.
Patients are generally informed in advance about the laborist system, allowing for understanding and consent regarding the possibility of an unfamiliar physician providing care. This arrangement provides continuity of care within the hospital, meaning a physician is always monitoring the patient, even when the private doctor is en route. The laborist’s presence ensures that a patient who may deliver rapidly or experience a sudden complication has a physician immediately available.