OB/GYN Salary (2026): What Obstetricians and Gynecologists Actually Earn — and the Malpractice Crisis Nobody Explains Clearly

This guide covers what OB/GYNs actually earn in 2026 by practice setting, subspecialty, and geography — with the malpractice math fully integrated into the compensation picture, because any OB/GYN salary analysis that omits the malpractice variable is giving you an incomplete and potentially misleading picture.

What the Data Shows: OB/GYN Salary in 2026

Multiple compensation surveys produce different figures depending on methodology and what components of compensation are counted:

The 25th percentile sits at $410,000 and the 75th percentile reaches $490,000, per SalaryDr's verified 2026 database. Top earners at the 90th percentile reach $3,100,000 annually — driven by high-volume private practice partnerships with ownership in ambulatory surgery centers and subspecialty procedural practices.

The 91 percent "would choose again" satisfaction rate reported in SalaryDr's verified data reflects the strong clinical identity most OB/GYNs feel toward their specialty — despite the malpractice burden that is genuinely the highest of any physician discipline.

The Medscape 2025 report showed OB/GYN compensation growing 6 percent year-over-year — solid growth for a specialty that has historically lagged the surgical fields it competes with for training talent. The National Center for Health Workforce Analysis projects that by 2030, demand for OB/GYNs will exceed supply in every U.S. region except the Northeast — a shortage dynamic that is beginning to push compensation upward in markets with the most acute access problems.

The Malpractice Reality: The Number That Changes Everything

Before analyzing OB/GYN salary by setting or subspecialty, the malpractice insurance cost must be understood — because it is the variable that more than any other determines what an OB/GYN actually takes home from any given gross salary.

Nearly two out of three OB/GYNs face legal action at some point — the highest rate of all physician specialties. Birth injuries are the primary driver of obstetric claims, and when verdicts occur, they tend to be among the largest in medical malpractice — life-care plans for neurologically injured infants often run into the tens of millions of dollars.

This claims profile produces malpractice premiums that are categorically different from any other medical specialty:

The Florida number deserves its own section. An obstetrician in Florida might pay $205,380 annually, while their colleague in California pays just $49,804 — a $155,576 annual difference on identical coverage for identical work. In Miami-Dade specifically, OB/GYNs and general surgeons faced premiums of $243,988 based on 2025 AMA data — meaning the malpractice premium alone consumes more than half of what many national salary surveys report as the average OB/GYN income.

What this means in net income terms:

An OB/GYN earning $430,000 in gross salary in Miami-Dade County, paying $243,988 in malpractice insurance, has $186,012 remaining before federal income tax, state income tax, retirement contributions, health insurance, and every other professional expense. That is less take-home than a family medicine physician in Minnesota earning $280,000 gross with $15,000 in malpractice costs.

This is not theoretical — it is the lived financial reality of OB/GYNs practicing in high-litigation markets and the primary driver of obstetric practice closures in Florida, Illinois, New York, and New Jersey over the past decade.

The tort reform variable: States with statutory caps on non-economic damages — primarily California, which operates under MICRA (Medical Injury Compensation Reform Act) — have dramatically lower malpractice premiums than states without caps. California's OB/GYN premium in Los Angeles is $49,804 versus $243,988 in Miami-Dade — a 390 percent difference for the same specialty on different sides of a state line. Indiana and Wisconsin are consistently cited for the lowest malpractice premiums nationally across all specialties as a direct result of their tort reform laws.

For OB/GYNs evaluating geographic opportunities, the malpractice premium difference between states — not the nominal salary difference — is frequently the largest financial variable in a career-level decision.

For a full breakdown of malpractice insurance cost by specialty and state, see our malpractice insurance review page.

OB/GYN Salary by Practice Setting

Private Practice and Partnership: $450,000 – $900,000+

Private practice OB/GYN represents the highest compensation ceiling in the specialty and the environment where the gross-to-net malpractice math is most acute — because private practice physicians pay their own malpractice premiums directly rather than having them absorbed by an employer.

An OB/GYN partner in a well-run private group with ownership in an ambulatory surgery center typically earns $500,000 to $750,000 in combined clinical and distribution income — before the malpractice premium is subtracted. In a low-premium state like Indiana or Wisconsin, that subtraction is $20,000 to $35,000, leaving net pre-tax income of $465,000 to $730,000. In Cook County, Illinois, subtracting $140,000 in malpractice premiums from the same gross income produces $360,000 to $610,000 — a $105,000 effective penalty for geographic location.

The ASC ownership angle is significant for OB/GYNs who perform high volumes of outpatient gynecological procedures — hysteroscopy, endometrial ablation, laparoscopy, myomectomy, colposcopy, and minor gynecological surgeries. An OB/GYN with a 20 percent ownership stake in a high-volume ambulatory surgery center generating $3 million annually in distributions receives $600,000 in ASC income on top of their clinical salary — producing total annual compensation that reaches $1 million or more and explains the top-percentile figures in SalaryDr's database.

Hospital and Health System Employment: $350,000 – $500,000

Hospital employment is the most common OB/GYN practice arrangement in 2026, driven by the liability absorption advantage it provides. When an OB/GYN is hospital-employed, the hospital typically pays the malpractice premium — which in a high-litigation state can be worth $100,000 to $240,000 annually in gross compensation value that never appears in the stated salary.

This makes the nominal salary comparison between a $380,000 hospital-employed OB/GYN and a $450,000 private practice OB/GYN in the same market potentially misleading. The employed physician's $380,000 comes with $140,000 in employer-paid malpractice coverage — bringing the effective total compensation to $520,000 equivalent. The private practice OB/GYN earning $450,000 who pays $140,000 in their own malpractice premiums is taking home less on a net basis.

Call requirements are the most significant compensation variable within hospital-employed OB/GYN positions. Labor and delivery coverage requires around-the-clock physician availability. OB/GYN call stipends run $1,500 to $3,500 per 24-hour call day — an OB/GYN taking 10 call days per month at $2,000 each adds $240,000 annually in call pay on top of their base salary. Total compensation including call pay commonly reaches $450,000 to $550,000 for high-call hospital-employed OB/GYNs.

OB/GYN Hospitalist Model: $350,000 – $480,000

The OB/GYN hospitalist model — dedicated in-house obstetric coverage physicians — has grown substantially over the past decade as hospital systems have recognized that 24/7 in-house obstetric physician coverage reduces adverse outcomes and malpractice exposure simultaneously.

OB hospitalists work shift-based schedules — typically 12 to 24-hour shifts — covering labor and delivery for all obstetric patients regardless of who their outpatient OB is. The model provides income predictability, structured hours, and importantly, malpractice coverage provided by the hospital rather than the individual physician.

For OB/GYNs who want to exit the demanding continuity-of-care model of private obstetrics while maintaining procedural skills, the hospitalist pathway provides income in the $350,000 to $480,000 range with meaningfully better lifestyle characteristics than a full scope OB/GYN private practice.

Academic Medicine: $280,000 – $380,000

Academic OB/GYN pays the least of any practice setting — typically $280,000 to $380,000 — in exchange for protected research time, teaching, subspecialty exposure, and the liability coverage that academic medical centers provide for their physician employees.

For OB/GYNs with significant student loan debt at qualifying nonprofit academic medical centers, PSLF eligibility creates real financial value that partially offsets the salary gap. An academic OB/GYN with $280,000 in federal student loans pursuing PSLF at a qualifying academic employer is accumulating $20,000 to $35,000 annually in equivalent compensation value through loan forgiveness. Use our PSLF Calculator to model what forgiveness is worth in your specific situation.

OB/GYN Subspecialties: The Fellowship Decision

OB/GYN has four fellowship subspecialties — and the financial logic of each differs significantly from the others.

Maternal-Fetal Medicine (MFM): $430,000 – $650,000

MFM is the highest-compensating OB/GYN fellowship and the one with the strongest structural demand dynamics. Maternal-fetal medicine specialists manage high-risk pregnancies — multiple gestations, fetal anomalies, severe maternal medical disease, preterm labor — that general OB/GYNs refer out.

The three-year fellowship (after a four-year OB/GYN residency) produces income that typically runs $80,000 to $150,000 above general OB/GYN at comparable career stages. MFM physicians in academic medical centers earn $430,000 to $550,000. Private group MFM specialists in high-volume maternal medicine practices reach $600,000 to $650,000 or more.

The demand picture is acute. The American College of Obstetricians and Gynecologists has documented persistent MFM shortages across most U.S. regions — driven by increasing maternal age at delivery, rising rates of preexisting chronic conditions in reproductive-age women, and the downstream effect of more complex pregnancies requiring specialist management. New MFM graduates are entering one of the strongest job markets in obstetric medicine.

Gynecologic Oncology: $450,000 – $700,000

Gynecologic oncology combines surgical oncology and medical oncology for cancers of the female reproductive system — ovarian, uterine, cervical, vaginal, and vulvar cancers. It is procedurally intensive, involving complex pelvic surgery that commands significant procedural billing.

Gynecologic oncologists in private practice with high surgical volume earn the highest gross incomes in the subspecialty — $550,000 to $700,000 is achievable for high-volume pelvic surgeons at major cancer centers or affiliated surgical programs. Academic gynecologic oncologists earn $450,000 to $550,000 with the benefit of research opportunities and institutional support.

The chemotherapy buy-and-bill model that drives heme/onc private practice income also applies partially to gynecologic oncology — practices that administer chemotherapy capture the margin between acquisition cost and reimbursement, which in certain treatment regimens can add meaningful supplemental income beyond professional fee billing.

Reproductive Endocrinology and Infertility (REI): $380,000 – $600,000+

REI is the fertility subspecialty — intrauterine insemination, in vitro fertilization, egg freezing, genetic preimplantation diagnosis, and related treatments for infertility. The practice model is structurally unique: a significant portion of fertility care is cash-pay, because most commercial insurance plans cover infertility treatment poorly or not at all.

This cash-pay component is what drives REI income above the nominal salary surveys suggest. A fertility clinic charging $15,000 to $25,000 per IVF cycle and performing 200 cycles annually generates $3 million to $5 million in gross revenue. An REI physician with an equity stake in a well-run fertility clinic can earn $400,000 to $700,000 or more in combined clinical and ownership income.

REI physicians in academic settings earn $380,000 to $480,000 without the cash-pay clinic upside. The fellowship is two to three years and is among the most competitive in OB/GYN to match.

Female Pelvic Medicine and Reconstructive Surgery (FPMRS): $350,000 – $500,000

FPMRS — formerly called urogynecology — manages pelvic floor disorders including urinary incontinence, pelvic organ prolapse, and related functional pelvic conditions. The specialty is procedural with both surgical and office-based procedure components.

Compensation runs $350,000 to $500,000 depending on setting and procedural volume. Academic FPMRS is at the lower end; private practice with high surgical volume and office-based procedure capability reaches the higher end. The two-year fellowship produces a modestly higher income than general OB/GYN in most markets, making the ROI calculation less compelling than MFM or gynecologic oncology — though practitioners consistently cite high job satisfaction and manageable lifestyle characteristics.

The Workforce Crisis: Obstetric Deserts and What They Mean for Compensation

The United States is experiencing a documented obstetric access crisis that has direct implications for OB/GYN compensation in specific markets and is reshaping where obstetric practice is economically sustainable.

The March of Dimes' 2024 Maternity Care Desert report identified that over one-third of U.S. counties have no hospitals providing obstetric care and no OB/GYNs or certified nurse midwives. This figure has been increasing — the combination of malpractice premium burden, reimbursement compression, and the demanding lifestyle of full-scope obstetric practice has driven OB/GYNs out of rural markets faster than they have been replaced.

What obstetric deserts mean for physician compensation:

Markets with documented obstetric care shortages are increasingly offering compensation packages that reflect the scarcity. Rural and critical shortage area OB/GYN positions command salary premiums of 25 to 50 percent above metropolitan markets. Hospital-employed positions at critical access hospitals in shortage areas offer $450,000 to $550,000 base salary plus employer-paid malpractice — and then stack loan repayment programs on top.

The National Health Service Corps loan repayment program is accessible to OB/GYNs practicing at HPSA-designated sites — providing $50,000 in tax-free loan forgiveness in exchange for a two-year service commitment. For an OB/GYN with $300,000 in student debt, NHSC loan repayment combined with PSLF eligibility creates a loan repayment trajectory that eliminates most or all of the student loan obligation within 10 years while earning a competitive salary.

The legislative landscape is also shifting. Several states have passed or are considering targeted tort reform specifically aimed at obstetric malpractice — recognizing that the liability environment is directly causing obstetric care deserts. In states where reform passes, OB/GYN malpractice premiums typically decline within 3 to 5 years, which has a direct positive effect on net income and physician retention.

OB/GYN Salary by Career Stage

OB/GYN has a meaningful career income curve — more so than most procedural specialties — because procedural volume and partnership status drive income in ways that continue accumulating over a multi-decade career.

• •Residency (PGY-1 through PGY-4): Residency stipends run $68,000 to $84,000 depending on year and program location. OB/GYN residency is four years, with fellowship adding two to three additional years at $78,000 to $95,000 annually.
• •New attending (years 1–3): Most new OB/GYNs enter employed positions at income guarantee salaries of $300,000 to $380,000 during the panel-building and credentialing phase. Signing bonuses of $30,000 to $75,000 are common, with higher amounts in shortage markets. The income guarantee typically transitions to a productivity-based model after 18 to 24 months.
• •Mid-career (years 4–8): Full productivity-based income kicks in, typically landing at $380,000 to $500,000 in employed settings. The partnership track at private groups produces income jumps of $100,000 to $200,000 in the year of partnership transition.
• •Senior physician (10+ years): Private practice partners with procedural volume and ASC ownership reach $550,000 to $900,000 or more. Employed senior OB/GYNs with strong panels reach $450,000 to $600,000 including call pay. The gap between the employed and private practice senior income is larger in OB/GYN than most other specialties — and the malpractice premium is the main reason more OB/GYNs are staying employed rather than going private.

The Gender Pay Gap in OB/GYN

OB/GYN is a majority-female specialty — approximately 60 percent of currently practicing OB/GYNs are women, and over 80 percent of current OB/GYN residents are women. Despite this demographic composition, a documented gender pay gap persists.

The gender pay gap in OB/GYN runs approximately 25 percent — male OB/GYN physicians earn approximately 25 percent more than their female counterparts despite practicing in the same specialty. Medscape's data shows the gap narrowing modestly but remaining substantial at every career stage.

The gap is more pronounced in private practice settings where compensation is individually negotiated — and significantly narrower in hospital employment settings with transparent salary structures. Self-reported data shows that self-employed OB/GYNs earn approximately 9 percent more than employed counterparts on average — but that premium varies substantially by gender, with women OB/GYNs in private practice not capturing the same self-employment premium as their male colleagues.

For women OB/GYNs benchmarking their compensation — which is most OB/GYNs entering the specialty — this data is not just informational. It is negotiating leverage. Knowing the gender-adjusted market rate for your specialty and market before entering any compensation discussion is the most important preparation step in the process.

The Waning Obstetrics Model: More OB/GYNs Dropping the "OB"

One of the most significant and underreported trends in OB/GYN compensation is the increasing number of OB/GYN physicians who practice gynecology only — dropping obstetric care entirely to eliminate the malpractice burden that deliveries uniquely create.

The obstetric component of OB/GYN practice is where the vast majority of large malpractice claims originate. Birth injury cases with neurologically damaged infants produce the multi-million dollar verdicts that drive premiums to the levels documented above. A gynecology-only OB/GYN — who performs office gynecology, surgery, and gynecological oncology screening but delivers no babies — has a malpractice profile that approaches a surgical generalist rather than an obstetrician.

In high-premium states, the financial case for dropping obstetrics from an OB/GYN practice is increasingly compelling:

• •Malpractice premium reduction: $100,000 to $200,000 per year in states like Florida or Illinois
• •Elimination of overnight and weekend call coverage obligations
• •More predictable scheduling and lifestyle
• •Preserved income from office and surgical gynecology

The trade-off is reduced clinical scope and the loss of the delivery and newborn care component that many OB/GYNs entered the specialty to practice. But in markets where the economics of full obstetric practice have become prohibitive, this trend is real and accelerating.

What a Competitive OB/GYN Compensation Package Looks Like in 2026

• •Hospital-employed OB/GYN in moderate-premium state: $380,000–$470,000 base plus productivity bonus and call stipends. Employer-paid malpractice coverage of $30,000–$80,000 in most states — real compensation value not visible in the stated salary. PSLF eligible at nonprofit systems. Signing bonus of $30,000–$50,000 typical.
• •Hospital-employed OB/GYN in high-premium state (NY, IL, FL): $400,000–$500,000 base to offset the malpractice burden the employer absorbs. Employer-paid malpractice coverage of $100,000–$240,000 in premium states — this is the dominant reason employed positions pay more in high-litigation markets. Total economic package value including malpractice coverage can reach $600,000 to $700,000 equivalent.
• •Private practice associate OB/GYN (low-premium state): $400,000–$480,000 during the associate track. Physician-paid malpractice of $15,000–$35,000 in tort reform states. Net clinical income highly competitive.
• •Private practice associate OB/GYN (high-premium state): $400,000–$480,000 gross, minus $100,000–$240,000 in malpractice premiums. Net income substantially lower than the stated salary suggests. Evaluate carefully before accepting.
• •MFM or gynecologic oncology subspecialty, employed: $480,000–$600,000 with employer-paid malpractice. Strong job market with multiple competing offers common for qualified subspecialists.

Use our Contract Analyzer to model the full net economic value of any OB/GYN compensation package before signing.

For a complete comparison of physician salaries across all specialties including MGMA, Medscape, and Doximity data, see our Physician Salary by Specialty guide.

For malpractice insurance carrier comparisons, coverage options, and premium data by specialty, see our malpractice insurance review page. For understanding tail coverage — particularly important for OB/GYNs who carry the longest potential claims exposure of any specialty — see our Tail Coverage Guide.

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