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 $400,000 and the 75th percentile at $490,000 in SalaryDr's OB/GYN reports, with the 10th and 90th percentiles at $350,000 and $550,000. These are self-reported figures that SalaryDr reviews but does not independently verify, and outliers are excluded from its percentiles.

The 91 percent "would choose again" rate among the 75 SalaryDr respondents who answered that question reflects the strong clinical identity most OB/GYNs feel toward their specialty — despite a malpractice burden that is among the heaviest in medicine.

Medscape's 2026 report showed OB/GYN compensation up 5 percent from its prior-year survey, and Doximity's OB/GYN average rose from $389,566 in its 2025 report to $420,859 in 2026 — solid growth for a specialty that has historically lagged the surgical fields it competes with for training talent. HRSA's National Center for Health Workforce Analysis projects a shortage of 7,660 full-time-equivalent OB/GYNs in 2038, with a 46 percent shortage in nonmetro areas — 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.

In the AMA's April 2026 claim-frequency study, 59.6 percent of OB/GYNs had been sued at least once in their careers — the highest share of any specialty, ahead of general surgery at 53.1 percent. 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 puts OB/GYN premiums at or near the top of the market. The AMA's April 2026 analysis of Medical Liability Monitor data lists these 2025 manual premiums for $1 million/$3 million policies, each from one insurer per market:

The Florida number deserves its own section. In Miami-Dade, OB/GYNs and general surgeons faced premiums of $243,988 based on 2025 AMA data, while the listed OB/GYN rate in Los Angeles and Orange counties was $49,804 — a $194,184 annual difference for the same specialty and the same policy limits. The Miami-Dade premium alone equals more than half of the Doximity 2026 OB/GYN average of $420,859.

What this means in net income terms:

An OB/GYN earning $425,000 in gross salary in Miami-Dade County, paying $243,988 in malpractice insurance, has $181,012 remaining before federal income tax, state income tax, retirement contributions, health insurance, and every other professional expense. The same $425,000 in Los Angeles, at the $49,804 premium, leaves $375,196.

This is not theoretical — it is the lived financial reality of OB/GYNs practicing in high-litigation markets such as Miami-Dade, the Chicago area, and Long Island.

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 — the Miami-Dade figure is nearly five times higher for the same specialty. The AMA found that California's average premiums, across all insurers, were lower than those of every other state in its comparison for all three specialties it tracks, and noted that California was the only one of those states with a cap on noneconomic damages.

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

SalaryDr's self-reported OB/GYN data (reports through September 24, 2026) puts private practice on top: average total compensation of $566,097 in private practice (31 reports), versus $465,000 in hospital employment (15 reports) and $421,911 in academic practice (28 reports).

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. At the $49,804 premium the AMA lists for Los Angeles, that leaves roughly $450,000 to $700,000. At the $207,907 listed for Cook County, Illinois, the same gross income leaves roughly $292,000 to $542,000 — a $158,103 annual 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.

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

Hospital employment is a common OB/GYN practice arrangement, in part because of 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 market can be worth more than $100,000 a year (up to $243,988 in Miami-Dade, per the AMA's 2025 figures) in 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. In Nassau and Suffolk counties, where the AMA lists a 2025 OB/GYN premium of $176,358, the employed physician's $380,000 comes with that coverage paid by the employer — about $556,000 in combined value. The private practice OB/GYN earning $450,000 who pays the same premium personally keeps about $274,000.

Call requirements are the most significant compensation variable within hospital-employed OB/GYN positions. Labor and delivery coverage requires around-the-clock physician availability, but separate call pay is less common than many residents assume: only 21 percent of OB/GYNs on Marit Health report receiving it. Among those who do, the daily rate runs from $525 at the 25th percentile to $3,600 at the 75th, with a median of $1,000. At that median, five paid call days a month would add $60,000 a year on top of base salary.

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

Academic OB/GYN pays the least of the three main practice settings in SalaryDr's data — 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 long-established fellowship subspecialties (complex family planning is a newer fifth) — and the financial logic of each differs significantly from the others.

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

MFM is one of the higher-compensating OB/GYN fellowships — Marit Health's self-reported average is $535,500 across 87 salaries, behind gynecologic oncology ($607,500) and REI ($605,000) — 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 drivers are 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 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 three-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

Related reading: See where obgyn ranks in physician wealth in our Physician Net Worth by Specialty rankings.

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' 2026 "Nowhere to Go" report found that 1 in 3 U.S. counties remains a maternity care desert, with no obstetric clinicians or birthing facilities, and that at least 96 hospital labor and delivery units closed across 35 states between 2024 and early 2026. 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. 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 lists OB/GYNs among its eligible maternal care disciplines — paying up to $50,000, exempt from federal income and employment taxes, for a two-year full-time commitment at an NHSC-approved site. 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. Where reform lowers OB/GYN malpractice premiums, the savings flow straight to net income and help with 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): The AAMC's 2025 stipend survey, as reported by the AMA, puts average stipends at $68,166 in PGY-1 and $77,593 in PGY-4. OB/GYN residency is four years, with fellowship adding two to three additional years; average stipends for PGY-5 through PGY-7 run $81,807 to $89,187.
• •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.

SalaryDr's OB/GYN reports follow the same curve: average total compensation of $365,000 at 3–5 years of experience (14 reports), $445,019 at 6–10 years (26 reports), $500,000 at 11–15 years (17 reports), and $705,000 at 16 or more years (15 reports).

The Gender Pay Gap in OB/GYN

OB/GYN is a majority-female specialty — 64.1 percent of active OB/GYNs were women in 2024, according to AAMC workforce data, and women made up 88 percent of OB/GYN residents in 2023–24, per the AAMC Report on Residents. Despite this demographic composition, a documented gender pay gap persists.

Doximity's 2026 report found the overall physician gender pay gap held at 26 percent in 2025, and that women earned less than men in every specialty it examined, with gaps of 10 percent or more in all but pediatric cardiology. Medscape's 2026 survey put the gap across all specialties at just over $102,000, or 31 percent, up from 29 percent two years earlier.

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:

• •Lower malpractice premiums, since obstetric claims drive the largest verdicts — a major saving in high-premium 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.

Going further and dropping surgery as well usually means an office gynecology job at about $260,000 to $320,000 with no call. Our guide to OB/GYN salary without surgery works through the wRVU math, the malpractice savings, ABOG's certification rules and ten non-surgical career paths.

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 — 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 worth $176,358 to $243,988 at the AMA's 2025 rates for Nassau and Suffolk counties, Cook County and Miami-Dade — 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 is far lower in tort reform states — $49,804 in Los Angeles at the AMA's 2025 rates. Net clinical income highly competitive.
• •Private practice associate OB/GYN (high-premium state): $400,000–$480,000 gross, minus a malpractice premium that the AMA's 2025 figures put at $176,358 to $243,988 in the New York, Illinois and Florida markets it tracks. 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 Doximity, Medscape, and SalaryDr 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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