Obstetric nurse practitioners usually work in both obstetrics and gynecology. Obstetrics is the care of pregnant patients and their babies, while gynecology focuses on overall sexual and reproductive health of women.

There are several duties that obstetric nurse practitioners fulfill. For example, they can examine and monitor women throughout their pregnancy. They ensure that the mother is gaining a healthy amount of weight, taking prenatal supplements, and review the mother's physical activity. They also assess patients' psychosocial situations to make sure the baby is born into a healthy environment. They counsel on risk factors such as smoking, dietary restrictions, and medication use.

They also monitor the baby throughout the pregnancy. They perform transvaginal and abdominal ultrasounds to monitor fetal heart rate/tone and take measurements. They assess the level of amniotic fluid and note the fetal movements and positioning.

Obstetric nurse practitioners can also manage high-risk pregnancies. An example would be a mother with gestational diabetes. NPs can monitor the mother's blood sugars, ensure the fetus is not growing too large, and prescribe medications to the mother (oral medications as well as insulin). NPs can also provide nutrition education for mothers with gestational diabetes.

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Other high-risk conditions obstetric NPs can manage is hyperemesis gravidarum, pregnancy-induced hypertension, and preeclampsia. In some cases, physician oversight or input is needed, but obstetric NPs are qualified to manage and monitor high-risk patients.

When it comes to delivering babies, it depends on the state and organization of employment. Some states allow NPs to deliver, for example, if they work in the emergency room. Some require certification as a nurse midwife. Prospective NPs should research their state and organization's requirements/regulations.

Following delivery, obstetric NPs can examine and monitor the mother and baby for proper recovery. NPs monitor the amount of bleeding, tone of the fundus, and breastfeeding/lactation. They can also counsel on post-pregnancy birth control options.

While working as an obstetric NP can be extremely rewarding, it also has its challenges. One of the major challenges is fetal or maternal demise. This is something that is extremely difficult to encounter, and obstetric NPs need to be sure they find adequate coping mechanisms when or if it does. Having a healthy outlet for stress relief is essential; whether it's talking to peers, exercising, meditation, prayer, etc., finding a way to handle caregiver grief and re-kindling the joy in advance-practice nursing is a must.

Amanda Bucceri Androus RN, BSN

Amanda Bucceri Androus RN, BSN

Amanda Bucceri Androus is a Registered Nurse from Sacramento, California. She graduated from California State University, Sacramento in 2000 with a bachelor's degree in nursing. She began her career working night shifts on a pediatric/ med-surg unit for six years, later transferring to a telemetry unit where she worked for four more years. She currently works as a charge nurse in a busy outpatient primary care department. In her spare time she likes to read, travel, write, and spend time with her husband and two children.
Amanda Bucceri Androus RN, BSN

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