Become an Obstetric Nurse in 3 Steps

Nurse Types / Obstetric Nurse

Some nurses know they want to be an obstetric nurse before they even enter nursing school. A specialty very different from other areas of nursing, obstetric nurses seem to possess endless amounts of patience and compassion. OB nurses typically care for laboring mothers and their newborns through childbirth and the postpartum phase.

Don’t let their soft voices and smiles fool you. They possess specific knowledge and skills to care for the most vulnerable patients. Curious if you’re prepared to care for pregnant moms and new little bundles of joy? Keep reading to learn:

• What is an obstetric nurse?
• What do obstetric nurses do?
• Where do obstetric nurses work?
• What are specific types of obstetric nurses?
• How do you become an obstetric nurse in 3 steps?
• What are the additional requirements of obstetric nurses?
• What are the salary and career outlooks for obstetric nurses?
• Obstetric nurse FAQs

What is an obstetric nurse?

Obstetric nursing, also known as OB nursing, focuses on the care of women through their pregnancy journeys including labor and childbirth to ensure a healthy delivery and newborn. Obstetrics can be thought of as an umbrella term used to describe different phases of nursing care depending on the stage of reproduction. 

Qualities of a successful obstetric nurse

It goes without saying that OB nurses love babies. Supporting a mother through pregnancy and childbirth requires compassion and understanding. Childbirth is a special experience and no two deliveries will be the same. Successful OB nurses possess the following traits:

Empathy. OB nursing requires constant empathy. You must have an impeccable bedside manner, listening skills, and the ability to quickly build a trusting rapport with your patients.

Attention to detail. While emotional skills are a large part of successful OB care, there is no lack of critical thinking or medical intervention when required. Emergencies can arise in a flash and you must be on alert and react promptly.

Tolerance. A universal trait required of all nurses, this can be especially difficult when children are involved. Family dynamics come in all shapes and sizes so nurses must not be judgmental.

What do obstetric nurses do?

OB nurses monitor both mom and baby for complications. Responsibilities will depend on the setting.

Gynecological care often precedes and follows pregnancy and takes place in an OB/GYN setting. You will play a large role in:

• Educating on overall reproductive health
• Assessing the health of mom and baby through pregnancy by monitoring vital signs, glucose levels, and weight gain
• Diet recommendations and lifestyle modifications such as exercise or quitting smoking
• Collecting blood and urine samples for screenings
• Assessing and directing to resources for financial or psychosocial assistance

Once it’s time for the baby to make an appearance, labor and delivery (L&D) nurses take over. These responsibilities include:

• Monitoring fetal heart rate and contractions
• Administering Pitocin and pain medication as prescribed
• Providing emotional support for the mother and interventions for comfort
• Monitoring for complications in both mom and baby
• Closely communicating updates with the MD
• Preparing for C-section if necessary 

Once the baby is born, you will quickly perform an assessment of the newborn and ensure both mom and baby are stable.

Postpartum nurses care for mom and baby following delivery. The couplet may be transferred to the post-partum unit for ongoing assessment and teaching. You will perform the following tasks:

• Assess for bleeding complications by monitoring lochia, incisions, and fundal height
• Teach and assess newborn care such as bathing, swaddling, and feeding
• Provide lactation support if necessary
• Aid in comfort of mom by providing ice packs, sitz baths, and breast care interventions
• Promote bonding between newborns and parents

Most facilities promote keeping the baby with mom as much as possible but there may be situations when the newborn is taken to the nursery for assessments or to allow mom to rest. OB nurses in the nursery setting change diapers, feed babies, and provide cuddles which may be more of a perk than a responsibility.

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A day in the life of an obstetric nurse

As mentioned above, the responsibilities of an OB nurse vary by setting. The interesting part of this specialty is that you may frequently rotate through all of these roles which means you will never be bored and no two days will be the same.

For most obstetric nurses, you will provide care in an acute care hospital. This usually involves 12-hour shifts, weekend, and on-call requirements. Labor and delivery (L&D) units are unique in that they may be empty or overflowing. Unless an induction is scheduled, labor progresses at its own pace. 

You may spend your shift simply interpreting fetal monitors and frequently assessing dilation and effacement until it’s time to deliver. Other shifts may be fast-paced with multiple deliveries, management of complications, or preparation for cesarean sections.

In the postpartum setting, you’re now responsible for mom and baby – known as a couplet. Your assignment will contain multiple couplets. Your shift will include monitoring mom post-delivery, assessing vital signs of both mother and baby, keeping mom comfortable, and educating prior to discharge.

Common conditions treated by obstetric nurses

For the most part, women of childbearing age are relatively healthy and usually do not have a long list of chronic conditions. L&D can be complicated by pregnancy-related complications that you must assess, monitor, and prevent such as:

• Endometriosis
• Postpartum hemorrhage
• Preeclampsia and eclampsia
• Miscarriage
• Multiple gestation pregnancy
• Placenta abnormalities
• Preterm labor
• Premature birth
• Fetal distress
• HIV disease and sexually transmitted infections

Where do obstetric nurses work?

Most OB nurses work in hospitals on maternity units. Your time may be divided between the labor and delivery unit, the postpartum unit, and the nursery. You can expect to work 12-hour shifts.  

Some OB nurses work in obstetric-gynecologic clinics and offices or birthing centers. These settings likely operate on a scheduled 9-5 workweek.

What are specific types of obstetric nurses? 

Obstetric nurses have a thorough understanding of maternal and reproductive health. OB nurses may rotate between the following settings or may work strictly in one department:

• Prenatal and gynecological care
• Labor and delivery
• Postpartum

Closely related fields 

OB nursing is centered around women’s health. Additional specialties related to maternal health, pregnancy, and infants include:

• Fertility nurse
• Lactation consultant
• Birth doula
• NICU (neonatal) nurse
• Nurse midwife

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How do you become an obstetric nurse in 3 steps?

Step 1 – Become a registered nurse

You must first complete nursing school and pass the NCLEX exam to become a licensed registered nurse.

Earn a nursing degree 

You may complete either an Associate Degree in Nursing (ADN) program or a Bachelor of Science in Nursing (BSN) program to prepare for the NCLEX exam. Bachelor’s-degree prepared nurses are highly sought after by employers and give you a competitive edge among peers. 

RN to BSN programs are popular if you desire to start your nursing career immediately and advance your education later.

Pass the NCLEX exam

Once you graduate from your nursing program, you will be eligible for the NCLEX exam. This rigorous exam tests your foundational nursing knowledge and ability to provide safe care.

Step 2 – Accumulate experience

Obstetrics is a specialty that accepts new graduate nurses. Your hospital may offer a residency program that provides additional classroom and precepting to transition safely into this specialty.

Helpful skills and experience

Accredited nursing programs require a clinical OB rotation with maternal nursing as a traditional lecture component. The length of time spent in L&D, maternity wards, or pediatric units will depend on your nursing program. 

As a student, if you quickly recognize obstetrics is for you, you may be able to request a preceptorship in obstetrics to gain additional experience.

Changing specialty to an obstetric nurse

Changing your specialty from one hospital setting to obstetrics may not require much adapting regarding work hours or nursing skills such as starting IVs or medication administration. The bulk of the transition will come in the form of refreshing your knowledge on maternal and newborn health. A great place to start is taking continuing education courses to prepare.

Step 3 – Obtain certifications

The National Certification Corporation offers the Inpatient Obstetric Nursing (RNC-OB) certification. After completing 2 years and at least 2,000 hours in the specialty of obstetrics, you are eligible to take the exam. 

Additional certifications OB nurses may acquire include:

• Pediatric Advanced Life Support (PALS) 
• Electronic Fetal Monitoring (C-EFM®)
• Certified Lactation Counselor

What are the additional requirements of obstetric nurses? 

OB nursing is often thought of as a ‘cheerful’ specialty bringing new life into the world. Not all pregnancy situations are happy and tragic outcomes do occur. There may be times when you are a laboring person’s only support system and they rely on you for coaching and emotional guidance. 

In times of infant or maternal death, OB nursing can be emotional and mentally exhausting. While it’s certainly normal and expected to feel upset during these times, your resiliency and strength are required to support grieving parents and to continue to provide excellent care for other patients. 

What are the salary and career outlooks for obstetric nurses? 

L&D is often a higher-paying specialty. Salaries will depend on location and experience. The states that pay the most for OB nurses are found on the West coast in Alaska, California, Nevada, Oregon, and Washington. The average salary for OB/GYN nurses is just over $84,000 which equals $40 per hour. 

Reproduction is a natural part of life and as long as people keep having babies, they will need obstetric nurses. The outlook for registered nurses as a whole is expected to grow 9% within the decade.

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Job satisfaction

Research is lacking on job satisfaction specifically for obstetric nurses. The pandemic was detrimental to the field of nursing causing interrupted care and high turnover which impacted job satisfaction as a whole. In one study, 25% of maternity nurses screened positive for burnout and almost 20% reported job dissatisfaction.

In a Nebraska Medicine report, the following findings contribute to a fulfilling career:

• Connecting with patients and making a difference
• Positive work environment
• Finding your niche
• Professional growth and advancement

OB nursing certainly checks these boxes and may offer nurses a heightened sense of job satisfaction.

Next steps 

Obstetrics is a broad specialty with options for growth. As you gain experience you may find a deeper niche you are passionate about such as caring for the frailest little ones in the NICU. 

Another option is to advance your education and become a certified nurse midwife.

If you are interested in advocacy and further professional development you may consider becoming a member of the Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN).

For additional nursing career resources, Incredible Health offers license resources and a question and advice forum.

FAQs

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