What Is Obstetrics (OB/GYN) Nursing? The Ultimate Guide
The obstetric nursing specialty is becoming increasingly important in the United States. According to the Centers for Disease Control and Prevention (CDC), pregnancy-related deaths increased from 7.2 per 100,000 live births in 1987 to 18 in 2014. Moreover, severe maternal morbidity increased by almost 200 percent between 1993 and 2014. Add to these figures the fact that as much as 60 percent of pregnancy-related deaths from 2013 to 2017 were potentially preventable, and we are faced with maternal care systems in dire need of improvement.
In this context, an obstetrics nurse can be confident in the importance of their role in caring for women throughout pregnancy and childbirth in addition to catering to women’s healthcare needs throughout the rest of their lives. Are you interested in this essential nursing specialty? Then, you have come to the right place. This ultimate guide to OB/GYN nursing covers everything you need to know about this area of nursing: education, certifications, duties, salary, and more!
What Does OB/GYN Stand for, and What Does It Mean in Medical Terms?
The abbreviation OB/GYN stands for obstetrics and gynecology, a branch of medicine specializing in the diagnosis and treatment of diseases of the female reproductive organs and in the care of women during pregnancy and childbirth. Although often used as a synonym for labor and delivery, by definition, obstetricians and gynecologists—as well as OB/GYN nurses—also specialize in other women’s health issues, including birth control, infertility, hormone problems, and menopause.
What Is an Obstetric Unit in a Hospital?
The definition of an obstetric unit or department varies from one hospital to another. In some locations, this term may refer to the labor and delivery (L&D) unit; in others, it may refer to the mother and baby (M&B) unit; alternatively, it could encompass prenatal, labor and delivery, and postnatal care.
Furthermore, the description of an obstetric unit also varies depending on the level of care it offers. The following are definitions of obstetric units based on each level of care:
- Accredited birth centers: These centers, which may be freestanding or associated with hospitals, care for low-risk women with uncomplicated singleton, term, and vertex pregnancies expected to have uncomplicated births.
- Level I (Basic Care): These units care for women with low- to moderate-risk pregnancies. They have the ability to detect, stabilize, and initiate management of unanticipated maternal-fetal or neonatal healthcare needs occurring during the antepartum, intrapartum, or postnatal period until the patient can be transferred to a facility with specialty maternal care.
- Level II (Specialty Care): These units offer everything that a level I unit offers plus the care of moderate- to high-risk antepartum, intrapartum, or postnatal conditions.
- Level III (Subspecialty Care): These obstetric units offer everything that is available at level II facilities; plus, they provide care for women with more complex obstetric complications and maternal and fetal medical conditions.
- Level IV (Regional Perinatal Health Care Centers): Finally, these highly specialized units offer all the services and professionals available at a level III facility as well as on-site medical and surgical care of critically ill pregnant women and fetuses throughout antepartum, intrapartum, and postnatal care and the most complex maternal conditions.
What Is the Role of an Obstetrics Nurse?
The role of an OB/GYN nurse is largely dependent on their level of education. Although most obstetric nurses are registered nurses (RNs), nurses at all levels of education—from licensed practical nurses (LPNs) to advanced practice registered nurses (APRNs)—can find employment in this specialty.
Furthermore, the role of an OB/GYN nurse also varies significantly depending on their work setting. Although most obstetrics nurses work in hospitals, hospital birth centers, and obstetrician and gynecologist offices, an OB/GYN nurse may also work in the following settings:
- Midwifery practices
- Private birthing centers
- Community clinics
- Family planning centers
- Urgent care clinics
- U.S. Army Nurse Corps
Aside from these settings, an OB RN can also work from home as a telehealth nurse—a role that has grown exponentially since the beginning of the COVID-19 pandemic.
What Does an Obstetrics Nurse Do?
Although the duties of an OB nurse vary depending on their level of education and work setting, most obstetrics nurses care for women throughout pregnancy, childbirth, and postpartum. Therefore, regardless of the work setting, most OB nurses share the following typical responsibilities of a nurse in an OB/GYN’s office:
- Obtaining patient consent for care and ensuring patient confidentiality
- Obtaining and documenting a patient’s vital signs, health history, medical information, medication reconciliation, and health risk factors
- Assessing patient needs
- Providing patient care based on standards of care, practice guidelines, and federal/state laws and regulations
- Checking schedules and organizing patient flow
- Executing prescribed treatments and medical interventions, administering medications and vaccines, and monitoring patient response
- Referring patients to physicians, other healthcare providers, and community resources to prevent or resolve problems or concerns
- Educating patients and families about their health status, health maintenance, and management of both acute and chronic conditions
- Documenting patient assessments
- Participating in multidisciplinary teams to improve patient care processes and outcomes
- Maintaining and stocking exam rooms
- Monitoring expiration dates of medications and supplies
- Assisting with the performance of non-stress tests for obstetrical patients
- Assisting with telephone triage calls
- Assisting in the procedure room as needed
Additionally, this job description offered by an OB nurse on Reddit can help illustrate a day in the life of an obstetrics nurse:
“I work in a outpatient OBGYN clinic and it includes providing prenatal care to pregnant patients (High Risk pregnancies included), and seeing GYN patients for routine care, GYN-ONC, Uro-GYN, and family planning (inserting IUD's and Nexplanons). The clinic is in a larger community hospital and is part of a larger public hospital system…The nurses role in this case is usually see the patient, get V/S, get a history, medications, and see what their chief complaint is, do finger sticks for our GDM patients, get paperwork ready for procedures (EMBs, Colposcopies, etc) and possibly get care started…Out of the 11 nurses we have, 4 of us are trained to do Non-Stress Tests on high risk patients for which we have a separate part of the clinic for.” – Reddit user nervousnursecat
OB/GYN vs. Labor and Delivery Nurse?
Just as the term surgical nurse could encompass pre-operative, operating room (OR), and post-anesthesia care unit (PACU) nursing, the term OB/GYN nurse can refer to a nurse in a prenatal clinic, a labor and delivery unit, or a mother and baby unit. In some cases, an OB/GYN nurse may even be hired to work in more than one area. Therefore, OB/GYN nursing can be applied to different roles and settings, which may or may not include labor and delivery. In conclusion, nurses applying for OB/GYN nursing jobs should ask for detailed descriptions of what the jobs entail and avoid making assumptions.
How to Become an OB/GYN Nurse and How Long Does It Take?
Most nurses working in obstetrics are registered nurses, although the number of nurses pursuing advanced nursing degrees is steadily increasing across specialties.
To become a registered nurse, an aspiring OB/GYN nurse can complete an associate’s degree in nursing (ADN) or a bachelor’s of science in nursing (BSN). Both pathways qualify graduates to sit for the National Council Licensure Examination (NCLEX) to become licensed registered nurses. That said, many employers prefer hiring nurses with four-year BSNs to nurses with two-year ADNs. Additionally, although many places will hire new graduates to work in obstetrics, many employers prefer hiring nurses with at least one year of nursing experience.
For a nurse wishing to pursue higher education, a nurse practitioner (NP), certified nurse midwife, or nurse anesthetist can work in OB/GYN nursing. The following words of advice from an obstetrics nurse on Reddit can help aspiring advanced practice registered nurses (APRNs) decide which path to choose:
“...I would look into midwifery!...I work in a practice with several WHNPs and they do 4 clinic days and 1 hospital…The midwives are our practice see gyn patients in clinic but primarily deliver babies and provide OB care. NPs never do deliveries, at least at my practice…If you did pursue an NP masters I would pass along that every WHNP I know has said they wished they did a FNP program because they wouldn’t be confined to the one specialty.” – Reddit user notlivinmybestlife
OB/GYN Nurse Certifications?
As is the case in most nursing specialties, obstetric nurses need to complete a cardiopulmonary resuscitation (CPR) course to obtain a certification such as the American Heart Association’s Basic Life Support (BLS) certification. Furthermore, since obstetric nurses may work in labor and delivery and mother and baby units, newborn nursing certifications such as the following are also recommended or may even be required for some jobs:
- Low-risk neonatal nurse
- Maternal newborn nurse
- Neonatal intensive care nurse
- Inpatient obstetric nurse
Any of these certifications requires having a valid RN license, working as an RN for at least two years, and accruing at least 2,000 clinical hours in the area.
The Inpatient Obstetric Nursing (RNC-OB®) offered by the National Certification Corporation (NCC) is particularly suited to nurses working or hoping to work in obstetrics since it focuses on providing care to women during the antepartum, intrapartum, postpartum, and newborn periods.
How Much Does an OB Nurse Make?
A nurse’s salary depends on many factors, including their level of education, work experience, certifications, and location. That said, the following figures can give potential OBGYN nurses an idea of the expected job growth as well as how much they can aspire to earn:
Registered Nurses in Obstetrics
The number of registered nurses in the US is expected to grow by 6 percent between 2021 and 2031, the average rate across professions. Regarding salary, registered nurses earn, on average, $82,750 annually. However, this average varies significantly from one setting to another. The following are average RN salaries at the places where most OBGYN nurses work:
- Offices of physicians: $73,860
- General medical and surgical hospitals: $85,020
- Outpatient care centers: $93,070
Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners in Obstetrics
Registered nurses who have pursued higher education to become advanced practice registered nurses can expect to significantly increase their salaries and see much faster job growth than RNs. The number of APRNs—including nurse anesthetists, nurse midwives, and nurse practitioners—is expected to increase by 40 percent by 2031. Furthermore, the average salary for this group is $123,780 per year. APRNs with any of these specialties can work in obstetrics, so let’s take a look at the average salaries that each group can aspire to earn.
Nurse practitioners earn $118,040 on average. However, the following averages can give an aspiring nurse practitioner a better idea of how much they could earn in obstetrics:
- Offices of physicians: $114,870
- General medical and surgical hospitals: $122,960
- Outpatient care centers: $129,190
Certified nurse midwives earn, on average, $114,210—less than NPs. That said, a lot depends on where they work. The following are average CNM salaries in different settings:
- Offices of physicians: $113,920
- General medical and surgical hospitals: $119,900
- Outpatient care centers: $146,430
Finally, nurse anesthetists earn a whopping $202,470 annually, and this average increases in many settings where OBGYN nurses work:
- Offices of physicians: $194,240
- General medical and surgical hospitals: $212,340
- Outpatient care centers: $254,180
What Is OB/GYN Nursing Like?
The best way to learn what OB/GYN nursing is like is to go straight to the source. With that in mind, let’s see how these OB nurses on Reddit describe this nursing specialty:
“I work L&D in a nationally ranked teaching hospital, and the other day I had a nursing student shadowing me…Our floor blew up that day, and she got to run down the hallway with me pushing our patient’s bed for a stat section for failed vacuum/episiotomy, and we did a cystoscopy after the section. We then had a gnarly postpartum hemorrhage on another patient, a delivery in the ED a block or two away from our unit, and patients delivering in triage because we were overfilled with moms. OB is anything but boring in our hospital.” – Reddit user mar_issa13
“L&D can be stressful at times, especially when things start going wrong or there's an emergency, but teamwork is such a vital aspect of OBS nursing. Even if everything is going wrong and you are beyond stressed, you know you've got your team behind you. And in the end once your patient delivers, it's always worth it. And you know you've made a positive impact in your patient's, their support people's, and that baby's life.” – Reddit user Mon_cato
Is OB Nursing Hard?
Again, no one is better suited than an OB nurse to illustrate the challenges of obstetrics nursing. Let’s take a look at these testimonials of OB/GYN nurses on Reddit to learn about what makes this specialty hard:
“The L&D unit at my hospital is a revolving door though, none of us new grads wanted to stay there. Something you should understand about L&D versus mom/baby is L&D is literally like a pregnant woman ER. You have no clue what is going to walk in. It could be a routine water broke at home, mom is 3cm, and you start Pitocin if her contractions are inadequate, it could be a multip rolling in at 10cm screaming she needs to push, or it could be a mom comes in for a scheduled induction and no fetal heart rate is found…on mom/baby you can plan your night/day, whereas on L&D you have no clue…” – Reddit user Periwinkle912
“Downsides are the tough situations with patients experiencing loss. Sometimes the nights are insane and nothing seems to go right, but I feel like that happens no matter what area of nursing you work in. But the upsides are literally everything else!” – Reddit user Eilla1231
Why Choose Obstetrics and Gynecology as a Nursing Career?
Pregnancy, childbirth, and the early postpartum period are very meaningful times in women’s lives. In fact, a study by Penny Simkin found that—even after twenty years—women remembered the day their babies were born as if it had been the day before. The reason the results of this study are relevant for healthcare workers in obstetrics is that what the women in the study remembered the most was how they were treated during childbirth. In other words, it is in OB nurses’ hands to help make childbirth one of the most positive and empowering experiences of a woman’s life. For nurses wanting to make a difference, this impact on women’s lives is certainly a reason to choose obstetrics.
“OB nurses have a very specific skill set, and I am so so proud to be a part of that community. In all honesty, I love my job and I wouldn’t wanna be anywhere else. OB nurses are finally starting to get the recognition they deserve💕” – Reddit user barbiealexis
What Makes a Good OB/GYN Nurse: Tips for New Nurses?
OB/GYN nursing is a highly sought-after specialty, which can make finding jobs in this area a challenge. For new nurses hoping to enter this career path, the following tips from OB nurses on Reddit can help you get to the front of the crowd:
“This is usually a highly desired specialty and it can take time for nurses to break into…Pediatrics helps, and just having a job in the hospital will help because internal transfers are always easier.” – Reddit user merepug
“Our unit is relatively competitive as we hire maybe 1-2 new grads a year, and maybe 2 other staff. Usually people don’t leave Labor and Delivery until they retire or graduate with a higher degree…If you think it might be the area for you, reach out to your local hospital and ask about a shadow experience!” – Reddit user Eilla1231
Additionally, to help you be adequately prepared for this role when you have the chance to work in obstetrics, strive to develop these skills and abilities that employers look for in OB nurses:
- Skill in patient triage both in person and on the phone
- Skill in responding appropriately to emergencies and initiating crisis interventions
- Skill in time management, prioritizing, multitasking, problem-solving, and coordinating medical care
- Skill in using computers and computer systems (hardware and software)
- Responsibility and reliability in fulfilling obligations
- Ability to collaborate effectively with the rest of the healthcare team
- Ability to communicate clearly both orally and in writing
- Ability to read and understand physicians’ orders and notes
- Ability to accurately calculate and administer drug dosages and injections
- Ability to analyze options in order to counsel patients and families about their choices and make referrals to other providers and resources
- Ability to recognize and resolve hazardous conditions, dealing calmly with emergency situations
Final Thoughts on Obstetrics and Gynecology Nursing
There is no doubt that obstetric nursing is an essential and noble career path. The question is whether it’s the right career choice for you. Does it fit your nursing personality? Does it fit your particular strengths and interests? If so, this ultimate guide can be your launch pad to help you get started. Otherwise, browse other nursing specialties until you find the one that is right for you.