Obstetric nurses provide care for women during pregnancy, childbirth, and the postpartum period. While the majority of obstetrical nurses work under the guidance of an obstetrician, there are also many opportunities for obstetrical nurses to partner with nurse-midwives, nurse-practitioners and fertility specialists.
The varied duties of an OB nurse can most easily be outlined by considering the settings in which these nurses work:
Hospital Labor and Delivery Unit
As soon as a patient in labor arrives at the hospital, she will be continuously under the care of an OB nurse. The nurse oversees the admission process, takes the patient’s history and performs or assists with the initial examination. In addition, the nurse provides both the patient and her family with information about hospital procedures and the physiology of birth. In collaboration with the obstetrician or midwife who is managing the birth, the OB nurse will monitor the mother and fetus during labor and will administer oral and IV medication. The nurse will keep the chart updated, provide information to the patient’s family, and assist in the delivery of the baby. In regional medical centers, which handle high-risk patients, OB nurses with extra training assist with surgery and emergency obstetrical procedures.
Following birth, OB nurses continue to care for the mother, providing many hours of instruction and support with postpartum self-care, breastfeeding and other aspects of newborn care. In cases where infants require special medical care, the OB nurses work as team members in caring for the mother and baby.
Occasionally, the outcome of birth is less than ideal, and the OB nurse is the family’s primary liaison with intensive care staff and surgeons. If the baby’s life is lost, the OB nurse provides the mother and family with grief counseling and information for ongoing recovery.
Nursing duties at a birthing center are similar to those in a hospital, without the added component of high-tech or surgical deliveries. Birthing center nurses are focused on making the labor and delivery experience as pleasant and family-oriented as possible, and they often work in partnership with midwives or nurse-practitioners.
During pregnancy, the OB nurse assists the doctor or midwife with all aspects of prenatal care. The OB nurse will take vital signs, administer or assist with routine testing of the fetus, and physical examination of the mother. Nurses are chiefly responsible for maintaining and updating patient records and overseeing the scheduling of prenatal visits. In addition, the OB nurse provides education and support for the pregnant woman, which a busy physician may not have time to offer.
The role of the nurse in a fertility clinic is to provide the patient with full answers to all her questions, while also working with the physician to conduct physical examinations and insemination or implant procedures. The nurse keeps records, administers ultrasound and other types of tests, and offers counseling to patients who are dealing with the trauma of infertility. In fertility clinics, which also provide prenatal care, the same nurse often continues to follow the woman during the course of her pregnancy, providing guidance, monitoring, and scheduling.
As allies and sources of information to women during pregnancy, some OB nurses choose to have a role in providing high-quality care during elective abortions. Clinics such as Planned Parenthood need dedicated OB nurses who will support women throughout the process of pregnancy testing, decision-making, abortion procedure and post-abortion care. Wages in these types of centers are typically lower than in hospitals and medical clinics, but nurses who share the mission of the women’s clinic may find such positions worthwhile. Patients may be teenagers, and these jobs have a strong counseling component.
Since there is usually some choice involved in the events, which cause patients to enter obstetrical care, the OB nurse often assumes the role of educator in the larger community. Childbirth preparation classes are frequently taught by OB nurses, as are courses in sex education and contraceptive technology. These classes may be held at hospitals, women’s clinics or even at alternative high schools or community centers.