What Does it Take to Become an Obstetrical (OB) Nurse?

From prenatal screenings to postpartum education, an OB provides the care and education new parents need.

nurse filling vial from pregnant patient
nurse filling vial from pregnant patient

What is an OB Nurse?

As an obstetrics (OB) nurse, you’ll generally be part of an obstetrics team in a medical office or hospital setting. You’ll provide expert nursing care along with support and education to the patients you see.

Your work as an OB nurse won’t be limited to seeing patients during pregnancy and childbirth. OB nurses are women’s health specialists who are experts in sexual and reproductive health. They can help patients have healthy pregnancies, make sure patients take preventive care steps for serious issues like cervical and breast cancer, help patients determine the best birth control method for them, and more. 

OB nurses are often confused with other nursing specialists who focus on childbirth. These include neonatal nurses, who care for mothers immediately before, during, and after labor; and labor and delivery nurses, who focus on providing care during delivery.

Unlike those specialists, an OB nurse provides care starting during the early stages of pregnancy or even when a woman is trying to conceive. 

An OB nurse can provide care before a woman is even trying to conceive.

“Everyone thinks OB nurses just push on (stomachs) and rock babies all day,” says Sharla Paso, DNP, RNC-OB, CNS, an OB nurse and manager of clinical education at Oregon Health and Science University in Portland, Oregon, but their jobs can include a range of responsibilities depending on the trajectory of patients’ health during the pregnancy and birthing process. “In reality, they are an ED nurse, a medical/surgical nurse, an OR nurse, and an OB nurse all wrapped in one fantastic package.”

Minimum Education Requirements

You’ll need to be an RN to work as an OB nurse. That means you’ll need to earn either an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN) degree. You’ll also need to pass your NCLEX-RN exam before you work as an OB nurse.

Generally, you’ll also need some experience before you can work as an OB nurse. You might be able to find some OB nursing roles that are open to new graduates, but most will ask that you have at least some previous clinical experience.

If you’re interested in this specialty, it can help to work in labor and delivery or in another women’s health specialty area. This can help you gain the skills you need to work as an OB nurse.

What’s the Difference?
OB Nurse vs Midwife

Both OB nurses and nurse midwives provide essential care to patients during pregnancy and childbirth, but there are some key differences.

One huge difference? Education.

Nurse midwives are a type of advanced practice registered nurse (APRN). They need to have at least a master’s degree to practice. By contrast, OB nursing is an RN specialty that requires an associate or bachelor’s degree.

As APRNs, nurse midwives also have increased independence and responsibilities. A nurse midwife is able to prescribe medications and act as a primary care provider. This means they don’t work under a physician. Nurse midwives can deliver babies, although complications that warrant a C-section or other intervention will require a physician. OB nurses don’t have the scope of practice to take on these tasks. They play a vital role in childbirth, but they aren’t licensed to deliver babies, prescribe medications, or see patients independently.

OB nurses and nurse midwives often work together.

In fact, some nurse midwives with their own practices employ OB nurses to help provide complete care during pregnancy and childbirth. OB nurses and nurse midwives might also work alongside each other at birthing centers and other childbirth specialty medical locations.

Do I Need to be Certified?

nurse using stethoscope on pregnant patients belly

You don’t need any certifications to work as an OB nurse, but earning one can definitely give you an advantage. Plus, while certification isn’t a requirement for general work as an OB nurse, it might be required by some employers. Even when it’s not, certification can make your application stand out and show your prospective employer you’re an experienced professional.

OB nurses can earn the Inpatient Obstetric Nursing (RNC-OB) certification from the National Certification Corp. (NCC). You’ll need to be an active RN in good standing with at least two years of full-time work in OB nursing to take the exam.

The NCC asks that you provide a documented history of your work as an OB nurse when you apply for the exam. The NCC will review your application and notify you if you’re eligible to take it. You’ll then need to take and pass the exam to become certified.

What You’ll Study

You’ll need a general RN education to work as an OB nurse. However, if you know you want to work as an OB nurse, it’s a good idea to take any classes your program offers that focus on childbirth or women’s health. The exact specialty classes offered will depend on your program, but it can help to study:

  • Women’s health
  • Prenatal care
  • Labor and delivery
  • Infant health
  • Postnatal care

If your program offers it, it’s also a great idea to do a clinical rotation in a location that will give you OB experience. You could find opportunities in a labor and delivery unit, a women’s health specialty hospital, or a neonatal unit. This won’t be an option with all programs, but if you know OB nursing is your career goal, ask your advisor or professors if there are ways you can gain experience while you’re in school.

How Long Does It Take?

The time it takes to become an OB nurse will depend on your nursing track. Earning your ADN takes an average of two years, while earning your BSN takes an average of four. Your timeline might be different if you go to school part time, have credits to transfer in, or attend a fast-track program. 

You’ll also need experience if you want to earn certification once you graduate. The NCC requires at least two years of experience on top of your degree before you can take their certification exam.

What Do OB Nurses Do?

OB nurses have a wide range of job duties that keep their workdays busy and unpredictable. These nurses work alongside obstetricians or midwives to help ensure women are safe and healthy at every stage of pregnancy and during childbirth. They also care for infants after they’ve been delivered. Your duties will depend on your employer, but common tasks OB nurses take on include:

  • Assisting with prenatal screenings
  • Assisting with pelvic exams
  • Performing or assisting with ultrasounds
  • Taking patients’ vitals
  • Gathering lab samples, including urine samples and blood work, that help monitor the health of mother and baby
  • Educating expectant mothers about how to stay healthy during pregnancy
  • Educating women about birth control and fertility treatments
  • Assisting with cancer screenings such as mammograms
  • Helping support the new mother and providing pain relief during delivery
  • Assisting the physician or midwife during delivery
  • Weighing, measuring, and vaccinating newborns
  • Monitoring mothers and babies
  • Helping provide education and counseling if there are any complications during childbirth
  • Educating new moms about breastfeeding and infant nutrition

As you can see, there are a wide range of job duties you’ll be trusted with an OB nurse. In fact, says Paso, the only thing an OB nurse can count on during their day is clocking in and getting assignments.

“The assignments may or may not stay the same, depending on the situations and how many unscheduled patients come in,” says Paso. Unexpected medical issues may arise, requiring an OB nurse to shift priorities. Often nurses will take over patient duties for their fellow nurses and adjust duties when an emergency occurs. In other words, OB nurses need to expect the unexpected.

Do I Have What it Takes to Be an OB Nurse?

Your role as an OB nurse is vital. The specialty is unpredictable, and you’ll need to be prepared for the challenges it can bring, including complications during childbirth. You’ll need to be able to handle the joyous moments as well as the difficult moments when you take on this role.

“The number-one quality required of an OB nurse is humility,” says Paso. “Just when you think you have seen it all, another patient comes in and demonstrates how wrong you are.”

If you want a job with structure and predictability, OB nursing probably isn’t a good fit. However, if you’re able to respond in high-pressure situations and thrive in a fast-paced environment, you might love the world of OB nursing.

An OB nurse must be prepared to work in a fast-paced environment with little structure or predictability.

“Much flexibility is required,” explains Paso. “This is not an area for people who do not like to, or cannot, change directions quickly during a workday. Switching gears from ‘nothing happening’ boredom to sheer chaos is not uncommon.” 

Other qualities you’ll need as an OB nurse include the desire to always be learning and asking questions to improve your nursing skills, and the ability to set strong boundaries.

“Pregnancy is a highly stressful time in a woman’s life, and many people have little to no coping skills when the unexpected happens,” says Paso. “The nurse often bears the brunt of that and must have the ability to set boundaries and take nothing personally.”

Where Do OB Nurses Work?

You can find work in a variety of locations as an OB nurse. Some common employers include:

  • Obstetrics and gynecology offices
  • Midwifery offices
  • Birthing centers
  • Hospital maternity wards

OB nurses also work in urgent care clinics and community health clinics. In these settings, they might be the first healthcare professional a pregnant woman sees due to a lack of access to regular obstetrics care. The OB nurse will need to provide education along with care and will often be the person to point the patient to other resources that can help them in their pregnancy.

Average Salary

According to the U.S. Bureau of Labor Statistics (BLS), registered nurses, including OB nurses, make an average annual salary of $77,460. Your exact salary will depend on factors like your education, experience, and certification, as well as the setting you work in.

$77,460
Average Annual Salary for RNs

You can take steps to advance your career and potentially your salary in a few ways. Paso says one of the biggest ways is to take on the opportunities and challenges around them.

“Learn everywhere you can,” says Paso. “As opportunities to formally lead arise, apply yourself to them. The same for teaching and precepting. Get involved in work happening outside of your department as well.”

Additionally, Paso says, get to know others in leadership positions outside the OB realm. “OB tends to be its own little walled-off area of a hospital,” she explains. “It’s helpful to have representation from OB at the organizational level.”

Career Outlook

7%

RN Job Growth through 2029

The BLS predicts 7% job growth for all RNs by 2029. That number represents 221,900 new RN jobs, many of them needed in OB nursing and other women’s health fields. As in other nursing specialties, older OB nurses are retiring, leaving openings for new ones.

“There are a few baby boomer nurses left, and the next generation down is often moving to other types of nursing (such as) academia, advanced practice, entrepreneurship, and other areas,” says Paso. “OB or not, nursing is always going to have a shortage.”

Professional Resources

OB nursing is a fast-paced and fast-growing career. It’s important that you stay up to date on the latest research and news in the field. One great way to do this is through the Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN).

AWHONN provides resources such as professional development and continuing education, networking opportunities, and OB nursing advocacy. Plus, the association oversees another great resource for OB nurses, the Journal of Obstetric, Gynecologic, and Neonatal Nursing (JOGNN), which publishes articles on new research and findings in the field.

 


Written and reported by:

Stephanie Behring

Contributing Writer

With professional insight from:

sharla paso

Sharla Paso DNP, RNC-OB, CNS

Manager, clinical education, Oregon Health and Science University