What is a Perinatal Nurse?

Compassion is key for those interested in this competitive field.

nurse reviews pregnant patient vitals with her
nurse reviews pregnant patient vitals with her

Perinatal Nurse: Job and Education Details

What you’ll do: Care for women before, during, and shortly after the birth of their baby

Where you’ll work: Hospitals and clinics

Degree you’ll need: Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN)

Median salary: $75,330


Perinatal nurses work with women before, during, and shortly after birth. They help patients during one of the most significant life transitions someone can undergo, so they need an extra big dose of empathy. After earning your RN license, you can go on to work in a hospital, clinic, or other medical setting to help women and their babies.

How to Become a Perinatal Nurse

Becoming eligible to work as a perinatal nurse involves two steps: earning a nursing degree and becoming a licensed registered nurse (RN).

To begin, you’ll need to complete a two-year Associate Degree in Nursing (ADN) or four-year Bachelor of Science in Nursing (BSN). These degrees make you eligible to take the National Council Licensure Examination for RNs, or NCLEX-RN. Passage of this exam and subsequent licensure is required to practice as an RN. Although an ADN qualifies you to take the NCLEX-RN, an associate degree isn’t enough for many perinatal nursing jobs—or most RN-level nursing jobs, for that matter.

“In most parts of the U.S., you now need a bachelor’s to work in a hospital,” says Kathryn Dailey-Deaton, an RN specializing in perinatal nursing. Perinatal nursing is an especially competitive field, so you’ll want an education that makes you as strong a job candidate as possible.

In addition, “because it’s a competitive and specialized area of nursing, it’s hard to get a job without experience,” Dailey-Deaton says. She suggests several ways to gain that experience:

  • Be willing to move. If you’re not set on working as a perinatal nurse in a limited area, you’re more likely to find a job.
  • Apply for a nursing residency. While residencies for nurses aren’t yet common, they are a terrific way to gain specialization.
  • Begin in another department. “A lot of nurses get experience in another part of the hospital, such as med-surg (medical-surgical), before they’re able to get into labor and delivery,” Dailey-Deaton says. You can transfer to a perinatal nursing position later.

Licenses and Certifications

In addition to a RN license, certifications are available that are specific to the skills needed as a perinatal nurse. Some are required, while others are optional but beneficial; several are advanced and available only after years of experience.

Certification: Neonatal Resuscitation Program (NRP)

Agency: American Academy of Pediatrics

Prerequisites: Complete an NRP course from the American Academy of Pediatrics, then demonstrate your expertise through testing and hands-on simulations.

About the Certificate: The NRP shows that you have the knowledge and skills to perform chest compressions and intubation and administer medication during resuscitation of newborns. It is required that at least one medical provider certified in NRP is present at delivery.

Required or Optional? Required

Certification: Advanced Cardiac Life Support (ACLS)

Agency: American Heart Association

Prerequisites: Medical providers take an in-person or blended (online plus in-person) course. After completing it, providers earn an ACLS certification card.

About the Certificate: While the NRP ensures nurses are qualified to provide resuscitation to newborns, the ACLS is focused on adults—in this case the patient giving birth.

Required or Optional? Required

Certification: STABLE

Agency: The STABLE Program

Prerequisites: Attend a STABLE Learner course to earn the certificate.

About the Certificate: STABLE, which is an acronym for the steps of stabilizing and monitoring newborns (sugar, temperature, airway, blood pressure, lab work, and emotional support), applies to postpartum care in the baby’s first days of life.

Required or Optional? Required

Certification: Credential in Inpatient Obstetric Nursing (RNC-OB)

Agency: National Certification Corporation 

Prerequisites: Minimum 2 years (2,000 hours) of experience as a perinatal nurse (including antepartum, labor and delivery, postpartum, and newborn periods)

About the Certificate: The 3-hour computer-based exam includes 175 multiple-choice questions. It can be taken from home.

Required or Optional? Optional

What Do Perinatal Nurses Do?

Perinatal nurse duties can be expansive. Some perinatal nurses work with patients from antepartum through the few days following the baby’s birth. Some specialize in just one aspect of perinatal nursing.

A perinatal nurse’s duties can be organized into three categories: antepartum, labor and delivery, and postpartum.

Antepartum


Often, antepartum nurses work with patients experiencing high-risk pregnancies and who may need to stay in the hospital until birth. Depending on the health risk, the timeframe could be a few days or many months. Antepartum duties include external fetal monitoring, administering treatments, and monitoring patients’ conditions.

Labor and Delivery


Labor and delivery nurses work with patients from the time they are admitted in labor through the first few hours after a baby is born. They also work with patients who are induced for labor. They may also assist during cesarean deliveries.

Postpartum


After delivery, the patient is either moved to a postpartum unit, or nurses provide care in the room where she delivered. Postpartum nurses monitor newborns and mothers, give necessary medications, and help with lactation and newborn care. They also do some newborn screenings.

“As a perinatal nurse, I like being with families and supporting them, whatever they are experiencing,” Dailey-Deaton says. “Giving birth is one of the most vulnerable experiences of your life, and it’s so special to be with them and earn their trust.”

Where You’ll Work

Perinatal nurses can work in a variety of settings. These include:

  • Hospitals—Hospitals and healthcare systems are the primary employer of perinatal nurses.
  • Clinics and physicians’ offices—Family practitioners, OB/GYN offices, and maternal-fetal medicine practices employ perinatal nurses. Duties in these settings focus on antepartum and postpartum health, such as a visit six weeks after delivery.
  • Midwifery practices—Perinatal nurses may work with midwives.
  • Birthing centers—Perinatal nurses may work in a team of birthing center providers for patients with low-risk pregnancies.

What’s the Difference: Perinatal Nurse vs Neonatal Nurse

“Pregnancy itself is a high-risk condition,” Dailey-Deaton says, so it makes sense that there are so many types of nursing specialties for pregnancy, delivery, and newborns.

Perinatal Nurse:

Neonatal Nurse:


  • Means “around birth”
  • Work with mothers and babies
  • In general, work with babies up to their second or third day of life
  • Specialize in care provided in the labor and delivery and postpartum departments

  • Means “newborns”
  • Focus on babies
  • Work with babies until they no longer need neonatal support (up to several months for prematurely born babies or babies with complications)
  • Specialize in care provided in the neonatal intensive care unit (NICU)

Salary

Registered nurses earn a median salary of $75,330, according to the U.S. Bureau of Labor Statistics. The data aren’t separated by specialty, so the BLS does not provide median salary for RNs working as perinatal nurses specifically.

In general, though, nurses focusing on perinatal care earn salaries similar to those of RNs in other fields, Dailey-Deaton says. “Years of service, certifications, and education—not nursing specialty—get you a pay raise,” she adds.

Perinatal nurses earn salaries similar to those of RNs in other fields.

If you further your education and earn more advanced nursing degrees and licenses, you have a good chance of increasing your earning potential. The BLS shows that clinical nurse specialists (CNSs) who are healthcare diagnosing or treating practitioners may earn a higher salary, a median of $84,490, while nurse practitioners (NPs) earn a median $117,670 per year.

Career Outlook

In the next decade, the job outlook for RNs is steady and about average. The BLS projects a 9% increase in jobs from 2020 to 2030.

The demand for perinatal nurses is in line with RNs in general. Keep in mind that “perinatal nursing is very competitive,” Dailey-Deaton says. That means that at least in some areas, there are more nurses than available positions. Looking for jobs in places that typically see fewer applicants (such as nursing positions in rural areas) can increase your chances of working as a perinatal nurse.

Is Perinatal Nursing for Me?

“Perinatal nurses run the gamut of all personalities, but it’s best for people who are compassionate, patient, and kind,” Dailey-Deaton says. The period around birth is fraught with many feelings for families, and perinatal nurses must be ready to handle the whole range of emotions.

“There’s an expectation that perinatal nursing is very happy and joyful, but that’s not all,” Dailey-Deaton continues. “The perinatal experience runs from traumatic experiences to the most joyous experiences. You have to be with people where they are.”

Flexibility and grace under pressure are also important. Perinatal nurses must be ready to adapt to situations that change quickly—for example, when a patient needs emergency cesarean-section—or C-section—surgery.

Perinatal nurses must be ready to adapt to situations that change quickly.

Perinatal nurses should always be learning, too. Evidence-based care changes all the time, Dailey-Deaton says, and it’s critical to stay up to date. “Perinatal care is also so surprising. There are always things that are new, that you’ve never seen before, because reproductive health is just so incredible.”

Professional Resources

If you are interested in becoming a perinatal nurse, become familiar with the professional resources available. Understanding new developments, policies, and advocacy efforts in the field will not only keep you informed, it may also help you become a stronger job candidate.

Paying close attention to changes in perinatal nursing shows hiring managers that you are dedicated to excellence in nursing.

Some resources that may be helpful in your exploration of perinatal nursing include:

  • AWHONN–The Association of Women’s Health, Obstetric, and Neonatal Nurses distributes the latest in evidence-based care to promote the health of women and newborns. “Plus, membership in a state chapter looks good on job applications,” Dailey-Deaton says.
  • ANA–The American Nurses Association isn’t specific to perinatal nursing but is an excellent resource for your career.
  • ACNM–The American College of Nurse-Midwives represents certified nurse-midwives. Some perinatal nurses become CNMs, so if you are interested in that route, keep tabs on this organization.

catherine ryan gregory

Written and reported by:

Catherine Ryan Gregory

Contributing Writer

kathryn dailey

With professional insight from:

Katherine Dailey-Deaton

Perinatal Nurse