Adult NP vs FNP scope in women's health/pregnancy

[cinder123]

I am an adult NP and am wondering how to figure out where my scope of practice ends with regard to women's health, specifically pregnancy. Currently I handle all kinds of women's health issues, do pap smears, prescribe birth control and certainly diagnose pregnancy. But how do I determine at what point I must refer if one of my patients becomes pregnant (if they want to stay with me)? Is it upon diagnosis of pregnancy (whether this is at 3 weeks or 3 months)? At 32 weeks? If it's a high risk pregnancy? And what about postpartum: how soon can my patient come back to me? Can I do the 6 week postpartum visit?

My BON isn't specific about these boundaries beyond that I am licensed to 'care for adults.' I haven't been able to find anything on the ANCC or AANP websites. If anybody has encountered this issue please let me know or if you can direct me somewhere, that would be wonderful! Thank you.

[traumaRUs, MSN, APRN]

Hmmm - interesting point. I'm an adult health CNS and do care for pregnant pts in an ER setting but only for ER issues: bleeding, vag discharge or a non-related pregnancy issue: they cut their hand, etc.

I personally didn't receive education in the care of pregnancy in my program. Did your program include this? Does your physician care (if you work with one) care for pregnant women?

[Bonosgrrl]

what type of setting do you work in? are you talking about seeing pregnant patients for routine primary care visits, or are you talking about providing prenatal care?

as for the post partum visit, I would assume the practitioner who delivered the baby would be the one the pt returned to for the 6wk follow up visit.

I am an adult NP and i saw pregnant patients in a primary care setting, they had their own OB to follow their pregnancy. I would see them for whatever routine things came up.

[jer_sd]

I would vote for not providing prenatal care as an ANP. Since that is care for the mother and baby then if anything went wrong with the pregnancy you will have been acting beyond your scope of training. 6 week post partum, not an issue since that is care to the mother. Diagnose pregnancy as a ANP no problem then referal to a FNP/WHNP/CNM/MD/DO/PA.

Jeremy