Dual Specialty

[Michelle2026]

Hi everyone!

I am interested in being a Nurse Practitioner, but I have a question about it. I am interested in both Neonatology and MFM; is it possible for a nurse practitioner to work in both? Perhaps with a NNP certification and MFM experience? Could something like that work? I'm also interested in research, so I would love to work in both if at all possible. 

Thank you guys!

[adventure_rn, MSN, NP]

I'm not an NP, but I do have a lot of experience in NICU, so I can take a stab at it.

If you'd like to do MFM, NNP probably isn't the way to go about it. NNPs care for babies pretty much exclusively after they're born (including in the immediate moments after delivery). MFM follows the mom and baby through the pregnancy; when it's time for delivery, they had off the care to OB. After delivery, OB continues to follow the mom, and the baby's care is handed off to peds (either gen peds if they're healthy or neonatology if they're sick). There isn't any one provider or team who manages care at all three points; in fact, if a physician wanted to work in MFM and NICU, they'd have to do two completely different residencies (OB vs. peds) and fellowships (MFM vs. neonatology).

Plenty of our babies are prenatally diagnosed with congenital problems, but NNPs pretty much have zero interaction with moms while they're still pregnant. After birth, they are focused on the day-to-day aspects of keeping the babies alive and well (I.e. writing for meds and labs, ordering fluids, placing breathing tubes and lines, etc.) You can definitely work at a center that focuses on congenital anomolies, but it will only be managing the babies after the fact. If you're interested in MFM because you're interested in the specific prenatally diagnosed congenital conditions, you'll se a lot of that in larger academic NICUs with robust surgical programs.

It's more likely that you could get into MFM as a Women's Health NP (WHNP), or potentially as a Certified Nurse Midwife (CNM); they actually care for the moms and babies during pregnancy. However, it's important to note that on the whole, WHNPs and CNMs generally work with moms who are relatively low-risk; there are MFM NP roles available, but they may be few and far between.

If you're interested in research, you could potentially consider getting your PhD in nursing after you get some bedside experience.

Regardless, I think you'll have a lot more clarity about what the providers actually do, and what you actually enjoy doing, once you get some bedside experience.

I googled MFM NPs after reading your post, and I found these pages/sites. A lot of these people have Linkedins if you want to try your luck asking them directly...

https://www.npwomenshealthcare.com/my-journey-to-become-a-specialist/

https://www.pennmedicine.org/for-patients-and-visitors/find-a-program-or-service/obstetrics/maternity-care/high-risk-pregnancy/treatment-teams

https://blog.pediatrix.com/advanced-practice-nursing-in-maternal-fetal-medicine

[adventure_rn, MSN, NP]

Just to follow-up on my above comment, if you want to get experience working with high-risk pregnancies, you could try to get a job in Antepartum--that's the unit in the hospital where women with high-risk pregnancies stay until they're ready to deliver.

That said, the vast majority of Antepartum nurses also have to be cross-trained to do regular L&D (and potentially also regular Post-partum/Mom-Baby). Different units are staffed differently, but it's unlikely that you could only work specifically in Antepartum. It would give you beneficial experience if you did want to pursue your WHNP or CNM.

[Michelle2026]

That’s very helpful, thank you! I really appreciate it!