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Both perinatal and neonatal nurses are involved in the childbirth process. The main difference between the two is that perinatal ("around the birth") nurses take care of pregnant women before, during and just after birth, while neonatal ("newly born") nurses care for newborn infants through the first 28 days of life.
Perinatal Nurse Duties
Perinatal nurses are often called obstetric nurses or labor and delivery nurses. They assist with prenatal education, attend and help the mother during the birth, and give advice on breast-feeding and mother-child bonding after the child is born. The health and well-being of the mother and unborn fetus and a successful birth are their primary concerns. A certified nurse midwife is a perinatal nurse specialist who requires extra training.
Registered nurses who want to work in labor and delivery usually do not have additional training, but many hospitals require certain continuing education classes to brush up on procedures. To become a perinatal nurse practitioner, perinatal clinical nurse specialist or certified nurse midwife, a master's degree in nursing is required. After the candidate obtains the degree, passes the exam and obtains the necessary experience, the nurse can be certified by the American Nurses Credentialing Center or another certification body. These specialists can act as primary care providers for women of childbearing age, providing advice on contraception, prenatal care, supervising the birth and helping with postpartum and menopausal issues. They can oversee home births or work in an office or birth center.
Neonatal Nurse Duties
Neonatal nurses take care of babies who are less than 28 days old, called neonates. They are most often found in the neonatal intensive care unit or NICU (pronounced nick-you) of a hospital. Most neonates in the NICU are premature or delivered before 37 weeks' gestation, and can have a number of urgent medical problems that need specialized intervention. Premature babies typically have underdeveloped respiratory systems and problems maintaining body heat, so they may be kept on a respirator or in an incubator. While their primary focus is the health of the babies, neonatal nurses obviously will spend a lot of time with anxious parents who are visiting their children in the NICU and must be able to calmly and clearly explain the babies' illnesses and treatment, as well as involve the parents in their care.
Levels of Neonatal Care
Neonatal care in the United States is categorized by three levels. Level I is for healthy babies born at term, and these babies are kept in the nursery as opposed to the NICU. There is less demand for Level I nursing care because babies are spending more time in the room with their mothers and go home sooner. Level II nurses work in the NICU with preterm and sick babies. Level II NICUs are usually found in medium-sized to larger community hospitals. Level III nurses are most in demand and work with the sickest babies, those requiring around-the-clock monitoring, ventilation and other invasive care. Level III NICUs are usually found in large metropolitan city centers or in specialty children's hospitals.
In order to work in the NICU, you must be a registered nurse with a bachelor's degree in nursing. You must be certified in neonatal resuscitation or have an additional certification in NICU nursing. You must have prior clinical hospital experience; this is not an entry-level position. To become a neonatal nurse practitioner or neonatal clinical nurse specialist, you must earn a master's degree and become certified by your state board of nursing.
First Aid Certifications
Both perinatal and neonatal nurses, in addition to the Basic Life Support for Health Care Providers certification required of all registered nurses working in a hospital, must also have Advanced Life Support (ALS) and Pediatric Advanced Life Support (PALS) certifications. All these certifications are available from the American Heart Association, Red Cross or private training facilities and must be renewed every two years. Also, the American Association of Family Physicians has developed an optional protocol called Advanced Life Support for Obstetrics (ALSO), which specifically addresses perinatal issues. This is available directly from AAFP.