Day in the Life of a Women’s Health Nurse Practitioner (NP)

Meet the Expert: Kathryn Jane Trotter, DNP, CNM, FNP-BC, CHSE, FAANP, FAAN

Dr. Kathryn Trotter is an associate clinical professor in the School of Nursing at Duke University, where she is the director of the women’s health nurse practitioner program. She teaches advanced women’s health courses, as well as the basic perinatal health course and gynecology content within other courses for all NP students.

Dr. Trotter maintains clinical practice as a certified nurse-midwife and family nurse practitioner at the Duke University Medical Center and is a senior NP for the high-risk breast cancer clinic at the Duke Comprehensive Cancer Center.

Dr. Trotter earned her BSN from George Mason University and her MSN with a specialty in midwifery from the University of Kentucky. She earned both her post-master’s certificate as a family nurse practitioner and her DNP from Duke University School of Nursing.

Before joining the faculty of the Duke University School of Nursing, Dr. Trotter held faculty positions with physician resident education in the Department of Family Medicine within the University of North Carolina-Chapel Hill Medical School and was a full-time primary care provider. Her current research focuses on the application of group healthcare models to prenatal care, parenting, and chronic illnesses.

Dr. Trotter was interviewed for this feature in 2022 and 2025.

A Typical Day for a Women’s Health/Gender-Related Nurse Practitioner

WHNPs can work in various settings, but most typically find themselves in outpatient clinics. However, there’s still a wide range of different outpatient clinics—i.e. prenatal clinics, family planning clinics, and OB/GYN clinics—each of which will present a WHNP with a slightly different typical day and a different set of patients.

“In the outpatient clinical setting, you see patients with a wide range of conditions,” Dr. Trotter says. “Some are there for their annual check-up. Some suspect that they’re pregnant. Some have pelvic pain. Sometimes it turns out they’ve got anxiety and depression, too. It’s hard work because it’s a variety of issues, and there’s not always an emotional component, but there sometimes is. As WHNPs, we’re on the front line for women.”

In settings where the WHNP owns their own practice and operates independently, a WHNP may only interface with a small number of support staff. But in larger settings, there’s a broad collaboration between WHNPs and physician assistants (PAs), registered nurses (RNs), certified nurse-midwives (CNMs), medical doctors (MDs), administrative staff, and other NPs. WHNPs also need to coordinate with other WHNPs who subspecialize in other areas.

The Centering Model

WHNPs are also at the forefront of some unique and progressive practices, like the centering model. The centering model brings together a group of patients along with a healthcare provider like a WHNP and focuses on holistic, relationship-based care. It’s particularly effective in prenatal care, where a group of eight to ten women who are pregnant and due in the same month can come together and form a small community. It can also be adopted for women with diabetes, or women who have survived breast cancer.

On a purely logistical level, the centering model boosts efficiency for the healthcare provider, who doesn’t have to repeat the same instructions eight to ten times over the course of several one-on-one appointments; but the main benefits come from the improved quality of the time spent with the patients.

“It’s about the empowerment of women,” Dr. Trotter says. “Instead of sort of patriarchically saying you should do this and you should do that, we turn to the patients and ask, what do you think and what should we try here?”

Update 2025: Champions of Women’s Health

In 2025, Women’s Health Nurse Practitioners are more important than they’ve ever been. Over a third of American counties are considered maternity care deserts: areas that lack hospitals with obstetric services and/or maternal care providers. Restrictive abortion laws in some states have resulted in measurable increases in maternal and infant mortality (JHU 2024). Access to basic women’s healthcare remains an issue in many parts of the US, and disproportionately affects women of color. 

“In a world of competing interests and policies, women’s health is our priority,” Dr. Trotter says. “That’s what motivates us. That’s what gets us up in the morning: to keep it as a priority.”

In 2024, the National Association of Nurse Practitioners in Women’s Health (NPWH) released a comprehensive document outlining the Scope of Practice for Board-Certified Women’s Health Nurse Practitioners (WHNP-BC). It emphasized the advanced role of WHNPs as independent practitioners who deliver a full spectrum of women’s and gender-related healthcare across the lifespan. 

“When the role was formed in the 1970s, Women’s Health NPs were mostly focused on reproductive health,” Dr. Trotter says. “But the broadening of the women’s health movement and the broadening of our scope of practice has helped us realize we need to do more.”

Viewing the patient across the lifespan aligns with the NP’s holistic approach. A post-birth gynecological check-up with a healthy 35 year old patient can be an opportunity to re-consider what risk factors might present themselves further down the road: hypertension, diabetes, cancer. Having those conversations early on can lead to better patient outcomes. 

“Over time, women tend to live longer than men, and they’re living longer than they’ve ever lived before,” Dr. Trotter says. “That gives them more time for chronic illness.”

Women in the US have a life expectancy of around 80 years, which is at least two years lower than the life expectancy for women in all other rich nations (Commonwealth Fund 2024). America also has by far the worst maternal mortality rate of rich nations. These are dismal statistics for the largest economy in the world, and they’re caused, in large part, by a lack of access to care. 

“Women play a central role in managing family health as parents and caregivers,” Dr. Trotter says. “You can’t get around it: if we don’t make women’s healthcare a priority, that’s a problem for the whole country. Women’s Health NPs are a part of the solution.”

When it comes to maternal mortality and a lack of access to care, rural areas and women of color are hugely disproportionately affected. But NPs are far more likely than physicians to practice in rural areas. And WHNPs are increasingly diverse: approximately 30 percent of Duke’s WHNP cohort is Black, and many graduates of the program go on to practice in rural and underserved areas, providing the type of prenatal care that has been shown to decrease preterm birth rates. They also foster the type of trusting relationships that lead to healthier outcomes. 

“That diversity serves those neighborhoods and communities well,” Dr. Trotter says. “Because it’s not just the practitioner’s expertise, but how they deliver care, that really makes for a critical change. It gets patients engaged with their healthcare.”

Women’s reproductive health in America has always been a political battleground. Federal challenges on the legality of abortion, restrictions on gender-affirming care, and limited Medicaid provisions for prenatal and postpartum care in a dozen states affect the population that WHNPs serve. But as long as there’s advocacy needed, Women’s Health NPs know what side they’re on. 

“Our emphasis remains on increasing access to care through a smart, innovative, diverse group of nurses who are dedicated to women’s health,” Dr. Trotter says. “Our WHNP program at Duke has doubled in size. We’re on the right trail.”

Resources for Women’s Health/Gender-Related Nurse Practitioners

To learn more about the work and advocacy of WHNPs and to connect with those working in this specialty area, check out some of the resources below.

• American Association of Nurse Practitioners (AANP): Representing the interests of the more than 385,000 licensed NPs in the country, AANP is the largest organization for nurse practitioners, and they play a crucial role in advocating for NPs and their patients across the nation. You can find information about their specialty practice group (SPG) for women’s health NPs here.
• American Journal of Obstetrics & Gynecology (AJOG): Also known as “The Gray Journal,” the American Journal of Obstetrics & Gynecology covers the full spectrum of obstetrics and gynecology, publishing research, reviews, opinions, and interviews that have an impact on the understanding of health and disease and that has the potential to change the practice of women’s healthcare.
• Centering Healthcare Institute: With over two decades of experience as the go-to resource for group care, the Centering Healthcare Institute has developed and sustained the centering model in nearly 500 practice sites and in some of the largest health systems in the world.
• North American Menopause Society (NAMS): Dedicated to promoting the health and quality of life for all women during midlife and beyond through an understanding of menopause and healthy aging, NAMS has a multidisciplinary membership of over 2,900 experts in the field.
• Nurse Practitioners in Women’s Health (NPWH): Formed in 1980 by 20 NPs from Planned Parenthood, NPWH has grown into a large professional community for women’s health nurse practitioners and other advanced practice registered nurses who provide women’s and gender-related healthcare.