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I am currently working on undergrad and interested in working in the maternal fetal medicine specialty, but unsure on which path to take, either nurse prac or physician assist. I prefer more of the autonomy I've heard that comes with NP but I've also heard that PAs are more accepted in surgical specialties. I have always preferred the MD route, however after weighing the benefits, I think I've decided on a mid-level profession.
 
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pamac

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I don’t know what “maternal fetal” is, but if you mean NICU nurse practitioner, then yes, NPs have a lot of exposure in that realm compared to PAs.

If you want to be in surgery, become a surgeon, because otherwise, you’ll be assisting. There will be no autonomy. If you want autonomy, Neonatal NP would give you that, but you would take you mostly out of surgery. Some folks say that NPs own he market on maternal and neonatal, but I don’t think that it’s out of the question to find PAs doing that. I know PAs are hired near me to work in women’s health. My facility and it’s satelites just hire Nps for that and NICU, but we are a large entity, and like uniform hiring practices.

The reason I suggest becoming a physician is that if someone wants to have a narrowly tailored specialty, that’s really the only way to be able to do it and not have to hunt all over the country for a position, you really need to take control. As an NP (or PA especially) you go where you can find a doctor in that specialty to hire you (or else settle in to a job that is acceptable to you as a close enough match).
 
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