How to Become a Labor and Delivery Nurse: A Guide to Getting into Obstetrical Nursing

What Does a Labor and Delivery Nurse Do?

Due to the unique and unpredictable nature of childbirth and maternal care, working in a maternity ward involves various daily tasks and challenges. Here are some typical daily tasks faced in maternity wards:

• Patient assessments
• Labor support
• Assisting with deliveries
• Neonatal care
• Medication administration
• Documentation
• Patient education
• Communication with the healthcare team

The unpredictability of childbirth and the uniqueness of each mother’s labor means each day will be different. Emergencies such as fetal distress, hemorrhage, or other complications require immediate and decisive action. The day can become emotionally intense and providing support to women and families requires empathy, resilience, and stress-management skills.

Balancing the well-being of the mother and the baby, particularly when medical interventions are necessary, might present an L&D nurse with an ethical dilemma. And, throughout it all, L&D nurses must maintain cultural sensitivity to a diverse patient population while working long shifts.

Working in a maternity ward involves a dynamic mix of tasks and challenges that require a combination of medical expertise, empathy, and adaptability. Providing safe and compassionate care in a rapidly changing environment is essential for healthcare professionals in maternity wards.

How to Become a Labor & Delivery or OB/GYN Nurse

Becoming a labor and delivery (L&D) nurse or an obstetrics and gynecology (OB/GYN) nurse involves multiple steps and training. Here’s a general roadmap:

Education:

• Obtain a high school diploma or equivalent.
• Enroll in an accredited nursing program to receive a diploma, associate degree in nursing (ADN), or bachelor of science in nursing (BSN) program

Licensing:

• After completing the nursing program, pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to become a licensed registered nurse (RN)

Experience:

• Gain general clinical experience. Many hospitals require new nurses to work for a certain period in various nursing units before transferring to Labor & Delivery

Specialization:

• Acquire specialized knowledge and skills in obstetrics and maternal care through on-the-job training, workshops, and seminars
• Pursue certifications like the Inpatient Obstetric Nursing (RNC-OB) certification offered by the National Certification Corporation (NCC)

Apply for L&D Positions:

• Aspiring L&D nurses should look for open positions in Labor and delivery units and apply for the ones that match their qualifications

The requirements for an L&D position will likely vary among locations and institutions.

Labor & Delivery Nurse Programs: Where to Start?

Before a future labor and delivery nurse can even sit for a certification exam, they must become a licensed registered nurse. The first step to sit for the licensure exams is to obtain a nursing degree. 

U.S. News and World Report has ranked the best nursing colleges in the country. For 2024, the University of Pennsylvania is first on the list, followed by Emory University and Duke University. 

At the University of Pennsylvania, students can access a state-of-the-art simulation lab, team-based clinical practice, and dual-degree programs. Students at Emory University can take an accelerated program, and 100 percent of pre-licensure graduates had job offers in three months. Small clinical groups enhance learning and Duke University, and they offer an accelerated degree program for a BSN that can be completed in just 16 months.

Diving Deeper: Labor & Delivery Nurse Certification Requirements

Certification does more than give L&D nurses the knowledge and skills to do the job—it demonstrates their commitment to the field of labor and delivery. Many hospitals require certification before allowing nurses to work in this department. 

With certification comes improved patient outcomes, as certified obstetrical care providers are more likely to have a deeper understanding of best practices, evidence-based guidelines, and current trends in obstetrics. Because certification programs typically have rigorous eligibility criteria and exams, the certification enhances a nurse’s credibility in obstetrical care.

Pursuing certification requires ongoing education and staying up-to-date with the latest advancements in obstetrical care. This commitment to continuous learning promotes personal and professional growth and opens more career opportunities. Certification also increases the trust that patients and their families have in healthcare providers.

Certification contributes to improved patient outcomes, credibility, career advancement, and overall quality of care in obstetrics. Here are some of the notable certifications for L&D nurses:

• Inpatient Obstetric Nursing (RNC-OB)
• Maternal Newborn Nursing (RNC-MNN)
• Certified Electronic Fetal Monitoring (C-EFM)
• Neonatal Resuscitation Program (NRP)
• Obstetric and Neonatal Quality and Safety (C-ONQS)

Labor and delivery nurse certification requirements include a current, unencumbered RN license. To register for the exam, nurses must submit an application and pay all registration and testing fees.

What Makes a Good Labor & Delivery Nurse?

A good labor and delivery (L&D) nurse possesses hard and soft skills to succeed at their jobs. 

Hard skills relate to knowledge and competency gained through study and certification programs. A good L&D nurse has a strong foundation of medical knowledge, understands the stages of labor, and can assess and manage both routine and complex situations that may arise during childbirth. They can apply critical thinking skills and pay close attention to detail while monitoring fetal heart rates, contractions, vital signs, and other maternal and fetal well-being indicators.

Empathy, compassion, and the ability to stay calm under pressure are soft skills. An L&D nurse works with women and families during one of the most significant and emotional experiences of their lives. They must remain calm under pressure, communicate effectively with multiple individuals, and adapt to a rapidly changing situation.

In addition, a good L&D nurse advocates for their patients, is sensitive to their cultural backgrounds, and is a team player. All of that while continually learning and maintaining a high level of professionalism. 

An experienced labor and delivery nurse provides safe, supportive, and compassionate care to women and families during the transformative childbirth experience.

The Realities: How Hard is Being a Labor & Delivery Nurse?

While the job of a labor and delivery nurse has its challenges, it also has its rewards. The emotional and physical demands of the job—including long shifts, running or standing on their feet for extended periods, and the emotional toll of difficult outcomes—balance out with the reward of being present as a baby takes its first breath. 

In a fast-paced environment, where rapid changes in patient condition can result in complex situations, L&D nurses have to balance providing a high level of care with their own stress and emotions. The stakes are high in L&D nursing, as L&D nurses are responsible for the well-being of both the mother and the baby. There can be intense pressure to make critical decisions while maintaining patient safety at the same time L&D nurses are called upon to clearly and calmly communicate.

While there’s much joy in helping bring new life into the world, there can also be heart-wrenching moments when complications arise. Managing both positive outcomes and challenging situations can be emotionally demanding. Coping with the emotional rollercoaster of birth experiences, while also taking care of their own mental and emotional well-being, becomes an essential skill for a successful L&D nurse.

Many L&D nurses work on-call shifts, which means being available to work anytime, including nights, weekends, and holidays. This can disrupt the work-life balance. Staying up-to-date with the latest practices and advancements in obstetric care requires a commitment to continuous learning.

Despite the challenges, many L&D nurses find that being part of such a profound moment in people’s lives and positively impacting maternal and infant health is incredibly fulfilling.

Compensation: How Much Do Labor & Delivery Nurses Make?

The compensation range for L&D nurses depends on where the nurse practices, the facility in which they work, and their experience level. 

The average L&D nurse in the United States makes $79,700 a year; the typical salary range is $72,300 to $90,000. The lowest paid L&D Nurses live in Florida, where they make on average $70,203 a year, and the highest live in New Jersey with an average salary of $104,513.

Salaried nurses receive healthcare and dental, paid time off, continuing education reimbursement, and more benefits depending on their employer. More experience and certifications can open more opportunities for a L&D nurse. 

L&D Nurses: Key Professionals in the Healthcare System

For some babies, an L&D nurse is one of the first healthcare professionals they meet in their lifetime. Labor and delivery nurses are uniquely positioned to set new moms and babies on the path to lifelong success. Working in obstetrical care has its challenges, but upon reaching the end of the journey, L&D nurses will find its rewards.