Becoming a Labor and Delivery Nurse

Registered nurses (RN) who work in labor and delivery are privileged to spend their days in an intense but joyful environment. While all new parents hope for relatively seamless childbirth, in those instances where complications arise, nurses play an indispensable role, providing care and support as families deal with premature birth, unexpected outcomes, and loss. 

Becoming a labor and delivery nurse is a career choice laden with emotional ups and downs, but if your goal is to help make birth a safer, smoother process, then it’s a good one. Obstetricians and midwives tend to be present only at the culmination of labor or when there’s a significant problem, but labor and delivery nurses assist nearly the entire childbirth process and the postpartum days as well. 

In this role, you’re more than just a caregiver in the women’s health field. You’ll form strong bonds with the families in your care and act as a liaison between families and doctors. You will be there for the best and worst moments in your patients’ lives. 

In this article, we’ll cover:

• What a labor and delivery registered nurse does
• The different types of labor and delivery registered nurses
• The educational requirements for becoming a labor and delivery registered nurse
• The career advancement path for a labor and delivery registered nurse

The responsibilities of a labor and delivery registered nurse

Labor and delivery nurses do more than monitor birthing mothers and their babies. They are the primary caregivers for these patients throughout the four stages of childbirth: antepartum, intrapartum, postpartum, and neonatal. 

Responsibilies of a labor and delivery nurse:

• Watching for potential problems
• Giving medications
• Measuring contractions
• Assisting when a c-section is deemed necessary
• Answer a family’s questions
• Give emotional support
• Prepare birthing mothers for what’s to come at each stage of birth

In many ways, reassuring families is the most crucial thing a registered nurse will do in labor and delivery. That’s why nursing in labor and delivery is about more than medical aptitude, critical thinking, and hands-on nursing skills (required in any medical-surgical nursing specialty). 

Characteristics of of labor and delivery nurses:

• Empathetic
• Kind
• Good communicators
• Cool-headed when dealing with severe patients

There are definite pros and cons of becoming a labor and delivery registered nurse. The labor and delivery floor is often fast-paced and emotionally-charged, and there are days full of heartbreak. Dealing with all of that while also assessing mothers and babies, collaborating with doctors, creating and implementing care plans, and educating new parents about the safest care procedures is challenging, and sometimes exhausting, work.

On the other hand, in this job, you will frequently be present for the happiest moment in people’s lives. Most people can’t say that about their jobs.

Kinds of labor and delivery registered nurse careers

Labor and delivery registered nurses may take on many roles depending on the needs of the floor or the institution. In addition to providing care to patients having routine deliveries, a nurse’s day to day work might focus on one area or one type of patient.

For instance, labor and delivery nurses may spend the majority of their time as:

• Antepartum nurses: These nurses care for patients who have pregnancy-related complications that require hospitalization.
• Nursery nurses: These labor and delivery registered nurses provide care to newborns who aren’t rooming in with their mothers.
• Circulating nurses: These nurses manage patient care in the operating room during c-sections.
• Scrub nurses: These labor and delivery nurses work directly with surgeons, assisting during c-section births.
• Postpartum nurses: These nurses care for mothers who have recently delivered. They shouldn’t be confused with neonatal nurses who care for babies in the Neonatal Intensive Care Unit (NICU). 

Labor and delivery registered nurses don’t always work directly with mothers and babies, however. Some are responsible for coordinating patient care on the labor and delivery floor while still others may not work in L&D at all, instead, holding positions in research or clinical education. 

Educational commitment to become a labor and delivery registered nurse

The path to becoming a labor and delivery registered nurse begins with a degree program and ends with voluntary certifications specific to labor and delivery specialties.

Step One: Earn a Degree

At a bare minimum, you’ll need to earn an associate’s degree in nursing (ASN), although a bachelor’s degree in nursing (BSN) or a nursing diploma from an accredited nursing school or hospital will likely serve you better on the job market.

Earning an ASN typically takes about two years, which is appealing to students who value convenience and want to get to work more quickly. Mount Saint Mary’s University even offers an online program and an on-campus evening/weekend program. However, while earning a BSN from a highly rated nursing program like the one at Duke University takes about twice as long (and is significantly more expensive), keep in mind that BSN holders are also generally more attractive to employers. 

Think about your job prospects first when deciding between ASN and BSN nursing programs. If you’ve already completed an ASN, there are RN-to-BSN programs that can get you into L&D more quickly. The University of Oklahoma – Health Sciences Center’s online program can be completed in just nine months.

There is, as noted, the third option. While there are only a handful of hospital-based nursing schools still offering nursing diploma programs in the US—like Western Pennsylvania Hospital School of Nursing and Roxborough Memorial Hospital School of Nursing—there are some advantages to looking into these programs: 

• First, your education will include significantly more clinical work. 
• Second, you’ll be able to complete most of your clinical rotations (like pediatrics, surgical medicine) on site. 
• Third, you’ll spend most of your time in a medical setting around doctors, administrators, and other people you can tap to build a professional network. 
• Finally, hiring from within is common practice at many hospitals with these types of diploma programs.

Step Two: Pass the NCLEX

Becoming a licensed RN means passing the National Council Licensure Examination (NCLEX) exam. Passing this exam confirms basic nursing skills and knowledge; you will also need to provide transcripts showing that you’ve earned your ADN, BSN, or degree from a hospital-based nursing school. 

In some states, RNs renew their license every two or three years, but RNs only need to retake the NCLEX if they allow their nursing license to expire.

Step Three: Get Work Experience

Any licensed registered nurse can work in labor and delivery, though many hospitals require applicants to have worked as a staff nurse before applying for positions in L&D—and to have training in neonatal resuscitation and fetal monitoring. The more experience you have, the more likely it is you will be able to move quickly into a nursing career in L&D.

Step Four: Get Certified

No special certification is required to begin working as a registered nurse in labor and delivery other than the Basic Life Support and Advanced Cardiac Life Support certifications offered by the American Heart Association.

Most hospitals will eventually require labor and delivery registered nurses to earn an Inpatient Obstetric Nursing (RNC-OB) certification after a set period of employment. But other than that, the licensure and accreditation for becoming a labor and delivery registered nurse is simple.

However, having specialty-specific certifications can make you a more attractive job candidate or help you find a better paying position. Labor and delivery registered nurses can become certified—through the National Certification Corporation after they meet specific work experience requirements—in L&D and specialty areas like:

• Intrapartum nursing
• High-risk obstetrics
• Postpartum nursing
• Nursery care 

Most certification programs require nurses to meet certain continuing education to maintain a given certification. 

The advancement path for a labor and delivery registered nurse involves education

There are many ways for labor and delivery nurses to advance in their careers. Earning new certifications is one way to make more money in nursing. 

RNs can advance by earning a master’s degree in nursing (MSN) and becoming a nurse practitioner in obstetrics (a role that comes with more responsibilities and prescriptive authority). Some nurses in this field of medicine also choose to earn a midwifery degree and become a certified nurse-midwife (CNM) — a path that can lead to opening a prenatal care practice or birthing center or working as a nurse practitioner in L&D. 

Other career-advancing positions include: 

• Director of Nursing
• Chief Nursing Officer
• Chief Nurse Executive 

Nurses seeking these positions should explore dual-degree MSN/MBA or MHA programs like the one offered by California University of Pennsylvania.

This is an impactful career

Don’t choose to become a labor and delivery registered nurse lightly. According to salary.com, the annual earnings for a labor and delivery nurse ranges from $65,400 to $81,300. Payscale offers a wider range, reporting that an L&D RN can earn anywhere between $49,000 and $93,000 a year.

Depending on where you live, that may sound great, or it may be less than ideal, but it’s important to remember that very few people enter the nursing profession for the money. 

If you choose this career, the chances are that you’ll do so for the satisfaction of knowing that you’re doing something important for moms and families.

As Michelle Davis (RNC, BSN) put it on Instagram, “I have the privilege of sharing in this special time. Like many nurses, I enjoy making a difference in people’s lives, and I am privileged to help women birth their babies every day. Usually a joyous time, childbirth can be a scary experience for some, especially if medical conditions complicate it. With education and empathy, I can help my patients through this experience and help them find the wonder and joy of birth.”

(Last Updated on February 26, 2024)

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