How to Become a Labor and Delivery Nurse

Whether you are choosing a specialty as you enter the profession as a brand-new nurse or you’re looking for a bit of a change from your regular nursing specialty, becoming a labor and delivery (L&D) nurse is an excellent option. If you are considering becoming a labor and delivery nurse, here is some important information you should know.

What is a Labor and Delivery Nurse?

While most nurses care for those experiencing acute medical problems and chronic health issues, a labor and delivery nurse participates in one of the most common, and joyful, medical events to happen all over the world – the birth of a child. In fact, this is one of the areas of medicine and health care that will be around as long as humankind is.

Essentially, a labor and delivery nurse is someone who assists the OB/GYN in helping a laboring woman give birth to a child. A labor and delivery nurse helps make sure that the outcome is as positive as possible, and that mother and baby are in good health. In fact, labor and delivery nurses are the health care professional that spends the most time with a laboring mother – the OB/GYN checks-in occasionally and is there during the last stages of the delivery.

What are the Duties of a Labor and Delivery Nurse?

An L&D nurse cares for women before, during, and after the labor and birth process. There are specific duties associated with each part of the labor and delivery process:

Before Delivery: Nurses meet with mothers regularly throughout her pregnancy in a clinic setting to make sure that mother and baby are in good health. This is particularly important for high-risk pregnancies. These nurses may be considered antenatal nurses. A L&D nurse might also teach childbirth preparation classes to help new mothers understand the process of giving birth and what they can expect when their term comes to its end. They will also provide continual information and guidance to expecting mothers as they go through each stage of pregnancy. At routine checkups, they will monitor the fetal heartbeat and keep mothers up to date on the baby’s condition.

During Labor: When a mother goes into labor, the labor and delivery nurse will monitor the length and intensity of contractions, which serves to monitor the baby during labor and track the progress of labor. They will also help with any complications that may occur during delivery, such as blood loss. L&D nurses also serve as labor coaches and can help laboring women with techniques to ease labor pains.

After Delivery: Once the baby is born, the labor and delivery nurse will perform all necessary tests and assessments on the baby and administer any needed injections or medications. The nurse will then assist the new mother as she recovers from the birthing process. This could range from instructions on breastfeeding to how to properly swaddle the infant.

What are the Qualities of a Good Labor and Delivery Nurse?

If you are hoping to become an L&D nurse, there are a few characteristics you should possess. This will make your job more enjoyable and help the mother to have a more relaxing experience:

Ethics: While ethics is hard to define, it basically means that the nurse will do their best to do the right thing in tricky situations. The labor and delivery department can be very different from every other department in that there are two patients involved in the situation instead of just one. There are also often a father and other support persons present during labor and delivery. As such, it is extremely important that the nurse understand the intense relationship these patients share and how that needs to be considered in difficult situations.

The ability to stay calm: There are many complications that can occur at all stages of pregnancy, labor, and delivery. A good labor and delivery nurse will need to ensure that she can stay calm during these times. The mother will likely be experiencing tension if something appears to be going wrong, and reducing stress is massively important to keep the baby safe. As such, an L&D nurse needs to be able to deescalate tense situations and remain calm in the face of difficulties.

Patience: Many mothers are giving birth for the very first time and will most likely have a lot of questions or feel scared. It’s up to the nurse to help educate and inform new mothers in a patient and compassionate way. It’s also important to help other family members understand the importance of the whole process and instructing family on an issue that doesn’t directly involve them can already be quite difficult. Here, patience is key for a good outcome and a healthy and confident mother.

Excellent communication skills: There will often be situations as a labor and delivery nurse that will be incredibly stressful and where time matters. A good L&D nurse will have the ability to communicate quickly and clearly throughout the tension, with the mother, with other nurses, and with the physician. And don’t forget – listening is just as important as talking when it comes to effective communication, especially during a tense birth or dangerous delivery. Good labor and delivery nurses will listen to the mother as she goes through the process, from pre- to post-delivery.

Flexibility: Giving birth is not something you can usually time, so it’s important to remain flexible in your work. You’ll most likely be working long shifts typical of nursing, and L&D departments often require nurses to rotate being on-call in case of an influx of laboring women.

What are the Requirements for a Labor and Delivery Nurse?

Unlike a midwife, a labor and delivery nurse must have a degree in nursing. This could be either an associate degree (ADN) or a bachelor’s degree (BSN) in nursing, although a BSN will automatically make you very competitive in the specialty. Additionally, nurses must have passed the NCLEX-RN exam to receive proper licensure from their state of residence. To snag a job on labor and delivery, a nurse is usually expected to have at least one full year of bedside nursing experience or have completed a student nurse residency. Some positions also require nurses to have worked on a postpartum unit before moving to labor and delivery.

Additionally, there are also field-specific requirements that nurses must complete before entering the labor and delivery department. Certification in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) are often requirements since labor and delivery is such an intense specialty. Inpatient Obstetric Nursing is also a certification that might be required by most hospitals. To take this exam, you’ll need at least two years’ experience in the nursing field, which helps with making sure you have enough experience under your belt. Most of these certifications are offered through the National Certification Corporation, which includes most additional certifications and continuing education courses for nurses. When you take labor and delivery-specific courses, you’ll learn the stages of delivery, the ins and outs of the C-section birth, best practices for labor and delivery for specific types of patients (including geriatric pregnancies and other high-risk populations), and pregnancy/delivery related pharmacology.

Where do Labor and Delivery Nurses Usually Work?

Since most births around the country are done in hospitals, that is the most likely place that a labor and delivery nurse might expect to work. However, there are also other options to work in specific birthing centers, which provide private rooms for all birthing mothers and a more holistic birthing experience. Alternatively, labor and delivery nurses often put their skills and expertise to good use as community resources: think birthing classes, prenatal counseling, and postpartum assistance.

What is a Labor and Delivery Nurse Salary Like?

There are a lot of things that factor into how much you could make as a labor and delivery nurse. The state, the city, and even the specific facility you work in will all determine your salary. However, the current national average salary for a labor and delivery nurse is around $55k, though you can expect to make anywhere in the range of $46k-$86k per year. This can be higher than other specialties due to the complex nature of the position.

If you would like to earn on the higher end of that range, it’s a good idea to take extra courses and get more certifications, especially ones related directly to L&D. Even as birth rates fall slightly each year, it is certain there will always be a need for labor and delivery nurses.

Final Thoughts

Becoming a labor and delivery nurse in an excellent specialty to go into. You’ll have the opportunity to work with a varied population of women who are getting ready to give birth to a new child. You’ll get to experience birth as the wonderful medical miracle it is and help women find strength within themselves to accomplish bringing new life into the world.

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Dr. Jenna Liphart Rhoads, Ph.D, RN, CNE

Dr. Jenna Liphart Rhoads is a registered nurse and a nurse educator. She earned a BSN from Saint Francis Medical Center College of Nursing and an MS in nursing education from Northern Illinois University. Jenna earned a Ph.D. in education with a concentration in nursing education from Capella University where she researched the moderation effects of emotional intelligence on the relationship of stress and GPA in military veteran nursing students.