Navigating the Path to a Rewarding Career: Labor and Delivery Nursing

Labor and delivery nursing is a deeply rewarding specialty that plays a vital role in guiding mothers through one of life’s most significant moments: childbirth. Labor and delivery nurses are a critical part of a multidisciplinary team responsible for monitoring and caring for mothers and newborns before, during, and after birth. This guide will help give you an overview of how to become a labor and delivery nurse.

The Role of a Labor and Delivery Nurse

Labor and delivery (L&D) nurses specialize in caring for individuals before, during, and immediately after childbirth. They must function with compassion, strong communication, and critical thinking skills in an environment where emergencies can quickly develop. Responsibilities include monitoring fetal heart rates, identifying potential risks, and assessing labor progression. L&D nurses also support the obstetric team during vaginal and cesarean deliveries and provide early postpartum care and education to new parents. Labor and delivery nurses remain with patients during active labor under direction of a doctor.

Work settings may include hospitals, birthing centers, and maternity units, where these nurses collaborate with multidisciplinary teams of obstetricians, nurse-midwives, anesthesiologists, and pediatric staff. They are frequently in demand for travel nursing roles because of their specialized skills. Because every patient is unique, L&D nurses must offer age-specific, culturally sensitive care tailored to individual needs. As a nurse in a labor and delivery unit, you may monitor the vital signs of the mother and fetus and help communicate progress between the expectant mother and the care team.

Educational Pathways to Becoming a Labor and Delivery Nurse

A first step to becoming a labor and delivery nurse is to earn a degree in nursing. For those wondering how to become a labor and delivery nurse, pursuing a nursing degree, passing the NCLEX-RN, and gaining clinical experience will put you on the right path. To enter the field, you need an active registered nurse (RN) license. While an associate degree in nursing (ADN) is sufficient, many employers prefer their nurses to hold a (BSN).

Associate Degree in Nursing (ADN)

It’s possible to become a registered nurse with an associate degree in nursing (ADN). An ADN is a two-year degree that qualifies you to take the NCLEX-RN for licensure and prepares you for entry-level nursing roles. This two-year degree focuses on building core knowledge in patient care and clinical skills. The program meets the minimum requirements for practice and provides a faster and more affordable way to enter nursing. Over 2,500 colleges and universities offer ASN or BSN programs nationwide. There are also online degree options, such as those offered by Purdue Global and Western Governors University.

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Admission Requirements: A high school diploma or its equivalent; math and reading courses and a writing proficiency exam; minimum 2.5 GPA; prerequisite courses

Program Curriculum: 60-70 credits in developmental psychology, microbiology, human anatomy and physiology, pharmacology, family health nursing, and nursing clinical hours

Time to Complete: 1-2 years

Skills Learned: Clinical training to monitor and care for patients; using catheters and tube feeding systems; dispensing medication; clinical experience in a healthcare facility

Bachelor of Science in Nursing (BSN)

Earning a bachelor’s degree in nursing (BSN) takes two more years of study, but it also makes more career paths possible. A BSN is a four-year nursing degree that provides a comprehensive educational experience in clinical care, leadership, and public health. This four-year bachelor’s degree teaches foundational patient care and clinical skills but also offers advanced coursework in leadership, research, health policy, community health, and ethics. Employers may prioritize hiring BSN-educated nurses for labor and delivery roles. Having a BSN may lead to more responsibilities and leadership roles at work. Licensed RNs may complete an RN-to-BSN bridge program or an accelerated BSN program more quickly. According to study data, treatment from BSN-prepared nurses results in better patient outcomes, lower death rates, and fewer hospital readmissions.

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Admission Requirements: Minimum 3.0 GPA or higher, some programs are flexible and accept 2.5; high school diploma or equivalent, or an ADN degree; resume; letters of reference; a personal essay; clinical or volunteer experience is not required in all programs but highly recommended

Program Curriculum: Biomedical statistics and research; evidence-based practice; nursing fundamentals; physical assessment in nursing; pharmacology; leadership and management; community health; medical-surgical nursing; psychiatric and mental health nursing

Time to Complete: 2-4 years

Skills Learned: Critical thinking; evidence-based practice; clinical assessments; information management; patient care technology; leadership and management

Licensure and Certification

Passing the NCLEX-RN

Once you have completed a degree in nursing, you’ll take the National Council Licensing Exam (NCLEX). You are eligible for the National Council Licensure Examination for Registered Nurses (NCLEX-RN) after earning an ADN or BSN from an accredited school. Completing an accredited BSN program can prepare you for this exam. This is a good reason for choosing an accredited program. Passing this test demonstrates your knowledge of medical competencies and that you’re ready to become a registered nurse. The NCLEX is an adaptive test with 75 to 145 questions, with the easiest presented first. With a five-hour time limit, the test includes multiple-choice, fill-in-the-blank, drag-and-drop, and illustration-based questions. Familiarizing yourself with the exam before taking it can boost your confidence, as you'll know what to expect.

Obtaining State Licensure

The next usual step in the journey to becoming a labor and delivery nurse is obtaining state licensure. Each state’s board of nursing is charged with assuring that nurses working in that state are prepared and qualified to deliver optimal care to patients. Licensure requirements may vary by type of nursing career and state requirements. State labor and delivery nurse licenses must be renewed about every two years. This process may require you to submit proof of hours worked and completion of continuing education hours.

Certifications

For L&D nurses, practical experience is a crucial part of transitioning from nursing education to a professional setting. After gaining experience, certifications can validate your expertise. Certifications validate your expertise as a labor and delivery nurse. While certifications are not mandatory, they demonstrate your expertise, commitment to maternal care, and improve your job security. To be more competitive in the labor and delivery nursing field, it can be helpful to earn credentials such as the inpatient obstetric nursing (RNC-OB) certification. With this certification, you may find yourself working closely with women with high-risk pregnancies, early births, cesarean section births and other challenges. There are several certifications you can pursue that are unique to the labor and delivery field, with one of the most popular being Inpatient Obstetric Nursing (RNC-OB). This certification covers topics like fetal monitoring and assessment, maternal risk factors, labor management, and postpartum and newborn care. You may be able to access certification exam study guides online from the certifying organization, such as the National Certification Corporation, which issues the RNC-OB. The National Certification Corporation (NCC) offers several examinations, including core certifications in maternal newborn, inpatient obstetric nursing, and inpatient antepartum nursing. They also offer subspecialty certifications in reproductive health and infertility, electronic fetal monitoring, and obstetric and neonatal quality and safety. Core certifications require at least 2,000 hours of specialty experience. However, subspecialty certifications do not have work experience requirements, making them accessible earlier in your career.

Each of the following examples has eligibility and renewal requirements:

Neonatal Resuscitation Program: Designed to improve neonatal health outcomes by providing evidence-based guidelines and hands-on training. The American Academy of Pediatrics offers a neonatal resuscitation program to disseminate evidence-based neonatal resuscitation education.
Inpatient Obstetric Nursing (RNC-OB): Provides a competency-based validation of nurse knowledge and its application. Nurses are eligible after two years of specialty experience providing hospital-based care during antepartum, intrapartum, postpartum, and newborn periods.
Care of the Extremely Low Birth Weight Neonate (C-ELBW): For nurses who provide care to seriously ill and extremely low birth weight babies and their families. or Canada, 24 months and 2,000 hours of specialty experience, and employment in the specialty in the past 24 months.

Gaining Experience

New graduates interested in working in an L&D unit may need to begin in other nursing units to gain a broad foundation of clinical practice experience. Some hospitals hire new RNs directly in hospital labor and delivery units, but most require one or two years of experience to handle the unique challenges of an L&D unit. Postpartum or couplet care units are often great starting points, providing exposure to maternal and newborn care in a less-intense setting. Some hospitals offer nurse residency programs or clinical rotations for recent graduates. Shadowing experienced nurses on delivery units during their shifts is another way to gain relevant clinical experience.

Internship Programs

You will experience the day-to-day life of an Registered Nurse in a variety of roles and settings. This hands-on internship will expand your clinical skills and knowledge under the guidance of an experienced nurse preceptor. This is a great opportunity to make a difference for those served in your care and to strengthen your clinical skill set.

About the Program (Example):

Applicant must be enrolled in an accredited RN program (Associate or Bachelor degree) and have participated in an academic clinical experience. Associates Degree Nursing Students are not eligible for placement at Sanford Medical Center in Sioux Falls.
Must be enrolled in a state board of nursing approved internship course. This does not apply to internships held in the state of South Dakota and Iowa.
At the time of the internship, students must be within 1 or 2 semesters of your expected graduation date. Applicant must have an anticipated graduation date of Winter 2026 or Spring 2027.
Must have completed 1 semester of clinical experiences prior to the internship.
Submission of an accumulative transcript, including your most recently completed semester at time of application.
Current BLS certification through the American Heart Association (AHA) required.

Reasons to Participate:

Gain experience and skill within actual patient care situations within a large healthcare organization.
Participate in professional development sessions.
Work in partnership with an RN preceptor serving as a personal clinical coach.
Apply didactic knowledge to clinical practice.
Develop an increased level of competence and confidence.
Mature interpersonal, clinical judgment, and technical nursing skills.
Network with peers from other colleges and universities regionally and nationally.
Apply to participate in the Extended Sanford Student Nurse Internship Program until graduation.
Build a relationship with a future employer.
Leverage knowledge and skills gained to transition quicker into independent practice.

Career Advancement and Specialization

If you want more training, specialization and career opportunities, consider getting an advanced nursing degree. Obtaining these positions can mean more responsibility and possibly higher salaries. You can earn an MSN with on-campus and online MSN programs available to qualified candidates. When you want to advance your career, roles like women’s health nurse practitioner or certified nurse-midwife, provide a more independent practice. You may also choose to move into leadership, education, or administrative positions.

Labor and Delivery Nurse vs. Certified Nurse-Midwife (CNM)

Not sure if you would rather be a labor and delivery nurse or a certified nurse-midwife (CNM)? There are some important differences between a labor and delivery nurse and a midwife. Labor and delivery nurses and certified nurse midwives are both RNs. Both positions require specialized training and certification pertaining to the care of pregnant women. However, CNMs may care for women before and throughout the pregnancy term, while labor and delivery nurses are usually limited to providing care during labor and delivery and, sometimes, immediately after delivery. CNMs may advise women on proper nutrition and the emotional and physical aspects of pregnancy. Labor and delivery nurses signal the doctor when it’s time for the baby’s arrival. A CNM must train and be certified as a certified nurse-midwife. Labor and delivery nurses are not required to have this certification. It’s also worth noting that a CNM is different from a certified midwife (CM). CNMs are graduates of nurse-midwifery programs. Certified nurse-midwife programs are usually pursued through master’s in nursing programs. CNMs may provide a wide range of healthcare related to women before and after childbirth. Labor and delivery nurses are typically limited to providing care during labor and delivery and immediately following birth.

Compensation and Job Outlook

Labor and delivery nurses can earn a comfortable living. The BLS lists the median annual salary for all registered nursing professions. Salaries specific to labor and delivery nurses exclusive from RNs are not currently available from the Bureau of Labor Statistics (BLS). Labor and delivery nurse salaries can vary widely based on many factors, including the medical institution type, regional salary trends, professional experience level and the skills and qualifications the candidate brings with them.

Demand for RNs in general is expected to grow.

Essential Skills and Qualities

To succeed in this specialty, labor and delivery nurses should demonstrate empathy and the ability to build trust and rapport with patients quickly. A nursing degree prepares you for work in this specialty by teaching foundational clinical skills, as well as patient assessment and pharmacology.

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