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Labor and Delivery (L&D) Nurse at a Glance

Labor and delivery is emotionally and physically intense for any mother, no matter how many times they’ve been through it, the birth plan they’re following, or the unforeseen choices they may have to make. As a Labor and Delivery (L&D) Nurse, you’ll help care for mothers and newborns before, during, and after the birth. Your patients will look to you for information, reassurance and guidance in handling a delicate new life, new family member, and entirely new experience. It’s on you to meet their emotions with compassion, address their questions with a calm and honest attitude, monitor their pain with proper treatment and support, and prioritize the health and safety of their newborn.
What is a Labor and Delivery Nurse?
From admission to discharge, Labor and Delivery (L&D) Nurses are there for every step of the birthing process and postpartum care. This means that L&D Nurses monitor vitals of both mother and baby; track and measure contractions; proactively assess and address mothers’ needs (e.g., pain medications or other support); assist with delivery and provide care.

Since it’s hard to predict labor duration and potential postpartum challenges, L&D Nurses often form unique bonds with patients and their families, as they’re one of the most consistent points of support while in the hospital. Because of this, the best L&D Nurses are compassionate and clear communicators. At a moment when everything is moving and changing at a rapid pace, it’s important for L&D Nurses to be a point of stability for both patients and doctors in the room.

What’s the Demand for Labor and Delivery Nurses?

Labor and Delivery Nurses are constantly in demand. With about 3.8 million babies born in the US in 2018 , L&D Nurses are essential members of the medical profession, ensuring the health and safety of mothers and their newly welcomed children. And with the U.S. Bureau of Labor Statistics predicting a 12% growth in registered nurse employment between 2018 and 2028, averaging about 210,400 openings for registered nurses each year over the decade, job security and opportunities are high.

How Do You Become a Labor and Delivery Nurse?

To become a Labor and Delivery Nurse, you must have an Associates Degree in Nursing (ADN) or Bachelor’s in Science of Nursing (BSN) from an accredited program. As with most professions, a higher degree of education provides a competitive edge when being assessed by potential employers, so earning a BSN is highly recommended.

Similar to other nursing professions, any aspiring L&D Nurse must first work as a registered nurse for at least one year before pursuing a more specialized focus. During this time, many employers require their future L&D Nurses to work as a Postpartum Nurse to get a base understanding of the skills and responsibilities of the larger role.

Also, all L&D Nurses are required to be certified in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) so they are able to assist doctors with potentially life threatening emergencies that can occur during childbirth.

Overview
The best Labor and Delivery (L&D) Nurses are those who are compassionate, clear, and attentive communicators. As an L&D Nurse, you should be comfortable dealing with a broad range of emotions, addressing questions, adapting to emotional and medical challenges, and being proactive in your care approach.
How much does a Delivery Nurse make?
$45k - $88k
As of 2020, the average salary for a Labor and Delivery (L&D) Nurse is about $63k, with a general range of $45k-$88k. As with any profession, factors such as years of experience, the kind of employer you work for, and your area’s cost of living and level of demand can have a significant impact on how you are compensated. Additionally, whether you choose to specialize within L&D, like focusing on high risk neonatal care, or pursue further education, can of course play a role in your annual salary.
Fast-paced
As a Labor and Delivery Nurse, you’re expected to be able to react and make decisions quickly in demanding circumstances. Active Labor moves at varying speeds, but your ability to react in a timely manner can make a world of a difference for your patient.
Patient-facing
As an L&D Nurse, you have two patients under your care and supervision, the mother and her child. Given that the length of labor and delivery is unique to each patient, L&D Nurses tend to spend a lot of time with patients and their families. Because of this, and given the stressful nature of childbirth, it’s important to be as calm, collected, and compassionate as possible. You should be able to establish trust from the get-go so that you and your patient are able to communicate effectively, ensuring the safety of both mother and child.
Structured
When working in stressful situations, like labor and delivery, having a set structure to lean on allows you to be more attentive and adaptable to the situation at hand, and allows all care providers to prioritize and address the health and safety of their patients.
Varied
No labor and delivery process is the same, so adaptability and proactivity are essential attributes of any L&D Nurse. It’s important to get as much varied experience as possible from the start, as it’ll allow you to hone your skills in communication, delivery assistance and neonatal care.
You’ll be calm and practical as you prepare women and their families for a comfortable and safe childbirth.”
What Does a Labor and Delivery Nurse Do?
Overview
Overview

Labor and Delivery Nurses work as main points of support for OBGYNs, monitoring of patient vitals, administering medication, and establishing a trusted line of communication with expectant mothers. Once a baby is born, the L&D Nurse acts as an informational resource to parents, to monitor neonatal vitals, to ensure the mother isn’t experiencing postpartum complications, and to make sure their patients are leaving their care as confident as possible.

Evaluate
Evaluate

During and after labor, you’ll assess the needs of parents and how you can help them. During labor, this means maintaining a clear line of communication so you can assist mothers through their contractions, providing whatever physical, emotional or medicinal support they need. Postpartum, this means helping them with any care questions or concerns they may have, and connecting them to resources they might require, like a lactation consultant. The better you’re able to communicate with your patients, the better you’ll anticipate and evaluate their needs, so make sure to prioritize this relationship from the moment an expectant mother enters your care and trusts you with their delivery.

Education
Education

As an L&D Nurse, your expertise is invaluable to new and expecting parents. It’s your job to make them feel as informed and prepared as possible for everything from labor and delivery to what to do once they walk out of those hospital doors. Be prepared to answer questions, validate emotions, and help birthing partners know how to best support their loved ones.

Monitor
Monitor

As a professional consistently in the room with expectant mothers, it’s on you to keep a close eye on vital signs, like the mother’s blood pressure, timing of contractions, and the baby’s heart rate.

Treatment
Treatment

Every mother’s birth plan and birth process will vary, which means that necessary treatment differs on a case by case basis. If an epidural is part of your patient’s birth plan, you’ll be in charge of administering it. If your patient’s birth ends up needing to be induced, you’ll provide them with the medication and support. In the event of a C-section, you’ll prep them for the procedure. In short, there are many factors that play a role in how you go about treating each patient, and it’s your job as an L&D Nurse to be prepared for and knowledgeable about all of them.

Innovate
Innovate

As experts in various labor and delivery experiences, L&D Nurses are constantly using what they learn to help their next patients. Because of this, L&D Nurses are some of the top innovators when it comes to finding new ways to accommodate the experience and health of laboring mothers and their children. Take a listen to our SEE YOU NOW Podcast episode “Empowering Childbirth” where Pioneer, MacArthur Fellow and Nurse Midwife Ruth Watson Lubic, EdD, RN, CNM, FAAN, FACNM, discusses her six decades of experience in nurse-midwifery and her groundbreaking experience opening the first freestanding birth center for low-income families in New York City.

Stages of Childbirth Care
  • Antepartum

    Antepartum refers to the 40-week period from conception to labor. During this time, L&D Nurses are responsible for monitoring both mother and baby, taking vitals, performing ultrasounds and antepartum fetal assessments, and providing support to expectant mothers unique to their individual health needs.

  • Intrapartum

    Intrapartum refers to the period of active labor, delivery of the child, and delivery of the placenta. This is where L&D Nurses step up as active members of the birthing team, supporting the mother throughout her birthing process, and assisting the doctors in the safe delivery of the baby or babies. L&D Nurses need to be ready for any change in birth plan so that they can effectively care for both mother and child. This means being prepared to assist in any kind of delivery– vaginal, breech, or cesarean– troubleshoot complications, address emergency situations, and have everything set for care.

  • Postpartum

    Postpartum care relies heavily on careful observation and communication between L&D Nurses and their patients. No labor and delivery process is the same, so proper postpartum care needs to address the unique needs of each mother and child. This period can be a jarring transition for mothers, and it’s important to be an active listener and supporter, as well as an attentive caretaker. L&D Nurses are relied upon to communicate the mental and physical changes that coincide with childbirth, validating the trauma that both body and mind have just been put through, and supplying or sourcing necessary support, such as lactation consultants or mental health providers.

  • Neonatal

    Neonatal care refers to the direct care of a newborn. Because there are varying levels of neonatal care that depend on multiple factors of newborn health, this is an area in which some L&D Nurses choose to pursue a more specialized skillset. These levels can cover low risk care, assisted ventilation, preterm birth and post-op care, and critical care for infants with high risk of mortality.

Where Can a Labor and Delivery Nurse Work?
  • Birthing Centers
    Birthing Centers are healthcare facilities dedicated to a wellness-centric approach to birthing. Here, L&D Nurses function as midwives or doulas, who differ from registered nurses in that they don’t require the same level of medical certifications. However, a Labor & Delivery Nurse’s skill set is applicable and valuable.
  • Hospitals
    A large majority of L&D Nurses work in hospitals. Here, you’ll have the opportunity to work in the maternity ward in delivery rooms, hospital nurseries, and neonatal care units.
  • Patients’ homes
    Similar to their roles in birthing centers, L&D Nurses can assist in home births as a midwife or doula, bringing their expertise to a home setting, and guiding mother and child through the process.
Labor And Delivery Nurse Path

Get an Associate’s Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) taking elective courses in labor and delivery.

A strong base of knowledge in all areas of nursing will help you as you move forward into your clinical practice, and further education.

Pass the NCLEX-RN.

To become a Labor and Delivery Nurse, you must pass the NCLEX-RN exam and earn your license as a Registered nurse.

Work as a Registered Nurse, gaining experience in labor and delivery.

Once a licensed RN, you must gain at least one year of professional experience before being able to pursue a more specialized path.

Get your Inpatient Obstetric Nursing Certification through the National Certification Corporation.

You’re ready to work as a Labor and Delivery Nurse.

Join an Organization
Become a member of an Labor and Delivery Nurse organization to find career opportunities, learn from your colleagues, and support the profession.

Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN)

American Association of Critical-Care Nurses
Resources
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