How to become a Labor and Delivery Nurse in The USA?
Labor and delivery (L&D) nurses care for mothers and newborns. You coach parents during labor, assist mothers with pregnancy and delivery complications, offer advice on caring for babies, and even look after newborns in their first days of life.
Becoming a labor and delivery nurse takes more in-depth training than becoming a registered nurse. This guide will cover the entire process step-by-step so that you can turn your dream nursing job into a reality.
Before we start, it’s a good idea to explore labor and delivery nursing in greater detail. There are many nursing specializations, so reading up on different career paths can help you land the perfect job.
If you’re already considering L&D nursing or are confident this is the career for you, it’s time to dive into the details!
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What are the steps to becoming a qualified Labor and Delivery Nurse?
Attend Nursing School
Nursing school is every nurse’s first stop in their career development. There are two types of degrees you can earn as a nurse:
An associate’s degree in nursing (ADN, ASN, AAS). A two-year program prepares students with the essential nursing education and skills they need to work as a registered nurse (RN). In addition to classroom instruction, you’ll also complete clinical rounds with actual patients.
A bachelor’s degree in nursing (BSN). The standard four-year undergraduate degree is the hallmark of nursing education. In many states, you must earn a BSN after becoming an RN through an associate’s program within a certain number of years. Luckily, there are many ADSN to BSN programs that help you get your bachelor’s while working in the field.
Whether you decide to earn an associate’s or bachelor’s is a matter of preference and time commitment. Earning your associate’s degree allows you to become a registered nurse faster, but it can limit your ability to get promoted.
Most labor and delivery nurses, and even many RN employers, seek nurses with at least a bachelor’s degree. A BSN gives you greater education in nursing, including clinical management and leadership. It also makes it easier to enter varying nursing roles and qualify for more opportunities immediately.
Study and Pass the NCLEX-RN exam
Whether you earn an associate’s or bachelor’s degree in nursing, you’ll need to pass the national NCLEX-RN exam before holding a nursing license.
Many students think that a nursing degree automatically makes them a nurse, but this isn’t true. You aren’t an RN until you’ve passed the NCLEX-RN and obtained your state nursing license.
The NCLEX-RN is issued by The National Council of State Boards of Nursing (NCSBN). This organization regulates nursing in both the United States and Canada. It tests nurses' competency after training to ensure they’re ready to work with patients.
The NCLEX-RN has four sections:
Creating a safe and effective care environment
Promotion and maintenance of health
Psychosocial integrity
Physiological integrity
There are many NCLEX-RN prep courses and books you can read to prepare ahead of time. While you’ll learn everything you need in school, a comprehensive study program before the exam will give you the greatest chance of passing your first time.
Obtain State Registered Nurse License
After you pass the NCLEX-RN, your next step is registering as a nurse in your state. This step is done by applying to your state’s board of nursing. Once you pass all of the requirements, you’ll be issued a license. Then you can apply for RN jobs near you.
Gain Bedside Experience in the Delivery Room
Many new nurses who want to work in labor and delivery seek jobs in hospital maternity wards. This gives them the ability to gain experience as they further their credentials.
In most hospital settings, labor & delivery nurses must hold additional certifications and at least two years of nursing experience.
Consider Earning a Labor and Delivery Nursing Certification
Labor and delivery nurses can hold several types of certifications. One of the most popular is the RNC-OB. This certificate licenses you as an inpatient obstetric nurse. With this certification, you’ll have the knowledge and skills necessary to work with mothers during pregnancy, labor, and childbirth.
An RNC-OB certification can make you a more valued labor & delivery nurse candidate when applying for jobs. It shows you have the experience and knowledge required to provide your patients with the most comprehensive quality of care.
You can also look for certifications such as Neonatal Resuscitation Program certification (NRP) and a certificate in electronic fetal monitoring (C-EFM).
You will also need to earn your basic life support (BLS) and advanced cardiac life support (ACLS) certifications during nursing school or immediately after. These are standard qualifications required for nurses working in any department.
To further advance your career, you may pursue more education to become an obstetrics-gynecologist nurse practitioner or certified nurse-midwife. If you choose this path, you can work side by side with an OB/GYN or become your own boss as a certified midwife.
Can you become a Labor and Delivery Nurse online?
You can start your nursing career online, but you’ll still need to complete clinical rounds in a hospital setting. There are many associate’s degrees and online bachelor’s in nursing programs to choose from. However, once you reach a certain point in your curriculum, you’ll have to find a school-approved hospital.
So, while you can get basic classroom education online, the skills training and mentoring critical to becoming a nurse must be in person. In addition, each state has specific rules and regulations regarding clinical hours, which you must complete before working as an L&D nurse.
What positions can you progress to from being a Labor and Delivery Nurse?
After you become a labor and delivery nurse, there are a few ways you might decide to advance your career.
The first would be becoming a certified nurse-midwife (CNM) through the American Midwifery Certification Board. These are advanced practice registered nurses (APRNs) who hold master's or doctorate degrees in nursing.
In addition to being highly trained in labor and delivery, nurse midwives also provide reproductive care and pregnancy counseling. In some states, CNMs can also become licensed to write prescriptions for their patients.
You could also consider becoming an obstetrics-gynecologist nurse practitioner (OGNP). These medical professionals hold master’s or doctorate degrees and specialize in female sexual and reproductive health.
Obstetric nurse practitioners can also choose specialties like reproductive health and infertility, maternal-fetal medicine, critical care, and family planning.
Do your Labor and Delivery Nurse exam qualifications expire?
Every registered nurse has to renew their license, usually every three years. The same applies to most nursing certifications. In addition, you may be required to participate in continued education courses to ensure that your knowledge is always up-to-date with the latest medical research and best practices.
Becoming a nurse means always providing the most excellent quality of care. Continued education courses are another great way to further your career.
How much do Labor and Delivery Nurses Make?
Labor and delivery nurse salaries vary across the United States. Most nurses work three to four days or nights weekly for 12-hour shifts in a hospital. Your schedule may vary, but this is the average work week for most nurses who work in hospital settings. You may also choose to work weekend shifts, which run from Fridays through Mondays or Saturdays through Tuesdays.
Labor & delivery nurse salaries in America range between $65,400 and $85,600, with an average of $75,192, or $36 an hour.
Earnings will vary by hospital, location, experience, and additional qualifications. In addition to living in a state that pays higher on average, you can further your career and boost your earning potential with additional degrees or certifications.
For example, the average nurse midwife earns $116,253 annually, and a nurse practitioner makes $116,438.
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How long does becoming a Labor and Delivery Nurse take?
Becoming a labor & delivery nurse with RNC-OB takes 6 to 8 years. Qualifying for the RNC-OB exam takes two years or 2000 hours of work experience as an RN in the U.S. or Canada. Therefore, before finding work as a labor & delivery nurse in most hospitals, you must complete your RN, work for at least two years, and earn further certifications.
Before working in a maternity ward, you will need at least an RN and certificate in BLS (Basic Life Support) and ACLS (Advanced Cardiac Life Support).
Nursing school takes 2 to 4 years, depending on whether you earn an associate’s or bachelor's. If you decide to go back to school and earn an MSN (master’s of science in nursing), you will need to spend an additional two years studying. If you choose to earn an additional degree, you may be able to do so online in your off-hours. However, this will depend on your state’s specifics.
Is being a Labor & Delivery Nurse difficult?
There are moments in every nursing career that are extremely difficult. However, depending on your specialization, you may work in more fast-paced, high-stress situations than other nurses.
In labor & delivery, there are many beautiful moments filled with joy as you witness a new life come into the world. However, not all births are happy moments. Sometimes, a baby is stillborn, premature, or injured during childbirth.
Mothers can also experience complications during labor & delivery that are life-threatening and require your immediate intervention.
At times, a lot of grief and heartache are involved, and it can be emotionally draining as a nurse to witness such despair in your patients. However, there are so many incredible moments that you’ll also experience.
Being able to stand beside patients no matter what they’re going through is what makes labor & delivery worth it for so many nurses.
Do Labor & Delivery Nurses deliver babies?
You will assist the obstetrician during delivery, but as a nurse, you will not deliver babies or perform C-sections. In rare cases, the nurse may have to stand by and deliver the baby if it arrives before the doctor can make it to the room.
However, in most cases, the labor & delivery nurse doesn’t perform birthing procedures. Instead, your role is to stand by the parent, coach the mother, and handle the newborn immediately following delivery to ensure it receives appropriate post-delivery care.