How to Become a Labor and Delivery Nurse

How to Become a Labor and Delivery Nurse: A Step-by-Step Guide

With infant mortality rates on the rise in the U.S., the need for skilled labor and delivery nurses and improved maternal and infant care has never been more urgent. Labor and delivery (L&D) nurses provide a safe and supportive birth experience, combining expert medical care with empathetic emotional care. During the childbirth journey, they monitor vitals, manage pain, and respond swiftly to emergencies. These nursing professionals offer reassurance and guidance, creating an environment where mothers feel cared for through one of life’s most profound experiences. 

Interested in learning how to become a labor and delivery nurse? We’ll go over what it means to be an L&D nurse, outline the steps and skills required, walk through an L&D nurse’s role during childbirth, and explore career opportunities in this rewarding field.

Table of Contents

• What is a Labor and Delivery Nurse?
• 6 Steps to Become a Labor and Delivery Nurse
• Skills and Qualities for Success
• Job Outlook and Salary
• Conclusion

What is a Labor and Delivery Nurse?

A labor and delivery nurse is a registered nurse (RN) who specializes in caring for mothers and newborns during pregnancy, childbirth, and postpartum recovery. This role demands specialized training and certification beyond general nursing requirements. These nurses stay calm under pressure, think critically in emergencies, and provide compassion and support to families. Labor and delivery is ideal for those passionate about helping mothers through both their greatest moments and most difficult challenges.

L&D nurses are integral to assisting in labor and delivery procedures, monitoring the health of both mother and baby, and offering emotional support to families. They work alongside obstetricians, midwives, and other healthcare providers to give patient-centered care through the birthing process. Labor and delivery nurses are the first line of response in the event of complications and emergencies, ensuring quick interventions for mother and child. They stand as mothers’ greatest advocates and pillars of support within the healthcare system.

L&D Nurses Guide Mothers Through the Childbirth Journey

More than just healthcare providers, labor and delivery nurses offer guidance and reassurance to support mothers through every challenge and decision before, during, and after childbirth. We’ll go through the stages of childbirth and how L&D nurses are there every step of the way.

1. Early Labor: Preparation & Encouragement

Emotions are high as labor begins — excitement, fear, and irritability are common at this stage. L&D nurses provide reassurance, monitor vitals, and explain what to expect.

2. Active Labor: Comfort & Pain Management

Contractions are starting to get stronger and closer together at this stage. L&D nurses coach mothers on breathing techniques and offer pain relief options. They help mothers make informed decisions about epidurals and alternative pain management methods. Nurses remain vigilant for any sign of distress.

3. Transition Phase: Grounding & Guidance

This can be the shortest, but most intense, stage of labor. Strong contractions last over a minute, and the cervix fully dilates. Nurses offer grounding emotional support and assist mothers with pant-blow breathing. They also monitor maternal vital signs and fetal heart rate, ready to act quickly in case of complications.

4. Pushing: Coaching & Vigilance

The mother is exhausted at this point, but it’s time to push — and every contraction counts. L&D nurses coach mothers on pushing and provide positive feedback as moms focus on bearing down. They watch for signs of distress in the baby and will intervene with repositioning, oxygen, or calling for an emergency C-section.

5. Birth: Assessment & Stability

One last push and the baby is born! Most women experience an intense mix of relief, exhaustion, and overwhelming love as they officially transition from woman to mother. L&D nurses start immediate care for both newborn and mother, which includes: 

• Apgar scoring: Assessing the baby’s vitals, skin color, muscle tone, and reflexes
• Skin-to-skin contact: Helping mothers to start bonding with their babies
• Cord-cutting: Offering partners the opportunity to participate
• Post-birth checks: Monitoring for excessive bleeding, placenta delivery, and uterine contractions

6. Postpartum: Recovery & Education

Childbirth is over, but the parenthood journey is just beginning for mom. L&D nurses continue monitoring mother and baby, assisting with bonding and breastfeeding (if chosen), and watching for postpartum warning signs. They also provide education on postpartum recovery and newborn care before preparing for discharge. 

Labor and delivery nurses support mothers and their babies through every stage of childbirth and postpartum recovery. Their expertise, compassion, and quick thinking make all the difference in a successful experience.

6 Steps to Become a Labor and Delivery Nurse

Helping women bring new life into the world is an incredible privilege. L&D nurses make it a safe and supportive experience. If you’re passionate about maternal care, here’s a six-step roadmap to becoming a labor and delivery nurse.

1. Earn a Nursing Degree

There are two degree options for nursing hopefuls: Earn an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). An ADN typically takes about two years to complete, while a BSN takes four. 

We recommend pursuing a BSN because it will open up more career opportunities and higher earning potential. Many magnet hospitals — known for nursing excellence and better nurse outcomes — prefer BSN-prepared nurses. For labor and delivery nurses, working at a magnet hospital means higher pay, lower burnout, and significantly better work environments.

2. Obtain RN Licensure

After earning a degree, the next step is passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN). It typically takes candidates anywhere from 4 to 12 weeks to effectively prepare for the NCLEX. As of 2024, US-educated first-time test takers had a 91.16 percent pass rate.

After passing the NCLEX, nurses will need to apply for an RN license from their state’s Board of Nursing. State licensure may require background checks, fingerprinting, or additional paperwork. Each state has its own requirements for nurses to maintain their RN license. This typically includes:

• Manual renewal every two years for most states (others range from one to four years)
• Completing continuing education (CE) credits
• Paying a renewal fee 

Letting a license lapse means a nurse cannot legally practice until they meet renewal requirements.

3. Gain Clinical Experience

With licensure work complete, it’s time to get some hands-on experience in a hospital or clinical setting. New nurses typically get their feet wet in various nursing units, such as med-surg, before transferring to labor and delivery. This general nursing experience strengthens core skills and boosts confidence. To transition into labor and delivery, aspiring nurses should seek opportunities in maternal or women’s health units to get specialized experience.

4. Pursue Certification in Labor and Delivery Nursing

Alongside their nursing degree and RN licensure, labor and delivery nurses are required to have certifications in:

• Basic life support (BLS): Includes instruction in CPR, first aid, and basic cardiovascular life support skills.
• Advanced Cardiac Life Support (ACLS): Teaches basic life support skills, airway management, emergency interventions (e.g., chest compressions and AED use), related pharmacology, and how to manage strokes and cardiac emergencies.

For a competitive edge, labor and delivery nurses can pursue specialized certifications and training to gain and demonstrate competence. Continuing education options include:

• Neonatal Resuscitation Program (NRP): Provides evidence-based neonatal care, training, and skills needed to respond to critical situations.
• Inpatient Obstetric Nursing (RNC-OB): Certification demonstrates competency in fetal assessment, pregnancy complications, labor and delivery, recovery, postpartum, and newborn care.
• Care of the Extremely Low Birth Weight Neonate (C-ELBW): Designed for nurses caring for critically ill and extremely low birthweight babies. This certificate shows competence in managing complex neonatal conditions and providing support for families within an intensive care setting.
• Maternal Newborn Nursing (RNC-MNN): Completion demonstrates knowledge in maternal postpartum care, newborn assessment, pregnancy-related risk factors, and patient education.
• Inpatient Antepartum Nursing (RNC-IAP): Establishes competency in providing specialized care to high-risk pregnant women before birth.

5. Apply for Labor and Delivery Nursing Positions

Breaking into labor and delivery can be a challenge, but a polished resume and networking with professionals in maternal healthcare can set nurses apart. Here are a few of our favorite tips for success: 

• Follow resume best practices and highlight:
  • Relevant clinical experience and certifications
  • Professional contributions (e.g., published articles or poster podium presentations at conferences)
  • Involvement in hospital initiatives like councils and committees
  • Progression in a clinical ladder program
• Seek mentorship within a hospital, professional group, or nursing school
• Connect with industry professionals at conferences, workshops, or local nursing events

6. Consider Advanced Education

For nurses looking to elevate their careers, graduate programs can open doors to leadership and specialized care. Earning a Master of Science in Nursing (MSN) with a focus on women’s health or nurse midwifery qualifies nurses to provide advanced care to women and babies. 

Those seeking advanced practice roles can become Nurse Practitioners (NPs) or Certified Nurse-Midwives (CNMs), expanding their scope of practice and taking on greater responsibilities in patient care. Each of these options also puts nurses on the path to leadership positions.

Skills and Qualities for Success

Labor and delivery nursing requires a blend of technical expertise, empathy, resilience, and critical thinking to deliver the best possible outcomes for mother and child. Some days are joyful, while others mean supporting patients through the worst moments of their lives. Successful L&D nurses possess the following essential skills and qualities: 

• Clinical skills: Proficiency in fetal monitoring, emergency care, and postpartum recovery
• Critical thinking: Recognizing early warning signs of complications and making fast, informed decisions to prevent adverse outcomes
• Emotional support: Comforting and guiding patients through the birthing process with compassion
• Teamwork: Collaborating effectively with obstetricians, midwives, and other healthcare providers
• Adaptability: Staying calm under pressure and responding to emergencies

Job Outlook and Salary

Despite the declining U.S. birth rate, the demand for labor and delivery nurses remains high. This is driven by the continuous need for childbirth care, an aging nursing workforce, and the specialized skills required for maternal support.

The median salary for RNs is $86,070 per year, so L&D nurses may have higher earnings in specialized settings. The job growth for RNs is expected to be 6 percent from 2023 to 2033, which is faster than the average for all occupations.

Conclusion

Becoming a labor and delivery nurse is a rewarding career path that combines technical expertise with compassionate care. This is a career that is as demanding as it is rewarding. It’s not just about welcoming babies into the world — it’s about advocating for mothers,  making split-second decisions in high-stakes situations, and being present for both joyful and heartbreaking moments.

L&D nurses aren’t just baby nurses; they provide critical care, patient advocacy, emergency response, and emotional support for mothers and their families. This work can be exhausting, but if you thrive in fast-paced, high-pressure environments, it’s a deeply fulfilling career. 

If you’re passionate about supporting mothers through childbirth, L&D could be your calling. National University offers convenient, flexible nursing and healthcare programs designed to fit your schedule. Start your journey toward a meaningful career in maternal and neonatal patient care today!