There are a lot of specializations that can seem appealing when you decide to become a registered nurse, but it can be hard to narrow things down.
If you believe you might love assisting families through the ups and downs of childbirth, a career as a labor and delivery nurse may be right for you. With strong nursing skills, a nurse in this field can make all the difference for an expectant mother in the scary and exciting time that leads to new life.
A labor and delivery (L&D) nurse is a nurse that’s specialized in monitoring pregnancies and helping expectant parents every step along the way to childbirth and beyond. It can be one of the most rewarding medical careers as you help new families grow in a safe and happy environment.
Labor and delivery nurses do more than just deliver babies, though that is a part of the journey that most participate in. These nurses work very closely with a few patients to make sure their care is going smoothly.
Nurses in this field work closely with obstetric and neonatal nurses to care for both the mother and the developing baby. Though they may not see as many patients as other disciplines in the field, the ones they do see matter quite a bit as they’re getting care in a stage of life that can be very nerve-wracking.
Though this position may sound similar to a midwife, there are a few key differences between a labor and delivery nurse and a certified nurse midwife (CNM).
CNMs handle family planning, gynecological check-ups, and require additional schooling on top of a four-year bachelor of science in nursing (BSN). After a prospective CNM finishes their BSN program, they’re looking at an 18-month master’s degree program. An RN with a two-year associate’s degree in nursing can become a labor and delivery nurse immediately.
As every pregnancy is different, labor and delivery nurses find themselves wearing several different hats, but there are a few that you’ll use most commonly.
L&D nurses do a good amount of heavy lifting when it comes to monitoring a pregnancy at a hospital. They look for potential problems during screening, help make sure everything is as it is supposed to be, and administer medication that has been prescribed for the patient, among other duties.
As pregnancies last over the course of nine months, a lot of things can change for a potential family over that time, so even if things may seem to be running smoothly over that stretch, these nurses must remain vigilant. If something seems off during a check-up, an L&D nurse is responsible for relaying any potential issues to the doctor.
Labor and delivery nurses are responsible for keeping track of everything going on with patients under their care. If there is a hiccup along the road, they must be prepared to step in and help at a moment’s notice.
As noted above, every pregnancy is different. Though families may have an idea of what to expect by the time they have their second or third child, there will still be questions here and there.
An L&D nurse, because of their familiarity with a family’s case and their expertise in the field, is usually the first person that pregnant women will think to ask about their situation. A good nurse will be ready for almost any inquiries that come their way and will know how to find an answer if they don’t know it off the top of their heads.
Naturally, as a labor and delivery nurse, you’re expected to be there when your patient goes into delivery.
When your patient goes into labor, you will be by their side, though in the cases of more difficult births or c-sections, teams of nurses may end up working shifts in and around the birthing center to make sure everything goes smoothly for the new baby.
These nurses can expect to measure contractions, give emotional support, administer medication and epidurals, coach new mothers through the process, and sometimes even induce labor.
During the birthing process, they’re also responsible for making sure the mother and the new baby’s vitals are performing well, or as expected, and for providing general support and encouragement throughout the process.
If the patient requires a c-section, L&D nurses will usually assist with the procedure.
Labor and delivery nurses will have to help out in plenty of different ways over the course of their nursing career. Though you will learn how to conduct the job while obtaining a labor and delivery nursing education, there are several skills that you may have to acquire to have a successful career in the field.
Though modern medicine has mostly nailed down the science of childbirth, it can still be quite unpredictable.
So many variables can lead to tweaks and complications, large and small, throughout the course of a pregnancy. It’s an L&D nurse’s job to make sure they can roll with the punches throughout these changes.
Though it can be difficult to keep a positive attitude with so many pregnancies at different stages with different challenges, it’s key to surviving the difficult times and coaching parents to have a positive outlook when it comes time to deliver their child.
As you’ll often be the medical professional in the room during the majority of pregnancy checkups, it’s key to ensure that everything is going according to plan throughout the process.
L&D nurses need a great eye for detail to make sure that the fetus is developing on schedule, and they need to be sure the parents understand their role in making sure they have a happy and healthy child during the process.
Watching for changes of any size and knowing when to contact a doctor to step into the case is a big part of any successful birth for a labor and delivery nurse.
You’ll be watching several pregnancies closely as they come to term, and though some of the expectant parents' births may fall at different times throughout your caseload, the job will require a lot of waiting and strong nerves.
New parents can be understandably anxious during their childbirth, so it’s key to not only be able to reassure them in the good times, but also to ensure that they understand any news about their pregnancy going a little off-script.
In time, as parents become more comfortable throughout the pregnancy, they may start to worry less. But the ability to help them remain calm and stick to a treatment plan over a nine-month pregnancy is going to be key to ensuring plenty of happy babies.
The median salary for a registered nurse is $73,300, according to the Bureau of Labor Statistics. That salary ranges from as low as a mean of $59,540 in South Dakota all the way up to around $140,740 in San Jose, CA.
There will always be a need for L&D nurses as long as people are giving birth to children. As there are hospitals across the country that specialize in providing safe, painless birthing experiences for mothers, and L&D nurses tend to only be able to carry a few pregnancies on their caseload, the position is constantly in demand.
If you decide to become an L&D nurse, you’re looking at anywhere from one and a half to five years before you start your first job. To become an RN, you need either a two-year associate's degree or a four-year bachelor’s degree.
After you obtain your degree, you’ll need to study for, and pass the NCLEX, or National Council Licensure Examination, which should happen relatively soon after graduation, then it can take as long as six weeks to receive your test results.
The road to becoming an L&D nurse can be relatively long, or relatively short, but this breakdown should help you decide on which path is right for you.
An associate degree will get you into the field faster, which means earning money faster. However, people with associate degrees are unable to become nurse practitioners, who make more money over the long run, have more responsibility, and are more often promoted within a healthcare system faster.
If you opt for an associate degree, you can always go to school to obtain a BSN later, so you’re not locked into one choice or the other after you make a decision.
As we’ve already discussed, once you’ve determined your path and gotten your degree, you’ll need to get your RN certification from the NCLEX.
Generally, you’re looking at rigorous studying for the six-hour test, but you should be confident at this point, as you’re simply being tested on the knowledge you’ve obtained over your course of study throughout your nursing program.
Once you’ve finished your RN education and started your career as an L&D nurse, you have the opportunity to continue your education and become a CNM, or continue work as an L&D nurse.
Again, this is not something that you have to decide upon immediately, and you may even have an easier time becoming a CNM once you’ve got a few years of L&D experience under your belt.
All you need to start working as a labor and delivery nurse is an RN certification, which requires either an associate degree or a bachelor’s degree. There are some great nursing programs out there to get you started, depending on which course you choose.
There are many programs from prestigious institutions that will help you join the long line of professionals that guide people through the birth process. Here are just a few.
Chabot College offers a great associate degree in nursing (ADN) program with a 100 percent NCLEX pass rate.
This California school is hard to beat for a two-year degree. Though it may seem as if a four-year degree is the right move, getting the ADN is always a significantly cheaper investment to becoming an RN. You should have an easier time paying for school if you do decide to get your four-year degree later thanks to the money you’ll be saving initially.
The University of Pennsylvania, or UPenn, is consistently one of the top 5 schools for nursing students around the country.
They partner with local healthcare providers to give students the best experience possible with their clinicals throughout their courses for a four-year degree. It’s hard to do better than this school as a jumping-off point for your career.
If you decide that you want to get your bachelor’s after an associate’s, you always have the option of earning it online to fit better within your schedule.
Purdue Global is a great online option for RN’s that are looking to advance in their career without committing to attending classes at a local university, and they’ll work with you to form an individualized plan that works best for you.
You really only need to be an RN to find work as an L&D nurse. However, there is one certificate that may increase your employment opportunities.
The National Certification Corporation offers its credential in inpatient obstetric nursing (RNC-OB) to seasoned labor and delivery nurses.
In order to qualify for eligibility, you must have at least two years of experience in the field and proof of working over 2,000 hours with pregnant patients.
By earning this certificate, you’re proving to people that come to you for treatment that you’re an experienced professional that has seen enough cases to be ready for just about anything. Potential employers also take this expertise as a sign that you’ll be a competent, professional addition to their staff, and are willing to pay more for the peace of mind of having a professional on staff.
There’s never a bad time to become a labor and delivery nurse. If you enjoy helping people and are prepared to handle the highs and lows of the birthing process, this would make a wonderful career. Just prepare for the road of study ahead and you should be fine.