How to Become a Labor and Delivery Nurse (Salary 2025)

Labor and delivery nursing is one of the most gratifying and most harrowing specialties in the field. When a birth goes well, you share one of the best moments of a family's life. When it goes wrong, your calm and clinical judgment are what hold the room together. L&D nurses spend more time with a laboring patient than anyone else, including the doctor who delivers the baby.

Career Snapshot

Where you'll work: Labor and delivery units and birthing centers in hospitals.

What you'll do: Care for patients from admission through delivery.

Minimum degree: Most hospitals require a BSN, though some accept an ADN.

Good fit for: Nurses who stay calm under pressure, communicate well, and adapt fast when complications hit. You're often the person a patient looks to for reassurance.

Job perks: A strong jumping-off point for related specialties like nurse-midwifery and neonatal nursing.

Median annual salary: $93,600 (RN, BLS)

What an L&D Nurse Does

You spend the most time with a laboring patient of anyone on the team. For quick births, you may be at the bedside from admission until shortly after delivery. For longer or complicated births that span shifts, multiple nurses share the care, so you won't always see a birth through to the end.

"When you are a labor and delivery nurse, you're the one who has to know what's going on with the mother and child at all times," says Mary Terranova, CNM, MSN, BSN, a certified nurse midwife who spent more than 12 years in L&D. "Especially at night. You're the only one around."

You watch the fetal heart monitor and the patient's status through what can be a long stretch before delivery, calling the doctor only at signs of trouble or when birth is imminent. Even a slow labor can turn critical in seconds, so the single most important skill beyond clinical knowledge is staying calm and reassuring.

"Labor and delivery nurses have to be able to handle an emergency and the adrenaline rush," Terranova says. "It can all be quiet and then, in a second, everyone is rushing to save lives."

Kathleen "Kitty" Law, RN, of Port Charlotte, Florida, cared for laboring patients across much of her 46-year career. The key skill, she says, is appearing calm even when the outcome may not be a live birth. "Every delivery really is considered high risk. You never know what may happen and you have to be ready for anything."

The specialty also opens doors. Terranova has practiced as a midwife for 22 years. Law spent 15 years in a high-risk birth unit. Others move into neonatal nursing or prenatal and fertility care.

Education and Licensing

Most hospitals require a BSN rather than a two-year associate degree, says Joan Edwards, PhD, RNC, CNS, FAAN, a labor and delivery nurse and former president of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN). A BSN takes about four years. Many nurses go on to master's or doctoral degrees, adding two to four more.

Most of the actual training happens onsite. Brandy Colletti, MSN-ED, MBA/HCM, PHN, RN, who spent 23 years in L&D and teaches at West Coast University, recommends taking at least one maternity or newborn course with clinical hours while in school.

To practice, you must be a registered nurse: earn your BSN, then pass the NCLEX-RN. The exam fee is typically $200. States charge an initial licensing fee between $40 and $375, renewed periodically, usually every two years. Check your state's specific rules. Any facility with acute care areas requires basic life support (BLS) certification.

Certification

Certification isn't required, but it gives you an edge. "Once a new grad passes NCLEX, they can start a labor and delivery position without any previous specialty education," Edwards says. Most facilities run internships of six weeks up to one year, pairing classroom content with a preceptor until you're a safe practitioner. Topics include stages of labor, Cesarean births, anesthesia, and non-pharmacologic pain relief. Many nurses also take fetal heart monitoring courses.

Some facilities prefer or eventually require the Inpatient Obstetric Nursing Certification (RNC-OB) through the National Certification Corporation. Candidates must be RNs with at least 2,000 hours of relevant education, research, or L&D experience and recent employment in the specialty. The exam costs $325.

Continuing Education

Most states require continuing education to renew a license. "Most states only require a certain number, usually about 20 CEUs," Edwards says. Renewal is typically every two years. Some states require part of those hours to be in your specialty; some don't.

Career Outlook

Even with more families choosing home and natural births, the field keeps growing. The BLS projects registered nursing will grow 5% from 2024 to 2034, faster than average. Birth rates have dropped slightly in recent years and the average age of mothers has risen, but demand for L&D nurses continues.

L&D is competitive because it's a sought-after field. Hospitals usually hire new graduates around the end of spring and fall semesters, plus throughout the year to fill retirements and vacancies. Edwards' tips for standing out:

• Get your BSN. Some hospitals won't take an associate degree. An RNC-OB certification helps too.
• Get relevant experience. Any prior exposure to L&D staff and supervisors is a plus.
• Network. A reference from someone known to perinatal directors at local hospitals can make the difference.
• Show you're a team player. Strong clinical hours in an L&D department carry weight.
• Stay professionally active. Join a relevant nursing association.
• Break language barriers. Fluency in Spanish, Vietnamese, or Mandarin is a real advantage.
• Join an honor society. Membership in Sigma Theta Tau International signals commitment.
• Show your work. An evidence-based practice project on an L&D topic, especially one accepted at a conference, stands out.

Salary

The BLS reports a median annual RN salary of $93,600. The bureau doesn't break out L&D specifically. Nurses with education beyond a bachelor's earn more, and L&D nurses can add income by teaching in related fields like lactation consulting, prenatal care, and home care support. As in most of nursing, pay tends to track your level of schooling.

Stay Informed

• AWHONN, a nonprofit focused on the health of women and newborns.
• National Association of Neonatal Nurses, dedicated to neonatal nursing, with some education relevant to L&D.

Is It Right for You?

Colletti and Edwards agree the essential traits are critical thinking under pressure and the ability to handle the adrenaline of a birth. Spending time in an ICU or emergency room is a good way to test whether the work suits you.