Labor and Delivery Nursing

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Labor and delivery nursing is a specialty in obstetrics where nurses take care of pregnant patients during labor, obstetrical emergencies, and other obstetric conditions. The labor and delivery nurse provides care during the intrapartum period (labor and birth).  A labor and delivery nurse provides support, medical care, and constant monitoring of the pregnant patient and her fetus throughout labor and birth. Labor and delivery nurses assist and educate patients with labor and delivery conditions.  Labor and delivery nurses provide incredible patient support, critical nursing care, and comprehensive pregnancy and postpartum education.

Labor and delivery nurses typically work in hospital units, freestanding birth centers, or attend home births.  However, they may also work in outpatient clinics or private practice offices.  Labor and delivery nurses care for women of childbearing age and their newborn babies. Labor and delivery nurses work variable shifts depending on where they work.   For example, office nurses usually work during the day, but nurses in hospital inpatient units maywork day, evening, or night shift. They may be required to work weekends and holidays, but will generally receive a higher rate for these shifts.

A labor and delivery nurse is skilled in caring for patients during labor and delivery issues. The labor and delivery nurse works closely with the patient, their family, and the obstetric team to ensure a smooth labor birth.  These obstetric and intrapartum issues include conditions like preterm labor, premature rupture of membranes, placenta previa, placental abruption, and cord prolapse.  Labor and delivery nurses are familiar with managing medications and IV drips for conditions like preeclampsia, gestational diabetes, and hypertension.

They must be familiar with usual chronic and acute conditions but also be aware of the impact these disorders have on the childbearing woman.  Hence, labor and delivery nurses must be familiar with a considerable range of knowledge regarding pregnancy compatibility with medications and obstetric conditions.  Labor and delivery nurses assist with obstetric surgeries like cesarean section and dilation and curettage.  They also assist with procedures like artificial rupture of membranes, internal fetal monitoring, and external cephalic version.

Labor and delivery nurses educate patients and their family about what to expect during the labor and birth period. Labor and delivery nurses are knowledgeable about obstetric conditions and are able to counsel patients on the risks and complications of treatment. Labor and delivery nurses assist obstetricians with outpatient and inpatient procedures, as well as care for patients preoperatively and postoperatively. Obstetric nurses are compassionate, skilled, and perceptive.

Education Requirements

You must first obtain a nursing degree from an accredited nursing program to become a labor and delivery nurse. Labor and delivery nurses usually Registered Nurses.  In order to become a Registered Nurse, you can attend an Associate Degree program (two years) or pursues a Bachelor of Science in Nursing (four years).  After graduating from nursing school, you must take the NCLEX-RN exam to become licensed as a nurse.  The last step is to apply to the Board of Nursing in your state to become an RN.  Once school is over, continuing education and obstetric training at your facility will keep your labor and delivery nursing education fresh.

Certification

When labor and delivery nurses choose to pursue certification, it displays their specialized knowledge and experience in their specialty. Labor and delivery nurses must have the appropriate experience before they can take the Obstetric Nurse Certification Examination to become a Registered Nurse, Certified in Obstetrics (RNC-OB), which is given by the National Certification Corporation. When a nurse is an RNC-OB, they have an expert level of inpatient obstetrics nursing competence and skill.

To take the RNC-OB exam, you must have:

  • A current Registered Nurse license in the United States or Canada,
  • Two years experience as a Registered Nurse,
  • A minimum of 2000 clinical practice hours in labor and delivery nursing practice direct patient care, education, administration, or research).
  • Employment in the specialty in the last 24 months.

The exam is a 175 question multiple-choice examination that covers a wide variety of labor and delivery nursing topics like labor and birth, fetal assessment, obstetric complications, maternal factors, professional issues, and postpartum and newborn care. You have three hours to finish your exam to achieve certification.  Labor and delivery nurse certification is valid for three years and you can recertify by taking the certification exam again or taking 45 hours of continuing education.

Job Description & Duties

Alabor and delivery nurse performs important responsibilities in caring for the pregnant women.  Your duties as a labor and delivery nurse will vary basedon your facility, your patient population, and where you live.

  • Triage potential laboring patients, preterm labor patients, patients who have ruptured their membranes (broken their water), and identify obstetric emergencies.
  • Admit the pregnant patient to the labor and delivery unit, perform an admission assessment, and develop a nursing plan of care.
  • Insert intravenous (IV) catheter and initiate and maintain IV fluids and medications.
  • Provide labor support and emotional support during and after traumatic incidents like miscarriage, stillbirth, and newborn resuscitation.
  • Assess the pregnant patient, document their medical history
  • Determine dilation, effacement, and fetal station from vaginal exams.
  • Monitor, review, and report vital signs related to stage and phase of labor and other obstetrical considerations.
  • Assist the physician in the birth of a baby, preparing for an obstetrical emergency, and assessing vital signs to ensure postpartum stabilization.
  • Circulate in the operating room for cesarean section, providing assistance to the surgical team and providing reassurance to the patient.
  • Provide care for postoperative cesarean section patients.
  • Deliver initial stabilization of the newborn, administer newborn medications, assist with newborn procedures, and monitor early newborn vital signs.
  • Provide immediate postpartum care by monitoring fundal height, bleeding, and vital signs.
  • Record newborn feeding schedule.  Assist with breastfeeding, if possible, or refer to a lactation consultant.

Job Outlook and Salary

The average salary for a Labor and Delivery Registered Nurse is $65,470 annually.  Salaries for labor and delivery nurses will vary related to your job description, your nursing experience, and your geographical location.  As predicted by the US Bureau of Labor Statistics, the career outlook for Registered Nurses is an increase of 19% in the next 10 years.

Resources

National Certification Corporation Inpatient Obstetrics Exam https://www.nccwebsite.org/Certification/Exam-detail.aspx?eid=1

Association of Women’s Health, Obstetrics, and Neonatal Nurses http://www.awhonn.org