How to become A Labor and Delivery Nurse

Labour and Delivery Nurses strive to make the period before, during and after the exciting yet challenging birthing process one of unmitigated joy and care for the mother and her baby/babies.

• L & D Nurse
• Obstetrics Nurse
• OB Nurse
• Antepartum/Before Birth Nurse

What do Labour And Delivery Nurses do?

A Labour And Delivery Nurse would typically need to:

• Assist and care for mothers during labour and birth; assist the attending physician or nurse-midwife in providing the infant’s initial postpartum care
• Monitor mother and foetus during the antepartum (40-week period from conception to labour)
• Take vitals, perform ultrasounds and antepartum foetal assessments, time contractions, and provide customised support to expectant mothers
• Help keep the mother as comfortable as possible and find ways to manage their pain; monitor the mother and foetus for signs of impending delivery
• Assess for preterm labour, active labour, rupture of amniotic fluids, and pregnancy/co-existing issues; update members of the multidisciplinary health team
• Coach the mother through the birthing process and assist the doctors in the safe delivery of the baby/babies during the intrapartum (period of active labour, delivery of the child, and delivery of the placenta)
• Offer induction and epidural assistance, pain management, pushing, and delivering; start IV lines
• Be prepared for the occasional medical emergency and so provide optimal care to both mother and child/children
• Be ready to help with any kind of delivery - vaginal, breech, or caesarean; deal with complications and address emergencies
• Take care of the unique needs of each mother and child during postpartum care which revolves around careful observation and communication
• Clean, weigh, measure, vaccinate, and monitor the infant; listen to, support and assist the mother in handling the jarring transition as smoothly as possible
• Explain the mental and physical changes that coincide with childbirth and validate the trauma that both mind and body have gone through
• Teach both parents and caretakers primary infant care, such as swaddling, feeding, changing, and bathing
• Offer or source essential support, such as lactation consultants and mental health providers
• Provide low-risk care, assisted ventilation, preterm birth and post-op care, or critical care for infants with a high risk of mortality, if specialising in the neonatal or direct care of a newborn

Labour and Delivery Nurses may work in the maternity ward, outpatient clinic, operating theatre list or specialist clinic in a healthcare setting. They work closely with an interdisciplinary team, including an anesthesiologist, physician or midwife, lactation nurse, neonatal nurse practitioner, and the expectant mother’s family.

Labour and Delivery Nurses typically work 8- to 12-hour shifts in a role that calls for 24/7 readiness to attend to emergencies and bond with the expectant mother.

Labour and Delivery Nurses may choose to be part of a group practice. They may opt to be employed by healthcare facilities or work with them on an independent contractor basis. They may also choose temporary locum tenens positions offered by practices, hospitals, or healthcare organisations with an unfilled clinical need.

Labour and Delivery Nurses are generally employed by: 

• Private and Public Hospitals
• Private Obstetric & Gynaecology Practices
• Private Birthing Centers
• Private Midwife Practices
• Family Planning Center
• Urgent Care Clinics
• Community Healthcare Clinics
• The Armed Forces

Healthcare associations, such as The International Childbirth Education Association, provide unparalleled networking and educational opportunities. They offer all the certification courses members will need throughout their professional careers. 

Affiliated Labour and Delivery Nurses may attend conventions, seminars, and dinners frequented by peers, mentors, and other industry leaders. The events help them keep up with the newest breakthroughs and latest developments in the field, including plum jobs. 

• Stress and emotional burnout from the occasional tragedy

• Physical exhaustion, foot problems and back issues due to the long and erratic hours of standing and running around

• Constant and patient adaptation to the expectant mother’s changing needs

• Need to make informed decisions under pressure from unforeseen pregnancy-related health risks

• Foetal monitoring

• Exposure to infectious viruses
  

To show their commitment to the long qualifying period, every applicant to a nursing program needs work experience in their local hospital, doctor's surgery, nursing home, or mental health trust. It will help them understand some of the physical and emotional demands of a career in medicine.

Some teaching hospitals also offer work experience in their Obstetrics department, specifically for secondary school students interested in a Labour and Delivery Nurse career. It can be a helpful way to gain insight.

RNs who wish to become Labour and Delivery Nurses would need to work in obstetrics for two years and put in at least 2,000 hours of direct patient care, administration, research, or education) during that duration. The exact period may vary by location, between 2,000 and 2,400 hours.

Some employers would lean towards applicants who completed additional education or an internship in obstetrics. Such practicum experiences will help you gain optimal benefit from your tasks outside of the classroom when they line up perfectly with your lessons inside it. 

You may get to hear countless stories from more experienced professionals and obtain valuable hands-on experience when they manage to turn seemingly routine incidents into unique learning moments.

Read about the profession, perform community service, undertake relevant research work and interview/job shadow experts working in labour and delivery to prove your commitment to course providers and prospective employers. It helps document any such experiences on letters of recommendation to be submitted with nursing school applications.

The first step towards qualifying as a Labour and Delivery Nurse is to acquire an accredited ADN (Associate Degree in Nursing) or a BSN (Bachelor of Science in Nursing), specialising in obstetrics and women’s health. The latter will prove advantageous in getting a lucrative job with enhanced career prospects and applying for higher education.

Take college preparatory courses in health sciences, physical education, and psychology during high school. English and speech classes will help you develop your research, writing, and oral communication skills.

After completing an ADN or BSN degree, all nursing students must pass a national licensure examination and be registered with their state nursing council before they can begin to practice their profession. Typically, licensure requires an application, processing fees, an examination, and relevant education and experience.

RNs with experience as staff nurses and clinical expertise in a specific area of female health can become fully certified obstetrics nurses (RNCs-OB) after passing the Inpatient Obstetric Nursing certification. 

Certification in obstetrics, gynaecology, perinatal nursing, and labour and delivery nursing will help career progression. While BLS (Basic Life Support) and ACLS (Advanced Cardiac Life Support) certifications are mandatory, most employers prefer applicants with certification in Electronic Foetal Monitoring (C-EFM) and Neonatal Resuscitation Programme.

A combination of education, experience, and testing is generally required to gain certification, though requirements differ from region to region. Successful certification programs protect public welfare by incorporating a Code of Ethics.

A promising labour and Delivery Nurse may also need to undergo an employment background check which can include but is not limited to a person’s work history, education, credit history, motor vehicle reports (MVRs), criminal record, medical history, use of social media, and drug screening.

Performance, experience, and the acquisition of professional qualifications drive career progression. Labour and Delivery Nurses can become Nurse Practitioners who specialise in fertility care or high-risk obstetrics. Another option is to become a Certified Nurse-Midwife (CNM) or Certified Midwife.

You can also conduct research in the areas mentioned earlier or teach the next generation of medical students and postgraduate students-in-training.

RNCs-OB with additional certifications in specific areas of feminine and newborn health have the best job prospects.

Continuing professional development (CPD) is essential in the healthcare sector for public wellbeing and career progression. It embraces several new learning objectives, educational methodologies, and novel technological developments, especially in education, management, and IT. CPD also enablers the regular renewal of desirable licences and certifications.

Most Labour and Delivery Nurses receive extensive on-the-job training after their recruitment and will have a mentor to guide and support them. Those who wish to qualify as CNMs must obtain the required board certification.

Reflective learning, interaction with peer groups, comprehensive inclusion, workshops, and professional publications educate, influence, support, and foster lifelong enlightenment in all career-grade Labour and Delivery Nurses.

If you wish to focus on research, you can expect support and additional training from the academic institution or from Vitae, a non-profit global leader with over 50 years of experience in enhancing the skills of researchers. 

In partnership with governments, funders of research, professional bodies, trusts & foundations, universities, and research institutes, Vitae offers training, resources, events, consultancy, and membership.

What It Takes To Be A Competent Labour and Delivery Nurse

Besides the rigorous academic qualifications, certifications and internships a prospective Labour and Delivery Nurse needs are the skills they must either have or acquire. 

Of critical importance are practical communication skills, detailed patient assessment, prioritisation of duties, critical thinking and problem solving, and a reassuring bedside manner.

Potential Pros & Cons of Freelancing vs Full-Time Employment

Freelancing Labour and Delivery Nurses have more flexible work schedules and locations. They have full ownership of the business and can select their projects and clients. However, they experience inconsistent work and cash flow, which means more responsibility, effort and risk.

On the other hand, a full-time Labour and Delivery Nurse has company-sponsored health benefits, insurance, and retirement plans. They have job security with a fixed, reliable source of income and guidance from their bosses. Yet, they may experience boredom due to a lack of flexibility, ownership, and variety.

When deciding between freelancing or being a full-time employee, consider the pros and cons to see what works best for you.

Locum Tenens 

It is an alternative to more permanent employment. Locum tenens positions are temporary (up to a year) offered by practices, hospitals, and healthcare organisations with an unfilled clinical need. The compensation rate is generally higher than what the permanent position would suggest. Locum tenens allows Labour and Delivery Nurses to gauge a specific type of practice or location without committing to long-term employment.

Most babies are born on a Tuesday; May babies are the heaviest.

Although it will not be full of fun and rainbows, a career as a Labour and Delivery Nurse will leave you even at the end of a gruelling day with quite a few sweet memories of the family expecting or welcoming a new member.

“You get a picture taken with you giving the baby’s first bath. You know that’s going into a baby book, and that kid will see your face when he’s older. Those are those cool moments when you realise ‘this is why I do this.’”

By Danielle Logano