How to become a labor and delivery nurse

1. 1Complete an ADN or BSN nursing program

   Time: 2-4 yearsCost: $4,716-$9,456 a year at public collegesSources 1, 3

   Choose a state-approved, accredited nursing program. Both associate and bachelor's graduates can sit for the NCLEX, but many hospitals with labor units prefer or require a BSN. Courses cover anatomy, pharmacology and adult health, and every program includes a maternal-newborn (obstetric) clinical rotation. Ask for an L&D placement for your final practicum, since it is often how students get hired onto the unit.

2. 2Pass the NCLEX-RN and get licensed

   Time: A few weeks to a few monthsCost: $200 NCLEX registration (rising to $350 on Feb. 1, 2027)Sources 4, 6, 7

   After graduation, apply to your state board of nursing for licensure and register for the NCLEX-RN with Pearson VUE. The exam is computer adaptive and tests clinical judgment. States add their own requirements such as fingerprinting and background checks. If you live in one of the 43 Nurse Licensure Compact jurisdictions, you may qualify for a multistate license that is useful for L&D travel work.

3. 3Get hired onto a labor unit

   Time: At graduation or after 1-2 years elsewhereSources 1

   Apply to new graduate nurse residency programs that include labor and delivery, or start on a postpartum, mother-baby, nursery or medical-surgical unit and transfer when an L&D opening comes up. Hospitals train new L&D nurses through a precepted orientation of several months, covering fetal monitoring, labor support, obstetric emergencies and operating room circulating for cesarean births.

4. 4Complete NRP and other required courses

   Time: A few hours to a day eachCost: Varies by providerSources 8, 1

   Hospitals usually require Basic Life Support and the American Academy of Pediatrics Neonatal Resuscitation Program. NRP has an online part followed by an in-person, instructor-led event within 90 days, and learners choose the Essentials or Advanced curriculum; hospitals set which one their L&D nurses need. Many units also require fetal monitoring education and, in some hospitals, ACLS.

5. 5Earn specialty certification

   Time: After 2 years in L&DCost: $325 RNC-OB; $210 C-EFMSources 5, 9

   The RNC-OB credential from the National Certification Corporation requires an active RN license, 24 months and at least 2,000 hours of specialty experience, and work in the field within the last 24 months. The exam is a 3-hour, 175-question computer test. C-EFM, which focuses on fetal monitoring, is a 2-hour, 125-question exam with no experience minimum. Some hospitals pay exam fees or reward certification.

Programs, tuition and graduates’ earnings

U.S. Department of Education, College Scorecard (most recent cohorts, released 2026-10-15). Scorecard groups programs by 4-digit field, so a row can include related programs. Tuition is the median published undergraduate tuition and fees of the colleges offering the program (shown only for undergraduate credentials); debt is the median of programs’ median federal loan debt at completion; earnings are the national median for the field and credential four years after completion.

Requirements differ by state. Check your state’s rules in the CareerOneStop License Finder (U.S. Department of Labor) before you enroll.

Fetal monitor interpretation

Reading heart rate patterns correctly is how an L&D nurse catches a baby in distress early enough to act.

Quick response in emergencies

Hemorrhage, cord prolapse and shoulder dystocia need the nurse to call for help and start interventions within seconds.

Calm, supportive communication

Patients in labor are in pain and often frightened, and clear coaching helps them through pushing and unexpected changes in plan.

Newborn assessment

The nurse is often the first to judge a newborn's breathing and color and to start resuscitation if needed.

Stamina

Twelve-hour shifts on your feet, holding legs during pushing and moving patients add up physically.

O*NET 31.0 rates these skills as most important for the occupation: active listening, speaking, critical thinking, reading comprehension, writing.

Training cost

$9.6K–$38.3K

Before financial aid

Time

3-5 years

Typical path

Median pay

$97,550

All US jobs: $50,980

Payback once qualified

Under 1 year

Pay above the all-jobs median vs. cost

Low: 2 years of an associate degree at the College Scorecard median public in-state tuition for nursing, $4,716 a year, plus the $200 NCLEX registration fee = $9,632. High: 4 years of a bachelor's degree at the median public in-state tuition of $9,456 a year, plus $200 for the NCLEX and $325 for the RNC-OB exam = $38,349. The NCLEX fee rises to $350 for registrations on or after February 1, 2027. Not included: prerequisites, books, uniforms, state license fees, background checks, NRP course fees and living costs.

Rough guide only: ignores taxes, aid, interest and earnings given up during training. How we calculate it.

• Certified nurse-midwife$134,040 median

  Requires a graduate nurse-midwifery degree and passing a national midwifery certification exam; L&D experience is a strong foundation.

• Nurse practitioner (women's health)$132,300 median

  A master's or doctoral NP program in women's health or family practice, followed by national NP certification.

• NICU nurse$97,550 median

  L&D nurses with strong newborn skills can transfer to the neonatal intensive care unit with additional orientation.

• Travel nurse$97,550 median

  Experienced L&D nurses, often with one to two years on the unit, take short-term contracts at hospitals in other cities.

• Charge nurse or unit manager

  Senior L&D nurses lead shifts and later manage the unit; manager roles usually require a BSN and often a master's.