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Labor and Delivery Nurse Salary By State – (2023 Figures)
Written By: Pattie Trumble, MPP, MPH
Labor and delivery nurses provide mothers with support throughout the birth process, and mothers and newborn infants with care throughout the immediate postpartum period. Despite the specialized skills L&D RNs must learn, labor and delivery nurse salary is essentially the same as the salaries of other registered nurses, though this can vary according to an individual L&D nurse’s experience, practice setting, certifications, and geographic location.
How much does a labor and delivery nurse make? This article will provide you with a comprehensive look at labor and delivery nurse salary in 2023.
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Is There A High Demand For Labor and Delivery Nurses?
The demand for labor and delivery nurses will depend partly upon the fertility rate in any given geographical locale and partly upon that geographical locale’s existing population. (“Fertility rate” is the ratio of live births per number of women of childbearing age in a given geographical locale
Childbirth is the leading reason for hospital admissions across the U.S.
, functioning as a loss leader that doesn’t bring revenue on its own but may lead to profits if a laboring mother and her family continues to seek medical attention at the hospital where she delivered. But the birthrate in the U.S. has been declining steadily for several years. (“Birthrate” is the ratio of live births per 1,000 members of a population in any given place in a given year
.) In 2018, 3,788,235 babies were born in the U.S.—a decline of 2 percent from 2017
. Preliminary data from the period following the beginning of the COVID-19 pandemic suggests that the U.S. birthrate is continuing to decrease and what’s more, it is decreasing more rapidly
. The demand for L&D services is decreasing. Furthermore, labor and delivery units in many smaller hospitals are closing because hospitals are losing money on them.
Fertility rates vary considerably from state to state. In 2020, the state with the highest fertility rate was South Dakota: 73.6
. In contrast, California’s fertility rate was 56.2. However, California’s population is much higher than South Dakota’s. In 2020, California registered 469,884 live births while South Dakota registered 12,522 live births. Obviously, the demand for labor and delivery nurses will be higher in California than it will be in South Dakota.
Where Do Labor and Delivery Nurses Work?
The vast majority of labor and delivery nurses work in hospitals or in stand-alone birthing centers
. Many hospitals have specialized units specifically dedicated to the needs of pregnant and laboring women. Within a labor and delivery unit, an L&D nurse may work with laboring mothers, with postpartum mother/infant couplets, or in a surgical operating room, assisting with Caesarian sections, tubal ligations, and emergency obstetric and gynecological procedures. L&D nurses may also work in special triage rooms assessing what stage of labor a laboring mother is in so that she can either be admitted to the hospital or sent home.
When working with mothers, L&D nurses typically monitor contractions, administer medications, monitor the laboring mother’s vital signs, and check upon the unborn infant’s heartbeat by means of a specialized fetal monitor. Labor and delivery nurses also act as labor coaches once a woman is in active labor.
Some L&D nurses help out in home births, acting as midwife assistants or doulas.
What Is The Typical Work Schedule For Labor and Delivery Nurses?
For the most part, babies set their own schedules when it comes to being born, and hospitals must accommodate this fact when it comes to staffing. Hospitals are open 24 hours a day and are typically divided either into two 12-hour shifts or three 8-hour shifts. Twelve-hour shifts are scheduled from 7 a.m. to 7 p.m. and from 7 p.m. to 7 a.m., while 8-hour shifts are scheduled from 7:00 a.m. to 3:30 p.m., 3:00 p.m. to 11:30 p.m., and 11:00 p.m. to 7:30 a.m.
Most labor and delivery nurses are hourly rather than salaried employees, and that means The Fair Labor Standards Act (FLSA)
applies to the average labor and delivery nurse salary. Labor and delivery nurses working more than 40 hours a week must be paid overtime wages. Shift differentials are not mandated by law, but most medical centers and hospitals pay them because otherwise, it would be extremely difficult to find nurses willing to work outside the standard 9-to-5 workday.
How Satisfied Are Labor and Delivery Nurses With Their Jobs?
On the whole, labor and delivery nurses are extremely satisfied with their jobs. Among the aspects of the job they enjoy the most are the ability to witness firsthand the miracle of childbirth, the potential for career growth, and labor and delivery nurse salaries.
Labor and delivery units, however, can often be staffed inadequately since it’s never possible to predict how many laboring mothers will be admitted as patients at any given time with a degree of confidence. Poor staffing ratios are a major cause of burnout among L&D nurses
What Is The Salary Per Hour Of A Labor and Delivery Nurse?
What is the labor and delivery nurse salary per hour in 2023? The average labor and delivery nurse salary per hour in 2023 is $32.29. This figure includes shift differentials. L&D nurses typically reach this milestone sometime during the fifth year of working in this field.
Hourly wages are typically determined by aggregate demand in any given locale as well as by industry and market pay rates for other individuals engaged in a similar line of work within that locale. As noted above, the market pay rate for labor and delivery nurses is more or less the same as that of other nurses. The fertility rate, which can be viewed as a rough indicator of demand, doesn’t seem to have as much influence upon the hourly salary of a labor and delivery nurse as market pay rates.
Alabama, for example, has a comparatively high fertility rate: 60.9, and in 2019, some 58,615 babies were born in the Yellowhammer State
. Yet, the lowest-paid labor and delivery nurses in the U.S. are the L&D RNs who work in Alabama where their salaries average just $50,560 a year. This is because Alabama RNs also make one of the lowest salaries in the U.S., and L&D nurse salaries are commensurate with other RN salaries.
|Hourly Labor & Delivery Nurse Salary |
|Level of Experience||Hourly Earnings|
|1-4 Years of Experience||$24.88|
|5-9 Years of Experience||$30.40|
|10-19 Years of Experience||$37.77|
|20 Years or More Experience||$46.91|
|Average Hourly Earnings||$32.29|
What Is The Starting Salary Of A Labor and Delivery Nurse?
What is the starting salary of a labor and delivery nurse in 2023? The starting salary of a labor and delivery nurse in 2023 is $44,840 a year, which breaks down to $21.56 an hour, $897 a week, $3,740 a month, or $44,840 a year. Entry-level L&D nurses make 33 percent less than the average labor and delivery nurse salary.
Why does this salary discrepancy exist? Because most nurses don’t graduate from an undergraduate nursing degree program with the specialized skills necessary to be a successful L&D nurse. Most nursing schools only devote one semester to labor and delivery, so much of the hands-on skill set is something labor and delivery nurses are either taught on the job or learn by furthering their clinical training through continuing education.
While they are orienting to the unit, L&D nurses can’t take on a full patient load, and neither can the nurse who’s mentoring them. Nurses and their preceptors work with the same patient, essentially cutting down a unit’s available staff by one position. The unit’s operational costs rise accordingly. The reason why entry-level labor & delivery nurses make less than nurses who have been on the job for a year is because the medical center that hired those entry-level RNs is trying to recoup some of its excess operational costs by cutting back on salaries.
|Starting Labor &|
Delivery Nurse Salary
What Is The Average Salary Of A Labor and Delivery Nurse?
What is the average labor and delivery nurse salary in 2023? The average labor and delivery nurse salary in 2023 is $32.29 an hour, which multiplies out to $1,292 a week, $5,600 a month, or $67,170 a year. This is only 16 percent higher than the average salary for all occupations across the U.S.
Average salaries reflect the cost of living indices to a large degree: If a locale with a higher than average cost of living doesn’t pay its service providers more, then service providers won’t be able to afford to live there, and local residents’ need for services will remain unmet.
The highest-paid labor and delivery nurses work in California where they make 50 percent more than the average salary of a labor and delivery nurse nationwide. But the cost of living in California is 50 percent more than it is in the U.S. as a whole
. In a very real sense, then, California L&D RNs’ higher salaries don’t represent any real increase in purchasing power; they merely make it possible for L&D RNs to continue living in the Golden State.
In contrast, as noted above, the lowest-paid labor and delivery nurses are employed in Alabama where they earn 25 percent less than the average labor and delivery nurse salary nationwide. But the cost of living in the Yellowhammer State is 18 percent less than it is in the rest of the U.S.
and 68 percent less than it is in California. In some ways, even with a lower average salary, Alabama labor and delivery nurses are coming out ahead.
|Average Labor &|
Delivery Nurse Salary
Labor and Delivery Nurse Salary By Years Of Experience
Employers value seasoned labor and delivery nurses. One to four years into their careers, labor and delivery nurses can expect to make 15 percent more than the labor and delivery nurse salary they made as entry-level nurses. When they’ve accumulated five to nine years of experience, L&D RNs can expect to earn 22 percent more than their colleagues with one to four years of experience. Labor and delivery RNs who’ve been on the job for two or more decades make 24 percent more than L&D nurses with 10 to 19 years of experience and more than twice the labor and delivery nurse salary they made as an entry-level L&D RN.
There may be another reason why more experienced RNs make higher labor and delivery nurse salaries too: Several studies have found that older and more experienced nurses have better labor support skills
. Since labor support can lessen the need for medical interventions during childbirth, it’s highly valued.
|Level of Experience||Hourly||Weekly||Monthly||Annual|
|1-4 Years of Experience||$24.88||$995||$4,310||$51,740|
|5-9 Years of Experience||$30.40||$1,216||$5,270||$63,240|
|10-19 Years of Experience||$37.77||$1,511||$6,550||$78,570|
|20 Years or More Experience||$46.91||$1,877||$8,130||$97,580|
Average Annual Compensation (Salary + Benefits) For Labor and Delivery Nurses
Salary isn’t the only compensation a labor and delivery nurse receives. Labor and delivery nurses also receive benefits, which are a form of non-cash compensation. Some benefits, like workers’ compensation, COBRA health coverage and unemployment insurance, are mandated by law; others are offered as incentives at an employer’s own discretion to attract and retain a loyal, productive workforce. Labor and delivery nurses who work in medical centers can typically look forward to benefits that include paid sick days and vacation days; medical insurance; and contributions on their behalf to a 401(k) retirement account. Some labor and delivery nurses even get professional liability insurance, and paid time off, and reimbursement for professional development activities.
The cash value of compensation perks can really add up. For labor and delivery nurses employed in the private sector, the total cash value of benefits can be 44 percent of their average labor and delivery nurse salary, bringing their total compensation package to $95,121 annually. For labor and delivery nurses employed by state and local governments, the total cash value of benefits can be 62 percent of their average labor and delivery nurse salary, bringing their total compensation package to $110,905 annually.
|Component||Private Industry||State and|
|Paid Leave||$7,039 ||$8,429 |
|Supplemental Pay||$3,329 ||$1,109 |
|Insurance||$7,419 ||$12,976 |
|Retirement and Savings||$3,234 ||$13,752 |
|Legally Required||$7,229 ||$6,100 |
|Total Benefits||$28,251 ||$42,255 |
|Average Annual Salary||$66,870 ||$68,650 |
|Total Compensation||$95,121 ||$110,905 |
7 Ways You Can Increase Your Salary As A Labor and Delivery Nurse
There are many ways a labor and delivery nurse can increase his or her salary. Here are seven:
1. Volunteer for extra shifts:
It’s difficult to predict with a fair degree of accuracy how many labor and delivery nurses will be needed on any given shift. But when they need you, they really need you. If your time is flexible, consider coming to work on your days off when staffing is short.
2. Take on extra labor and delivery assignments through a nurse registry:
Nurse registries provide per diem
employees to hospitals.
3. Work an evening or night shift:
Shift differentials are not required by law, but most hospitals offer them as a way of staffing shifts that might otherwise be difficult to fill. The average night shift differential is between $1 and $5 an hour.
4. Train as an L&D charge nurse:
An L&D charge nurse coordinates activities that take place on the labor and delivery unit during a hospital shift. He or she makes patient assignments, loans an extra pair of hands when another L&D nurse needs assistance, and facilitates communication between staff members and physicians or administrators. While in some hospitals, “charge nurse” is a permanent salaried position, in many hospitals, it’s a rotating position.
5. Pursue certification:
Three certifications are available to labor and delivery nurses:
◦ NCC Credential in Inpatient Obstetric Nursing: This credential can be earned by passing a written test after you’ve worked in labor and delivery for at least two years.
◦ Electronic Fetal Monitoring Certification: The test for this credential involves live remote proctoring that allows testers to evaluate your hands-on competency.
◦ Neonatal Resuscitation Program Certification: This is one of several advanced cardiac life support (ACLS) certifications based on guidelines recommended by the American Heart Association.
6. Become a traveling L&D nurse:
Traveling nurses are deployed by hospitals that can’t employ enough nurses to fulfill their staffing needs. Typically, traveling L&D nurses make higher salaries than staff labor and delivery nurses, but they receive no benefits.
7. Complete your graduate degree and become a midwife:
Additional education will allow you to become a certified nurse-midwife. Nurse-midwives are advanced practice nurses. The average salary for a certified nurse-midwife in the U.S. is $99,295 a year
What Is The Future Outlook For Labor and Delivery Nurse Salary?
Even accounting for variability in the fertility rate, Americans are not about to stop having babies any time in the near future. The demand for labor and delivery nurses will continue to be strong even if there are fluctuations in that demand around the margins.
As we have seen, labor and delivery nurse salary tracks pretty closely with the average salaries of registered nurses overall. In the five years preceding the COVID-19 pandemic, nurse salaries climbed significantly. Between 2019 and 2020 alone, the salaries of registered nurses climbed by 3.3 percent
. In Arkansas, a state where L&D RNs and other nurses traditionally have averaged their lowest salaries, nursing salaries rose 3.8 percent between 2019 and 2020. There’s every reason to believe that labor and delivery nurse salary will continue to move upwards in the coming years.
LABOR AND DELIVERY NURSE SALARY COMPARISON
Labor and Delivery Nurse Salary VS. All Other Occupations
The average salaries earned by labor and delivery nurses is 16 percent higher than the average salary earned by all occupations throughout the U.S. In part, this reflects the high demand for labor and delivery nursing services, but in part, it also reflects the numerous opportunities L&D nurses have to augment their base salaries through overtime, shift differentials, and the like.
Labor and Delivery Nurse Salary VS. Similar Nursing Jobs
Labor and delivery nurses are frontline healthcare providers during childbirth. L&D RNs work hard to ensure that childbirth is as free from unwelcome medical complications as possible. In that sense, one might say that their expertise is in the field of wellness support and prevention, which makes them primary healthcare providers.
Nurses who work with patients in life-threatening situations typically earn higher salaries than nurses who focus on primary care. While it’s true that childbirth carries some risk of mortality, that risk is very low. In 2019, the maternal mortality rate was just 20.1 deaths per every 100,000 live births
. Thus, labor and delivery nurses earn 32 percent less than cardiac nurses, 12 percent less than oncology nurses and 5 percent less than intensive care unit nurses, three nursing specialties whose primary focus is upon saving lives.
|5||Occupational Health Nurse||$73,961||-$6,791||-10.11%|
|8||ER Nurse||$70,858 ||-$3,688||-5.49%|
|12||Labor and Delivery Nurse||$67,170||$0||0.00%|
|18||Public Health Nurse||$59,882||+$7,288||+10.85%|
Labor and Delivery Nurse Salary VS. Other Healthcare Jobs
Even highly experienced labor and delivery nurses work under the supervision of a physician, a physician’s assistant, a certified nurse-midwife, or a nurse practitioner. Labor and delivery RNs are not advanced practitioners; they don’t have the training to make decisions pertaining to patient treatment. They cannot initiate treatment protocols without specific permission although they can initiate nursing interventions. So, it’s not surprising that they earn significantly lower salaries than healthcare providers whose education and legally mandated scope of practice allow them to make patient care decisions.
The salaries earned by L&D nurses on average are 140 percent lower than the salaries earned by certified registered nurse anesthetists, 48 percent lower than the salaries earned by nurse practitioners, and 47 percent less than the salaries earned by physician assistants. But labor and delivery RNs make significantly higher salaries than healthcare workers whose scope of practice focuses upon rehabilitation rather than treatment. L&D RNs earn 8 percent more than dental hygienists, 14 percent more than respiratory therapists, and 22 percent more than dieticians.
|7||Labor and Delivery Nurse||$67,170||$0||0.00%|
|14||Dietitian and Nutritionist||$52,148||+$15,022||+22.36%|
|15||Physical Therapist Assistant||$51,108||+$16,062||+23.91%|
Technician and Paramedic
|20||Certified Nursing Assistant||$29,743||+$37,427||+55.72%|
AVERAGE LABOR AND DELIVERY NURSE SALARY IN YOUR STATE
Labor and delivery nurses in Alabama earn lower salaries than labor and delivery nurses working anywhere else in the U.S. On average, the salary for labor and delivery nurses in Alabama is $24.31 an hour, $4,210 a month, or $50,560. Alabama has a fertility rate of 60.9, and in 2019, 58,615 births were registered in the Yellowhammer State
. Alabama mothers die from pregnancy and childbirth complications more than twice as often as pregnant mothers do in other states
In Alaska, L&D nurses average $38.45 an hour, $6,670 a month, and $79,980 a year. Alaska’s fertility rate is 69.3, and in 2019, 9,822 babies were born in the Last Frontier State
. Many hospitals in rural parts of Alaska have closed obstetric units in an effort to lower operational costs
, and this has led to the creation of maternity healthcare deserts in certain parts of the state.
3. Arizona: In 2019, 79,375 infants were born in Arizona
, and the state had a fertility rate of 58.6. The salary of a labor and delivery nurse in Arizona is $32.44 an hour, $5,620 a month or $67,480 a year, but in Phoenix, the average salary is 1 percent higher while in Tucson, it’s 5 percent lower. The number of obstetrics beds in rural parts of the Grand Canyon State has been declining
as hospitals seek to decrease operational costs.
Labor and delivery nurses in Arkansas average $25.69 an hour, $4,450 a month or $53,430 a year, which is the fifth-lowest rate of pay for L&D nurses in the U.S. In 2019, 36,564 infants were born in Arkansas, and the fertility rate was 64. More than 22 percent of Arkansas births were to parents living in maternity deserts. The state’s innovative Antenatal and Neonatal Guidelines, Education and Learning System (ANGELS) program
provides training for physicians and L&D nurses who are dealing with high-risk pregnancies.
The highest-paid labor and delivery nurses in the U.S. are employed in California. The average labor and delivery nurse salary in California is $48.66 an hour, $8,430 a month, or $101,210 a year. The 10 metropolitan areas in the U.S. where L&D RNs earn their highest wages are all in the Golden State. In San Francisco Bay Area cities like Oakland and San Francisco, labor and delivery nurses average 24 percent more than the state average salary and 86 percent more than the average salary nationwide.
The average salary of a labor and delivery nurse in Colorado is $65,370 a year, which comes out to $31.43 an hour or $5,450 a month. L&D nurses in Denver and Colorado make fractionally more than this, but L&D nurses in Colorado Springs make 2 percent less. The Centennial State’s fertility rate is 54.1, and in 2019, 62,869 babies were born there
. Twenty-four counties in Colorado are without hospitals or birthing centers offering any type of obstetric care
and have been have been classified as maternity healthcare deserts.
7. Connecticut: Connecticut registered 34,258 births in 2019
with a fertility rate of 51.8. March of Dimes has identified nine areas across the state, including parts of urban areas like New Haven and New London, as maternity healthcare deserts
where mothers-to-be may face problems getting access to the obstetric services they’ll need for safe deliveries. Labor and delivery nurses in the Granite State average annual salaries of $71,230, which breaks down to $34.25 an hour or $5,940 a month.
8. Delaware: Delaware is one of only six states where certified midwives (CMs) can practice
. Certified midwives are childbirth practitioners who have graduated from an accredited midwifery education program and who have passed the American Midwifery Certification Board exam but who are not nurses. In Delaware, L&D nurses earn $30 an hour, $5,200 a month, or $62,400 a year on average. In 2019, the total number of births in the First State was 10,562
, and the state’s fertility rate was 59.1.
The average labor and delivery nurse salary in Florida is $28.06 an hour, which multiplies out to $4,860 a month or $58,360 a year. In St. Petersburg and Tampa, L&D nurses make 3 percent more than this, and in Miami, they make 4 percent more. But in Orlando and Jacksonville, they make 3 percent less. There were 220,002 births in the Sunshine State in 2019
, and the state’s fertility rate was 57.2.
10. Georgia: Some 126,371 babies were born in Georgia during 2019
. The state’s fertility rate was 58.3. The average labor and delivery nurse salary in Georgia is $28.86 an hour, $5,000 a month, or $60,030 a year, but in Atlanta, salaries are 6 percent higher. Seventy-nine of the Peach State’s 159 counties are without a single obstetric provider, and pregnant women in Georgia are at greater risk of dying during delivery or in the week thereafter than they are anywhere else in the U.S.
The second-highest-paid labor and delivery nurses work in Hawaii where they earn $42.31 an hour, $7,330 a month, or $88,010 a year. Honolulu-based L&D RNs make 2 percent more than that. In 2019, 16,797 babies were born in the Aloha State
, and the state’s fertility rate was 64.2. The average cost for an uncomplicated vaginal delivery in Hawaii is approximately 30 percent less than it is on the mainland
although analysts aren’t sure why this discrepancy exists.
Approximately 10 percent of the 22,063 births that took place in Idaho in 2019
were to parents who lived in maternity healthcare deserts. Idaho is one of the few states where Medicaid and many commercial healthcare insurance providers won’t cover the cost of childbirth. The Gem State’s fertility rate is 63.4. Idaho-based L&D RNs average $28.91 an hour, $5,010 a month or $60,140 annually, but labor and delivery nurses in the Boise area earn salaries that are 3 percent higher than the state average.
The average labor and delivery nurse salary in Illinois is $30.09 an hour, $5,220 or $62,590 a year, but labor and delivery nurses working in the Greater Chicago Metropolitan Area make 5 percent more. In 2019, Illinois hospitals and birthing centers had 2,510 available obstetric beds
. The state’s fertility rate is 57.5, and in 2019, Illinois registered 140,128 births
. The March of Dimes estimates that slightly more than 5 percent of these births were to parents who live in maternity healthcare deserts
14. Indiana: Some 80,859 infants were born in Indiana during 2019
, but 33 counties throughout the state lack hospitals with a maternity wing
. The average salary of a labor and delivery nurse in Indiana is $27.24 an hour, $4,720 a month or $56,660 a year, but L&D nurses based in Fort Wayne earn 7 percent less while L&D nurses based in Indianapolis earn 5 percent more. Indiana’s fertility rate is 62.8.
15. Iowa: More than 30 hospital birth units throughout Iowa have shut down in the past two decades
, as hospitals make considerably higher revenues catering to the medical needs of Iowa’s rapidly aging population. Fifteen percent of the 37,649 births that took place in the state in 2019
were to parents living in a maternity healthcare desert. The state’s fertility rate is 63.5. On average, Iowa’s labor and delivery nurses make $52,530 annually, which breaks down to $25.25 an hour or $4,380 a month.
Kansas-based labor and delivery nurses earn $25.91 an hour, $4,490 a month, or $53,900 annually on average. Births in Kansas numbered 35,395 in 2019, and the state’s fertility rate was 64.7. Births have been declining steadily in the Sunflower State since 2007, and the 2019 birthrate figure represented the biggest percentage drop
since the state created its centralized record-keeping system in 2011. Insurance companies in Kansas don’t offer malpractice insurance to midwife practices
, so there are very few non-hospital birthing centers in the state.
The salary for labor and delivery nurses in Kentucky averages $26.13 an hour, $4,530 a month, or $54,340 a year. In Lexington, average L&D RN salaries are 1 percent less while in Louisville, they’re 3 percent more. Some 53,069 babies were born in Kentucky in 2019
, and the state’s fertility rate is 63.5. The Bluegrass State has experienced a precipitous decline in the number of rural hospitals offering maternity services, but in 2019, Kansas lifted its collaborative agreement rule for certified nurse-midwives, which means CNMs can now provide services to medically underserved communities without the need for physician oversight.
The salary for labor and delivery nurses in Louisiana is $27.45 an hour, $4,760 a month or $57,100 a year, but L&D nurses working in New Orleans earn salaries that are 4 percent higher than the state average. In 1999, the Bayou State implemented an innovative nurse-family partnership program
in 90 percent of its parishes whereby pregnant people receive support services from specially trained nurses until their child’s second birthday. Louisiana’s fertility rate is 64.3. In 2019, 58,941 babies were born in Louisiana
Maine is another state where birth rates have been declining since 2007
. In 2019, 11,779 babies were born in the Pine Tree State
, and the state’s fertility rate was 53.2. Labor and delivery nurses in Maine make salaries that average $28.67 an hour, $4,970 a month, or $59,640 a year. Maine is one of the six states where non-nurse certified midwives are allowed to practice.
The salary for labor and delivery nurses in Maryland is $32.93 an hour, $5,710 a month or $68,500 annually on average, but in Baltimore, salaries are 1 percent higher than the state average. Maryland has 24 counties that have been designated maternity healthcare deserts, and these include both rural and urban areas. Maternity wards in Maryland’s primarily Black areas are the likeliest to be tagged for closure. The Old Line State registered 70,178 births in 2019
with a fertility rate of 59.9.
Massachusetts is one of the best states in the nation for obstetric care. There are hospitals with labor and delivery wings in every county in the state. The Bay State ranks number three in terms of high-paying salaries for labor and delivery nurses: The average labor and delivery nurse salary in Massachusetts is $38.85 an hour, $6,730 a month or $80,800 a year, and L&D nurses in Boston make 3 percent more than that. In 2019, Massachusetts’ fertility rate was 49.5, and the state registered 69,117 births
The average labor and delivery nurse salary in Michigan is $29.86 an hour, $5,180 a month, or $62,110 annually. In Detroit where the preterm birth rate is 55 percent higher than it is in the rest of the state
, labor and delivery nurses make salaries that average 3 percent more. Only 25 hospitals in Michigan’s 57 most rural counties have hospitals that provide labor and delivery support
. In 2019, 107,886 babies were born across the Wolverine State
. Michigan’s fertility rate is 58.5.
23. Minnesota: A growing number of rural hospitals across Minnesota will no longer do planned baby deliveries
because of rising malpractice insurance costs. In 2017, 38 of Minnesota’s 87 counties had neither birthing centers nor hospitals with labor and delivery units. Some 66,027 babies were born in the Land of Lakes in 2019
, and the fertility rate was 58.5. The average labor and delivery nurse salary in Minnesota is $32.68 an hour, $5,660 a month or $67,970 annually, but L&D RNs in the Greater Metropolitan Minneapolis/St. Paul Region make 6 percent more than that.
Labor and delivery nurse salaries are comparatively low in Mississippi with L&D RNs earning just $24.72 an hour, $4,290 a month, or $51,420 a year. Mississippi has more maternity healthcare deserts than any other state in the nation
despite the fact that 36,636 infants were born in the Magnolia State in 2019
. It’s not a coincidence that Mississippi also has the nation’s highest infant mortality rate. The state’s fertility rate is 62.8.
Eighteen percent of Missouri’s 72,127 births in 2019
were to parents living in maternity healthcare deserts. Pregnancy-related deaths throughout Missouri are 47 percent higher in rural areas than they are in urban areas
. Missouri labor and delivery nurses average $26.60 an hour, $4,610 a month or $55,320 a year, but labor and delivery nurses working in St. Louis earn 4 percent more while labor and delivery nurses working in Kansas City, MO, earn 7 percent more.
In Montana, L&D nurses average $28.47 an hour, $4,930 a month, or $59,210 a year. Montana is a primarily rural state, and a big state geographically, so even in rural counties that still have a hospital with a labor and delivery unit, parents-to-be can find themselves traveling long distances to get the obstetric services they need. Some 11,070 infants were born in the Big Sky State in 2019
. Montana’s fertility rate is 59.6.
Nebraska labor and delivery nurses earn $58,330 a year on average, which comes to $28.04 an hour or $4,860 a month. In Lincoln, L&D RNs make 2 percent less than that while in Omaha, they make 1 percent more. Sixteen percent of the 24,755 babies born in Nebraska in 2019
were born to parents living in maternity healthcare deserts. The lack of obstetric services in the Cornhusker State hits native American parents-to-be particularly hard. Nebraska’s fertility rate is 68.4.
In Nevada, L&D nurses earn $36.23 an hour, $6,280 a month or $75,350 a year. Las Vegas-based labor and delivery RNs earn 3 percent more. Like many other states, Nevada has had access issues where labor and delivery services are concerned, but in June 2021, a bill passed the state legislature that should make it easier for midwife-operated birthing centers to open throughout the state
. In 2019, 35,072 births were registered in the Silver State. Nevada has a fertility rate of 60.
29. New Hampshire: In the past two decades, 20 labor and delivery units have closed throughout rural New Hampshire
, leaving parents in many parts of the state without any hospital units that specialize in delivering newborns. Some 11,839 infants were born in New Hampshire during 2019
, and the state’s fertility rate was 49.1. In the Granite State, labor and delivery nurses earn $30.66 an hour, $5,320 a month, or $63,780 annually.
30. New Jersey:
The average labor and delivery nurse salary in New Jersey is $34.60 an hour, $6,000 a month or $71,960 annually, but L&D nurses employed in Newark and Jersey City, which are part of the Greater New York City Metropolitan Area, average salaries that are 11 percent higher while L&D nurses in Camden, which is part of the Greater Philadelphia Metropolitan Area, earn salaries that are 7 percent lower. The Garden State’s fertility rate is 60.1, and in 2019, 99,585 infants were born there
31. New Mexico: Since 2010, a number of hospitals throughout rural New Mexico have discontinued maternity services
. The reasons they’ve cited for the discontinuation of maternity services include the low rates of Medicaid reimbursement. (Some 71 percent of births in the Land of Enchantment are covered by Medicaid.) Nine counties in the state are without any support services for women giving birth. In 2019, 22,960 infants were born in New Mexico
. New Mexico has a fertility rate of 58.
32. New York:
The average labor and delivery nurse salary in New York is $36.23 an hour, which multiplies out to $6,280 a month or $75,360 a year. In New York City, labor and delivery nurses average 6 percent more than the state average while in upstate Buffalo, they average 14 percent less and in upstate Rochester, 24 percent less. One hundred and twenty-two hospitals throughout the Empire State have maternity units
. New York’s fertility rate is 57.9, and 221,539 babies were born in the Empire State throughout 2019
33. North Carolina:
While North Carolina has made significant population gains in the past decade, the gains aren’t connected to a spike in births. At least 10 counties in rural parts of the state are without any sort of maternity services
. North Carolina registered 118,725 births in 2019
, and the state’s fertility rate is 58.4. The average labor and delivery nurse salary in North Carolina is $27.83 an hour, $4,820 a month, or $57,880 annually.
34. North Dakota: Twenty percent
of North Dakota’s 10,454 births in 2019
involved parents who lived in maternity healthcare deserts. The Peace Garden State’s Native American population is particularly hard hit by the lack of maternity services in rural areas, and infant mortality rates among North Dakota’s Native American infants are twice that of white infants. North Dakota’s fertility rate is 72.2. Labor and delivery nurses in North Dakota can expect to earn $28.11 an hour, $4,870 a month, or $58,460 a year.
The average labor and delivery nurse salary in Ohio is $28.15 an hour, $4,880 a month or $58,560 a year, but labor and delivery nurses in Columbus make fractionally less than that while labor and delivery nurses in Cincinnati and Cleveland make 3 percent and 5 percent more respectively. The Buckeye State is dealing with a serious nursing shortage that is affecting labor and delivery staffing. Ohio registered 134,461 births in 2019
. The state’s fertility rate is 61.1.
Since 2010, 14 labor and delivery units have closed in hospitals throughout Oklahoma. Seventeen percent of the 49,143 births registered in the Sooner State throughout 2019
were to parents who lived in maternity health deserts. The state’s fertility rate is 64.6. Oklahoma labor and delivery nurses can expect to earn $26.88 an hour, $4,660 a month or $55,910 a year, but L&D nurses in Tulsa make 1 percent more than that while L&D nurses in Oklahoma City make 3 percent more than that.
Seven counties in the Beaver State are without birthing centers or hospitals equipped with labor and delivery wings. Some 41,858 infants were born in Oregon throughout 2019
, and the state’s fertility rate is 51.4. L&D RNs in Oregon average $38.84 an hour, $6,730 a month or $80,790 annually, but labor and delivery nurses in the Greater Portland Metropolitan Area make 3 percent more than that.
The average labor and delivery nurse salary in Pennsylvania is $29.94 an hour, $5,190 a month or $62,270 annually. L&D RNs employed in the Greater Philadelphia Metropolitan Area make 8 percent more than that while Pittsburgh-based L&D RNs make 5 percent less. Obstetric malpractice premiums in Pennsylvania are very high
, and this has impacted the availability of labor and delivery services throughout the state, particularly in the Philadelphia area. The Keystone State registered 134,230 births in 2019
, and its fertility rate is 56.9.
39. Rhode Island:
Labor and delivery nurses average $33.41 an hour, $5,790 a month or $69,500 a year in Rhode Island. In 2019, 10,175 babies were born in the state
, and the fertility rate was 50.5. All of the Ocean State’s counties have either birthing centers or hospitals with labor and delivery wings, but the state has the highest costs associated with childbirth in all of New England
40. South Carolina: Seven counties in South Carolina have no hospitals
, and 11 counties are entirely without obstetric services of any sort. Black infants delivered in these rural counties have an infant mortality rate that’s more than three times the state average. The salary for labor and delivery nurses in South Carolina is $27.10 an hour, $4,700 a month, or $56,370 annually. The Palmetto State’s fertility rate is 58.1, and 57,038 babies were born there in 2019
41. South Dakota:
Closures in rural hospitals across South Dakota have disproportionately affected Native Americans. In 2016, the Rosebud Sioux Tribe sued the federal government
for closing the emergency department in the reservation’s only hospital, thereby disrupting obstetrical care; courts eventually found in the tribe’s favor, but it was a tough battle. Some 11,449 infants were born in the Mount Rushmore State in 2019
. The state’s fertility rate is 73.6. South Dakota labor and delivery nurses earn $24.61 an hour, $4,270 a month, or $51,180 annually.
42. Tennessee: Since 2913, 12 hospitals have closed across rural Tennessee
, limiting the access of mothers-to-be to labor and delivery services. Thirty-seven percent of the Volunteer State’s counties have been designated maternity healthcare deserts. Tennessee registered 80,450 births in 2019
, and its fertility rate is 61.1. The average salary of a labor and delivery nurse in Tennessee is $25.88 an hour, $4,490 a month or $53,830 a year, but L&D nurses in Memphis and Nashville make 7 percent more.
The average labor and delivery nurse salary in Texas is $31 an hour, $5,370 a month or $64,480 a year, but salary figures vary enormously throughout the Lone Star State. In Houston, L&D RNs make 11 percent more than the state average while in Corpus Christi, they make 13 percent less. Texas counted 377,599 new births in 2019
. The Lone Star State’s fertility rate is 63.4.
44. Utah: Twenty-nine percent of Utah’s counties offer pregnant people little or no access to obstetric services.
In the remainder of the state, 40 hospitals
are equipped with labor and delivery wings. The state’s fertility rate is 68.4, and 46,826 infants were born there in 2019
. Labor and delivery nurses in the Bee Hive State earn $59,080 a year, which breaks down to $28.40 an hour or $4,920 a month.
45. Vermont: Vermont is widely cited as the best state in which to give birth
because of the availability of obstetric services, the number of midwives and OB/GYN physicians, and comparatively low birthing costs. In the Green Mountain State, labor and delivery nurses can expect to make $29.12 an hour, $5,050 a month, or $60,560 a year. Vermont’s fertility rate is 47.2. In 2019, 5,361 infants were born in Vermont
The average salary of a labor and delivery nurse in Virginia is $30.02 an hour, $5,200 a month, or $62,440 a year. In Virginia Beach, labor and delivery nurses make 1 percent less than that, but in Richmond, they make 7 percent more while in regions of the state that are considered to be part of the greater District of Columbia Metropolitan Area, they make 12 percent more. The Old Dominion State’s fertility rate is 59.1. Some 97,429 infants were born in Virginia throughout 2019
The average salary of a labor and delivery nurse in Washington State is $36.86 an hour, $6,390 a month or $76,660 a year, but in Spokane, labor and delivery nurses make 2 percent less than that while in Seattle and Tacoma, they make 4 percent more. Though the Evergreen State has been hit by rural hospital closures, access to obstetric services is not as big an issue here as elsewhere because the state’s advanced practice midwives are free to practice autonomously. Some 84,895 infants were born in Washington in 2019
. The state’s fertility rate is 57.5.
48. West Virginia:
Access to maternity care services is a serious issue for parents-to-be living in West Virginia’s many rural counties. In 2019, 20 percent of the state’s 18,136 births
were to parents living in a designated maternity healthcare desert. The U.S. Department of Health and Human Services recently gave a $1 million grant to the Mountain State’s Rural Maternity and Obstetrics Management Strategies Program
. West Virginia’s fertility rate is 57.2. West Virginia’s L&D RNs average $26.29 an hour, $4,560 a month, or $54,680 annually.
The average salary of a labor and delivery nurse in Wisconsin is $62,760 annually, which breaks down to $30.17 an hour or $5,230 a month. In Milwaukee, salaries are 3 percent higher, and in Madison, they are 10 percent higher. Wisconsin has largely managed to avoid the closure of rural hospitals
that have impacted access to labor and delivery services in other states. Wisconsin’s fertility rate is 58.9. In 2019, 63,270 infants were born in the Badger State
50. Wyoming: Wyoming counted 6,565 births in 2019
. The state’s fertility rate was 61. Seven of Wyoming’s 23 counties have no access to labor and delivery services
, and one out of every four women in the Cowboy State receives little or no prenatal care. Wyoming L&D nurses make $29.30 an hour, $5,080 a month, or $60,950 a year.
AVERAGE LABOR AND DELIVERY NURSE SALARY IN YOUR CITY
Not only does the salary of a labor and delivery nurse vary from state to state, it can also vary significantly from city to city in the same state. In Texas, for example, the average annual labor and delivery nurse salary is $64,480. But in Houston, the average L&D RN salary is 11 percent higher than that while in Corpus Christi, the average salary is 13 percent lower.
In part, such differentials reflect the relative cost of living indices across various locales: The cost of living in Houston is 3 percent higher
than the cost of living in the Lone Star State as a whole
, but in Corpus Christi, the cost of living is 10 percent lower
than it is in the rest of the state. Salary fluctuation between cities in the same state also reflect varying levels of demand for services. Houston’s population is approximately ten times that of Corpus Christi’s, so more babies are born every year in Houston than in Corpus Christi, and that means the demand for the services labor and delivery nurses provide is higher.
|Baton Rouge, LA||$26.30||$4,560||$54,700|
|Colorado Springs, CO||$30.93||$5,360||$64,340|
|Corpus Christi, TX||$26.85||$4,650||$55,850|
|Des Moines, IA||$25.89||$4,490||$53,850|
|El Paso, TX||$29.50||$5,110||$61,370|
|Fort Wayne, IN||$25.25||$4,380||$52,510|
|Fort Worth, TX||$31.48||$5,460||$65,470|
|Jersey City, NJ||$38.31||$6,640||$79,690|
|Kansas City, MO||$28.35||$4,910||$58,970|
|Las Vegas, NV||$37.42||$6,490||$77,840|
|Little Rock, AR||$27.88||$4,830||$57,980|
|Long Beach, CA||$45.66||$7,910||$94,970|
|Los Angeles, CA||$45.66||$7,910||$94,970|
|New Orleans, LA||$28.63||$4,960||$59,550|
|New York City, NY||$38.31||$6,640||$79,690|
|North Las Vegas, NV||$37.42||$6,490||$77,840|
|Oklahoma City, OK||$27.65||$4,790||$57,520|
|Port St. Lucie, FL||$27.98||$4,850||$58,200|
|Saint Paul, MN||$34.76||$6,030||$72,310|
|San Antonio, TX||$30.32||$5,260||$63,060|
|San Bernardino, CA||$44.33||$7,680||$92,200|
|San Diego, CA||$45.05||$7,810||$93,710|
|San Francisco, CA||$60.22||$10,440||$125,260|
|San Jose, CA||$59.28||$10,280||$123,300|
|St. Louis, MO||$27.54||$4,770||$57,280|
|St. Petersburg, FL||$28.78||$4,990||$59,860|
|Virginia Beach, VA||$29.61||$5,130||$61,590|
HIGHEST AND LOWEST-PAYING LABOR AND DELIVERY NURSE JOBS
What Are The Highest And Lowest Paying Workplaces For Labor and Delivery Nurses?
The highest-paid labor and delivery nurses are those who work in hospitals in major metropolitan areas. Labor and delivery nurses who work with midwives in rural practice settings tend to make the lowest salaries.
What Are The Highest And Lowest Paying States For Labor and Delivery Nurses?
The highest-paid labor and delivery nurses are those who work in California where the average L&D RN salary is $101,210 a year. Other states where labor and delivery nurses earn comparatively high salaries include Hawaii ($88,010), Massachusetts ($80,800), Oregon ($80,790), and Alaska ($79,980).
Alabama labor and delivery nurses earn $50,560 a year on average, which is the lowest salary paid to L&D RNs in any of the 50 states. Other states where labor and delivery nurses earn comparatively low salaries include South Dakota ($51,180), Mississippi ($51,420), Iowa ($52,530), and Arkansas ($53,430).
|Rank||Highest Paying||Lowest Paying|
|State||Annual Salary||State||Annual Salary|
|9||New Jersey||$71,960||West Virginia||$54,680|
What Are The Highest And Lowest Paying Cities For Labor and Delivery Nurses?
The cities where labor and delivery nurses earn their highest salaries are all in California and include Oakland ($125,260), San Francisco ($125,260), San Jose ($123,300), Sacramento ($112,790), and Modesto ($101,660).
The cities where labor and delivery nurses earn their lowest salaries are scattered throughout the south and Midwest, and include Huntsville, Al, ($49,200); Wichita, KS, ($49,930); Fort Wayne, IN, ($52,510); Des Moines, IA, ($53,850); and Lexington, KY, ($53,990).
|Rank||Highest Paying||Lowest Paying|
|1||Oakland, CA||$125,260||Huntsville, AL||$49,200|
|2||San Francisco, CA||$125,260||Wichita, KS||$49,930|
|3||San Jose, CA||$123,300||Fort Wayne, IN||$52,510|
|4||Sacramento, CA||$112,790||Des Moines, IA||$53,850|
|5||Modesto, CA||$101,660||Lexington, KY||$53,990|
|6||Stockton, CA||$97,270||Columbus, GA||$54,080|
|7||Anaheim, CA||$94,970||Baton Rouge, LA||$54,700|
|8||Long Beach, CA||$94,970||Louisville, KY||$55,780|
|9||Los Angeles, CA||$94,970||Corpus Christi, TX||$55,850|
|10||San Diego, CA||$93,710||Orlando, FL||$56,520|
What States In The Northeast Pay The Highest And Lowest Salaries For Labor and Delivery Nurses?
The two states in the northeast where labor and delivery nurses earn the highest salaries are Massachusetts ($89,800) and New York ($75,360). The two states in the northeast where labor and delivery nurses earn the lowest salaries are Maine ($59,640) and Vermont ($60,560).
|Highest Paying||Lowest Paying|
|State||Annual Salary||State||Annual Salary|
What States In The Midwest Pay The Highest And Lowest Salaries For Labor and Delivery Nurses?
The two states in the Midwest where labor and delivery nurses earn the highest salaries are Minnesota ($67,970) and Wisconsin ($62,760). The two states in the Midwest where labor and delivery nurses earn the lowest salaries are South Dakota ($51,180) and Iowa ($52,530).
|Highest Paying||Lowest Paying|
|State||Annual Salary||State||Annual Salary|
What States In The Southeast Pay The Highest And Lowest Salaries For Labor and Delivery Nurses?
The two states in the southeast where labor and delivery nurses earn the highest salaries are Virginia ($62,440) and Georgia ($60,030). The two states in the southeast where labor and delivery nurses earn the lowest salaries are Alabama ($50,560) and Mississippi ($51,420).
|Highest Paying||Lowest Paying|
|State||Annual Salary||State||Annual Salary|
What States In The Southwest Pay The Highest And Lowest Salaries For Labor and Delivery Nurses?
The two states in the southwest where labor and delivery nurses earn the highest salaries are Arizona ($67.480) and Texas ($64,480). The two states in the southwest where labor and delivery nurses earn the lowest salaries are Oklahoma ($55,910) and New Mexico ($63,550).
|Highest Paying||Lowest Paying|
|State||Annual Salary||State||Annual Salary|
What States In The Western Region Pay The Highest And Lowest Salaries For Labor and Delivery Nurses?
The two states in the western region where labor and delivery nurses earn the highest salaries are California ($101,210) and Hawaii ($88,010). The two states in the western region where labor and delivery nurses earn the lowest salaries are Utah ($59,080) and Montana ($59,210).
|Highest Paying||Lowest Paying|
|State||Annual Salary||State||Annual Salary|
My Final Thoughts
How much does a labor and delivery nurse make? Labor and delivery nurse salary in 2023 tracks closely to the salary average for all registered nurses who don’t hold advanced practice degrees. While this is a comfortable salary, and higher than the average salary for all occupations across the U.S., it is not one of the highest salaries you can earn with a nursing degree.
However, L&D nurses report a great deal of satisfaction with their job choice. Bringing new life into the world is one of the most joyful occasions in any human being’s life, and labor and delivery nurses get to share this joy. If you’re looking for a nursing career that can give you a unique bond with the patients you care for, labor and delivery may well be the right choice for you.
We have used the following sources to compile the salary data on this page.
2. U.S. Bureau of Labor Statistics
3. NP Editorial Assessment
Pattie Trumble, MPP, MPH
Pattie Trumble is a nurse who worked in both California and New York for many years as an emergency room nurse. She holds a Bachelor’s Degree in Economics from the University of California, Berkeley, and an Associate Degree in Nursing from the Samuel Merritt Hospital School of Nursing. After 10 years of providing direct care, she went back to school and earned concurrent Master’s degrees in both public policy and public health from the University of California, Berkeley. Thereafter, she worked for various public health agencies in California at both the community and state levels providing economic and legislative analysis.