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What Is A Labor And Delivery Nurse Practitioner? (Answered By A Nurse)


Written By: Lauren Rivera BSN, RNC-NIC

A labor and delivery nurse is a licensed registered nurse who cares for women throughout the birth process. These nurses may choose to further their education and become a labor and delivery nurse practitioner via an advanced practice degree in obstetrics and gynecology or women’s health.

Nurse practitioners specializing in labor and delivery are trained to handle pregnant patients, provide examinations, and assist with labor and deliveries. These NPs may also practice in offices or clinics providing prenatal care, or general women’s health preventative care. If a labor and delivery NP wishes to deliver infants, they must become certified nurse midwives, which requires specialized training, delivering a required number of babies, and an exam with the American Midwifery Certification Board. Labor and delivery nurse practitioners have a rewarding career, they also have the immense responsibility and honor of helping to bring new life into this world. This article will discuss in-depth about what is a labor and delivery nurse practitioner?


What Does A Labor And Delivery Nurse Practitioner Do?


Labor and delivery nurse practitioners who practice as women’s health nurse practitioners perform examinations, screenings, diagnostic tests, and provide postpartum care. These advanced practice nurses take on additional medical responsibilities and are able to prescribe medication.

Labor and delivery nurse practitioner duties include supporting the pregnant patient on a labor and delivery unit in conjunction with the nursing staff through monitoring contractions and labor progression, providing pain relief, and monitoring the well-being of the mother and infant. Labor and delivery nurse practitioners are not legally allowed to deliver babies, they must obtain a degree as a certified midwife to physically deliver a baby. However, the labor and delivery NP is part of the healthcare team that helps to deliver a healthy baby while ensuring the safety of the mother through labor, birth, and the immediate postpartum period. In addition to caring for the mother, labor and delivery nurse practitioners are also expected to be certified in neonatal resuscitation. To become a labor and delivery nurse practitioner you need to be experienced in various birthing situations ranging from a natural vaginal delivery to an emergency cesarean section, and any scenario in between.


Where Do Labor And Delivery Nurse Practitioners Work?


Most labor and delivery nurse practitioners work in the hospital setting in labor and delivery units or on antepartum units monitoring high-risk pregnant women. They may also practice in private offices or clinics conducting well, visits for pregnant patients, or providing reproductive preventative care for women in the role of a women’s health nurse practitioner. Some labor and delivery nurse practitioners may be found working in fertility clinics as well.

Other labor and delivery NPs may choose to assist at birthing centers providing a more holistic approach to the birthing process. These nurse practitioners may also practice in the home setting with mothers who chose to birth their infant in the comfort of their own home.


Typical Working Hours


Labor and delivery nurse practitioners work variable shifts depending on where they practice. Labor and delivery NPs who work in the office typically work during the day and are not required to work on weekends.

Babies are born at any time of the day, labor and delivery nurse practitioners who practice in hospital or home birth settings work varying shifts from day, to evening, to night and weekends. They usually have scheduled shifts and may be “on call” several times a month.


Why Become A Labor And Delivery Nurse Practitioner?


Nurses who become a labor and delivery nurse practitioner experience a rewarding career. Labor and delivery nurse practitioners assist parents in bringing new life into the world. They are privileged to be present at the most vulnerable and happiest time in a patient’s life, as well as offer support during the saddest times, such as when there is an infant loss.

Other advantages include:

◦ Advanced practice education and skills.
◦ Exciting and rewarding career.
◦ Up to a six-figure salary.
◦ Career satisfaction.
◦ Work-life balance if the choice is made to work in an office.
◦ Flexibility to work across several different settings.
◦ Build lasting relationships with patients.
◦ Opportunity to advocate for women’s health.
◦ Job security: A career that is always in demand.



Following Is A Step-By-Step Process Of Becoming A Labor And Delivery Nurse Practitioner


Becoming a labor and delivery nurse practitioner may seem daunting at first as there is no clear path leading to this NP position. Here is a step-by-step process to help guide you through your journey of becoming a labor & delivery NP in what we think is the best possible route.

1. Graduate high school and apply to college: Choose either an associate’s degree in nursing (ADN)- 2-year program or a Bachelor of Science in Nursing (BSN)- a 4-year program which is a more preferable option.

2. Graduate from an accredited nursing program: Ensure the program you choose, whether two-year or four-year is accredited.

3. Pass the NCLEX exam: Known as The National Council Licensure of RNs NCLEX, this is a computer-based test assessing proficiency in entry-level nursing knowledge and skill.

4. Obtain Registered Nurse licensure: Apply for licensure through your state’s board of nursing.

5. Gain a few years of experience as a labor and delivery nurse: This is not required but is extremely helpful in preparing you for a career as an NP. Typically, 2-3 years is ideal, so you gain experience in all aspects of what is required on a labor and delivery unit and supporting the patient through the birth process.

6. Complete Bachelors Program if not previously completed: It is preferred that you complete a BSN before you go on to the next level of graduate nursing.

7. Obtain specialty certifications: These specialty certification options not only enhance your marketability but also help you in your job role as a labor and delivery nurse practitioner.

◦ Basic Life Support Certification (BLS)
◦ Advanced Life Support Certification (ACLS)
◦ Neonatal Resuscitation Program Certification (NRP)
◦ Inpatient Obstetric Nursing Certification (RNC-OB)
◦ Electric Fetal Monitoring (C-EFM)


8. Apply to Graduate School: Before applying to a graduate school, ensure you do your homework about the pre-requisites and eligibility criteria. Admission requirements vary from one NP school to another so, spending this time in preparing a strong portfolio will greatly improve your odds of admission into a school of your choice.

9. Attend and Graduate from an accredited Nurse Practitioner Program: For the role of a labor and delivery nurse, there are two MSN specializations that you can pursue, the Women’s Health Nurse Practitioner track that takes three years and the Nurse Midwife which is also typically a three-year program. While the WHNP track is more preferred for this role, adding the Midwifery certification is required if you wish to deliver infants. In such a case, you must opt for dual certification in WHNP and CNM. So, based on your career goals, you can certify either as a WHNP or get dually certified in two specialty areas of Women’s Health and Midwifery. Applying to the Midwifery specialization requires you to have observed a required number of deliveries. For example, Frontier School of Midwifery requires you to have observed at least 40 deliveries.

10. Become a certified NP by passing the National Certification Exam: Upon completing your graduate studies, you must take the WHNP-BC and also, Midwifery certification, depending on whether you complete a single certification track or choose the dual certification. While the WHNP certification requires you to take a Comprehensive exam of 175 questions that tests specialty knowledge in inpatient and outpatient settings in obstetrics, gynecology, and primary care in women, the midwifery exam tests your knowledge in normal & abnormal deliveries, physical exams findings, physiology, pharmacology and clinical decision making.

11. Obtain State Licensure: To qualify for state licensure as an APRN you must possess the following:

◦ MSN degree
◦ National certification as a nurse practitioner in your chosen specialty
◦ A current registered nurse license


Apply for prescriptive authority if mandated by your state. Apply for DEA registration to prescribe controlled substances.

Renewal varies by state but is usually required every 3 years, and a minimum amount of practice hours and continuing education credits are necessary. Maintaining a nurse practitioner license/certification is always contingent on maintaining a registered nurse (RN) license.

12. Apply for a Labor and Delivery nurse practitioner position: Decide whether you want to practice in the home setting, hospital, office, or both. Make sure all licenses are in order and create a resume. Ask to shadow on a unit or in an office that you are interested in. Practice your interviewing skills and follow up with a thank you for the interview.

13. Earn Doctor of Nursing Practice (DNP) with a specialty in Women’s Health if desired: A Doctor of Nursing Practice (DNP) degree focuses highly on leadership and administration. Women’s health nurse practitioners with doctoral training have the practical expertise to manage providing primary care for women, including specialized care in reproductive, preventative, prenatal, and postpartum care. The DNP program in women’s health requires 69 credits, 1,000 clinical hours, and 2 clinical intensives. Nurses who possess a DNP may choose to continue to provide direct patient care or transition into leadership and administration. DNPs may work in nurse management, organizational leadership, health policy, and health informatics.


List Of Fellowships & Residency Programs For Labor And Delivery Nurse Practitioners


Although fellowships or residency programs are not required for labor and delivery nurse practitioners, several programs have become available for aspiring Labor And Delivery nurse practitioners.

John’s Hopkins Global Women’s Health Fellowship Program
This is a 2-year post-graduate fellowship pairing an OB/GYN with an advanced practice nurse addressing critical women’s health issues throughout the globe.

Atrium Health Advanced Practice Provider (APP) Fellowship in Women’s Health
This is a 12-month fellowship program providing general obstetrics and gynecological training for physician’s assistants, women’s health nurse practitioners, and certified nurse midwives teaching basic knowledge and skills in:

◦ Reproductive endocrinology
◦ Maternal-fetal medicine
◦ Labor induction
◦ Episiotomy
◦ Assisted or spontaneous vaginal and first assist c-section deliveries
◦ Ultrasound assessment



List Of Certification Options For Labor And Delivery Nurse Practitioners


There are several Labor and Delivery nurse practitioner certifications that can be obtained to further enhance knowledge and expertise.

1. Women’s Health Nurse Practitioner Certification (WHNP-BC): The women’s health nurse practitioner certification is required for the position of a labor and delivery NP and is available to any Advanced Practiced Nurse who has completed an NP program. The fee is $325, consists of 175 questions, and must be renewed every 3 years. The exam must be completed within the first 8 years of graduation from an NP program. This website can provide you with specific information. Requirements vary by state, some states require WHNP-BC to practice, while others do not, be sure to check your state's requirements. Regardless of the state requirement, obtaining the women’s health nurse practitioner certification can showcase the NP’s advanced knowledge and help further their career.

2. Certified Nurse Midwife-Exam: Many institutions and most states require a graduate degree nurse to sit for the Certified Nurse Midwife Exam to practice as a labor and delivery nurse practitioner. The exam is provided by the American Midwifery Certification Board (AMCB) for a $500 fee, a current RN license is needed as well as proven graduation from an accredited nurse-midwifery program. The exam must be taken within 24 months of completing a CNM program.

3. Registered Nurse Inpatient Obstetric Nursing Certification (RNC-OB): The Inpatient Obstetric Nursing Core Certification tests specialty knowledge for licensed registered nurses with a minimum of 2 years of clinical experience in caring for hospitalized pregnant women during antepartum, intrapartum, postpartum, and the newborn period. A valid Us or Canadian license is required to sit for the certification exam, there is a $275 fee, and the test consists of 175 questions. The certification must be renewed every 3 years. While the RNC-OB certification is not a requirement, many hospital systems prefer specialty certifications, and it will often be expected or at least be a factor that will increase the chances of being hired.

4. Certification in Electric Fetal Monitoring (C-EFM): The Electric Fetal Monitoring Certification is intended for licensed nurses who utilize the application of electronic fetal monitoring and interpretation of the data obtained to provide care to pregnant patients in inpatient and outpatient settings. The test is 125 questions and there is a fee of $210. The certification must be renewed every 3 years. Again, this is an optional certification that will enhance your career as a labor and delivery NP.

5. Neonatal Resuscitation Program Certification: The Neonatal Resuscitation Program Certification (NRP) is required for any health care professional involved in the delivery of newborns. It consists of learning activities, an exam, and a hands-on demonstration session. It is required to be renewed every 2 years.

6. Basic Life Support Certification: Basic Life Support Certification (BLS) is required by any health care professional practicing either inpatient or outpatient. It consists of CPR and basic life-saving skills. The certification must be renewed every 2 years.


Starting Salary Of A Labor And Delivery Nurse Practitioner



The starting salary of a labor and delivery nurse practitioner varies greatly depending on the city and state, in which they practice. Rural areas tend to pay less than urban areas. Salary can vary greatly depending on the setting in which a nurse practitioner practices, private offices, hospitals, clinics, and alternative birthing centers all have a different pay scale.

A labor and delivery practitioner’s salary starts off at about $82,000 with a per hour rate of $39.86 and a monthly rate of $6,910.

Per Hour$39.86
Per Month$6,910
Per Year$82,910


Average Salary Of A Labor And Delivery Nurse Practitioner


The average salary for a labor and delivery nurse practitioner varies greatly, as stated above, depending on location, setting, and experience. Years of experience, education level, certifications, and credentials increase salary potential.

The national average salary for labor and delivery nurse practitioners is about $111,000-$113,000, which of course varies from state to state. For example, California is consistently the highest paying state for Labor and Delivery nurse practitioners.

Per Hour$54.76
Per Month$9,490
Per Year$113,899


Job Market For Labor And Delivery Nurse Practitioners


The job market for Labor and Delivery nurse practitioners is always lucrative. As long as women continue to have babies and require postpartum and preventative care, the need for practitioners will always be there.

New Labor and Delivery NPs will be needed to replace those who have retired or chosen to practice in other areas of expertise. Job opportunities for Labor and Delivery nurse practitioners are projected to be excellent, NPs are in high demand, especially as APRNs are being recognized more widely as a vital asset to healthcare.


Useful Organizations & Associations


Association of Women, Health Obstetric and Neonatal Nurses: The mission of the Association of Women, Health Obstetric and Neonatal Nurses (AWHONN) is “to empower and support nurses caring for women, newborns, and their families through research, education, and advocacy.” AWHONN encourages a diverse workforce and provides nurses education based on evidence-based practice.

NPWH: Nurse Practitioners in Women’s Health is a professional membership organization for nurse practitioners who provide women’s healthcare. They promote current research, evidence-based clinical guidance, continuing education, and advocate for patients, and WHNP providers.

American College of Nurse-Midwives (ACNM): The American College of Nurse-Midwives is a professional association that represents Certified Nurse-Midwives in the United States. Members include primary care providers for women with an emphasis on gynecologic and reproductive health, pregnancy, and childbirth. They focus on standards of practice and continuing education.

AANP | The American Association of Nurse Practitioners: The American Association of Nurse Practitioners is a professional organization for NP students and nurse practitioners. Their mission is to empower all nurse practitioners to advance quality healthcare through education, practice, research, advocacy, and leadership.


Summing It Up


Labor and delivery nurse practitioners are skilled professionals who play a vital role in supporting women throughout their lives. They provide preventative care for women’s health issues and support women throughout pregnancy and birth. Labor and delivery NPs may practice in the role of a Women’s Health nurse practitioner or even as a Certified Nurse Midwife, as some NPs hold both degrees. These nurse practitioners work in hospitals, clinics, private offices, or home settings. Now that you have learned what is a labor and delivery nurse practitioner and what it takes to become one, I wish you luck in pursuing a rewarding career.


FREQUENTLY ASKED QUESTIONS ANSWERED BY OUR EXPERT


How Long Does it take to Become a Labor and Delivery NP?

Becoming a labor and delivery nurse practitioner can take a minimum of 6 to 7 years between a Bachelor of Science in Nursing Degree and a Master of Science in Nursing Degree. It can take even longer if the nurse decides to gain experience in a labor and delivery unit prior to starting a master’s program.

How Much Does it Cost to Become a Labor and Delivery NP?

The cost of becoming a labor and delivery NP varies greatly depending on which state, school, or program is chosen. A traditional four-year BSN program typically costs at least $40,000 but may extend upwards of $100,000. An MSN program varies greatly as well, beginning at about $35,000 up to $100,000.

The cost differs widely between in-state public tuition and private and out-of-state tuition. Costs may be decreased by choosing public in-state programs.

Labor and delivery nurse practitioners must also pay for licensing exams, the costs are listed above in the article.

What is The Difference Between Labor and Delivery Nurse Practitioner and Labor And Delivery Nurse?

Labor and delivery nurses help guide mothers through the different stages of labor, coach them through their contractions, and provide pain relief either through holistic or medical interventions prescribed by the NP or Physician. The nurse must constantly monitor both the mother and the baby throughout the labor process. Labor and delivery nurses also help mothers with skin-to-skin care and breastfeeding in the immediate postpartum period.

A labor and delivery nurse practitioner oversees the antepartum period, birth process, and postpartum period. They are responsible for communicating with the nursing staff to monitor all aspects of the labor and delivery process. The Labor and delivery NP may write orders and prescribe medication. They may not deliver an infant without the presence of a physician unless they are certified as nurse-midwives.

Can a Labor and Delivery Nurse Practitioner Deliver an Infant?

The short answer is no. A Labor and Delivery nurse practitioner may help support women in labor by writing orders, monitoring contractions and deciphering fetal monitor strips, prescribing medication, and assisting a physician with the birth of an infant. However, legally a Labor and Delivery nurse practitioner cannot deliver an infant on their own. If a Labor and Delivery nurse practitioner wishes to deliver infants on their own, they must complete a certified nurse-midwife program and obtain certification and licensure.


Lauren Rivera BSN, RNC-NIC
Lauren Rivera is a registered nurse with over 13 years of experience in the Neonatal Intensive Care Unit. Besides her nursing license, she is nationally certified in neonatal nursing, and is a certified breastfeeding counselor.