Labor and Delivery Nurse Salary in Texas 2026,
$95,970 Median | BLS Data by City

The published Texas figure is $95,970 a year, or $46.14 an hour, per BLS OEWS May 2025 — 1.6% below the national median of $97,550, and Texas takes no state income tax from it. That is the all-Registered-Nurses estimate; BLS publishes no obstetric nursing series. The band runs $67,120 at the 10th percentile to $127,950 at the 90th.

Dallas-Fort Worth-Arlington at $101,420, then Houston-Pasadena-The Woodlands $99,830, Austin-Round Rock-San Marcos $97,890, San Antonio-New Braunfels $94,370 and Killeen-Temple $93,440. For obstetric nurses the metro ranking is also a volume ranking — these are the markets where the state's births are concentrated and where the busiest delivery units sit.

Many do not. A substantial number of rural Texas counties have no hospital offering obstetric care, and the number has grown as small hospitals found delivery services impossible to sustain — round-the-clock obstetric, anaesthetic and neonatal cover is a heavy fixed cost at low volume. The effect on nurses is that obstetric work concentrates in metro and regional units, which absorb transfers from a wide catchment and therefore carry higher acuity. For patients in the affected counties it means long journeys to give birth.

The state requires only a Texas RN licence from the Board of Nursing, or a multistate licence from another Nurse Licensure Compact state — there is no obstetric licence. Employers require more: neonatal resuscitation credentialing is effectively mandatory, fetal monitoring competency is expected, and the RNC-OB certification is the recognised specialty credential and generally carries differential pay. In high-volume Texas units, documented experience with obstetric emergencies is what distinguishes candidates for the highest-acuity posts.

On volume and tax, yes. Texas has more births than any state except California, so experience accumulates quickly and the specialty is not short of work; and no state income tax means the differential-heavy earnings of shift work come through intact. The counterweights are that the work is concentrated in metro units carrying transferred acuity from a wide rural catchment, which makes it demanding, and that the state's rural obstetric access gaps mean a nurse wanting this specialty has limited geographic choice.

It changes their case mix as much as their volume. When a rural hospital stops delivering babies, the routine low-risk births in that catchment are redistributed to the nearest units — but so are the complications, and they arrive later and less stable than they would have if care had begun locally. Metro and regional Texas obstetric units therefore see a caseload weighted toward transfers, later presentations and higher acuity, alongside the normal volume of a fast-growing state. For a labour and delivery nurse that means the job in Dallas-Fort Worth or Houston is not simply a bigger version of the job in a small town; it is a more acute one.

SOC 29-1141 pools about 271,380 Texas registered nurses across every setting. Obstetric nursing is a shift-heavy specialty whose real compensation includes night, weekend, holiday and on-call differentials plus RNC-OB certification premiums that the base estimate does not separate out. The figure also cannot show the geographic concentration created by rural obstetric closures, which is the single most important structural fact about this specialty in Texas. And agency and contract nursing, common in high-volume obstetric units, is outside the estimate entirely.

Acuity and unit level first — high-risk obstetric and regional referral units pay above community delivery services, and in Texas those are also the units absorbing rural transfers. Certification second, with RNC-OB the recognised credential and neonatal resuscitation the baseline. Shift pattern third, and it is worth proportionally more in Texas than in taxing states because differentials arrive untaxed. Charge and preceptor responsibility fourth, which is what reaches the $105,100 seventy-fifth percentile and the $127,950 ninetieth.