Delivering a baby is extremely hard work and for many it can be very painful.
Women choose many ways to cope with the pain of contractions, some are non- pharmacological such as massage, hypno birthing or hydrotherapy. Sometimes, though, labor is very tough and women want something stronger, but do not want something as strong as an epidural or narcotics. This is when nitrous oxide may be a great choice.
Nitrous oxide is a fairly new method for relieving pain in labor for women in the United States. Known to many as “laughing gas,” the relatively mild anesthetic has been broadly used to alleviate pain during childbirth in Europe, Canada and Australia, and is generally known in the United States as an anesthetic used in dentistry. More than half of the women who used nitrous oxide to relieve labor pain say that it helped them, and that they would use it again.
Nitrous oxide is mixed with oxygen and fed into a facemask you hold in your hand. You control how much you breathe, as you are the best person to regulate your intake. Ideally, you will breathe in just enough to “take the edge off” of labor pain; the gas also lowers anxiety, which can help to relax women during contractions. Some women find that the gas is not enough for them, or don’t like how it makes them feel. In these cases they may choose alternate options as other pain medications may still be used after nitrous oxide. You do not have to choose between using nitrous oxide and having an epidural —you can have both — though your specific situation will determine whether your provider allows you to have both nitrous oxide and some injected or IV opioid medications such as stadol or morphine. It is important to discuss your wishes with your doctor or midwife so that they can help you have a labor and delivery that is best for you and your baby.
If you breathe in too much nitrous oxide and get very sleepy, your hand that is holding the mask will fall from your face and the nitrous oxide quickly wears off after a few breaths of air. Some women report feeling nauseous from the gas, and can take medication for the nausea if they wish to continue using the nitrous oxide. Rarely, women have said that it makes them feel restless or confused. It has no effect on the uterus, contractions, the progress of labor or the baby.
Nitrous oxide is the only pain relief method used for labor that is cleared from the body through the lungs — that is, it doesn’t linger in the bloodstream and as soon as you pull the mask away, the effects are gone after a few breaths. No extra monitoring is needed for you or the baby, though if you do get too sleepy, a monitor to check oxygen levels might be placed on your finger. Nitrous oxide is safe for your baby, so if your baby’s heart rate is being checked intermittently rather than continuously with a fetal monitor, that is still OK. If because of a risk factor it is best to have your baby checked continuously with an electronic fetal monitor, nitrous oxide is still safe to use.
Nitrous oxide should not be used if certain medical conditions exist. A vitamin B-12 deficiency known as pernicious anemia is one. Other conditions should be disclosed so that they can be assessed by your medical providers.
While it is still uncommon in the U.S., as many as eight in 10 women use nitrous oxide to help alleviate labor pain in countries where it has been available for many years; the option has been available in western Massachusetts through the Cooley Dickinson Hospital Childbirth Center for more than a year now.
Annemarie Heath, a certified nurse midwife at Cooley Dickinson Women’s Health in Northampton, has delivered more than 1,000 babies.
Women’s Health is written by health care professionals affiliated with Cooley Dickinson Hospital in Northampton. It appears here monthly.