Irene Beach is a certified nurse midwife at The Vancouver Clinic
Mothers opting for a natural birth, and women who need help managing labor pains until the anesthesiologist arrives, now have another option during labor.
Nitrous oxide, also known as laughing gas, is newly available at PeaceHealth Southwest Medical Center and Legacy Salmon Creek Medical Center. This colorless, odorless gas is absorbed by inhalation and works rapidly to help patients disassociate from pain.
Midwives have been using nitrous for decades in Scandinavia, Canada, the U.K., Australia and New Zealand. But while it was used here in the U.S. in the early 20th century, it fell out of favor when epidural and IV medications became more popular. A lack of peer-reviewed, scientific research on the safety of the gas for the mother and baby also kept it from becoming widely accessible.
Fast-forward to today and it is on the rise again, thanks to better research and patients and providers— including myself—who have been advocating for it to be option.
Safe for mothers
and babies
One of the most important reasons nitrous is becoming mainstream in the U.S. again is because it’s an extremely safe option with few side effects. While the gas does cross the placenta, it doesn’t affect fetal heart rates or APGAR scores (used to evaluate a newborn’s physical condition), disrupt the progression of labor, or interfere with the release of oxytocin, which promotes bonding after delivery.
Another benefit? It can be used during any stage of labor and delivery. I’ve used it with mothers who were having a natural labor and needed help making it through transition, as well as with mothers who arrived at the hospital too late to get an epidural. It made the pain more manageable in both situations.
Nitrous may also be used during water births, in cases where low platelets or a spinal surgery make an epidural impossible, and during repairs.
Love it or leave it
While about half of women love it, or at least find it useful, the other half actively dislike it. Because nitrous is an “analgesic” rather than an “anesthesia,” it doesn’t get rid of the pain. It helps women cope, but doesn’t make it go away.
The nitrous blend at the hospital isn’t as strong as what’s provided in the dentist’s office. Hospitals use a 50 percent oxygen and 50 percent nitrous oxide blend, rather than the 80 to 100 percent nitrous used to calm nerves during dental work.
Using nitrous
If you are interested in using nitrous during labor, start by talking to your provider. While it’s safe for most women, those with a B12 vitamin deficiency shouldn’t use it.If you and your provider agree that it’s a good option, you’ll need to sign a release form once you’re at the hospital. You’ll be asked to hold the mask yourself, which will ensure you don’t become over-sedated. Next, you’ll take slow, deep breaths during contractions.
The mask is designed to syphon the gas away, keeping it out of the room and ensuring support people, doctors, midwives and nurses aren’t exposed. You can stop taking nitrous at any time, and its effects will largely disappear within three minutes.
Bringing a new baby into the world is a demanding experience for any woman’s body. Nitrous oxide adds another tool to the labor toolkit and can help you have the type of delivery you want for yourself and your infant.
Irene Beach is a certified nurse midwife at The Vancouver Clinic.
