In this age of the epidural, nitrous oxide, or “laughing gas”, can be a perfect solution for many women who would love to give birth naturally but who are afraid to be without any access to pharmacological pain relief in labor. Since 2012, women in the U.S. have had access to nitrous oxide in select birth centers and hospitals. It is a safe, non-invasive, self-administered, fast-acting and of short duration (the effects wear off in minutes) analgesic for labor. In most other developed countries, nitrous oxide has been used for labor pain management for decades. It gives women an alternative to other methods of pain relief, such as epidurals, which can have side effects of an increased chance of having a cesarean section and problems with breastfeeding. In the United Kingdom, 50% of laboring women use nitrous oxide at some point in their labors, in Finland 60%, and it is widely used in Canada. Holly Powell Kennedy, a nurse-midwife who teaches at Yale University and who has attended births in England says, “Nitrous oxide is just part of life; women expect they will have access to it. It’s in every birth room and every bathroom so women can use it and still be mobile.”
Nitrous oxide works by increasing the release of hormones made in the mother’s brain that reduce anxiety and provide her with pain relief and a sense of well-being. It is mixed with oxygen and self-administered by the mother herself through a mask she holds to her face – usually at the peak of contractions. This allows the woman to decide when and how much nitrous oxide she needs for pain control. She can stop using nitrous oxide at any time, and it begins to dissipate immediately after she stops breathing it through the mask, taking the effects only minutes to disappear. It is typical when women chose nitrous oxide that they use it later in labor at the peak of contractions. Informal surveys on the use of nitrous oxide in free-standing births centers, when it is available, indicate that less than 20% of women will use it during their labors. Mothers report an added sense of comfort and security even knowing that it is available. Midwives report that the availability of nitrous oxide can support some women to stay at the birth center rather than transferring for pain relief in labor.
Over the course of widespread use in many countries for the last 100 years, nitrous oxide has not been shown to have any adverse effects on the mother or on the progress of labor. Studies have found no significant adverse effects on the baby. Babies whose mothers have used this method of pain relief are as alert and responsive as babies whose mothers did not use nitrous oxide, and no effects have been found on mothers and babies bonding with each other or on breastfeeding.
If you suffer from certain diseases or conditions, or eat a strictly vegan diet, you may be at risk and will be advised to not use nitrous oxide.
For the past 3 years, the Monadnock Birth Center has been the only birthing facility in southern New Hampshire to offer nitrous oxide to women. Our midwives are happy to provide you with additional information on this method of pain relief.