You might have heard a lot about the epidural as a form of pain relief… but you may not have heard as much about the return of a different kind of pain relief -nitrous oxide, commonly known as laughing gas.
Commonly used in the UK and throughout the rest of Europe, nitrous oxide is self administered and is made of a 50/50 blend of nitrous oxide and oxygen. Surprised it wasn’t offered to you before? That’s because St. Mary’s and St. Francis are one of the few hospitals, nationwide, and the only ones in Virginia to offer nitrous oxide as a form of pain management to birthing women.
Richmond Top Doc, Dr. Alice Hirata took some time out of her busy schedule at Virginia Women’s Center to answer our questions about nitrous oxide and it’s use during labor.
Rmom: Nitrous oxide for labor has been around for quite a long time (over 50 years) why has it recently gained popularity?
Dr. Hirata: I think nitrous got overlooked in the United States for years because births became hospital-based procedures and stronger alternatives, like epidurals and twilight sleep, became available. More recently, couples are realizing the risks associated with over medicated, highly procedural deliveries. Allowing space, time and more natural support for the birth process frequently leads to beautiful, safe vaginal births. Simpler can be better. This movement includes nitrous oxide or laughing gas as another tool to offer aid in the natural birth process.
Rmom: Does the use of nitrous oxide prohibit me from walking, using the tub, or using other labor positions?
Dr. Hirata: Nitrous oxide is quick acting and very simple to use. The laboring woman has full control of how much gas she’d like to use as she holds a mask to her face and only breaths as much gas as benefits her. The gas can be used intermittently or regularly over a short span of time or several hours. The gas is cleared by a tube attached to the wall so it limits use to about 10 feet. That’s why it can’t be used in tub or shower. The woman can use it in bed, standing, on a birthing ball and right up to the time of birthing or getting an epidural. It’s use is very flexible especially because it clears from her body very rapidly.
Rmom: Do I have to choose between using nitrous oxide or an epidural?
Dr. Hirata: Nitrous can be used along with numerous support measures and doesn’t preclude a woman getting an epidural.
Rmom: Do I need to tell my doctor before I go into labor that I plan on using nitrous oxide for pain relief? At what stage of labor can nitrous oxide be used?
Dr. Hirata: It’s helpful if a laboring couple share with their caregivers their interest in possibly using nitrous. That way an easy consent can be reviewed early in labor and there be no delay in the woman receiving this option should it become desired as a labor progresses. Typically it’s best to hold off on use of nitrous until the woman is finding that other comfort measures are no longer helping her cope adequately. Nitrous can buffer the tricky transitions of labor; it doesn’t remove discomfort but can decrease fear and anxiety. It can help keep discomfort under her control.
Rmom: Are there any side effects from nitrous oxide for me or my baby?
Dr. Hirata: Nitrous is thought to be quite safe for mom and baby. In some women, it can cause lightheadedness or nausea. These sensations clear quickly after stopping use of the gas. The baby is not affected. However, anyone with celiac disease or problems with vitamin b12 should not use nitrous.