Laughing gas a new alternative to ease labor pains


by Baylor Scott & White Health

Jun 21, 2018

Over the last 16 years, I have had the absolute privilege of helping countless moms navigate the journey of childbirth. Childbirth has always been one of the most unique and individualized experiences a family will go through. Every birth story is different. Individuals have their own special and unique circumstances that are like no one else’s.

As a childbirth instructor, I see fear, tension and anxiety surface in moms-to-be as we watch the childbearing videos and discuss the pain associated with labor. However, while the concerns are typically the same, discussing the topic of pain is different among moms. For some, it’s the pink elephant in the room, while others ask endless questions about what the pain will be like.

One of my goals as a childbirth instructor and labor and delivery nurse is to encourage moms to view the pain associated with labor as normal and expected, as well as a part of the journey and story of their child’s birth.

The Pain of Labor and How Moms Choose to Manage It

The bulk of labor is most often described as both manageable and uncomfortable. Early labor is the longest phase and it is — most often — very manageable. In the later phases of labor, the pain becomes more intense, but this phase doesn’t last as long. This pain doesn’t have to be scary, but we do have to figure out what to do about it.

Just like each birthing journey is unique, each mom is unique in her opinion about how she would like to cope with the pain in labor.

Some moms are adamant that they don’t want to feel anything. They would prefer an epidural about a week prior to delivery (ha!), whereas other mothers long to feel and experience everything that labor has to offer; they don’t even want medication offered while they are in labor.

But there is also a large group of moms who sit somewhere in the middle. These moms would like something to help ease the pain of labor, but are still able to feel some things. They prefer an option that helps them remain mobile during labor while helping take the edge off at the same time.

My entire career I’ve had to tell moms, “Sorry, but it’s all or nothing. You can’t have your cake and eat it too.” I can offer IV narcotics, but once labor has progressed to the active phase, I can’t safely administer IV narcotics because of the risk of decreased respiratory effort in the baby after delivery. So, my patients had to choose between complete immobilization and complete blockage of the pain via epidural or experience all the pain that comes with active labor and transition.

New Option For Pain Management

Fortunately, now there is one more option — nitrous oxide during labor.

Yes, it’s exactly what you are thinking: laughing gas. Nitrous oxide can be safely administered right up until the moment the baby peeks his or her sweet little head into the world. The medication is self-administered through a mask. Mom inhales the gas when she feels a contraction coming on and releases the mask when she feels relaxed. Because the gas is self-administered, there is no risk of overdose. If you get too relaxed, you release the mask.

This may have you wondering: Why does my dentist not allow me to have nitrous oxide during dental procedures when I’m pregnant? Why is it unsafe at the dentist but safe for delivery?

Laughing gas is safe in labor for a few reasons. First, the concentration of the medication is different, which makes it safe to use during labor but not safe for dental procedures. Secondly, the nitrous oxide is used for term labor patients when the fetus is fully developed and not early in pregnancy when all the baby’s sweet little parts are still being knit together. Unlike an epidural, nitrous oxide will not block the pain sensation. However, it does decrease anxiety as well as a mom’s perception of the pain.

The Effectiveness and Benefits of Nitrous Oxide

The effectiveness of this self-administered gas peaks in about two minutes and is completely out of mom’s system in five minutes. Because nitrous is so short-acting, there is no risk of affecting the baby’s respiratory efforts at delivery.

One major benefit of nitrous oxide is that it is non-invasive. No IV’s, no catheters, no needles — just inhalation. And if you try the nitrous and it is not enough pain coverage for you, you can still get an epidural.

This new alternative to pain management is so exciting because it truly offers moms an in-between option for pain control while in labor. I tell my patients all the time, “I want you to have the experience you want to have. This is your day, your memory, your story.”

At the end of it all, my goal is to have a happy, healthy mom and baby. With nitrous oxide offered as a way to ease labor pain and anxiety, I’m able to do an even better job in accomplishing that goal!

Learn more about labor and delivery care at Baylor Scott & White Health, here.

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