Nitrous for Labor

General Information

Nitrous Oxide (N2O) ("Nitrous") is a colorless, nearly odorless, non-flammable gas first synthesized in the 1700's (4). It was not widely used medically until the mid 1850's and was introduced as an analgesic for dental procedures (4). It is also frequently used as anesthesia during pediatric surgical procedures due to its quick onset, quick dissipation, and low side effect profile. It is sometimes called "laughing gas" and is widely used throughout the industrialized world. In fact, in many counties, up to 80% of women will use Nitrous at some point during their labor (1). In the United States, Nitrous was widely used for labor, beginning in the 1930's through the 1970's, prior to wide spread use of epidural anesthesia (2). Recently, there has been interest in bringing back the use of Nitrous in the United States. Currently, there are several facilities, both hospitals and free standing birth centers, using Nitrous Oxide for pain management in labor.

In labor, Nitrous Oxide is used as an analgesic, not an anesthetic. In essence, an anesthetic creates a feeling of numbness usually with loss of consciousness, while an analgesic helps to alleviate the sensation of pain while remaining alert. In this sense, Nitrous Oxide can be a powerful tool helping some women cope with the sensations of labor. In addition to being an analgesic, Nitrous also acts as an anxiolytic, decreasing anxiety and allowing the user to reach a deeper state of relaxation (4). Nitrous is also known to increase the release of endorphins and prolactin while decreasing the release of cortisol, or the "stress hormone" (4). However, Nitrous has no effect on the release of oxytocin so it will not inhibit contractions or labor progress (4). In this way, Nitrous can facilitate relaxation, reduce the perception of pain, and give women a sense of control over her pain management. One cannot overdose on Nitrous, as it is mixed 50/50 with oxygen.

A key component of Nitrous use is patient autonomy and control. The laboring woman must be in complete control of the timing and use. When a contraction starts, the mom breathes in the gas and rapidly feels more relaxed. The effects of nitrous are felt within seconds and then also dissipate within seconds. Due to this level of control, many women report feeling empowered, increasing a sense of confidence after using nitrous. (1,2,3,4). Nitrous does not relieve all sensation, it simply allows the user to relax and work easier through contractions.

Maternal Effects

When Nitrous is used as an analgesic in labor, it has been clearly documented to be a safe option for women (1, 2, 4). Women remain alert, retain motor and sensory function and their uterine activity is not inhibited (2,3). Unlike narcotics and the epidural, nitrous can't slow down labor.

Newborn Effects

In over 100 years of use as analgesia during labor, there have never been any published studies or cases of Nitrous having a negative effect on the newborn (1,2,4). Several studies have clearly demonstrated a lack of negative effects, for example: there are no effects on newborn heart rate during labor or Apgar scores, no increase in rates of meconium stained fluid, no effects on newborn cord blood gases (1,2,4). It has also been demonstrated that when women use Nitrous, no increased need for neonatal resuscitative efforts was found (1).

The use of Nitrous in labor has been shown to have no negative impact on breastfeeding initiation or long term success (1, 2).

Use at Baby Love

We are excited to be able to offer this option to our clients and are proud to be one the first facilities in the state to offer Nitrous for labor. We want to be clear that this is an option: we still believe strongly in Hypnobirthing and water labor and birth. So far, the majority of moms who have requested and used Nitrous were unable to attend the Hypnobirthing class, but if you took the class and still want Nitrous for relaxation, that doesn't mean that you "failed" in any way.

Nitrous is simply an additional tool for women to enjoy labor. Nitrous does not inhibit labor progression, is completely controlled by the laboring woman, does not require more invasive monitoring, does not inhibit the ability to remain aware, and does not require the restriction of movement.

We charge $150 for Nitrous, covering the cost of the supplies, Nitrous and Oxygen gases, and setup of the equipment.

References

1. ACNM Statement
2. Nitrous Oxide as Labor Analgeia
3. Collins Starr Baysinger Bishop Publication
4. Safety & Risks of Nitrous Oxide