You see it in dentists’ offices nationwide, but until about five years ago, there was one place you didn’t see nitrous oxide (laughing gas): in the delivery room.

But this isn’t true everywhere. Nitrous oxide is an anesthesia option for laboring women in Canada, Europe, and Australia as an alternative that rests somewhere between an unmedicated childbirth and epidural anesthesia. In the United States, only five hospitals and medical centers offer nitrous oxide specifically for labor analgesia:

  • The Birth Center at the University of California San Francisco
  • Okanogan Douglas District Hospital in Washington State
  • St. Joseph Regional Medical Center in Idaho
  • University of Washington Hospital in Seattle
  • Vanderbilt University Medical Center in Nashville

Independent, free-standing birthing centers may also offer nitrous oxide. In 2014, several hospitals are expected to add nitrous oxide anesthesia to their services list, including Brigham and Women’s Medical Center in Boston.

Nitrous oxide is not new to the delivery room—it just fell out of fashion with improvements to the epidural. American women commonly used nitrous oxide between 1930 and 1970 as a way to reduce labor pains and promote relaxation. When inhaled, nitrous oxide works quickly in one minute or less to relieve anxiety and reduce pain. While these effects are not as pronounced as an epidural, they offer a laboring mother greater control without limiting a mother’s feeling in her legs and back.

Today’s nitrous oxide is not the same as what your grandmother used, however. The nitrous oxide utilized more than 30 years ago was often administered in stronger percentages than today’s blend. For example, some women gave birth breathing in 80 percent nitrous oxide mixed with 20 percent oxygen. This was often combined with heavier pain medications, such as morphine, to induce pain relief.

Today, concentrations are 50 percent nitrous oxide, 50 percent oxygen, which minimizes side effects, such as reduced oxygen saturation. To utilize the nitrous oxide, a laboring mother places a mask over her face that delivers the gas. If she becomes sleepy or the pain starts to subside, she then drops the mask, and the gas quickly leaves her system.

Hospitals and medical centers must first acquire the infrastructure to mix the two gases. Currently, the U.S. Food and Drug Administration has not approved the use of pre-mixed nitrous oxide and oxygen tanks.

With an estimated 40-60 percent of European women utilizing nitrous oxide during labor, the number of American women and hospitals offering the service is likely to increase as well. Nitrous oxide will not provide pain-free labor, but it can comfort some laboring mothers and give them added control over their pain relief.

Reviewed by Dr. Jen Lincoln, November 2018

Takeaways

  • Nitrous oxide was commonly utilized during labor in the 1930s-1970s. It is now experiencing a resurgence in popularity.
  • Five hospitals and several independent medical centers offer nitrous oxide administration during labor in the U.S..
  • Laboring mothers can control the use of the gas during labor, making it a self-administered anesthesia.

References

  1. Medscape. Nitrous Oxide Administration.
  2. MedPage Today. Laughing Gas Bringing Smiles to More Women in Labor.
  3. Stewart, L., & Collins, M. (2012). Nitrous Oxide as Labor Analgesia. 2013 Feb; 17(1): 12]. Nursing For Women’s Health, 16(5), 398-409. doi:10.1111/j.1751-486X.2012.01763.x
  4. Vanderbilt Center for Women’s Health. Labor and Baby’s Birth.

Comments

  1. they have it in the hospital where im delivering and they say it doesnt cross the placenta at all…the safest alternative from what i hear….i am definitly going to give it a shot so ill let you know how it goes in a couple weeks 🙂

    Reply
    1. Yes, definitely let us know about your experience, and good luck!

      Reply
  2. I find this article very interesting. I’d love to see some info on how the child is affected, though. I’m definitely intrigued…

    Reply
    1. Kristen I am there with you – since this is a technology I (and most American OB/GYNs!) have never been exposed to, I would also like those studies. I imagine it has similar effects to IV pain medications that we give in labor, but it would be nice to see more to that effect.

      Reply
    2. Agreed. My biggest concern going into labor was the effect of any pain relief having an effect on the baby. I’d be for this if studies showed the baby wasn’t exposed to anything dangerous!

      Reply
  3. This is great news! If it will help ease anxiety and some pain during labor I’m all for it (as long as it’s safe for the little one). 🙂 I especially think the fact that mothers can control the use of the gas is amazing! This way they feel more comfortable and aren’t undergoing unbearable pain. They can have just the right amount they need to provide some relief.

    Reply

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