Nitrous oxide, often recognized as “laughing gas,” is a pain relief option that has gained renewed interest for use during labor. It involves inhaling a mixture of nitrous oxide and oxygen to help manage discomfort. This article explores how nitrous oxide works during labor, its safety considerations for both mother and baby, and various factors that influence its suitability as a pain management choice.
How Nitrous Oxide Works During Labor
Nitrous oxide provides pain relief and relaxation by affecting the brain’s perception of pain and reducing anxiety. This effect helps to dull pain rather than eliminate it entirely.
The administration of nitrous oxide during labor is self-controlled by the laboring person. They inhale the gas through a mask or mouthpiece, which is connected to a demand valve that releases the gas only when they breathe in. For optimal effect, it is recommended to begin inhaling the gas approximately 30 to 50 seconds before the peak of a contraction. This timing allows the gas to reach its peak concentration in the bloodstream as the contraction intensifies.
Nitrous oxide has a rapid onset and offset of effects. Pain relief begins within 30 to 50 seconds of inhalation. Once the person stops inhaling, the gas is quickly exhaled from the lungs, and its effects dissipate within 3 to 5 minutes. This rapid clearance means that the person maintains control and can remain mobile between contractions.
Safety for Mother and Baby
Nitrous oxide is considered safe for both the laboring mother and the baby. For the mother, common side effects are mild and transient. These can include dizziness, light-headedness, nausea, or a feeling of drowsiness or euphoria. If these effects occur, they resolve quickly once the person stops inhaling the gas.
Minimal amounts of nitrous oxide cross the placenta. However, because the gas is poorly soluble and quickly exhaled through the lungs, it does not accumulate in the baby’s system. Studies examining outcomes have not found evidence of adverse neonatal effects associated with maternal nitrous oxide use.
Nitrous oxide does not cause respiratory depression in newborns or interfere with the baby’s heart rate. It also does not affect the progression of labor or the mother’s ability to push. It does not accumulate in breast milk, allowing for safe breastfeeding after delivery.
Considerations for Use
While widely considered safe, nitrous oxide may not be suitable for everyone during labor. Certain medical conditions can contraindicate its use, such as a significant vitamin B12 deficiency or pernicious anemia, as nitrous oxide can interfere with B12 metabolism. Conditions involving air-filled spaces, like a recent pneumothorax or certain inner ear or retinal surgeries, are also contraindications due to the gas’s ability to expand these spaces.
Nitrous oxide offers pain relief and anxiety reduction, but it does not completely eliminate labor pain. Many women report it helps “take the edge off” contractions and allows them to cope better. It can be used at any stage of labor, and even for postpartum procedures like laceration repair.
The decision to use nitrous oxide is made in consultation with healthcare providers, such as obstetricians, midwives, or anesthesiologists. They assess the individual’s medical history and current labor progression to determine if it is a suitable option. The self-administered nature of nitrous oxide gives the laboring person a sense of control over their pain management.