Investigating the Use of Nitrous Oxide in Labor

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Moms-to-be have several options for managing labor pain beyond an epidural. Get the facts about the safety, efficacy and use of nitrous oxide in labor.

Nitrous oxide, also known as N2O or laughing gas, is a clear, tasteless and odorless gas that patients inhale through their mouths. Most people are familiar with nitrous oxide’s role in dental care, but many don’t realize it can also be used during labor to help keep moms calm and make managing contractions easier.

An International Trend Comes Home

The use of nitrous oxide in labor isn’t new. Early reports of its use date back to 1881, according to the American Society of Anesthesiologists. In the United Kingdom, Canada, Australia, Norway and other countries around the world, nitrous oxide is commonly used to help manage labor pain. But in the United States, the popularity of laughing gas declined during the 1950s, and it’s just now starting to make a comeback.

How It Works

Low doses of nitrous oxide work differently than other pain management strategies. Epidurals, for example, relieve pain by causing some degree of lower-body numbness. Narcotic medications, according to MedlinePlus, block pain by binding to certain receptors in the brain.

Some women report pain relief when using laughing gas during labor, but nitrous oxide’s greatest benefit appears to be reducing anxiety. When women inhale nitrous oxide, it increases levels of several feel-good chemicals within the brain, including endorphins and dopamine, according to the American College of Nurse-Midwives.

Weighing Nitrous Oxide Risks and Benefits

Unlike epidurals, laughing gas doesn’t affect a woman’s ability to walk during labor. Laughing gas also differs from epidurals and narcotics because women can control how much gas they use. Moms self-administer the medication by using a portable mask to inhale the gas as needed.

The effects of nitrous gas are nearly immediate, and they dissipate rapidly. If women don’t like the way the gas makes them feel, for example, the gas completely clears their system within as little 5 minutes, according to the American College of Nurse-Midwives.

When it comes to assessing the safety of nitrous oxide, the American Society of Anesthesiologists notes that more current research is necessary. However, studies on nitrous oxide performed in other countries reveals that the medication is typically well-tolerated by moms and poses little risk to babies. Mild side effects can occur, however, and may include:

  • Drowsiness
  • Dizziness or lightheadedness
  • Nausea and vomiting

How Do Providers Use Nitrous Oxide in Labor?

Laughing gas administered during labor is typically a mixture of 50 percent N2O and 50 percent oxygen. Women can use nitrous oxide for comfort during all stages of labor or while receiving an epidural.

Have you picked a pediatrician? Meet Alan Brown, M.D., and Bird Gilmartin, M.D., board-certified Pediatricians in Evanston who provide super care for your super kid

Drs. Brown and Gilmartin are members of the medical staff at Evanston Regional Hospital.