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Nitrous Oxide Use for Labor and Birth

What is Nitrous Oxide

Nitrous oxide use for labor pain is a mixture of 50% nitrous gas and 50% oxygen that is inhaled through a mask or mouthpiece that a woman holds and self-administers, as she wishes. A version of nitrous oxide is used widely in dental offices, where most people know of it as "laughing gas". The blend that's used in laboring women is different, and does not have the same effect, as it is not anesthesia. The pain may still exist for some women but the gas should decrease the intensity. It has been, and still is, widely used in Canada and Europe for labor.

How Does Nitrous Oxide Work?

You hold your own mask or mouthpiece and begin to inhale the gas mixture about 30 seconds before a contraction begins. Starting to inhale before a contraction begins helps the gas to reach its peak effect at about the same time as the contraction reaches its peak, providing the greatest relief.

Frequently Asked Questions

Does it have any side effects? Some women have reported nausea after prolonged use; medication to help ease the nausea is available if that happens. It can also cause some unsteadiness when up, which is why there should always be a family member or staff person in the room when you would like to get out of the chair or bed, in case you need assistance.

Can I still be out of bed and use nitrous? Yes; you may be out of bed and use the nitrous. As long as you are steady on your feet, you may be up and about in your room.

Is there any extra monitoring required? There is no additional monitoring required when using Nitrous Oxide.

Do I need an IV? No. It is not necessary to have an IV inserted to use Nitrous Oxide.

Can I use nitrous and have intravenous narcotics at the same time? No, the combination of narcotics and nitrous can slow your breathing so they would not be used together.

Can I use nitrous in the tub? Yes, however, we will want to be sure we know how you will respond to Nitrous before hydrotherapy is initiated.

Are there any reasons I could not use it? Yes: you cannot use it if you:

  • cannot hold your own mouthpiece or facemask; 
  • have received a dose of narcotic in the past 2 hours;
  • have pernicious anemia or a B12 deficiency for which you take B12 supplements;

Are there any effects on baby? No, there are no known effects on the baby; nitrous is the only pain relief method used for labor that is cleared from the body through the lungs, so as soon as you pull the mask away, the nitrous effect is gone within a breath or two.

Do I have to choose between either using nitrous oxide OR having an epidural? No; some women may use nitrous prior to having an epidural placed. Though they would not be used together (the epidural and nitrous), it is perfectly fine to use nitrous first, and then move on to a different type of pain relief if you find you need to change to something else.

There are only a handful of hospitals in the country that offer this option for pain relief to laboring women; we are so pleased that we are able to make this option available to you!