Dec 092014

new-nitronox-system-retouchFor decades, women in Australia, Canada and the UK have had the option of using nitrous oxide in labor. In the US, women have had fewer options: no medication at all or options for pain management that affect the labor, the baby, or the mother in negative ways with resulting interventions.

Many people in the United States associate nitrous oxide with dental use: dentists have been prescribing various combinations of nitrous oxide and oxygen during procedures for over a century. While commonly called “laughing gas”, nitrous oxide provides a safe way to ease discomfort during dental care and surgery. We’re glad that nitrous oxide is now an option for laboring women in the U.S.!

At Andaluz, we have had nitrous oxide available for four months now, and most of our clients have continued to give birth with our midwives without the need for an analgesic, however, some of the women who have chosen to use it in labor most likely would have transported or had a cesarean without the availability of N20. We are excited to continue supporting families in their childbirth choices, with nitrous as an option to help women who desire or need pain relief in labor. 

We’ve gathered a list of great articles on the safety, politics, and use of nitrous oxide in labor for reference. As always, please discuss with your midwife any questions or concerns you may have regarding nitrous oxide in labor.

Nitrous Oxide for Laboring Women in the US – a great article on nitrous oxide for labor, written by Jill Arnold, from “The Unnecessarean”. She includes firsthand accounts of women that have used it in labor.

 It could only be ideologically or symbolically administered without full agency (to answer critics mentioned above), as successful administration of nitrous oxide depends on self-administration.

The 50/50 mixture of N2O with oxygen used in hospitals is eliminated through the lungs, not the liver, making it a safe option for mother and baby if self-administered properly. Women in countries that offer nitrous oxide (“gas and air”) routinely at both hospital and home births find it absolutely bizarre that the option is not available in the United States. Nitrous oxide is a medical gas that can be discontinued as quickly and easily as it is started. The effects are completely gone within five minutes.

Consider the Source: An Interview with Judith Rooks regarding nitrous oxide – Judith Rooks is a midwifery researcher that has long been fighting to get nitrous oxide available in the US for laboring women. This interview includes studies regarding safety and mode of delivery and effects on the mother, labor, and baby. Also included in this article is a video of a woman using nitrous oxide during her labor/birth.

Rapid elimination of N2O through the lungs means that if a woman decides after starting to use nitrous oxide that she doesn’t like it or no longer needs it, she can set the mask down and stop inhaling the gas. Her body will be completely free of nitrous oxide in less than 5 minutes. In contrast, it may take many hours for a woman’s body to be completely free of the effects of an opioid or epidural.

American College of Nurse Midwives statement on Nitrous Oxide during labor

Despite widespread and extensive use of N2O for labor analgesia in many countries since the early 1900s, no studies or published observations have identified significant adverse effects on the neonate. The need for neonatal resuscitation is not increased, and newborn alertness and responsiveness during the important early period of maternal-infant bonding and early effective breastfeeding are unaffected. It is safe for a woman to use N2O throughout the entire second stage of labor.


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