Labor is no laughing matter—or is it?
If you live in the west Michigan area, you might have seen the recent news report about Spectrum Health Zeeland Community Hospital using nitrous oxide in its Family Birth Center.
Here at Spectrum Health Gerber Memorial, we are also using nitrous oxide. And most of the other Spectrum Health hospitals will be in the near future.
It has been used in many other countries for decades and is considered safe.
I remember watching the show, “Call the Midwife” set in the 1950s in England and based on a midwife’s diary. They did an episode about the use of nitrous in labor.
England has been using this for many years. According to the American College of Nurse-Midwives, “Research has supported the reasonable efficacy, safety and unique and beneficial qualities of N2O as an analgesic for labor and its use as a widely accepted component of quality maternity care.”
What is it and why use it in labor?
Nitrious oxide is a tasteless and nearly odorless gas that you inhale to provide pain relief. Most people are familiar with this in the context of the dentist’s chair. It’s sometimes called “laughing gas.”
It has rapid onset (30 to 50 seconds) and clears the system completely within five minutes.
Nitrous provides pain relief by “helping to take the edge off” contractions. It is not meant to numb you like an epidural. It can be a great alternative, with minimal, if any risk, to narcotic or epidural analgesia.
According to the Journal of Midwifery & Women’s Health, “Nitrous oxide labor analgesia is safe for the mother, fetus, and neonate and can be made safe for caregivers. It is simple to administer, does not interfere with the release and function of endogenous oxytocin, and has no adverse effects on the normal physiology and progress of labor.”
The patient administers the gas herself, right before a contraction, by holding the face mask up to her face and breathing until the contraction is over. When the contraction is done, she moves the mask away.The gas is only to be used and administered by the pregnant woman.
Is there a reason you can’t use nitrous oxide?
Yes, reasons are as follows:
- The patient is unable to hold the mask
- The patient has impaired consciousness
- The patient has a documented vitamin B12 deficiency
- If the patient has received pain medication in the prior two hours
- If there are problems with the baby
The use of nitrous requires an order and evaluation by the provider. Also, an informed consent is signed.
When using the nitrous, the nurse will stay with the patient for the first 15 minutes to explain and monitor the use of the equipment. It may also be used while mom is in the labor tub with the nurse assisting.
Potential side effects include dizziness, nausea, lightheadedness, unsteadiness, dysphoria (feeling bad).
Mom has the choice, if she desires, to stop using the nitrous oxide and use another form of pain medication.