It’s a Gas: Nitrous Oxide During Labor

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Nitrous oxide, commonly referred to as “laughing gas” is a clear, almost odorless and tasteless gas.  It is widely used in medical and dental procedures for sedation and pain relief and has a long track record of safety.  In labor, a mixture of 50% nitrous oxide gas and 50% oxygen is used and is self-administered by the laboring woman using a mask to inhale the gas. Using nitrous oxide in labor decreases the perception of pain and decreases anxiety helping a woman manage contractions. Nitrous oxide was first used in obstetrics in the 1930s but fell out of favor in the U.S. in the 1970s. In the last 9 years, it has re-emerged in the U.S. market and is growing in popularity.   Since March 2017, nitrous oxide has been available at Cone Health Women’s Hospital, and the demand for it continues to rise.

Like most medications, nitrous oxide does cross the placenta, but because the medicine acts so fast, it is quickly expelled.  Babies are not affected by the drug, get normal scores on newborn tests and the baby’s heart rate monitor labor shows no effects when a woman uses nitrous oxide.  Women may experience nausea, dizziness or drowsiness while using nitrous oxide, but these side effects do not last long since the medicine wears off so quickly.   Contractions are also not affected by nitrous oxide and it does not speed up or slow down labor.

Nitrous oxide can be used in any stage of labor in which a woman experiences pain.  It can also be used during obstetric procedures, repairs of vaginal tears, manual removals of the placenta, or even for IV starts.  Nitrous oxide is used by women who want a natural birth experience but need a little help coping with contractions.  It is also used by women who plan to get an epidural later in labor but want something else for a short time or in early labor.  There are a few reasons a woman should NOT use nitrous oxide, including the inability to hold her own facemask, certain types of anemia, history of certain eye surgeries, or significant heart problems.  If you would like to know if nitrous oxide is a good option for you, ask your doctor or midwife. Women’s Hospital has a dedicated team of certified nurse midwives, OB/GYN specialists and other related medical providers on the clock 24/7 to provide support throughout patients’ delivery process.

Spokesperson Background:

Lisa Leftwich-Kirby is a certified nurse midwife at the Center for Women's Healthcare and a member of Cone Health Medical Group. She earned an associate’s degree in nursing from Cape Fear Community College and a Bachelor of Arts in psychology from the College of William and Mary. Lisa earned her Master of Science in nursing from Frontier Nursing University.