Nope, it’s not like going to the dentist.
If you’re thinking about your pain management options for labor, here’s a surprising (but not new) option – nitrous oxide, otherwise known as laughing gas. While folks in Finland, Canada, the UK, and Australia have been using laughing gas to relieve labor pain since the mid 1800’s, the US has been late to the party. According to a 2014 piece in The Atlantic, the laughing gas option has only been offered to women in labor by 1% of US hospitals. So, what’s up with laughing gas? How is it different from an epidural? Why aren’t more doctors in the U.S. using it?
When you hear “laughing gas,” you probably think of what you get when you go to the dentist, in order to relieve pain. What’s used in labor is a slightly different cocktail than what’s administered for a root canal. A combination of 50% of nitrous oxide and 50% of oxygen is used during labor, applied via a mask (as opposed to an epidural, given by way of an injection into the back while you lay on your side or sit up). The laughing gas also offers the added benefit of ending whenever you no longer want it. This level of the gas doesn’t knock you out, so when you feel a contraction, you take a deep breath in through the mask, inhaling the gas and processing the effects, but as soon as you take the mask off, you no longer experience what the gas can do.
While a traditional epidural blocks sensations in the lower part of the body until it wears off, laughing gas doesn’t eliminate pain or feeling, it just de-intensifies it. As Cynthia Voytas, a midwife and nurse in Rhode Island, told NPR in 2015, “It gives you this euphoria that helps you sort of forget about the pain for a little bit.”
Liza Maltz, founder of Birth Your Own Way Doula Services, advises those who are interested in a low intervention, vaginal birth to consider nitrous oxide. “It’s a little extra help coping with the pain and anxiety of labor,” she says. Since the administration of the gas is entirely up to the person in labor, it can especially help those who may want to maintain control and be mobile during labor. Nitrous oxide also doesn’t impact the newborn, because it dissipates so quickly, and for the same reason, there’s also no effect on breastfeeding. Laughing gas is a good alternative for those who are advised to avoid epidurals because they’re on blood thinners.
According to Nick Angelis, a nurse anesthetist in Florida, the best reason to use nitrous oxide is to avoid the back pain that may come with an epidural. “Having taken a patient’s blood and injected it into their epidural space to cure an unbearable spinal headache from the epidural going too deep, if I were female and pregnant, I would want to try laughing gas instead of an epidural,” says Angelis, who also recommends laughing gas for folks who are already interested in trying for a natural birth.
You might experience nausea and vomiting from using laughing gas, but probably the worst news about it is that it only works up until a certain point, and after that, it might be too late to administer an epidural (if it’s not too far long in the labor process, you can get one – laughing gas in no way interferes with it).
Since laughing gas is safe and effective, why is it still such an anomaly in U.S. hospitals? The number of hospitals offering it has increased, but why is it taking so long to catch on? Epidurals are strong, for one, which is why you might opt for one, and they’re also the most common means of pain management, so it’s not really a surprise that people are going with what they know.
It seems unlikely that laughing gas would completely replace epidurals for pain management during labor, because it’s not right for everyone, but the more options, the better.