Elevated Birth
  • Home
  • Services
    • Birth Support
    • Postpartum Support
    • Postpartum Meals
    • Gift Certificates
  • About
    • More About Me
    • Client Testimonials
    • Promotions & Events
  • Contact
  • Parent Resources
  • Blog

What You Need to Know About Nitrous Oxide in Labor

12/12/2018

Comments

 
nitrous oxide for labor
Curious about nitrous oxide as pain relief in labor?
If you are pregnant, sooner or later you will think about how to manage the pain of labor. Some clients know they want to get an epidural, and others would prefer to either forego pain medication entirely, or see how they feel in labor and make a decision in the moment.

Pain management and comfort measures are topics I discuss at length with my clients in our prenatal meetings. When clients want to avoid or delay pain medication, we talk about natural pain relief methods like counter pressure, hydrotherapy, heat therapy, and position changes. 

When clients are open to pain medications, but want to avoid or delay an epidural or narcotic medication, nitrous oxide can be a great option.

Nitrous oxide has been used by laboring people in the United Kingdom, Australia and Canada for decades. The ACNM (American College of Nurse-Midwives) supported its use in a 2011 position statement, affirming nitrous oxide as a pain relief option that fits into the midwifery model of care. 

​While nitrous oxide was once frequently used in United States, in the 1970’s its use declined as epidural analgesia surged in popularity.  As of 2017, one report stated that nitrous oxide was available in only around 150  hospitals and 50 birth centers nationwide. 

Fortunately for those in the Treasure Valley, both major hospital systems, St. Lukes and St. Alphonsus, offer nitrous oxide, also known simply as “nitrous,” in their labor and delivery rooms.

With all interventions, there are benefits and risks. Here’s what you need to know if you are considering using nitrous oxide in your upcoming birth:
​

The Benefits of Nitrous Oxide in Labor

  • It doesn’t affect the normal progress of labor. Often with an epidural, pitocin (artificial oxytocin) is used to compensate for reduced uterine contractions. Nitrous doesn't interfere with the normal course of labor.  It can also be used at any stage, from early labor to the pushing stage.
  • Your movement is not restricted. Although you may have to remain close to the nitrous tanks to utilize the gas, you can labor in any position: standing, squatting, bouncing on a birth ball, on all fours, etc. While you can lie in bed while using nitrous, you aren't limited to the bed as you would be if you were administered an epidural.​
Picture
  • You are in control. You administer the nitrous oxide yourself by holding your own mask; when you don’t want it anymore, you remove the mask. With other pain medications, like narcotics and with the epidural, if you have a negative reaction you may have to wait until the medication runs its course through your system, or you may not have the option to discontinue its use until after your baby is born.
  • Its effects are immediate. As soon as you breathe in the gas (which is actually a 50/50 mixture of nitrous oxide and oxygen), you begin to feel its analgesic (pain relieving) effects. As soon as you remove the mask, the gas dissipates quickly and its analgesic effects stop almost immediately.
  • It may help you breathe more efficiently. Often people tense up during contractions, and they forget to take the deep breaths which help them more effectively manage their pain. Because you have to take deep breaths into the nitrous mask to get its full effects, you may be better able to regulate your breathing, ensuring you get enough oxygen and helping you to remain calm.
  • It does not affect infant alertness at birth or interfere with breastfeeding. Pain medications like narcotics and the epidural can cause your baby to be “sleepy” at birth, which can delay the initiation of breastfeeding, or result in lower Apgar scores. These effects are not seen with the use of nitrous oxide.​
boise doulas
  • No drop in blood pressure, so no need for an IV. Epidurals cause a decrease in blood pressure. An IV is required when you get an epidural to help keep blood pressure stable.
  • No catheterization is required. When you get an epidural, a catheter is inserted into your urethra to catch urine. There is no such need when using nitrous.
  • No risk of maternal fever. When you get an epidural you are more likely to experience hyperthermia, or a rise in body temperature. Sometimes this manifests as a clinical fever, which can pose risks to the baby.
  • Continuous fetal monitoring is not required. When you get an epidural or narcotic medication, you will be continuously monitored for signs of fetal distress. (With narcotic medication you can usually revert to intermittent monitoring after a time). While this monitoring is usually external, sometimes internal fetal monitoring becomes necessary. No additional monitoring is required when using nitrous.​

The Risks, or Downsides of Nitrous Oxide in Labor

  • Nausea or vomiting. Some people don’t tolerate the gas well, and find that it makes them feel nauseous. If this occurs, you can discontinue its use and move on to another method of pain management. Know that nausea and vomiting are common symptoms in active labor, whether or not you utilize any pain medication.
  • Dizziness. Some people experience an uncomfortable dizziness or lightheadedness. You may choose to stop using the nitrous, and this feeling should go away.​
labor support boise
  • Nitrous oxide doesn’t completely eliminate pain. My clients who have used nitrous explain that they can still feel their contractions, but they feel more relaxed when managing them.
  • You must hold the mask yourself. The laboring person is required to hold the nitrous mask to their own face as a safety measure. If you become too dizzy or faint, the hand holding the mask will naturally fall away from your face, and the nitrous will dissipate. Some people find holding the mask cumbersome or tiring.
  • Long term effects on fetuses and newborns are unknown. While the use of nitrous oxide has been shown to have no effect on newborn alertness, the long term effects of exposure are unstudied. One study showed neurological dysfunction in rodents when given at high doses, and there have been some concerns about harmful reproductive effects from prolonged exposure in heath care workers.
  • Certain populations may have negative side effects. Those with Vitamin B12 deficiency, the MTHFR gene mutation, acute asthma or lung disease, or bowel obstruction are at risk for harmful side effects from using nitrous oxide. Consult your care provider if you fall into one of these at-risk groups.
I am a certified labor doula (birth doula) and postpartum doula serving clients in Boise, Eagle, Meridian, Nampa, and the Greater Treasure Valley. 
Are you considering using nitrous oxide in labor? Would you like more information about it?

Let's Talk!
elevated birth
​Copyright 2018
Comments

    Doula Raquel

    I've worked in the forest, in the lab, and in an office cubicle. My favorite and most passionate work has been alongside clients as they reach inside to find their innermost strength, and give birth to their babies. Each birth is an honor to witness.

    Picture

    Archives

    August 2019
    July 2019
    May 2019
    April 2019
    February 2019
    January 2019
    December 2018
    November 2018
    October 2018
    September 2018
    August 2018
    July 2018
    June 2018
    May 2018
    April 2018
    March 2018
    February 2018
    January 2018
    December 2017

    Categories

    All
    About Raquel
    Birth
    Birth Options
    Breastfeeding
    Cesarean Birth
    Childbirth Education
    Doula Support
    Healthy Living
    Labor
    Lifestyle
    Loss
    Newborn Education
    Out Of Hospital Birth
    Pain Management
    Parenting
    Planning For Baby
    Postpartum
    Postpartum Health
    Pregnancy
    Second Baby
    Treasure Valley

    RSS Feed

Location

What Our Clients Are Saying

"Five stars aren't enough - Raquel is incredible! She made sure that I was informed and comfortable with all of the decisions made both before and during labor. She's an excellent resource for information, and she respected every decision that I made along the way . . . I am so grateful that she was there for me through labor and delivery (and my husband is too!). If we have another baby, she'll be my number one choice of doula." - Alex H.

connect with me

    Subscribe TO my EMAIL LIST FOR UPDATES & PROMOTIONS

Subscribe
  • Home
  • Services
    • Birth Support
    • Postpartum Support
    • Postpartum Meals
    • Gift Certificates
  • About
    • More About Me
    • Client Testimonials
    • Promotions & Events
  • Contact
  • Parent Resources
  • Blog