A beautiful part of birthing in the twenty first century is our ability to choose the pain management tool that works best for us. For some, this is massaging hands of their partner and doula, heat and cool packs, electrical stimulation, epidurals or narcotics. For others, this is Nitrous Oxide.
Nitrous Oxide
Nitrous Oxide is a gas, commonly referred to as laughing gas, and is often used in dental offices for oral procedures.
Nitrous Oxide is considered an effective and noninvasive method of pain management for hospital based births because it is safe for both the laboring person and the baby. In labor, the gas is administered through a mask the birthing person holds to their face. It is important to note the only person allowed to administer nitrous gas is you, the laboring patient. Your partner, doula, nurse, nor medical provider is permitted to hold the mask for you. The effects of inhaling nitrous are short lasting, so once you remove the mask, the effects begin to dissipate within seconds. Therefore, if you decide you want to discontinue use for any reason, simply put the mask down.
Below are four strategies to making the most out of Nitrous Oxide as labor tool:
Sign consent forms in advance.
Many OBGYN providers will give the option to sign consent forms for administering Nitrous Oxide during labor while in the office during a regularly scheduled prenatal appointment. Usually around 37 weeks, your provider will likely discuss pain management options. Even if you are just thinking about using Nitrous Oxide during labor, you have the option to sign the consent form ahead of time. The provider will have this on file during labor saving you a little time when you are ready to use it. The other benefit of doing this ahead of time means you can ask any and all questions you may have about the treatment. Allow your provider to explain the risks, benefits, and logistics of using Nitrous before you’re distracted by the emotions and physical components of active labor.
Request set-up upon arrival.
Hospitals usually only have a few Nitrous set-ups on hand. If you know you are planning to use this method of pain management, ask your nurse to set it up once you have been admitted and settled into your hospital room. You don’t ever need to use it, but if it is set up, then you won’t have to wait once you decide you feel ready to give it a try. As you may have experienced in other medical situations, the nurses are often very busy attending to all of their patients. Sometimes that means a longer than desired wait for requests to be filled. If the Nitrous device is already set up, there is less risk of delay when the time comes to implement this tool.
Begin use during active labor.
Like many pain management tools and devices, there is a strategy and window in which each method is most helpful. If you begin to use Nitrous very early in labor, it may not feel as useful during active or transitional labor. During early labor, things like open squatting, walking, pelvic tilting on a birth ball, or warm baths are better pain management techniques. Larger movements that make space for baby to move down the birth canal are better suited during this time. Once baby has begun their decent and has become engaged in the pelvis, the laboring mother may feel that she needs a respite from the intensity of the strengthening contractions. At this time, many patients may bring up the need for some pain management stronger than encouragement, position changes, and hands on support. When the intensity of the contractions is overwhelming, if your contraction requires your complete concentration, you cannot walk, talk, or smile, or if you notice your legs begin involuntarily shaking during a contraction, this is a good time to use Nitrous Oxide.
Take full and complete breaths.
If you can control your breathing during transitional labor, you can effectively relax your body enough to make space for baby to come down the birth canal. The intensity of the contractions can often make that controlled, deep breathing feel impossible. One of the greatest benefits of using Nitrous Oxide is that it forces the laboring person to take deep, complete breaths. The mask goes onto the nose and mouth. The patient takes a deep inhale through the nose. The patient lets out a deep exhale through the mouth. As the contraction intensifies, the nitrous allows you to relax enough to ride through the contraction’s wave. Once your exhale is complete, you find yourself on the other side of that contraction, able to relax and rejuvenate before the next wave begins. In between these contractions, put the mask down. Take a cleansing, oxygen rich breath into your lungs to bring oxygen to your baby. On the next contraction, begin this same deep breathing technique.
What to expect.
The initial inhale of Nitrous gas may make you feel slightly dizzy. Patients have described a feeling of being inside a tunnel, feeling very relaxed, floating, or other various levels of euphoria.
Patients must remain on their bed or in a chair while using this gas. They can arrange themselves on hands and knees, side lying, or resting on the elevated back of the hospital bed. Due to feelings of light headedness, patient cannot be standing while inhaling Nitrous Gas. However, as soon as you put the mask down, you are considered safe to move about the room, use the bathroom, squat, etc.
Unlike the limiting mobility caused by an epidural, Nitrous allows you to use and discontinue use as you please. If you want to use it for ten contractions, then get up, take a shower, and come back to use it again thirty minutes later, you are free to do so. Nitrous allows you options with no time limit or intravenous medications.
Do not expect Nitrous to take away the feeling of each contraction, use this pain management tool to focus on deep, complete breathing. If you can relax your breath, you can relax your shoulders, and if you can relax your upper body, you can relax your lower body. When your body is relaxed, it will do its job and bring baby down exactly how he or she needs to travel.
Nitrous can be used during labor and the pushing phase of delivery. Some patients find it especially helpful once baby is born, to assist in coping with sensations during the delivery of the placenta and in the event that any repair is required after delivery.
Nitrous is not available at all birth locations. As with all medical interventions, be sure to understand all risks and limitations before consenting to any procedure.
By: Laura Martin
