Nitrous Oxide is now an option to manage pain, reduce anxiety during labor
By Jennifer Gallagher, R.N. May 16, 2018
In a state where the locals often joke that the newest products and technology come in on the pony express, nitrous oxide (N2O) is an exception.
The Ruth R. Ellbogen Family Birth Center recently implemented nitrous oxide for use on Labor and Delivery, making Wyoming Medical Center one of only two hospitals in the state to offer this option for laboring patients.
Nitrous oxide has been available in Europe for many years to decrease pain and anxiety during a variety of medical procedures. It was introduced for commercial use in 1965 as a form of inhalation analgesia during medical procedures, however the use of N2O for labor discomfort can be traced back to the late 1880s.
“I have a spinal cord injury so an epidural wasn’t even an option,” said Lisa Brown, mother of baby Claire Noel, born May 3 at Wyoming Medical Center. “So when they called me and told me nitrous oxide was an option, we decided to try it because there are no side effects for the baby.”
Labor nurses receive special training in the use of nitrous oxide for laboring patients to ensure the highest level of safety for both mom and baby. Specific education is provided to the laboring mom and her family as well, including a detailed consent form to ensure that our patients fully understand the process. With minimal side effects for most patients, this method of relief during labor is growing in favor. Some side effects that might occur with prolonged use include nausea, dizziness and dry mouth.
The concentration used in labor and delivery is a 50 percent mixture of oxygen and nitrous oxide in comparison to the 70 percent concentration often used in the dentists’ offices. It is self administered by the patient with strict instruction that family or staff cannot assist in holding the mask for the patient. Because nitrous oxide is not actually a pain reliever (analgesic) but instead, reduces anxiety (anxiolytic), the best results will come from the ability to stay in control during a painful contraction and to allow the body to respond naturally to the contractions.
During education, nurses talk about mind over matter and to remain in a positive state of mind. We suggest that nitrous oxide therapy be initiated early in the labor process whenever possible and to expect approximately 30 minutes of use before laboring women will feel its effects. Ideally, once a regular contraction pattern has been established, the patient will inhale the gas mixture through the mask throughout the contraction to receive the greatest relief. Patients who have used N2O have verbalized that it does not take away the pain, but helps them manage through it and gives them a break from the intensity.
“For me, it was an obvious choice,” Lisa said. “I’ve had to be on narcotics in the past, and I didn’t really want to mess with them again. We decided to have narcotics as a backup, but I didn’t feel the need to ask for them once labor started.”
Her husband, Chris Brown, said his wife seemed more at ease during labor than just before when she didn’t yet have access to the nitrous. Seeing it calm his wife’s anxiety helped calm him down as well.
“I felt absolutely useless the whole time, but it gave me peace of mind to know that it helped relieve her pain and get her through,” Chris said.
If you are interested or have questions regarding nitrous oxide when you come in to deliver your baby, please ask your nurse. The two of you can discuss the best labor options for you!
JENNIFER GALLAGHER, R.N.
Jennifer Gallagher is a registered nurse and clinical education coordinator for obstetrics. She has worked at Wyoming Medical Center for 24 years, starting in 1992 when she washed dishes in the cafeteria. She has worked as an OB nurse for 13 years. She has a bachelors of nursing degree from the University of Wyoming and is certified in Electronic Fetal Monitoring and Maternal-Newborn Nursing. She also teaches our Childbirth Education Classes. Email her at firstname.lastname@example.org.