Women Are Using Laughing Gas To Take The Edge Off Childbirth Pains


2. But you
may not know that you can actually use “laughing gas,” or
nitrous oxide, to take the edge off.

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Imagine a nurse or midwife rolling up a little cart with a
tank of gas, connected to a hose with a mask at one end.
Whenever you feel a contraction, you grab the mask and
breathe and relax into a little cloud of bliss. According to
a recent report from
NPR, this exact scenario is becoming
increasingly popular among women in the US.

So BuzzFeed Health reached out to Dr.
Michelle Collins, professor and director at Vanderbilt
University School of Nursing and member of the American College of
Nurse-Midwives, to find out more about this labor pain
alternative — which, according to Collins, is now offered in
over 300 hospitals and 50 birth centers in the US (compared
to just a few hospitals back in 2011).

ID: 9932096

3. Nitrous
oxide is a sedative agent that’s mixed with oxygen and
administered via mask or mouthpiece — like the kind you get
at the dentist.

Nitrous oxide is a sedative agent that's mixed with oxygen and administered via mask or mouthpiece — like the kind you get at the dentist.

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Yep, we’re talking about that gas that tastes kind of sweet
and makes you feel totally comfortable despite having a bunch
of sharp metal tools in your mouth.

Nitrous oxide doesn’t knock you out but it has anesthetic and
analgesic effects, so it can decrease sensation and pain
while you remain awake. “The name is a bit of a misnomer — it
doesn’t actually make you laugh, you just feel very relaxed
and the pain doesn’t bother you as much,” Collins says. There
can be side
effects like nausea and vomiting, but women are notified
about these before they give consent.

Collins explains that the nitrous oxide used for labor
doesn’t make you as loopy or out of it like it does during
dental procedures. That’s because the kind given to adults
during dental procedures has a higher concentration of
nitrous oxide as compared to the
50–50 nitrous oxide and oxygen mixture given fo
childbirth. Additionally, the nitrous oxide at the dentist is
usually free-flowing in a mask strapped to the patient’s face
so they breathe it in constantly. During labor, people
actually use the nitrous oxide intermittently, Collins says.

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4. During
childbirth, a person can pick up a mask and breathe in the
laughing gas whenever she chooses.

During childbirth, a person can pick up a mask and breathe in the laughing gas whenever she chooses.

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“The woman controls everything — they hold the mask or
mouthpiece up to their face and breathe in the gas when they
need it,” Collins says. Nobody else can hold the mask to the
patient’s face or assist them in inhaling. A bedside
physician or nurse will train them on how to use the mask or
mouthpiece properly, Collins says, and monitor how they’re
using it throughout labor.

Plus, the masks have a built-in safety control to prevent you
from breathing in too much of the gas. “There’s a demand
valve inside so it only releases gas when you create a tight
seal around your mouth with the mask or mouthpiece and
breathe deeply to create negative pressure,” Collins says.
When you’ve had enough laughing gas, it’s pretty difficult to
operate the equipment properly.

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5. So a lot
of people feel like this allows them to have more control
over their pain and their body.

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First, nitrous oxide is easy to use, works very quickly, and
it’s convenient for the patient and provider. But Collins
says the patient-controlled aspect can also give patients a
sense of control over the pain and even some
self-empowerment.

Plus, nitrous oxide won’t limit your ability to move around
during labor, the way some epidurals do. “Unless you get a
walking epidural (combined
spinal-epidural) which not all hospitals offer, you can
end up being confined to the bed during labor,” Collins says.
Nitrous oxide allows them to maintain mobility so they can
walk around, sit on a birthing ball, dip in a tub, etc.

Finally, it’s great for reducing anxiety. “It has a lot of
utility beyond just decreasing pain, such as helping women
relax while we turn around the baby in a breech birth or draw
blood or repair vaginal lacerations,” Collins says. “It gives
you this euphoria that helps you sort of forget about the
pain for a little bit,” one woman told
NPR.

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6. And it’s
totally safe for the baby.

And it's totally safe for the baby.

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There is data which shows that nitrous
oxide is safe for the baby and unlike narcotics which can
make a baby sleepy during birth, Collins says nitrous oxide
passes through the mother and the child too quickly to affect
the baby.

“After it’s inhaled, the gas is excreted through the mother’s
lung tissue and a very small amount will diffuse into the
placenta and reach the baby — but it’s such a secondary
method of receiving the gas that it doesn’t affect the baby
and it’s gone after it takes one or two breaths,” Collins
says.

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7. It’s
also safe for most women — but like any medication, it
isn’t recommended for everyone.

“Women shouldn’t use nitrous oxide during labor if they have
the potential for the gas to collect in a a space in their
body, for example if they’ve had a recent collapsed lung or
bypass surgery,” says Collins. It’s also not an option if you
are physically unable to hold the mask or mouthpiece, Collins
says, either because of a disability or due to impairment
from drug or alcohol abuse.

“Nitrous oxide also isn’t for women who are severely
deficient in B12 like we see in people with Crohn’s or celiac
disease, because the nitrous oxide binds with a core
component of B12 so using the gas could result in dangerously
low B12 levels,” Collins says.

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8. It’s
actually been widely used in Europe for over 100 years!

It's actually been widely used in Europe for over 100 years!

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It’s hugely popular in the United Kingdom, Sweden, and
Norway, Collins says, but also outside of Europe in Canada,
Australia, and New Zealand.

“We have a great deal of anecdotal evidence from nearly 100
years of use in very large populations and several countries
where 60–80% women use nitrous oxide during labor,” Collins
says. Some studies
have shown that nitrous oxide effectively reduces pain during
labor, but a systematic
literature review which compiled all studies on the topic
found that overall there isn’t a wealth of good medical
research and more needs to be done.

However, the first-hand experiences of women are still
important. “We can’t discount the positive experience of
millions of women who have used it in other countries for
nearly a century,” Collins says.

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9. It was
popular in the US too until the 1950s, when more potent
anesthetics like epidurals came onto the scene.

It was popular in the US too until the 1950s, when more potent anesthetics like epidurals came onto the scene.

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Laughing gas became a viable option for labor in the 1930s,
but by the 1950s doctors began
experimenting with anesthetics and opioids. These caused
negative side effects and basically knocked people out for
their entire labor.

The solution was regional anesthesia (like epidurals), which
eliminated pain during labor but allowed people to stay
awake. By the 1970s, most people in the US were opting for
regular
epidurals, a periodic injection through the lower back
into the spinal fluid which blocks all feeling below the
waist.

After laughing gas fell out of favor in the 1950s and 1960s,
Collins says there became a huge generation of providers in
the US who had never used or even seen nitrous oxide for
childbirth. So a major reason why it isn’t more popular in
the US is because so many OB/GYNs and nurse-midwives aren’t
trained to use it.

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10. But now
it seems that people are asking for more options when it
comes to managing pain during labor and delivery.

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In the US, the pain medications for
labor and delivery are pretty much limited to
anesthetics, which block all feeling, and analgesics, which
remove pain without losing all feeling — which come in IV or
shot form. However, Collins says that more people are
speaking up and saying they want access to all the available
and safe options for pain relief during labor — which
includes nitrous oxide in addition to anesthetics and
analgesics.

“Part of it is consumer demand — women are consumers of their
own healthcare and they want input in the choices made about
their childbirth,” Collins says. Plus, there’s the internet,
which has made it easier for people to research childbirth
practices around the world. “They might see that laughing gas
is an option in Europe and think ‘hey, I should have access
to this too’,” Collins says.

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11. But
you’ll still have to ask your provider for nitrous oxide or
find one who offers it for labor pain.

But you'll still have to ask your provider for nitrous oxide or find one who offers it for labor pain.

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Typically, laughing gas isn’t advertised next to anesthetics
and analgesics as a common medication to ease labor pain — at
least in the US. “Women have to ask their provider if nitrous
oxide is available where they plan to give birth or at any
other nearby hospital or birthing center,” Collins says.

An interesting detail is that despite its limited
availability, nitrous oxide is significantly cheaper than the
cost of epidurals. The gas only costs about 50 cents an hour
to run and the single-use mask is only $25.

“There’s no specific charge code yet so hospitals and
birthing centers have to find their own way to charge
patients but regardless, it’s a very small out of pocket
cost,” Collins says.

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12.
“Hospitals and providers should lay out all the options for
women to choose from, like a menu,” Collins says.

"Hospitals and providers should lay out all the options for women to choose from, like a menu," Collins says.

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Obviously whatever pain management you choose for your labor
and delivery is entirely up to you and your doctor. But when
it comes time to make that decision, Collins says that people
should be able to get the info on all of the options
available to them.

“Most providers only offer an epidural because nitrous oxide
isn’t available — but not all women want an epidural,”
Collins says. So your options may ultimately be limited by
your specific provider or birthing institution. Collins says
she hopes that more hospitals train staff to use nitrous
oxide for labor so that it can be an option for more women in
the US.

“It’s the patient’s birth and the patient’s right to
choose the method of pain relief,” she says.

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