Before giving birth, I was terrified of anything related to labor. To be honest, I wasn’t entirely convinced that the baby was going to come out the way they said she was. After doing some homework, a graphic documentary and three months of childbirth classes, I determined that I wanted to have an intervention-free delivery. I felt like my best bet was to be as well-informed and in control as possible. Unfortunately, the pain relief options available to me (Demerol and the infamous epidural) didn’t seem like they would leave me in control. Little did I know, nitrous oxide, the pain reliever that we associate most with dentist visits, could have helped.
The treatment, which has a two-hundred-year history in Europe, was also used in the United States early in the 20th century. But it was quickly replaced by more potent analgesia. Nitrous oxide -- also known as laughing gas -- is now making a resurgence in the U.S. as an option to manage pain during labor and is currently available in only about a dozen hospitals and birthing centers nationwide. Before you start humming the music from “Little Shop of Horrors,” though, you should know that although it’s the same gas that you get your cavities taken care of, it’s delivered in a strict ratio of 50% oxygen, 50% nitrous oxide, according to Drs. George Mussalli and Jaqueline Worth of Village Obstetrics. This regulation means that you won’t be singing any show tunes — and you can actually administer it yourself.
Using a mask similar to the ones used for asthma treatments, laboring mothers can inhale at will. It’s very different from the “all-or-nothing” approach that the epidural and Demerol provide. With either of the standard pain relief options, patients often worry about things like “is it too early in my labor to get pain relief? Is it too late? What if I have a bad reaction to it?” Nitrous oxide has the benefit of being available at any point in labor, even after you deliver the baby. That means that you can have something to distract you from the post-delivery cleanup, stitches, and that fundal massage.
Leaving someone who's in pain in charge of their own pain relief sounds worrisome. So is it possible to overdo it? Dr. Mussalli asserts that it's not. “You have to create a very tight seal with the mask,” he said. “If you’re too groggy, you won’t be able to hold the mask. It’s kind of its own fail-safe.”
Nitrous oxide also addresses some of the other concerns parents often have around the use of narcotics and anesthesia during labor. The substance leaves the mother’s system fairly quickly and seems to have no impact on the baby’s heart rate or APGAR scores. The side effects also seem to be mild, with patients rarely reporting adverse reactions such as nausea, vomiting and unsteadiness. Dr. Mussalli stated that given the relatively flexible nature of this particular pain relief option, it would be an ideal way to soothe patients with anxiety, fear of needles and those who were waiting for their window to receive an epidural.
If this seems like an option that you’d be interested in pursuing, Drs. Mussalli and Worth advise you to talk to your midwife about it early in your prenatal care. “It’s not widely available,” Mussalli said. “However, the equipment and the gas are not very expensive for the hospital to obtain.” It’s also not an expensive option for the patient, with the service frequently being offered at no cost or billed directly to insurance.
Personally, I loved the feeling of accomplishment that I got from having an unmedicated labor, and I would want to do so again. However, I would definitely want my hospital to have this available. I didn’t feel like I had a viable option for pain relief that would minimize the impact on myself and my baby, and so the harder labor got, the more afraid I felt that I wouldn’t be able to handle it. I love the idea of having an option that’s totally under my control, and one that would empower more mothers to take the reins in their care.