Top 10 Misconceptions About Nitrous Oxide in Labor

Top 10 list author Michelle Collins

1. Nitrous oxide makes you laugh (hence the nickname “laughing gas”). Because nitrous oxide decreases anxiety, it puts women more at ease and they may be more talkative and relaxed — but don’t count on side-splitting laughter.
2. Nitrous oxide is offered at many hospitals and birth centers. Not true; nitrous oxide use has dramatically increased since 2011, but there is still a long way to go to ensure that every woman who desires to use nitrous oxide in childbirth has the opportunity.
3. My family members can hold the nitrous oxide mask if I get tired. As well-meaning as family members are, this is one area where they can’t help. A safety precaution for nitrous oxide use is that the laboring woman holds her own mask or mouthpiece. When she has had sufficient nitrous oxide, she won’t be able to bring the device to her face.
4. There is a point in labor when it is too late to use nitrous oxide. Actually, some women don’t begin using nitrous oxide until they are in the pushing stage. Other women don’t use it at all during labor, but find it very helpful if they need repair of tears in their birth canal.
5. Nitrous oxide will harm the baby. Studies have not shown adverse effects on babies whose mothers used nitrous oxide in labor. A minimal amount of the gas does pass into your bloodstream, which means some can also pass through the placenta and go to your baby, but no ill effects in babies have been noted.
6. Nitrous oxide will stall your labor or slow contractions. There has not been any research showing that nitrous slows down labor or causes contractions to be less strong or frequent.
7. If you choose to use nitrous oxide, you cannot use any other pain medications. Wrong. A number of women who start out using nitrous go on to have epidurals later in their labor. Using nitrous oxide early on allows you to maintain mobility and stay upright, allowing the baby to move down well in your pelvis before you’re confined to bed with epidural anesthesia.
8. Continuous fetal monitoring is required. Using nitrous oxide for pain relief does not, in and of itself, require that continuous fetal monitoring also be used. Whether you have continuous or intermittent fetal monitoring should be dictated by your obstetrical status, not because you are using nitrous oxide.
9. You will be confined to bed while using nitrous oxide. Not true; You will still be able to move around. Many women use nitrous oxide while standing, squatting or sitting in a rocking chair or on a birth ball. About 10 percent of nitrous users may experience some dizziness.
10. Using nitrous oxide in labor is just like when you use it at the dentist. It’s not; in dental offices, the concentration of nitrous oxide to oxygen is variable so the dentist can increase or decrease the concentration based on the patient’s needs. During labor, nitrous oxide is only used at concentrations of 50 percent nitrous oxide to oxygen — no higher, and the woman administers it herself.

Adapted from an article by Michelle Collins, Ph.D., CNM, FACNM, FAAN,
for the Association of Women’s Health, Obstetric and Neonatal Nurses blog, AWHONN Connection