Nitrous Oxide During Labor: A Complete Guide to Using Laughing Gas for Birth Pain Management

If you’re expecting, you’re likely thinking a lot about your birth plan, especially when it comes to pain management. Epidurals, opioids, and natural birth techniques often top the list. But lately, a more familiar option is making a comeback: nitrous oxide—or as it’s commonly called, laughing gas. Widely used by dentists for dental procedures, this gas is also a viable pain relief option during labor, and it’s becoming increasingly available in hospitals and birth centers across the U.S.

In this post, I’ll walk you through everything you need to know about nitrous oxide during labor: how it works, its benefits, any potential risks, and what you can expect from your experience. Grab a cup of tea, and let’s dive in!

What Is Nitrous Oxide and How Does It Work?

Nitrous oxide is a colorless gas that’s made up of 50% nitrous oxide and 50% oxygen. During labor, it’s administered through a mask that you hold and control yourself. This means you can decide how much gas you inhale, giving you a sense of control during your labor experience.

When you inhale the gas, it triggers the release of natural pain-relieving chemicals like endorphins and dopamine, which help dull the pain of contractions. While nitrous oxide doesn’t completely eliminate pain, it does make it feel more manageable. Many women describe the sensation as a relaxing “buzz” that helps them stay calm and centered, even when the contractions intensify.

“Giving birth is an ecstatic moment not withstanding the pain.”
– Maharishi Mahesh Yogi

Why Choose Nitrous Oxide During Labor?

There are a few key reasons why many laboring women choose nitrous oxide as their pain relief option:

1. Control: With nitrous oxide, you control the mask and can breathe in as much or as little gas as you need. You’re not tied to a machine, and you can stop the gas anytime you want. This can help you feel more in charge of your labor experience.
2. Mobility: Unlike an epidural, which can limit your ability to move, nitrous oxide doesn’t interfere with your mobility. You’re free to walk around, change positions, or even use a birthing ball if you wish.
3. No Impact on Baby’s Alertness: One of the key benefits is that nitrous oxide doesn’t impact your baby’s alertness or breastfeeding abilities. It’s metabolized in the lungs, and the gas doesn’t linger in the system once you stop inhaling it. This means no worries about your baby being drowsy or having trouble breastfeeding after birth.
4. No Long-Term Impact on Baby: Research has shown that nitrous oxide does not affect the baby’s heart rate, respiration, or Apgar scores at birth. Studies are still being conducted on any potential long-term effects, but current evidence shows that it’s safe for most moms and babies.

My Personal Experience with Nitrous Oxide: The Cost and Decision-Making Process

Before I went into labor, I was eager to learn about the costs of using nitrous oxide, also known as laughing gas, as a pain relief option. I called the hospital where I planned to deliver, then insurance, and got shuffled from one number to the next then back to the hospital. I spent days trying to get a ballpark estimate! After all that back-and-forth, I decided to just play it by ear and see what happened when the time came.

When the time came, I had to be induced, and my progress was incredibly slow (24 hours to go from zero to 2.5cm dilated). At that point, I figured it wasn’t worth the unknowns to try the laughing gas. But I’m not giving up on it—I definitely hope to try it out during my next labor experience! The research shows it’s a great option for pain relief and mobility, and I’m looking forward to seeing how it works for me next time.

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Is It Safe for Everyone?

For most women, nitrous oxide is a safe option, but like anything, it’s not suitable for everyone. If you have certain health conditions—such as low blood pressure, a vitamin B12 deficiency, or specific gastrointestinal disorders (like Crohn’s disease or ulcerative colitis)—you should consult your doctor first.

It’s also important to note that nitrous oxide might not be as effective for everyone. While many women report feeling significant relief, about 31% of people find it enough to get through labor, while the remaining 69% end up requesting additional pain relief, like an epidural or opioids.

Potential Side Effects: What to Expect

Nitrous oxide isn’t without its side effects, although they are typically short-lived. Common side effects include:

• Dizziness (a big one—remember, you’ll want to stay seated while using it)
• Nausea and vomiting (though anti-nausea medication can help manage this)
• Drowsiness and hazy memory

If you experience any of these side effects, the good news is that they clear up quickly. Once you stop inhaling, the gas leaves your system within minutes, and the side effects tend to subside. If you’re feeling uncomfortable, you can simply stop using it.

The Process: What to Expect When Using Nitrous Oxide

Using nitrous oxide in labor is relatively straightforward, but there is a bit of a learning curve. You’ll be given a mask that’s connected to a supply of gas. The mask has a negative pressure demand valve, meaning the gas is only released when you inhale deeply.

For the best effect, you should start inhaling about 30 seconds before a contraction peaks. This allows the gas to kick in just as the pain from the contraction builds. You’ll want to hold the mask securely over your face to create a tight seal and take slow, deep breaths—counting to five can help regulate your breathing.

It’s also possible to use nitrous oxide at any stage of labor, including during the pushing phase or after delivery if you need stitches. Unlike an epidural, there are no time restrictions, and you can stop using the gas whenever you feel it’s no longer helping.

Is It Covered by Insurance?

One of the tricky parts about using nitrous oxide is the cost. While many hospitals and birth centers now offer it as an option, it’s not always included in your insurance coverage. Some hospitals charge a flat rate, while others bill based on how much gas you use or how long the tank is in your room. It’s a good idea to call your hospital and check with your insurance to understand the costs involved. You might end up paying out-of-pocket, depending on your plan.

Benefits for Your Birth Plan

While nitrous oxide might not be a complete substitute for other pain relief methods, many women appreciate its ability to take the edge off. It’s particularly helpful if you’re trying to avoid medications like an epidural but still want some pain relief. It can also serve as a useful option while waiting for an epidural if there’s a delay in anesthesiology availability.

Additionally, it’s worth noting that nitrous oxide doesn’t interfere with your labor progression or the release of natural hormones like oxytocin, which is key for labor. It’s one less thing to worry about when you’re in the thick of things.

Quick Tips for Using Nitrous Oxide in Labor:

• Timing is key: Start inhaling 30 seconds before a contraction peaks.
• Stay calm: Take slow, deep breaths and count to 5 to regulate your breathing.
• Listen to your body: If it’s not enough, don’t hesitate to ask for additional pain relief.
• Check the cost: Confirm with your hospital and insurance about coverage before delivery.
• Practice patience: There might be a learning curve, but don’t give up too soon—it takes a few tries to get the hang of it.

Final Thoughts

Like all decisions around birth, whether or not to use nitrous oxide is a personal choice—and it’s one you’ll want to make with plenty of information. It’s an option that’s low-risk for most women, offering pain relief without the need for more invasive interventions.

Remember, you’re not alone in figuring all this out. Many women have used nitrous oxide successfully in labor, and many more are giving it a try as it becomes more widely available. So, talk to your care team, consider your options, and most importantly, trust your instincts. The goal is to find the best way for you to feel supported and empowered during one of life’s most transformative experiences.

References

• https://www.nacmedicalcenter.com/home/newsroom/aughing-gas-is-no-laughing-matter-for-moms-in-labor
• https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/5-faq-about-laughing-gas-for-pain-relief
• https://www.asahq.org/about-asa/newsroom/news-releases/2019/10/2-nitrous-oxide-during-labor
• https://americanpregnancy.org/healthy-pregnancy/labor-and-birth/nitrous-oxide-labor/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6720045/
• https://www.northwell.edu/news/insights/laughing-gas-during-labor-what-you-need-to-know
• https://www.whattoexpect.com/pregnancy/laughing-gas-nitrous-oxide-labor
• https://ww2.aip.org/inside-science/laughing-gas-for-labor-pain
• https://www.npr.org/sections/health-shots/2019/05/28/726572880/bill-of-the-month-4-836-charge-for-laughing-gas-during-childbirth-is-no-joke
• https://nursing.vanderbilt.edu/news/top-10-misconceptions-about-nitrous-oxide-in-labor-2/
• https://stvincents.org/services/maternity/nitrous-oxide