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Pain Relief For Childbirth : Nitrous Oxide

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Pain Relief For Childbirth : Nitrous Oxide

Laughing gas (nitrous oxide) has been most well-known for filling cavities over the past decades; however, nitrous oxide is making a reappearance for another purpose: pain relief during childbirth.

In March, Sentara Martha Jefferson Hospital made nitrous oxide available to its laboring patients as an option for relieving pain and anxiety during labor.

“We want to provide as many options for our laboring moms as possible, and nitrous oxide is one that has been used effectively for some time, so we are glad we can offer it,” said Sharon Fickley, RN, at Sentara Martha Jefferson’s Family Birthing Center. “Nitrous oxide gives women who desire a low intervention birth an option for coping and managing pain that also gives them freedom of movement and a sense of control.”

Patient response has been positive, as many women are pleased to have an option that can be used throughout labor. Nitrous oxide moves through the system quickly, which means it takes effect quickly and wears off quickly once a woman stops breathing the gas. It is self-administered, easy to use, and allows patients more mobility than some other forms of pain control used during labor. Additionally, nitrous oxide is a mild anxiolytic, which means it can help relieve the anxiety associated with labor and delivery. To prepare to offer nitrous oxide, Sentara Martha Jefferson made some changes to their labor and delivery rooms to ensure that the gas could be administered safely as well as that any minute amount of waste-gas is safely scavenged out of the hospital.

Pregnant women and doctors check the symptoms.

The Nitronox™ device is used to deliver a fixed blend of 50% nitrous oxide and 50% oxygen directly to patients on an as-needed basis through a face mask.

“The nitrous oxide we use today in modern labor and delivery units is different than what some may think of historically,” noted Fickley.  “It does not make women ‘unconscious’ or make them go to sleep.  It helps them relax and alters their perception of pain, but they will respond when spoken to and are conscious at all times.”

Fickley added that a patient must hold the mask herself, and it is never fixed to her face. Patients usually breathe the gas intermittently to achieve the greatest effect of nitrous during the peak of a contraction.

Nitrous oxide can be used in conjunction with other forms of pain management as well.

“Patients can use the gas exclusively throughout labor if it fits their needs, but they can also use it before trying other options, such as an IV narcotic or an epidural,” Fickley said. “Additionally, they can use it after a break from IV narcotics if they prefer to try another form of pain management.”

Another benefit of using nitrous oxide is that patients can remain upright and have freedom of movement within their room. They are not confined to a bed as they might be with some other forms of pain management. Furthermore, there are few if any side effects, and no known effects on the newborn.

Although nitrous oxide can be beneficial to many women, there are some conditions that do not allow for its use.  Some examples include:

  • Women with a history of sleep apnea or whose screening for sleep apnea shows high risk for respiratory depression
  • Women with a very high body mass index  
  • Respiratory disease causing low oxygen saturation
  • Women with a severe and specific type of anemia
  • Women delivering pre-term

Ultimately, though, this new option is helpful to many women who are patients in Sentara Martha Jefferson’s Family Birthing Center

“We are really excited to be able to offer another option for women in labor,” said Fickley. “For women who desire a mostly unmedicated birth but who find they need something just to get through transition, or for women who would like to use nitrous oxide earlier in labor as a precursor to an epidural, it can be a good choice that allows them more control and another option for coping with labor.”

For more information about the Sentara Martha Jefferson Family Birthing Center, visit

Doctor and man comforting pregnant woman in ward
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