Chuckle through childbirth? Laughing gas may come back

The United States stopped using laughing gas during childbirth several decades ago, although it still used in Canada, Great Britain and other countries. The federal government is reviewing its use in the delivery room and it may make a comeback.

The Associated Press reports:

“CONCORD, N.H. – Labor pain is nothing to laugh at. Yet.”

“The use of nitrous oxide, or laughing gas, during childbirth fell out of favor in the United States decades ago, and just two hospitals — one in San Francisco and one in Seattle — still offer it. But interest in returning the dentist office staple to the delivery room is growing: respected hospitals including Dartmouth-Hitchcock Medical Center plan to start offering it, the federal government is reviewing it, and after a long hiatus, the equipment needed to administer it is expected to hit the market soon….”

“Though nitrous oxide is commonly used for labor pain relief in Canada, Great Britain and other countries, it’s been all but abandoned in the United States in favor of other options, such as epidurals, said Judith Bishop a certified nurse midwife at the University of California San Francisco Medical Center and leader in the effort to reintroduce nitrous oxide for labor.”

“With an epidural, medication to block pain seeps through a tube into space surrounding the spinal cord. Because it must be administered by an anesthesiologist, an epidural is significantly more expensive than nitrous oxide. Both are covered by insurance.”

” ‘In this country, most people when they hear about nitrous, they think it sounds pretty retro, that it sounds very old-fashioned and they’re sure there’s something bad or dangerous about it and we must’ve chosen to eliminate it. But I think we eliminated it because we went for the more specialized, higher-tech options,’ said Bishop, who will be among the speakers Monday at a conference for New Hampshire, Vermont and Maine hospital officials.”

“She and other advocates of reintroducing nitrous oxide emphasize that it is no silver bullet — it “takes the edge off” pain rather than eliminates it. But they say it should be among the options offered to women, particularly those who give birth at small or rural hospitals that lack round-the-clock anesthesiologists. Laughing gas is easy for women to self-administer, takes effect quickly, and can be used late in labor.”

“It’s not right for everybody, but it’s something that for many women will offer a certain amount of relief,” Bishop said.

“Michelle Collins, a certified nurse midwife and assistant nursing professor in Tennessee, previously worked as a nurse in London and saw how widely and well nitrous oxide was used there. She has been working with an anesthesiologist to bring nitrous oxide for laboring women at Vanderbilt University Medical Center and said she expects it to become available later this year.”

“Early Wednesday morning, she delivered a baby to a woman she said would have been a perfect candidate for nitrous oxide: the mother arrived at the hospital at midnight and gave birth about three hours later.

“There was a period of time just before birth when she was starting to lose it. Nitrous would’ve been awesome for her: just a few puffs to get her over that hump,” she said.”

(I love that quote!!)

“Vanderbilt has purchased second-hand equipment to deliver nitrous oxide, but Dartmouth-Hitchcock and others are hoping to buy new equipment that is expected to become available in April. After obstetric demand for nitrous oxide dropped, the one company that made the equipment stopped. But a new company has stepped into that gap and has begun taking orders.”

“At Dartmouth-Hitchcock, where officials plan to order two machines, nurse midwife Suzanne Serat estimated that 10-20 percent of her patients might try nitrous oxide.”

” ‘We have a number of people who don’t want to feel the pain of labor, and nitrous oxide would not be a good option for them. They really need an epidural, and that’s perfect for them,’ she said. ‘Then we have a number of people who are going to wait and see what happens, and when they’re in labor, decide they’d like something and then the only option for them is an epidural but they don’t need something that strong. So they would choose to use something in the middle, but we just don’t have anything in the middle.’ ”

“The hospital hopes to begin offering nitrous oxide for labor by summer. In the meantime, the federal Agency for Healthcare Research and Quality is reviewing the effectiveness and safety of nitrous oxide compared to other pain relief methods.”

I think laughing gas makes a lot of sense in the delivery room for several reasons.

No. 1 – In the last two years I have had a root canal and a crown put on. I am super afraid of drilling at the dentist. At let me just say that with that laughing gas I just didn’t care at all. I can absolutely see how that attitude would work well with giving birth. You can still follow commands, you still know what’s going on, it’s just that you are very relaxed and a little bit loopy. (I would start chuckling to myself over something very funny internally. The dentist loved that – what’s so funny?)

No. 2 – With Walsh I had some sort of painkiller cocktail which left you basically feeling drunk. (I was last in line to get an epidural so they gave me that to hold me until they could get to me.) It was fantastic. You were aware and with it but just felt a little drunk. You could still feel the contractions, but you just weren’t that concerned with them. So if the laughing gas acted similarly I think you could deliver on that.

No.3 – I did NOT have an epidural with my third and I swear I recovered so much faster! So that would seem to be a great advantage to me – also besides not potentially drugging the baby. I was up walking to the bathroom right after her birth and just overall seemed more with it faster. We nursed great, we slept great. (That could also be a function of a third.)

So what do you think: Would you choose laughing gas over an epidural? What do you make that other countries use and we don’t? Do you think it would be strong enough to get your through labor? If you are pregnant now, would you ask your doctor or midwife about it?

23 comments Add your comment

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deidre_NC

February 14th, 2011
7:39 am

i had natural childbirth (no meds at all) with 2 of mine…epideural with the 1st…epideural with the last (c-section) and i would opt for natural any day of the week. i hated the epideural-the numbness and not being able to get up right away-i hated that. not sure of the laughing gas…i have had that at the dentist because i have a deathly fear of dental stuff….and i really dont like it but at the dentist i will have it. it makes me kind of paranoid at first-dont like that at all.

Lame

February 14th, 2011
7:52 am

I agree with everything you say.

Photius

February 14th, 2011
8:08 am

A crown and a root canal in your late 30’s?

Someone is not flossing and brushing thier teeth on a regular basis.

theresa

February 14th, 2011
8:52 am

someone grinds their teeth at night and cracked a tooth. I haven’t had a cavity since childhood. And I floss almost every night.

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jarvis

February 14th, 2011
9:09 am

It also propels whipping cream much better than an epidural.

Emma

February 14th, 2011
9:17 am

I like the sound of laughing through childbirth. Especially if you just need a nip of something at the end.

But how long before hospitals adopt this idea? Something tells me Cartersville Medical Center will be last in line…

Techmom

February 14th, 2011
10:26 am

It’s about time the US started finding alternatives to the common place eipidural. It’s expensive and often more than many women want. Are there any studies that suggest how much of the laughing gas is passed on to the baby through the bloodstream? If it’s been used safely for decades now, I’m sure it’s been cleared.

Photius – Not everyone who needs dental work is a slacker when it comes to brushing & flossing. I’m going in for a crown next week. I haven’t had a cavity in years but have a tooth that was filled when I was about 10 and then again about 10 years ago when the filling went bad. The stability of the tooth is decreasing. Rather than lose it & have a gaping hole in my mouth, it will be getting a crown.

TinaTeach

February 14th, 2011
10:31 am

My little po-dunk hospital (Walton Regional, best hospital in Georgia 2 years running) has an around the clock anesthesiologist. It was fantastic to get that epi (especially since I had an emergency c-section 5 hours later!) but I felt like my legs were sausage! Couldn’t move them and that bothered the heck out of me, but not enough to go back to the pain!

If I were to go through labor again I would maybe opt for the NO2. I remember getting it at the dentist as a kid and thinking it was awesome! The bubblegum scented mask helped too! They would definitely need to bring back the bubblegum scented masks!

JATL

February 14th, 2011
10:57 am

I love the idea! I’m a complete nitrous head at the dentist, and I love the fact that a blast of pure oxygen perks you right back up! Of course every labor and woman are different, but I would have definitely given this a try instead of an epidural. I also like the fact that it can be given any time, so if a woman by-passes an epidural and then REALLY winds up in super pain and distress late in the game, this could keep her BP from spiking and help a lot. It feels great! I really hope hospitals nation-wide adopt it again.

jarvis

February 14th, 2011
11:28 am

Nitrous Oxide is AWESOME! It can be used medically, recreationally, it can make cars run faster, and it can make desserts yummier. What’s not to like?

Oh, there is the one part about it being about 300 times stronger in terms of being a greeenhouse gas when compared to C02, but I’m not a big believer in man caused climate change.

catlady

February 14th, 2011
12:02 pm

Would never do it. Laughing gas makes me feel like I am suffocating. Have tried it with 3 different dentists. They will just have to put up with me. Of course, the epidurals didn’t work, either.

Lori

February 14th, 2011
12:09 pm

Not sure I could concentrate enough to push with gas. It makes me feel really nauseous as well. But I guess it’s better than nothing, but I’d still prefer the epidural. But even that doesn’t take all the pain away. The ep takes care of the labor pains, but nothing seems to cover the pain of the baby actually coming out. They need to work on that!!! I’m pregnant now, and I know they say you forget the pain, but bull crap. I remember being shocked as heck at how bad it hurt!

JOD

February 14th, 2011
12:29 pm

@Lori – No kidding. If I could find the person who said ‘don’t worry, you’ll forget…’ I would knock his block off :o)

Laughing gas is awesome at the dentist, so if giving this option during L&D provides relief, then more power to those women. Unfortunately for me, next time will be a c-section regardless. Maybe a little laughing gas after? :o)

JATL

February 14th, 2011
1:34 pm

@Lori -NO, you certainly don’t forget the pain! That’s why I didn’t even question getting an epidural the second time around! know I still vividly remember the labor with my first. I did have the epidural to end all epidurals the 2nd time around and I didn’t feel anything -not the delivery -nothing. With the first, I finally had an epidural, but I could still feel everything. Maybe you had the same situation where you weren’t given a really strong one. I wondered after the first how on earth they could do a c-section on a woman using only an epidural, because I would have been able to feel it, but with the 2nd they could have cut my legs off and I wouldn’t have known.

Theresa Walsh Giarrusso

February 14th, 2011
1:47 pm

Catlady — maybe that have to test it before they get into a birthing situation to know how they react — it’s probably cheap and easy enough to try at preregistration or something where you would know — or someone could set up some dental work. My mom used to make us get our cavities filled with nothing — no Novocaine or laughing gas (she was like the marathon man dentist) so I adore laughing gas. and I know I feel OK on it. but that is an important point — i’m sure it’s not right for everyone.

Theresa Walsh Giarrusso

February 14th, 2011
1:48 pm

Second topic popping up at 2

DB

February 14th, 2011
3:43 pm

Sorry, but I have such a pronounced fear of the dentist, even nitrous oxide doesn’t help much. First, you have to get me IN the office – that’s a Valium, right there. Then if I hear a drill, all bets are off — panic sets in. It’s stupid, it’s ridiculous, and it’s pathetic — but there it is. For me, it’s not “laughing gas” — for me, it’s “not screaming, quivering hysteria gas.” Otherwise, I’m perfectly normal :-) My kids were dragged to the dentist religiously, and they have gorgeous, perfect teeth. But I could not stay in the office if the doctor was drilling on one of the patients — I’d have to go out in the hall or in the bathroom. Even in our house, if my husband needs to use the electric drill, he gives me a heads-up so I can go elsewhere. Stupid phobia. :-( But from what I remember of childbirth, nitrous would have been a nice little pick-me-up, especially towards the end.

DB

February 14th, 2011
3:45 pm

My comment got eaten — :-(

catlady

February 14th, 2011
5:30 pm

My hairdresser (the source of all knowledge) said he wasn’t surprised I have trouble with novacaine, procaine, etc. Said it is well-known that redheads have trouble with such–that it is even known with surgeons. I thought he was nuts, went on line, and found out that it is a theory. (I remember the lactation specialist told me redheads have more pain in nursing initially) I finally felt validated about my problems with dental work, baby-having, and surgery (I even woke up on the table while having a gall-bladder removal, and had some similar problem with a hysterectomy.) Hmm. Now I live in terror of having some serious problem, like a heart valve job or something.

Anyone else got a similar experience?

patricia

February 17th, 2011
3:26 am

OMH, I so identify with DB. I am the same with dentists, and it isn’t the shot, its the DRILL ! I have used nitrous so many times at the dentist, it is amazing. I just wish I could use it driving TO the dentist, and maybe even at home the night before. I get so apprehensive I develop stomach cramps and diarrhea. Sorry to be so graphic, but my dentophobia is very real, as yours is.

patricia

February 17th, 2011
3:29 am

On the subject of nitrous for L&D, I never could figure out why it was discontinued. It is safe, safe for the baby, very quick acting, and with no residual effects. Once you stop it, it is out of your system within a few minutes and you’re clear-headed and alert. It would be perfect for use before an epidural, or if an epidural doesn’t work properly- that can be a real nightmare.