I’ve been reading some articles recently about Nitrous Oxide (laughing gas) and birth. Laughing your way through contractions and pain to bring your baby earth side sounds like an ideal birth to me. As a birth doula, I want to be able to offer my clients more pain management options. Nitrous Oxide usage in obstetrical care has been around since the 1930’s. Long enough to produce studies on the pros and cons.
In Europe over 50% of laboring mothers use Nitrous Oxide as a pain management tool during births. If it is so common over there, why isn’t it used more in the United States? One of the reasons, according to Holly Powell, a nurse midwife and professor of midwifery at Yale University, is cultural norms. It simply isn’t something that has been heard of. When women are talking with other women about their births and what to expect, the use of Nitrous Oxide just doesn’t come up. Therefore, women don’t know it’s a viable option.
How safe is Nitrous Oxide and what are the side effects of usage? The Health and Safety Commission has a board of experts, in occupational health, study such things. This board (WATCH) has determined that Nitrous Oxide at a 50% to 50% ratio of N2O (Nitrous Oxide)- O2 (Oxygen) in a 50 ppm (parts per million) dosage is safe for 8 hours out of a 24 hour period. That’s a pretty long time. Take into account that the mask would not remain on the mother at all times, instead she would bring it to her face as needed, and you have wiggle room in event of a prolonged labor.
The side effects include a reduction in B12 in the system, which can result in drowsiness postpartum. Prolonged exposure to Nitrous Oxide can also cause miscarriage, reduced fertility (in both men and women), and low birth weight babies. Prolonged is indicative of exposure over multiple births, many hours, and in frequent contact with the gas. These side effects most often effect birth workers rather than the expectant parents.
There has been little study on the long-term effects of Nitrous Oxide and the laboring mother/baby diad. One study, Jacobsen et al (1988) in Sweden investigated the reasons for teenage addiction to amphetamines; they found a strong correlation between the exposure of an unborn baby to nitrous oxide during labour and a five-fold increased risk of that child developing an addiction to amphetamines in later life. The degree of risk was associated with the length of exposure to the gas during birth.
An American Congress of Obstetricians and Gynecologists practice bulletin, also published in 2002, cautioned that “all inhaled anesthetic agents readily cross the placenta and have been associated with neonatal depression.” “Most medicines that alter maternal consciousness — including pain medications we use in the U.S., like nubain — can alter the alertness of the baby after it is born,” said Dr. Laura Goetzl, an OBGYN and professor at Temple University who wrote the ACOG bulletin. “Depending on the dose, this effect can be minimal or increase the need for neonatal stimulation [or] resuscitation.”
As with any pain management tool utilized by a laboring mother, only the mother and her partner can decide what is the best choice for them. Since Nitrous Oxide still isn’t readily available in most hospitals, a birthing mother who is desiring it as a pain management option, will need to speak with her provider.