Safe deliveries with nitrous oxide

Expecting a baby is a time that is associated with many different feelings and expectations but may sometimes also be related to a certain level of anxiety. What happens during the delivery and how will you manage the pain in childbirth?


No matter how many mothers you ask these questions of, the resulting answers will be different from each, as childbirth is the most personal process you will ever experience. There is no one who will feel or experience the process exactly as you do. Experiencing pain in childbirth is inevitable, however there are solutions for pain management that are available, and your attitude to the entire process will influence your experience of it. We will illustrate the use of nitrous oxide in pain management, the advantages and disadvantages of it and what aspects you as a mother in labor should consider.


Mental preparation:

Childbirth for many may be a revolutionary experience. That is why it is good to be mentally prepared for the delivery and the period following it. It is good to have someone to discuss things with such as your partner, other parents-to-be and to read literature on the subject. Your mental preparation for the childbirth process may facilitate the entire delivery experience. If you are having feelings of anxiety, it is important to process them, so contact your local midwife or antenatal clinic when you have questions or are experiencing anxiety. Practical tips and advice you might need pre-delivery may be available on the internet – contact your local midwife or antenatal clinic for suggestons for useful links.


What is nitrous oxide and how does it work?

Nitrous oxide, or “laughing gas” is the most common method for medical pain management in childbirth and delivery. Nitrous oxide is a mildly-numbing gas which consists of a mixture of oxygen and nitrogen. Nitrous oxide dampens the central pain impulses in the brain. You will still experience the contractions in labor, but nitrous oxide dampens the pain of the most intense contractions. It is possible to receive different concentrations of nitrous oxide, depending on what level of pain management is required. Usually a lower dose is administered earlier in the delivery process. Nitrous oxide dosage is increased in relation to the longer the delivery process takes and the increasing intensity of the labor pains. Nitrous oxide sometimes may be the only pain management method that is available, and in other situations may be combined with other pain management methods. Many expecting mothers who have decided on for example an epidural prior to the delivery process may choose to have nitrous oxide during the initial and final stages of delivery. The use of nitrous oxide can make you more relaxed and facilitate ”prophylactic breathing”, read more about prophylaxis here….

Nitrous oxide is a well proven method of pain management in childbirth and there are no known risks for either the mother or child. Nitrous oxide has no influence on the process of contractions in labor.

Nitrous oxide is a greenhouse gas, and is not healthy for delivery room staff members who are continuously exposed to the gas. This is why it is important to have a good evacuation system close to the patient; for example, a Double mask that will capture any leaking gas and collect all gases. These gases are evacuated by means of a central fan system to a destructor/purifier where the nitrous oxide is cloven and converted to undamaging oxygen and nitrogen.


Get optimal use of nitrous oxide

If you choose to have nitrous oxide during your delivery, the midwife or other delivery room staff will instruct you how it is administered in the delivery room, and is usually an process. But as each delivery and birth process is very dynamic, it can valuable learn about nitrous oxide prior to the delivery.

As mentioned earlier, with nitrous oxide you will still feel contractions in labor but with less intensity. As the mother in delivery, you personally can steer the administration of nitrous oxide by breathing in the mask as you feel necessary.

When using the Double mask* for nitrous oxide, follow this procedure:

1. Breathe with deep and relaxed breaths as soon as you feel the beginning of a contraction. This will allow the gas to take effect during the most intensive pain of the contraction (approximately 30-45 seconds after inhalation is when the gas is most effective).

2. As the pain of the contraction decreases, loosen the mask and breathe a few relaxing breaths. Any potential gas leakage will be captured in the hard outer shell of the Double mask so that these will not affect the air quality in the delivery room environment. Some delivery room departments provide neckbands to the Double masks, so that the masks may lie below the chin when not in use, where they capture any expired nitrous oxide which may remain in the lungs for a period after inhalation.

3. Breathe normally and relax before the next contraction.


Summary of advantages and disadvantages with nitrous oxide

+ easy to use

+ may be combined with other methods of pain management

+ You determine the administration yourself

+ It is not necessary to lie down if you don’t want to

+ no influence to the child nor to the contractions in labor process

+ Painless to use, in contrast to being stuck by needles

+ is quickly eliminated by the body/short-term effect

+ well proven method of pain management in childbirth

– may cause short-term drowsiness

– some may experience dry mouth during use

– may cause you to feel short-term dizziness and nausea

– greenhouse gas

Some women may experience that they become a little dizzy and nauseous during inhalation of nitrous oxide. That is why it is important to inhale normal air in between contractions.