with epidural shortages, more people are opting for laughing gas during childbirth
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laughing gas use during labor is self-administered, allowing people to use as much or as little as they want. getty
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if you’ve had a baby, or are planning to get pregnant soon, would you consider taking laughing gas to help with the pain of delivery?
more and more women and child-bearing people are, according to people — especially with the ongoing epidural shortage.
nitrous oxide is a gas sometimes used for sedation and pain relief, particularly by dentists. it’s usually inhaled, and is classified as a “dissociative anesthetic,” meaning that rather than putting a patient to sleep, or numbing a part of their body, the person taking laughing gas may feel disconnected from their body — and the pain it’s going through. the gas, which slows the nervous system and can also cause a brief feeling of euphoria, is sometimes offered on its own, or it’s diluted with oxygen to form a gas called entonox.
some women and other birthing people may be hesitant to try laughing gas, as it’s generally a less widely-known pain relief option. but there are some benefits — namely, it’s much less invasive than an epidural, and it provides more agency to the person giving birth. it’s also self-administered, allowing people to use as much or as little as they want: it’s usually stored in a tank connected to a mask, which the patient can bring to their mouth and inhale for fast-acting relief. the gas also takes effect very quickly, and wears off quickly once the mask has been removed. according to the mayo clinic, some people choose to inhale the anesthetic during contractions, while others use it to relax in between contractions.
also, contrary to belief, although known as ‘laughing gas,’ nitrous oxide may give you the giggles, but it probably won’t make you laugh hysterically.
the benefits of laughing gas
one anonymous woman who used laughing gas to give birth told people that she liked the freedom of being able to move around while using the gas, which isn’t an option with an epidural.
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“you’re not confined. with the epidural there’s a lot of movement restriction,” she told the magazine.
she also liked the control: “you’re cognitively aware of everything that’s going on. if you don’t want the effects of it, you can simply stop using it.”
pain management options during childbirth
there are several options for pain management for people giving birth. the most common is an epidural, which involves either an injection or insertion of pain medication using a catheter into the space between spinal nerves. the medication stops pain signals from travelling from the spine to the brain and, in some cases, numbs the lower body.
since the spring, though, there’s been a global shortage of both the medication itself and the catheter product that’s frequently used in its administration, apparently due to pandemic-related supply chain issues. along with the nurse shortage, this is very bad news for expectant parents.
dr. tali bogler, chair of family medicine obstetrics at st. michael’s hospital, explained that when a pregnant person is in a lot of pain and anxious, it can be challenging to see a delivery progress.
“overall, people are often anxious when they are pregnant and the last thing they want to know is they are not going to get the care they need and the pain relief they need,” she said.
nitrous oxide used the be quite common for childbirth, according to pregnancy info centre what to expect. back in the first half of the 1900s, it was used first on its own, then in conjunction with narcotic drugs used for pain relief. by the 1950s and ’60s, nursing and midwifery professor dr. michelle collins told stat news, the norm became drugs that put people to sleep: childbirth essentially meant waking up with a baby in your arms. by the ’70s, epidurals were more common because they allowed birthing people to get relief from pain, yet stay alert during the birth.
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laughing gas is now sometimes thought of as harmful in a similar way to those narcotic drugs — but when it’s used on its own without other drugs, it’s much safer.
that’s not to say it’s definitely the right choice for everyone. the relief it provides is significantly less than an epidural, for instance. “some women may not respond to the medication at all or very minimally,” obstetrician and gynecologist dr. jennifer butt told parents. it can also cause drowsiness, nausea or vomiting. for various reasons, nitrous oxide may not be safe for people with sleep apnea or people who have had inner ear or gastric bypass surgery. it also lowers a patient’s b12 levels, so it’s not a great option for anyone who already has a vitamin b12 deficiency.
like many aspects of women’s medicine, there isn’t a huge amount of research on the use of nitrous oxide for childbirth, which can make it hard for people to make informed decisions about the option that’s right for them. “the scientific literature looking at nitrous oxide use for labour pain is poor,” dr. butt told parents, “so many of the recommendations come from clinician experience and expert opinion.”
maija kappler is a reporter and editor at healthing. you can reach her at mkappler@postmedia.com
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