Nitrous Oxide During Labor

“Nitrous oxide is a colorless and odorless gas that’s used to provide pain relief in labor,” said Liz Rowe, a certified nurse midwife at Ivinson’s Women’s Health Clinic. ​“It’s been used in other countries for years and is becoming more widely used in U.S. hospitals to help with labor pain management.”

Rowe delivers many of the 378 babies born annually at Ivinson. As a midwife, she helps women prepare for labor and delivery while advocating for her patients and equipping them with the tools they need for success.

For many patients, nitrous oxide is more familiar as ​“laughing gas” from dentist appointments. It is administered similarly in labor, through a mask that mixes 50% nitrous oxide with 50% oxygen.

“The mom places the mask on her face, inhales slowly and deeply, and exhales into the mask during a contraction,” Rowe explained.

While nitrous oxide does not eliminate pain entirely, it reduces awareness of pain and helps patients relax.

“Nitrous is a non-pharmacologic method. So, if someone is seeking an unmedicated birth, it’s a tool we can use. Nitrous isn’t a medication. Women are excited to have another kind of option in our toolbox.”

Among labor pain relief options, the most well-known is the epidural, which Ivinson offers around the clock through its anesthesia team. Nitrous oxide provides an additional intervention, often paired with rhythmic breathing techniques.

“I think it’s really exciting because, as a small community hospital, we talk a lot about elevating care and providing the best possible services locally so people don’t have to seek care elsewhere,” Rowe said.

Rowe and her team have worked to bring nitrous oxide to Ivinson’s labor and delivery floor since 2019. Their plans were delayed during the COVID-19 pandemic, but resumed following the opening of the new Women and Children Center.

“I’ve had several patients, many of them seeking unmedicated births, use nitrous for their labor and have really good success,” Rowe said. ​“They come out saying, ​‘Wow, I’m just so glad I had nitrous as an option because it really helped me get through the last hour of labor or birth.’”

One common concern among mothers is how nitrous oxide might affect their newborn.

“Nitrous oxide crosses the placenta, and the baby receives about 80% of the dose within 15 minutes,” Rowe said. ​“There’s no known effect on the fetal heart rate or APGAR scores. If it’s used right before birth, any effects on the newborn last less than five minutes after delivery, and there’s no evidence of respiratory compromise.”

Other potential side effects include temporary nausea or lightheadedness, but risks to both mother and baby are minimal.

“We’re continually working to provide more options for pain relief during labor, particularly non-pharmacologic methods,” Rowe said. ​“This is a very well-studied gas. It’s new to us, but it’s not new to labor. It’s a commonly used option, and moms are reporting that it works really well.”