Ask the Expert: Nitrous Oxide During Labor & Childbirth

Expectant mothers in North Alabama now have more options when it comes to pain management during childbirth. Nitrous oxide – also known as laughing gas – has been a popular choice of women in Europe to ease the pain of labor for years, and now it is available at Huntsville Hospital for Women & Children, as well as delivering mothers at Madison Hospital and Crestwood Hospital.

Nitrous Oxide During Labor

If you’ve ever had nitrous oxide at the dentist, you have some idea of its effects – feelings of lightness, floating, and distraction from pain and anxiety are common. Dentists can use concentrations of nitrous oxide up to 70%, and it is administered through a small mask fitted over the nose. Remember Mr. Nose?

The differences between using nitrous oxide for getting a tooth repaired and having a baby are notable. During labor, the nitrous to oxygen concentration is at 50%. It is usually administered by the mother herself – the gas releases when she breathes in through the mouthpiece and closes when she exhales.

The Benefits of Nitrous Oxide

A More Natural Birth

In patients who plan on a birth with no epidural, nitrous oxide can help them achieve that. It can “take the edge off” the peak of the contractions, and can help a patient cope during the transitional period and pushing. It also helps to lower anxiety. In addition, patients can use it during any stitching that needs to be done after delivery.

Plus, you can do both! For patients who plan on having an epidural, nitrous oxide is still often used to help a patient handle the pain of early labor and to extend the time before she gets an epidural.


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Mobility & Control

Dr. Anne Marie Reidy is an OB/GYN with Women4Women OB/GYN and a former chair of the OBGYN Department of Huntsville Hospital for Women & Children. She understands that many of her patients want alternatives to traditional pain management. Staying mobile is a big reason for that. “They want to continue to be mobile, which is not possible with traditional epidurals, and they want medications that do not affect the baby in the same way as IV pain medicine would.”

During the actual breathing of the nitrous oxide, patients must stay seated, but can get up and walk right after they stop breathing through the mask since it clears the system quickly. Patients are also excited by the idea that it is patient controlled – they get decide when and if to use the gas.

The pain relief typically peaks within 30 seconds and the effects wear off within 60 seconds.

Taking Off the Edge Without Affecting Baby

Dr. Will Stroud delivers a lot of babies at Madison Hospital. He sees many expectant moms who are afraid of getting an epidural because of concerns for their baby.


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“Nitrous oxide is a very safe alternative. Compared to other non-epidural options such as IV pain medications, nitrous oxide does not affect the infant’s fetal heart tracing. Oftentimes, after administration of IV pain medications, the fetal heart rate strip will appear ‘flat’, which prompts the physician to question if the infant is not doing well versus whether or not we are just seeing the effects of the drugs.”

Because of the rapid offset, nitrous oxide is safe for the infant and does not cause any noted respiratory depression with the newborn.

How It Works During Labor

Dr. Reidy and Dr. Stroud both said administering nitrous to a patient is a pretty simple process – and one that doesn’t involve needles.

The gas mixture is a 50/50 mixture of nitrous oxide and oxygen. The two are mixed in a regulator and inhaled via a face mask that the patient holds. Typically, after inhalation, the peak effects are reached within 30 seconds and last only one minute.


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Dizziness is the most common side effect, which is why you can’t be walking around while breathing the gas, and it’s good to have a support person there to help. Some moms also report nausea. Just taking a few deep breaths after stopping the nitrous will quickly eliminate the side effects.

The patient controls how often and for how long they would like to use the nitrous. This is a nice benefit as the patient is able to put the face mask down right as their baby is being delivered and have the effects out of their system within a minute —just in time to love on their new baby!

Families now have more options during childbirth in Huntsville and North Alabama. New moms have more choices than ever to help manage pain while they are in labor. Be sure to talk with your doctor to see if nitrous oxide is right for you to incorporate into your birth plan!

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