Labor has become a laughing matter for more and more women because of the increased use of nitrous oxide (N2O)—laughing gas—instead of epidurals for labor pain. Rediscovering this old favorite could mean you laugh during labor, too.
If you plan on using laughing gas during labor and birth, that birth preference can (and should be) talked over with your care provider and hospital. And stating in your birth plan that you want to use nitrous oxide helps your birth team help you.
American Pregnancy Association says laughing gas offers pain relief with very few risks.
And American College of Nurse-Midwives (ACNM) says: “Research has supported the reasonable efficacy, safety, and unique and beneficial qualities of N2O as an analgesic [pain relief] for labor and its use as a widely accepted component of quality maternity care.”
(Translation: N2O is effective, safe, and beneficial during labor.)
Why use laughing gas?
The US, unlike many other developed countries, often doesn’t offer N2O to women. In the US, most women receive either an epidural (the most popular) or intravenous narcotics for reducing labor pain.
But in Australia, Canada, Finland, Sweden, and the United Kingdom it is common for laboring moms to inhale a mixture of N2O 50% and oxygen 50%.
ACNM lists these benefits for using N2O:
- Newborn babies are not affected by it
- It can be given easily and quickly, and has rapid effects
- It can be stopped just as easily and its effects wear off within five minutes of when the woman stops breathing it
- No adverse affects on labor progress
- create maternal or fetal complications
- affect vaginal deliveries
- require constant monitoring
- Once she’s learned how to use it, each woman self-administers her own dose, deciding when and how much to take
- Women can stop and begin using another pain medication at any time
American Pregnancy Association adds that N2O:
- Doesn’t affect infant awareness at birth
- Doesn’t affect breastfeeding
- Doesn’t increase need for newborn resuscitation
- Allows women to stay aware of and participate in labor
Midwife Elizabeth Bachner advocates for N2O because it allows low-risk women so much freedom. Not only do they control the dose but they can move around. Movement and gravity make most labors easier or shorter because they help open the birth canal. And N2O can help avoid invasive interventions by empowering women with having control.
Though her accredited birthing center offers it, as do some others, hospitals are generally hesitant to offer it. Health insurance companies in CA do not have codes for laughing gas, so they won’t pay for it. In this case, families must pay cash out of pocket.
What are the risks?
- hereditary vitamin B12 deficiency disorder
- pernicious anemia
- Crohn’s disease
- ileal disease
- chronic malnutrition due to alcoholism
- pregnant women who adhere to a strict completely vegan diet could be at risk for vitamin B deficiency
But research from 2012 concludes, “Inhaled N2O has a long history of use in pregnancy, and provides a safe option for pain relief in labor.” This report encourages greater use of this inexpensive, safe pain option in the US.
Some women begin with nitrous oxide then decide to have an epidural as labor progresses.
No pain relief method is right for everyone, and each laboring low-risk woman needs to decide what works best for her.
So, if you are low-risk and decide to include laughing gas in the final version of your birth plan listed on your hospital bag checklist, remember that having your health care provider on your side greases the hospital or birthing center wheels.
And by requesting N2O as a birth preference, you are helping bring its use into more US hospitals.
 Sanders RD, Weimann J, Maze M. Biologic effects of nitrous oxide: a mechanistic and toxicologic review. Anesthesiol. 2008;109(4):707-722.
To learn more about labor tips, download our free Birth Plan eBook now. After three years of research, collaboration with more than 100 childbirth experts and resource centers from Healthy Child Healthy World to the American Association of Neonatal Nurses, the Best Ever Baby Birth Plan Guide is available for a free download.
This new resource for pregnant families is a compilation of top tips and advice from more than 20 nationally-recognized experts in the field including renowned pediatrician, Dr. Alan Greene and GraceFull Birthing founder, midwife Elizabeth Bachner. These trusted experts offer thoughtful guidance for whatever type of birthing experience parents want, in whichever setting they choose.
Published: April 17, 2017 | By SP Turgon, Certified Labor Doula | Reviewed by: The Best Ever Baby Expert Team | Last reviewed: April, 2017
By SP Turgon, Certified Labor Doula