Published on June 26, 2017

Maybe this is a laughing matter – for moms Maybe this is a laughing matter – for moms

Sarah McGuire photoWhen Sarah McGuire went into labor to deliver her son, Jackson, on Feb. 15, 2017, she had a surprising new option for pain relief. Nitrous oxide, also known as “laughing gas,” is now available for laboring moms at Cape Cod Hospital.

“I came in with a birth plan that I wanted it to be as natural as possible,” said McGuire, who lives in Harwich with her husband, Jared, and their son. “The nitrous oxide was enough to distract me, helping me breathe through it all.”

The gas is self-administered, according to certified nurse midwife Janice DiGioia, CNM, MSN. Women put the mask up to their face when they think they need it. Some women use it for a while and then get an epidural. So far, two or three moms-to-be per week are choosing to use it at Cape Cod Hospital, she said.

“It doesn’t take the pain away like an epidural does,” she said. “It gives them some pain relief and they are still conscious. They’re still able to move around.”

McGuire used the nitrous oxide for most, but not all contractions.

“For people who want to do a more natural route and be able to feel what’s going on, it’s a great option. It takes the edge off,” she said.

Not Just For Dentists

Many women are surprised to hear that nitrous oxide is an option during childbirth, DiGioia said.

“When you think about nitrous oxide, you think about going to the dentist and you go to sleep,” said. “That is not how it’s used in labor.

“It’s a blend of 50 percent oxygen and 50 percent nitrous oxide. When they breathe it in and then breathe it out, it provides about 30 seconds of relief. It’s an analgesic, as opposed to a narcotic.”

Nitrous oxide has been commonly available during childbirth in many countries, including Canada, Sweden, Finland and the United Kingdom since the 1930s, according to DiGioia. It was also used back then in the United States, but slowly fell out of use, she said

“Some of the anesthesiologists in our country felt there weren’t any long-term studies and they didn’t feel comfortable offering women this option. But after viewing the studies and advantages known with this option, they have changed their opinions to accept this as an option.”

Other hospitals around the state have also started offering the pain relief, including Brigham and Women’s, Massachusetts General Hospital and South Shore Hospital.

“It’s becoming a standard in our area,” DiGioia said.

After going through an approval process, the maternity department at Cape Cod Hospital began offering nitrous oxide to laboring moms in January.

A Totally Safe Option

Prior to McGuire’s delivery, the nurses and midwives at CCH reviewed the different options with her. It’s important for women to have access to a variety of options when coping with the challenges of labor, said DiGioia.

“This is an important tool in our toolbox to offer women during labor,” she said. “Nitrous oxide does not affect breast feeding and does not affect the baby in any long-term form. It doesn’t disrupt labor at all. It doesn’t change the labor process.”

The American College of Nurse-Midwives has a position statement [pdf] recommending that women have the opportunity to use it.

“Some women feel nauseous when using nitrous oxide, but that can also be a side effect of labor,” DiGioia said.

Women can’t use it if they have had any ear issues or any kind of eye problems because it can briefly build up pressure in those areas, and it’s not recommended for women who have had gastric bypasses or have a Vitamin B12 deficiency.

“Our obstetricians and gynecologists are happy to have this as an option,” she said. “They went to the meetings to support this happening for the women of Cape Cod.”

Sarah McGuire said she is glad they did.

“The nurses and midwives, everyone at the maternity department at Cape Cod Hospital, they’re amazing,” she said. “My husband Jared and I can’t say enough about them.”