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Birth: Nitrous vs Nothing

July 12, 2015
With nitrous oxide delivery mask at UCSF hospital in 2009.

With nitrous oxide delivery mask at UCSF hospital in 2009.

I’m one of few women in the U.S. to have birthed one baby with nitrous oxide and another without. Having experienced labor both with and without, I’m a big fan. A really big fan. This is the story of how nitrous made the two births different.

I birthed my first baby, Moby, at the UCSF Medical Center, a choice driven largely by the availability of nitrous oxide (full birth story here). I birthed my third baby, Sonoma, at Sequoia Hospital with no pain meds. Nitrous oxide, commonly used in labor in other developed countries, is offered for pain relief in labor in only a handful of U.S. hospitals.

Nitrous helped me labor. Moby’s birth hurt and hurt a lot but I didn’t fight the pain. I relaxed with the contractions. Nitrous dulled the pain to let my body let the baby out. In contrast, with no pain medications during Sonoma’s birth, once my body started pushing the pain was so severe that I fought the process. I pushed only after I became desperate enough to need the suffering to end. After I started to cooperate it only took two or three pushes to get Sonoma out, two or three horrifically painful and desperate pushes. The few final pushes which squeezed out Moby were involuntary, my body doing its effective best while my nitrous-assisted mind still focused on relaxing since no one had told me I was fully dilated.

Nitrous also helped me find a rhythm. Managing the nitrous to match my contractions gave me something to do, a way to focus on the labor without focusing on the pain. It also brought on a light mental haze. With Sonoma I was more distracted by the people around me and never able to effectively shut out the distractions of the labor room.

Nitrous doesn’t take away the pain entirely. It’s not a substitute for an epidural. It’s a tool for making labor a little easier. For women hoping to avoid epidural and IV anesthesia, nitrous oxide can be enough to avoid a desperate last minute request for stronger pain relief, just enough not to fight and undermine a body that can do what it needs to do.

Given how helpful I found nitrous oxide and what I saw it do for a friend in labor, I certainly wish more U.S. hospitals offered it. It’s probably the safest of the medical pain relief options in labor. And yet few U.S. hospitals offer it, probably through some combination of hospital tradition, anesthesiologist disbelief that partial pain relief is worthwhile, and cost.

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2 Comments
  1. montanapup permalink

    Actually, it’s because of the training required and not everyone is up on the use of nitrous Ania. We are going to start using it in the ER – mostly for peds patients. Use of new “techniques”, pain relief, meds is something a doc may push for but isnt necessarily used unless the entire group buys in. Unfortunate, because there is data that shows it can be effective for many, but alas the efficacy is also unclear. Either way, I’m glad you got to use it and it was helpful for you. It didnt make you nauseated?

  2. No, no nausea for me. No side effects (as in, undesired effects) at all.

    Having used it the “efficacy is unclear” sounds to me like a lack of understanding, probably due to lack of experience with it. I can totally believe that for many women the pain relief from nitrous oxide would be less than desired. But from having used it, watched another woman use it, and talked to a man whose wife used it, I’m also totally convinced that for some women it’s very useful. If you do a study and find that it doesn’t help 50% of women, you can draw the conclusion that “efficacy is unclear” or you can draw the conclusion that “it’s helpful for many”. I draw the latter conclusion. And if its efficacy were really so unclear, why would it be so common in oral surgeons’ operating rooms?

    My doctor actually asked an anesthesiologist about making nitrous available to me at Sequoia Hospital for Sonoma’s birth, though Sequoia does not routinely use it in labor. The short version is that nurses objected and it got shut down. I talked to the anesthesiologist who brought nitrous oxide to Stanford in 2014 and he said it was a long bureaucratic process that took something around a year.

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