Understanding Nitrous Oxide for Labor

Last Updated:
Liesel Teen, RN-BSN

By Liesel Teen

BSN, RN, Practicing Labor and Delivery Nurse

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Most women are familiar with the epidural as an option for managing pain during labor, but did you know that an epidural isn’t the only option?

Even though epidurals are typically known as the “gold standard” for pain management, IV pain medication and nitrous oxide are both options as well. 

In this article, I’m going to explore all the ins and outs of nitrous oxide to help you better understand its use for labor.

Come along with me, mama!

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What is nitrous oxide? How is it used in labor?

Also known as laughing gas, nitrous oxide is used as a means of pain management during labor. Nitrous oxide has been used in other countries for hundreds of years (Really! Since the 1880s at least!), but it’s only recently become more popular in the U.S. 

Before you get too excited, I encourage you to double-check with your provider to see if it’s an option where you plan on delivering. While it has become more readily available in the U.S., nitrous oxide is still not an option at all birth facilities, so check on that before you get your heart set on using it during labor.

Nitrous oxide is not meant to completely take your labor pain away. Instead, it slows down the body’s reaction time, resulting in a calm, euphoric feeling. Aka, it sort of makes you care a little less about the pain.

It might take a few contractions to get the hang of it, but once you get going, nitrous is pretty self-explanatory. 

Here is how to effectively use nitrous oxide during labor:

  1. 30-45 seconds before a contraction starts, place the mask on your face and make sure you have a tight seal
  2. Slowly inhale through your nose and exhale through your mouth, keeping the mask on your face the entire time
  3. Continue breathing this way until the contraction passes
  4. In between contractions you can either continue using the nitrous or take a break

Who should use nitrous oxide during labor?

In my L&D experience, I have found that nitrous is a good option for those mamas that have prepared for and are committed to an epidural-free birth. 

It is typically not an effective option for women that want all of their labor pain taken away. It’s all about setting realistic expectations.

A few nitrous anecdotes for you

I actually tried it during my first labor (mainly because I wanted to know what it was like!) and guess what…I didn’t like it! I felt like the mask was interfering with my breathing exercises, and it ended up being more of a negative distraction.

With that being said, a friend of mine was able to achieve her goal of an epidural-free birth primarily because of nitrous oxide. The nitrous allowed her to focus better on her breathing, a totally opposite experience from mine. 

The bottom line? There’s no way to know if it will be effective for you without trying. If you are looking to limit the amount of pain medication received during labor and avoid an epidural, certainly consider nitrous as a safe option!

Nitrous oxide during labor vs. at the dentist

If you have ever been to the dentist and received laughing gas for a procedure then it’s a fairly similar experience. The biggest difference between nitrous oxide during labor vs. nitrous oxide at the dentist is the amount of nitrous used.

The ratio of nitrous oxide to oxygen is much lower at the hospital than at the dentist. As a result, you won’t feel quite as “high” using nitrous during labor as you would at the dentist.

Does laughing gas help with pain?

Like I mentioned previously, nitrous oxide (aka laughing gas) is not going to make your pain completely vanish. What it might do though is provide a bit of a distraction from your labor pain and make it easier for you to cope with and manage your contractions. 

This would not necessarily be the best option for someone who is looking to completely eliminate labor pain and as some mamas come in saying, “ I don’t want to feel anything during labor.” 

Laughing gas is a more appropriate option for women that are wanting to have an epidural-free birth and are interested in pain management options (aside from an epidural) to help them achieve that goal! 

Birth Plan

Is it safe to use during birth?

Nitrous oxide is a safe option for both mom and baby during labor. Unlike IV pain medication, which can impact baby’s heart rate, nitrous oxide doesn’t affect baby’s alertness and therefore won’t interfere with early bonding after birth. 

It is also considered to be pretty safe for mom during labor as well. There are some potential, more mild symptoms that you might experience, such as dizziness, nausea, vomiting, or sedation. 

Should you experience any of these, simply remove the mask from your face and breathe normally. Nitrous doesn’t stay in your system long, so you should start to feel the side effects wear off pretty quickly. 

Pros and cons of nitrous oxide for labor

I mentioned how nitrous is generally a pretty safe option for pain management during labor. Nothing comes completely without risks though, so let’s take a minute to cover the pros and cons of nitrous oxide for labor.

Pros of nitrous oxide for labor

  1. Works quickly – Most women start to feel the effects within a minute
  2. Self-administered – You choose when you want to use it and for how long 
  3. Short half-life – Only takes about 5 minutes for it to leave the body once discontinued 
  4. Minimal side effects – Doesn’t affect infant alertness in the early bonding period after delivery 
  5. Used for all stages of labor – Including after delivery, if needed for any repairs

Cons of nitrous oxide for labor

  1. Potential side effects – Sedation, dizziness, nausea, vomiting
  2. Distracting – Can cause a disruption to your breathing techniques
  3. Effectiveness – Might not be as effective in relieving pain as an epidural or IV medications
  4. You have to hold the mask – You might be too exhausted to consistently hold the mask
  5. Limited availability in the U.S. – Not an option for pain relief everywhere

Creating your pain management plan for labor

Maybe you were familiar with nitrous oxide and maybe you weren’t, but hopefully you have learned something from this article! Nitrous oxide is only one of the many pain-coping techniques that can be used during labor. 

As a mama that has been through labor twice and has over 9 years of labor and delivery nurse experience, one thing I highly encourage you to do prior to giving birth is to create a birth plan! Just like good childbirth education, the process of creating a birth plan can help eliminate some of the fear and anxiety surrounding birth because it erases a bit of the unknown.

Trust me, mama, this is something you don’t want to skip! Plus, I’ve made it super easy for you to put together a birth plan by creating several FREE birth plan templates. You can snag them here!

Curious about other ways to prepare for labor and birth? Don’t skip out on the MLN resources below: 

Birth Plan
Liesel Teen, RN-BSN

Liesel Teen

BSN, RN, Practicing Labor and Delivery Nurse

As a labor and delivery nurse, I’ve spent countless hours with women who felt anxious — even fearful — about giving birth. I want you to know it doesn’t have to be that way for you!

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