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What it’s like to use laughing gas in labor: A conversation with Irene Beach, CNM

Irene Beach, a certified nurse midwife at Vancouver Clinic, worked with leaders at PeaceHealth Southwest Washington Medical Center to make nitrous oxide gas available to laboring mothers. We talked with her about how this pain relief option may help during delivery.

Q: What is nitrous oxide?
Irene: If you’ve ever seen Call the Midwife, it’s the gas women in labor used on the show. Of course, using it today looks quite a bit different than it did back then.

Q: How does it work?
Irene: Nitrous can be used during any stage of labor and delivery. Women breathe the gas into the lungs where it is quickly absorbed, helping them disassociate from labor pains. The effect dissipates quickly, so many women use it with each contraction.

Q: Where is it available?
Irene: As of this year, it’s available at both area hospitals: PeaceHealth Southwest Washington Medical Center and Legacy Salmon Creek Medical Center.

Q: How does it compare with laughing gas used at the dentist’s office?
Irene: The gas used in labor is a blend of 50 percent nitrous oxide and 50 percent oxygen. Dentists use a stronger concentration, usually 80 to 100 percent nitrous oxide.

Q: Is it safe for the baby?
Irene: Yes. While it does cross the placenta, it has no effect on fetal heart rate or APGAR scores (used to evaluate a newborn’s physical condition). It also doesn’t interfere with the release of the hormone oxytocin, which promotes bonding. Most of the gas is out of the mother and baby within three minutes. We just have to make sure moms don’t have a vitamin B12 deficiency, because that’s what takes nitrous out of the body.

Q: Does it work?
Irene: It doesn’t eliminate pain, so it won’t be like an epidural. But it helps a lot with anxiety in labor. It tends to work the best for patients who are nervous. It can take the edge off the pain and make it more manageable. While some women love it, many others find that it isn’t effective enough.

Q: Will using nitrous prevent someone from using other forms of pain relief?
Irene: Not at all. Because the effects wear off so quickly, women can still get an epidural. They can also use nitrous during a water birth and during repairs for perineal or vaginal tears.

Q: If a woman wants to use nitrous, what should she do?
Irene: Talk to your doctor or midwife about whether it’s a good option given your health history. Once you’re at the hospital, you just have to request it, sign some simple paperwork, and start breathing into the mask.