Health: The Rise of Nitrous Oxide for Labor and Delivery / Local hospitals and birthing centers are championing laughing gas as an alternative to epidurals

WORDS
Julia Bunch
ILLUSTRATION
Mary Dunn
PUBLISHED
April 2016 in
Dallas-FortWorthBaby
UPDATED
March 28, 2016
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The experience of childbirth is completely subjective, of course, but there’s no denying that there’s some degree of pain involved. Some women opt for an epidural to dull the discomfort; others choose to go au naturel. But for some women, there is another option that falls between natural and drugs. Expectant moms all over the world rely on nitrous oxide (more commonly known as laughing gas) to reduce labor pain — and have for decades. Now a few Dallas-Fort Worth hospitals and birthing centers are at the forefront of the gas’ U.S. comeback (it was widely used in American delivery rooms until the 1960s when the epidural was introduced), offering nitrous oxide to laboring moms to ease the pain of labor.   
 
Texas Health Harris Methodist Hospital Cleburne began offering the gas, an equal combination of nitrous oxide and oxygen (so it’s milder than what dentists use), to laboring moms in 2014, and three other Texas Health hospitals — including Texas Health Harris Methodist Hospital Fort Worth and Texas Health Presbyterian Hospital Dallas — jumped on board late last year. Allen Birthing Center and Birth & Women’s Center in Dallas offer it. And Baylor Health Care System hospitals are considering it.
 
“Nitrous is becoming more popular,” says Amy Giles, owner and certified nurse-midwife at Allen Birthing Center. “When moms come in for a tour of our center, about half of them ask about nitrous. Even a year ago, we never had that question.” Now 30 percent of moms who deliver at Allen Birthing Center use nitrous during labor or for any postpartum repairs.
 
After a brief how-to from a nurse, women self-administer the gas through a mask. Nitrous creates a mild analgesic effect rather than a numbing anesthetic effect, meaning that moms remain mobile between contractions (if they want). The gas enters and leaves Mom’s system quickly — within two to four breaths — making it possible to administer other medications after nitrous is out of Mom’s system, if needed.
 
While the gas does not remove all of the pain like an epidural or narcotics, it helps with the anxiety that often accompanies childbirth.
 
Laurie Jones, nurse manager of labor, delivery and recovery at Harris Methodist Fort Worth explains that anxiety can actually inhibit or stall labor progress. “Fear can put you in fight or flight mode,” she says.
 
This generation of mothers wants non-invasive births so nitrous is appealing, says Amy Thomas, day shift nurse supervisor of labor and delivery at Presbyterian Dallas. “It helps them during childbirth to control pain and anxiety.”
 
Richardson mom Cathy Scott is one of those moms. She gave birth to her first child, Truman, a healthy baby boy, at Texas Health Dallas in January. After 24 hours of laboring at home, Cathy and her husband Cody arrived at the hospital exhausted but determined to stick to their natural birth plan. After discussing her options with her doula, Cathy tried nitrous oxide.
 
“It helped take the edge off my contractions,” Cathy admits. “It helped me relax mentally, emotionally and a little physically.”
 
Still, nitrous isn’t for everyone. Possible side effects include nausea, dizziness and drowsiness. There is some debate on whether the gas reaches the baby, but medical professionals agree that even if the gas does reach the baby, it leaves his or her system within a breath or two and remains harmless. Babies born from mothers who used nitrous oxide show no unusual sleepiness, report normal APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) scores and have no issues breastfeeding. But the American Congress of Obstetricians and Gynecologists has yet to support the practice. The American College of Nurse Midwives, however, does.
 
“Offering nitrous is a huge step forward in an era when so many women are looking for alternatives [for pain management],” says Candis Hicks, a certified nurse-midwife on staff at Texas Health Fort Worth. “It’s empowering for women to get through birth without medication. I want things like nitrous to become more widely accepted because it puts women back in control.”
SIDEBAR

Self-Administered Relief

Allen Birthing Center
Allen, 214/495-9911
allenbirthingcenter.com

Birth & Women’s Center
Dallas, 214/821-8190
birthcenter.net

Texas Health Presbyterian Hospital Dallas
Dallas, 877/847-9355
texashealth.org/dallas

Texas Health Harris Methodist Hospital Fort Worth
Fort Worth, 817/250-2000
texashealth.org/fortworth


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