In February 2015 we have started with the use of laughing gas for pain relief.

What is laughing gas?

Laughing gas is a mixture of nitrous oxide (=laughing gas) and oxygen that is inhaled. It has been used as an anesthetic for approximately 200 years because it reportedly has an effect on the way the nerve system routes pain signals to the brain. The precise mechanism is not fully clear but due to it being commonly used in countries around us we know that it can be an effective way to relieve pain during labor. Research into the workings of gas and air for pain relief during delivery suggests that women experience a lot less discomfort. Laughing gas suffices for more than 50% of women and, for them, no other pain relief is necessary.

Laughing gas makes you drowsy and helps you relax better. It has a stimulating effect on your body’s ability to create its own pain relief (endorphins). This means you no longer feel the most acute pain. That makes it easier for you to handle labor contractions. The major advantage of laughing gas is that it has no impact on the birthing process and also has no after effects on the baby. Some women can feel somewhat euphoric and can even get the giggles. It won’t surprise you to hear that this is how laughing gas got its name.

Pain treatment

Let’s be upfront about this: in most cases, giving birth is a pretty painful experience. There’s good reason for that. Pain alerts you to the fact that something is going on in your body and that it’s time to consider precautionary measures. First step is to find a safe and tranquil place to welcome your baby to the world.

Going into labor and labor pains go hand-in-hand. It is a perfectly normal phenomenon. Almost all expectant mothers experience dilation – the contractions of the womb that open up the cervix – as painful. The same goes for the pushing contractions that together with the bearing-down reflex ensure the baby can be born.

The duration and intensity of pain during birth differs. Generally speaking, the pain tends to increase as full dilation approaches. You’ll feel uncomfortable in your belly or your lower back.

Women say they often find the pain unbearable, a feeling fuelled by exhaustion, anxiety and tension. A hot shower or bath and a massage can help. Moving into a different position can also alleviate the discomfort, but sometimes more is needed. Laughing gas can be part of the solution.

There are other forms of pain relief such as an epidural (regional anesthesia resulting from the injection of an anesthetic into the spinal pace between two discs); Pethidine (an intramuscular morphine injection in the leg); and Remifentanil (an intravenous morphine pump). You need to be referred to the hospital for these options, because the baby’s condition must always be monitored through a CTG (to check the baby’s heartbeat) if you choose these options.

When is laughing gas appropriate?

Women who have a midwife supervised pregnancy and the express desire for pain relief can be given nitrous oxide as long as the childbirth is uncomplicated. You can elect for this kind of pain relief in consultation with your midwife.

You can have nitrous oxide at any time during labor, but lengthy periods should be avoided. Therefore, it is recommended to start once labor had sufficiently established. It helps you to relax and works as a sedating agent. During the final stages of delivery, you can no longer use nitrous oxide, because you need be able to concentrate fully on the job at hand.

In the event that medical reasons require you to deliver your baby in the hospital with a clinical midwife or an obstetrician in attendance, you cannot choose nitrous oxide. You can only use other forms of pain treatment.

How is laughing gas administrated?

Laughing gas is an effective form of pain relief that is not difficult to administer. It is applied through a mask that you can hold in place yourself. Laughing gas tends to work the best if you start by taking a deep breath at the beginning of your contraction. This way, the laughing gas has the most impact. The chin mask you wear ensures the nitrous oxide you exhale does not circulate in the delivery room so that people around you are not exposed to it. Women do not appear to mind using the mask.

The midwife, with the assistance of the maternity assistant, is on hand to administer the laughing gas through the mask and will give you further instructions.

Are mother and child safe?

In The Netherlands, the use of laughing gas was less popular for a while, but it is on its way back. It fell into a certain disrepute when a small-scale study suggested incorrectly that laughing gas may have an unfavorable impact on the development of a baby in the womb of the caregiver. In hindsight we now know that under the correct circumstances and surrounded by the appropriate technical equipment, there are no damaging effects for either the mother, the baby or her pregnant caregiver. Laughing gas is much used in countries such as the UK, Canada, Australia, Finland, Sweden and Norway.

Potential side effects?

Side effects including nausea, vomiting, dizziness and euphoria have been known to happen.

Women with a Vitamin B12 deficiency or who have recently undergone an operation to the ear or eye with the help of gas injections are not allowed to use laughing gas.

In conclusion

Laughing gas can be used in all rooms of Bevalcentrum West. Should you have any questions, feel free to contact your midwife. She will be happy to respond to your queries.