As baby's birth nears, you've surely got a lot of questions on your mind. Likely one of the biggest — especially if this is your first baby — is how you'll manage labor pain.
While an epidural is the most common labor pain relief option,[1] there are other ways to help you feel more comfortable during labor — including one that sounds a little funny: laughing gas.
Also known as nitrous oxide, this inhaled gas used to be more prevalent during labor — but at that time it was often used in conjunction with narcotic painkillers, causing complications. After the epidural became the gold standard in the 1970s, the practice all but disappeared in the U.S. Now, laughing gas is more commonly associated with getting cavities filled than pushing out a baby.
That said, nitrous oxide remains a popular pain relief option in many other countries. In fact, more than 60% percent of women in the U.K.,[2] and roughly half of women in Australia,[3] have been found to rely on nitrous oxide throughout labor to take the edge off.
In the last several years, there has also been a resurgence of interest in the U.S., and today hundreds of hospitals and birthing centers offer nitrous oxide to laboring women. Here’s what you should you know if you're considering laughing gas as a labor pain relief option.
What is laughing gas?
Laughing gas, or nitrous oxide, is a colorless, odorless gas that's usually mixed 50/50 with oxygen for laboring moms. When inhaled, it reduces anxiety and increases feelings of relaxation and well-being.[4]
In small doses — like during labor (or even a cavity filling) — nitrous oxide is considered an analgesic, making pain easier to deal with. But unlike an epidural, it doesn’t numb pain entirely.
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Unlike what its name suggests, laughing gas doesn’t make you laugh uncontrollably — it just makes you feel calmer and more euphoric (though you may find yourself giggling a bit).[5]
How does laughing gas work during labor?
Unlike an epidural, laughing gas won't completely numb any parts of the body or significantly relieve pain, like narcotics do. Laughing gas is more often described as a disassociation from pain: You might still feel it, but you won't be as bothered or anxious about it.
Some moms like that laughing gas doesn't stay in your system for long.
"What I like about it is the effects are instant, and they also don’t last. So you feel relaxed while you’re breathing it in, and then it goes away pretty quickly," says What to Expect Community mom jessaham. "It definitely is not a pain reliever! It can help you relax, though."
Others say that nitrous oxide can soften the labor and delivery process.
"For me, it just takes the edge off a little and helps with my breathing," says What to Expect Community member Botherbaby23. "But don’t expect it to take the pain away."
There's not much you need to do to prepare for laughing gas — it's fine to eat and drink as usual up until labor. You also won't have to wait for an anesthesiologist to set you up like you do with an epidural.
Nitrous oxide is also self-administered — you’ll either hold a mask over your nose and mouth or breathe through a mouthpiece to inhale in the gas (a trained nurse can show you how).
How much of the drug you take is up to you, since you'll be holding the mask to breathe when you need it.
Benefits of laughing gas during labor
In places where nitrous oxide is frequently used in labor and delivery wards, practitioners report that it helps women by lessening anxiety. That said, some laboring moms don’t experience much (or any) relief from laughing gas.
Laughing gas may:
- Help you to relax and stay in position while a doctor is setting up an epidural (which can cause discomfort and/or anxiety, since it involves putting a small tube into the spinal column).
- Ease needle phobia if you're uneasy about having an IV placed.
- Increase your comfort during the most painful stages of labor and pushing if you aren't using other pain-relief medications. The American College of Obstetricians and Gynecologists (ACOG) recommends taking a breath of the gas about 30 seconds before a contraction starts to get the maximum effectiveness.
- Help you to relax and concentrate on your brand new baby while your practitioner inspects the perineum or sews up tears after labor.
Possible risks of nitrous oxide during labor
Experts generally agree that, for most people, nitrous oxide in the concentration recommended for labor is relatively safe. The side effects are similar to those from narcotics, though they're shorter-lasting.
Some women feel dizzy or nauseous while they're breathing the gas until a few minutes after they stop. The good news is that laughing gas leaves the lungs fairly quickly, so if you dislike the feeling, you can remove the mask and take a few deep breaths to feel better.
Although research is still ongoing, past studies have found that the amount of nitrous oxide currently used during labor usually given during labor has no effects on the health of a baby at birth or a newborn's alertness or ability to breastfeed.
Laughing gas vs. an epidural for pain relief during labor
Laughing gas has a few advantages compared to an epidural and some other labor pain relief options:
- It works quickly. Unlike some pain relief techniques, you'll begin feeling the effects of the drug after you stop using it. "Nitrous oxide is eliminated quickly via the lungs by simply breathing in room air," says Shannon Smith, M.D., a board-certified OB/GYN and partner at Brigham Faulkner Ob/Gyn Associates in Boston, Massachusetts, and member of the What to Expect Medical Review Board. "So if you start not feeling well, simply remove the mask and take a couple of good, big breaths."
- You can move around. Unlike with an epidural, you won’t be hooked up to an IV and monitor, so if you want to walk or sit on a birthing ball or change your position, you’ll be able to.
- You can stop at any time. Similarly, if you don't like the effects or don't feel like nitrous oxide is helping you, simply breathing regular air for a few minutes makes the feeling from laughing gas disappear. If you want to opt for an epidural afterwards, you can.
- There are usually fewer side effects. Compared to narcotics or epidurals, laughing gas comes with fewer side effects — it doesn't cause drowsiness or cloudy thinking after it's worn off, for instance.
Is laughing gas right for you?
Just as every pregnancy is different, every birth is unique too — and moms have a variety of ideas about how they want their experience to go down. You may, for instance, want to feel as little pain as possible, or it might be more important to experience all the sensations of labor, including pain.
If you're looking for relief that's self-controlled, fast-acting, has fewer side effects than narcotics, and allows you to move more than an epidural, laughing gas might be a good option for you.
Nitrous oxide, commonly referred to as “laughing gas,” is an inhaled gas that can be used during labor to take the edge off of labor pain. It's colorless and odorless, and usually mixed 50/50 with oxygen for laboring moms.
Laughing gas used to be more prevalent in the United States until the epidural became the gold standard for labor pain relief. Still, many women in countries such as the United Kingdom and Australia continue to rely on nitrous oxide during labor. And more recently, laughing gas has become a little more common again in the U.S.
Nitrous oxide increases feelings of relaxation and eases anxiety, which can make you feel more comfortable during labor and help make contractions easier to deal with. But it doesn’t numb pain the way an epidural does.
Nitrous oxide offers some benefits. For example, it’s self-administered and stops working when you take the mask off of your nose. This gives you more control during labor, which some moms like.
However, if you have any of the following conditions, your doctor likely won't recommend nitrous oxide:
- Severe vitamin B12 deficiency (the gas can lower B12 levels, so if they're already very low, nitrous oxide can be dangerous)
- Musculoskeletal disease or any impairment that keeps you from holding that mask yourself
- Collapsed lungs, a past gastric bypass, or inner ear surgery (these can lead to air pockets in your body, which nitrous oxide can enter and cause to expand even more)
Even if you think you want to try nitrous oxide, ask your health care practitioner whether it's an option — it's still only offered for birth at a few hundred hospitals and birthing centers around the country, although the numbers are growing.
Labor and delivery wards need special equipment that can mix nitrous oxide with oxygen. It's different equipment than what's used in dentists' offices because it's a slightly different ratio of laughing gas to oxygen. They also need special training and protocols for their nurses.
Whichever pain relief option you choose, just know that laughing gas has been shown to be safe for laboring moms and their babies — and the decision to use it (or opt for something else) may come down to how you’re feeling in the delivery room.
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