Bye, Epidurals? Why Laughing Gas Is the Latest Birth Trend

Angela Cabotaje Fact Checked
Nitrous oxide for labor
Clare McLean

OK, expecting mamas. Let’s start with the obvious: Having a baby hurts.

Ready for the good news? There are now more choices than ever to help you have the labor and delivery experience that you want, whether that’s sans medication, with the sweet relief of an I-can’t-feel-a-thing-when-I’m-with-you epidural or something in between.

One such pain-management option that’s generating lots of buzz in the United States is nitrous oxide. That’s right: laughing gas.

While this might make you think of your dentist preparing to yank out your wisdom teeth — uh, no thanks — you can rest easy. Birthing mothers have relied on the odorless, colorless gas to get through childbirth since the 1800s. In fact, mothers-to-be in places like Great Britain, Finland, Canada and Australia have used laughing gas for decades.

It’s taken U.S. hospitals and birthing centers a while to catch up. Some 10 years ago, only a handful allowed nitrous oxide for pain management during childbirth. Now hundreds nationwide offer it for labor and delivery. In the area, this includes UW Medical Center – Northwest in Seattle and Valley Medical Center in Renton.

So, what does nitrous oxide do, exactly, to help you get through those tough contractions? Why would you choose it over, say, an epidural? Is it safe for the baby? Can it really help that much?

We took these pressing questions to Mary Lou Kopas, chief of midwifery at the Childbirth Center at UW Medical Center – Northwest, for the lowdown on laughing gas.

Nitrous oxide will make you feel better — but not in the LOL way

Despite the nickname, laughing gas probably isn’t going to make you ROFL during a birth and delivery situation. That’s because, unlike at the dentist, you control the amount you receive at any given time, and the gas is offered in lower concentrations — usually a 50-50 mixture of oxygen to nitrous oxide.

What it does do is help you relax and tolerate the pain a little better.

“With nitrous oxide, it takes the edge off or it makes you care less,” Kopas says. “It has an anti-anxiety effect, and when things are moving really fast and things are intense, it helps birthing mothers cope.”

An added bonus? You’ll start to feel relief almost immediately.

When requested, nitrous oxide is usually wheeled into your delivery room in a tank that looks sort of like a vacuum cleaner. You’re in control the entire time. All you have to do is hold the mask over your nose and mouth, take a few breaths about 30 seconds before a contraction and — ta-da! — that vicelike grip around your middle may feel a whole lot more bearable.

There are pros and cons to laughing gas

While nitrous oxide can certainly make you feel better during labor, it won’t completely block the pain like an epidural.

Basically, you’ll still feel contractions, but you might be less bothered or overwhelmed by them. The usefulness of nitrous oxide, Kopas adds, will vary from person to person.

“Some people find it really helpful and use it off and on for a few hours,” she says. “Other people say, ‘This doesn’t help — I want an epidural.’”

While the epidural wins out when it comes to blocking pain, nitrous oxide has the upper hand when it comes to freedom of movement. Laughing gas doesn’t require an IV or catheter, so you’re not stuck in your bed. You can sit in a chair or bounce on a birthing ball for added comfort.

It’s safe for you and baby — as long as you’re not vegan

Like any drug, nitrous oxide can have side effects: Some women who use it during childbirth may feel dizzy, drowsy or nauseated. And those who have a vitamin B12 deficiency — including possibly vegans and those with Crohn’s or celiac disease — should not use nitrous oxide because it may make them more susceptible to a medical condition called hyperhomocysteinemia, which can lead to blood clots, cognitive impairment and potentially heart attacks.

As for the effects on your baby, studies have shown that using laughing gas during labor is very safe. The gas leaves your body within a few minutes, and it doesn’t cause any known harm to your baby or interfere with the progression of your labor or your ability to push.

“I compare it to epidurals,” Kopas says of the risks associated with nitrous oxide. “Epidurals are safe and effective. There are some risks to epidurals, but they are still considered a relatively low-risk form of pain relief. Nitrous oxide is the same.”

Nitrous oxide may or may not be for you — but it’s nice to have the option

Many of the laboring mamas that Kopas encounters choose nitrous oxide because they’re motivated to have a “natural,” epidural-free childbirth. Some had an epidural the last time they gave birth and didn’t like how it made them feel numb or that they had to be hooked up to an IV and catheter.

Other times, the woman comes in so far along in her labor that there’s not really time to get her an epidural. And there are situations where laughing gas isn’t even used for childbirth but rather for the post-birth stuff that still hurts like a, well, mother: a manual delivery of the placenta, for example, or having vaginal tears stitched up.

And, yes, there are women who give nitrous oxide a try, don’t feel any difference and opt for an epidural instead. That’s totally OK, Kopas says. The most important thing to keep in mind is that there’s no right or wrong way to get through childbirth.

Editor’s note: This article has been updated to reflect Northwest Hospital is now UW Medical Center – Northwest, a second campus of the University of Washington Medical Center in Seattle.