Saturday, December 16, 2017

The Sensations of Labor: Nitrous Oxide

Welcome back to my sensations in labor blog post series! We've made it through the two heavy hitters in terms of both pain relief, and side effects, but we're not through our medical bag of tricks yet.

Nitrous oxide, or laughing gas, or gas and air, can only be given by a doctor or midwife. Depending on state laws, and on individual midwives, it can be available in home births, as well as hospitals and birthing centers. If you've ever received laughing gas at the dentist, you have an idea of how this medication works, though you may have received a higher dose than is given to a laboring person. In labor, nitrous oxide is given 50/50 with oxygen, so the laboring person can't deprive themselves or their baby of oxygen by its use. Some people use nitrous oxide throughout labor. Others use it for particular uncomfortable procedures, like stitches after the birth, or inserting a foley balloon to augment labor. While nitrous oxide has been widely available for a very long time in the UK, it's still fairly new on the scene in the U.S., which means that a lot of pregnant people here aren't familiar with this option, and its pros and cons.

Let's break it down, shall we??

Pros:

Chill out and feel better! Nitrous oxide is a dissociative.  This means it makes you feel sort of separate from your body and whats going on with it. It's really effective for anxiety and fear around a situation or procedure. If you're struggling to cope with labor because you keep getting into your head about how these intense sensations can't possibly be a normal function of your body (even though you know logically that they are), or you can't stop worrying about something going wrong with baby, nitrous oxide can help you feel easy and relaxed about whats going on.

Easy to use! Nitrous oxide is inhaled through a mask. You hold the mask to your face, and inhale and exhale through it. This prevents the nitrous oxide you exhale from being released into the room and exposing your support team, and care provide to it. Any time you want to use it, you pop the mask on and breathe. And it's just as easy to stop using!

Non-committal! Not sure if you'll like how nitrous oxide feels? Not sure if it'll be worth being bed-bound (we'll get to it in the cons, but this is a common policy in hospitals in the U.S.)? Unlike an epidural, you can stop using nitrous oxide anytime just by taking the mask off! In fact, it's recommended to start breathing it as soon as you feel the first sign of a contraction, and take the mask off again as the contraction ebbs away. If it's not working well for you, or you'd rather try something else, it'll be out of your system within a couple of breaths without the mask. It doesn't linger in you or your baby's systems.

Stay yourself! Unlike a morphine rest with its heavy sedative effect, with nitrous oxide, you can spend most of labor (all the time between contractions) completely unmedicated. You won't feel loopy or goofy anymore as soon as you stop breathing the nitrous, so you won't miss out on the experience of your labor, or bonding with your partner as you wait for your baby together.

You're in control, and you're totally safe! Mask on, mask off, it's up to you! But does that make you nervous? How do you know if you've had too much?? Easy! You'll disassociate from your body so much that you'll let go of the mask! It'll fall away from your face, and within a breath or two, you'll be back to normal. This is why no one else can hold the mask for you, no matter what. Over the course of a normal contraction, you won't manage to get to this point, but should you have some strong contractions twin together, you can keep breathing in the nitrous oxide as long as you like, knowing that the failsafe is built into the system.

Cons:

Pain relief isn't exactly the point! So...dissociative, right? Nitrous oxide is great at that! How good is it at relieving pain though? We're talking about something very subjective, and it's going to vary a great deal from person to person depending on how much of their physical discomfort is caused by how their brain is processing the sensations and labeling them as 'scary' and 'bad'. For some people, it's all they need to sail through labor! For other people, it just doesn't seem to do that much!

Mask out? You're in bed! Most hospitals in the U.S. will require you to remain in bed not only while you use nitrous, but for a set amount of time after you breathe from the mask for the last time if you stop, usually about half an hour. This means that if you try nitrous, and and don't like it, you're stuck coping with labor in bed, without access to movement, a tub or shower, birth ball, etc. for comfort. That's a tough spot to be in!

It's not side effect free! Nitrous oxide makes some people uncomfortably nauseas. Other people just don't like the feeling of disassociating. Some people feel like they aren't getting enough air because you have to pull pretty hard to get a deep breath out of the mask. You may love it, or you may not!

Could nitrous oxide be a useful tool for your labor? There's only one way to find out! And if you think it might be, you'll want to find out if it's available where you'd like to give birth. It's still not widely available at all hospitals in he U.S.

Have you used nitrous oxide? Did it help you? Why or why not?

Live Omily,
~Emily

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