Can you laugh your way through labor pain?

[6 min read]

In this article: 

• Providence Swedish now offers laboring patients at our birthing centers the option of nitrous oxide, which is similar to laughing gas, to help with pain management. 
• Nitrous gas won't eliminate pain, but it can make it less intense. Your care team can advise you on how it can be used with other pain relief options. 
• Nitrous gas can be used to help give laboring parents some "breathing room" as they work toward vaginal delivery. It has no known side effects on the baby. 
• Be sure to read the full patient education handout linked in this blog. Your care team can help you decide if it's a good option for you.  

Labor pains are not a gas. Ask anyone who has gone through childbirth. Pain management is a central issue in helping moms deliver as safely and easily as possible. Providence Swedish’s birthing centers in First Hill, Edmonds and Issaquah are now offering laboring patients an additional pain relief option: nitrous oxide gas. Like the pain reliever commonly known as laughing gas, nitrous oxide gas does not relieve pain completely but makes it more tolerable. 

To learn more about this new option and how it’s helping birthing parents have safer and more comfortable deliveries, we spoke with Audrey Mcfarland, RN, a nurse at our First Hil birthing center and team leader for introducing the option of nitrous gas pain relief to our laboring parents.

“I know that our patients have already benefitted greatly from this nitrous rollout,” says McFarland, noting how the option fits in with Providence Swedish’s commitment to shared decision-making and supporting patients in having the best childbirth experience possible.

“Other things we are working on include our TeamBirth [initiative] where huddles are done at the bedside to ensure that the patient's preferences are being heard while formulating a plan of care,” she says. “Another thing we are working on is helping prevent primary C-sections for first-time moms."

McFarland points out that managing pain with nitrous gives patients some breathing room  when deciding to wait on a C-section and work toward vaginal delivery. In fact, Providence Swedish is having significant success turning around C-section rates among Black mothers. Recently released statistics from Swedish’s First Hill campus show that Providence Swedish’s TeamBirth and Justice Unity Support Trust (JUST) Birth initiatives heve helped reduce cesarean section rates among Black, Indigenous and POC mothers to less than 25 percent. 

"Managing pain in eraly labor helps people avoid feeling desperate and overwhelmed, allowing them to make informed decisions rather than just wanting the baby out,” she says. 

McFarland answered some common questions about nitrous gas and how it’s used in our birthing centers. You can learn more here about guidelines for nitrous and how it is being used to treat pain during labor. 

What is Nitrous? Nitrous oxide is a clear gas with no smell that is used for labor pain. It is a mix of 50% nitrous gas and 50% oxygen. You breathe it through a mask that you hold to your face. It is like “laughing gas” in a dentist office, but it is a different mix and won’t make you giggle. It will not take away all the pain, but it will make it less intense.

Does it have any side effects? Some people report nausea after using nitrous for a long time. If this happens, but it is still helping with your labor pain, we could give you a medication to help with the nausea. It can also make you feel unsteady when standing or walking. You should always have a support person or staff member with you in the room when getting up. Rarely, it can cause vomiting, tiredness and anxiety.

Can I use nitrous with other pain relief options? You can’t use nitrous with IV narcotics since the combination can slow down your breathing. You can start using nitrous about an hour after your last dose of IV narcotics or can use IV narcotics after you stop using nitrous.

Are there any effects on the baby? There are no known effects on the baby while using Nitrous during labor. The effects of nitrous in the 1st and 2nd trimester are unknown. Nitrous is cleared from the body through the lungs, so as soon as you pull the mask away the effect goes away quickly.

What should my support people know? Nitrous should only be used by the laboring person when they can hold the mask to their own face. If a support person helps to hold the mask to your face, it could slow down your breathing, and we will need to remove the nitrous machine from your room. Only the laboring person can inhale the gas. If anyone else uses the mask, the Nitrous machine will be removed from the room and the person may be asked to leave.

Learn more and find physician or advanced practice clinician (APC)

Swedish has three birthing centers — First Hill, Issaquah and Edmonds — making it convenient for people who live or work in the Seattle, Eastside and North End areas. Swedish patients can take classes, meet other families, get help with lactation and go for new parents and well-baby checkups at The Lytle Center for Pregnancy & Newborns at our First Hill birth center. You can also get expert advice there and help with wellness. Visit our website to learn more about midwives at Swedish and how they can partner with you to create the most personalized birthing experience possible. 

If you need a gynecologist, women's health specialist or primary care doctor, Swedish is here for you. Whether you require an in-person visit or want to consult a doctor virtually, you have options. Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow up as needed. If you need to find a doctor, you can use our provider directory.

Information for patients and visitors 

Additional resources

At Swedish, a historic drop in C-sections among Black mothers

“When it came to my birth plan, I just put my trust in Providence Swedish.”

Providence Swedish hospitals named among nation’s best for maternity care

Cutting-edge care for patients giving birth and their babies | king5.com

This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.

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