Should Childbirth in the U.S. Be a Laughing Matter?
Around the world, including neighboring Canada, nitrous oxide (N2O) is used as an analgesic option during childbirth. Even here in the United States, nitrous oxide--often called "laughing gas"--was used during childbirth until the early twentieth century whenever epidurals were discovered.
Epidurals specifically target the pain receptors so that the pain is "blocked" per se; however, nitrous oxide actually works by blocking the perception of pain in the brain. The woman giving childbirth will still experience the pain, but this feeling is not usually registered as being 'painful'. Yes, nitrous oxide is the gas that is most often used by dentists during routine dental procedures.
One advantage of nitrous oxide is the price differential. Nitrous oxide is only a fraction of the cost of epidural anesthesia. For women who would prefer natural childbirth, yet would like something to take the edge off, perhaps the use of nitrous oxide would offer a compromise of sorts. Many of the hospitals and midwives who now allow for the use of nitrous oxide also let the mother control the actual administration of the gas. Nitrous oxide is generally considered to be safe--as is evident by its widespread, international acceptance as a childbirth anesthesia. However, unlike an epidural, nitrous oxide can pass the placental membrane so the child would also feel the sedative effects. (I guess he/she would possibly literally come into this world laughing!) Currently, the FDA ironically considers this 'old' remedy a 'new' drug due to its combination with oxygen.
Dammer et al. have investigated the efficacy of the use of nitrous oxide as an inhaled analgesic during childbirth by studying both pregnant women and midwives. Their findings indicate that it is a safe alternative; moreover, they find a statistically relevant reduction in pain (or perceived pain). For a link to the actual article via pubmed, see the hyperlink below:
Introduction of Inhaled Nitrous Oxide and Oxygen for Pain Management during Labour – Evaluation of Patientsʼ and Midwivesʼ Satisfaction
For more information, feel free to read an abcnews article concerning this topic:
Laughing Gas Now Becoming Popular Option for Women Giving Birth
This was very interesting article and post! There are a couple of points that I read that make this option favorable.
ReplyDelete1) It was intriguing to see the difference in prices for a traditional epidural and nitrous oxide. Knowing several women who chose home births because of hospital costs, I would be interested to see if a midwife or doula would be able to allow a patient to use the nitrous oxide at home.
2) I was somewhat surprised at a couple of things. The first is that this option is more prevalent in other countries instead of the US. It seems like this is analgesic option is becoming more popular now. Second, I was surprised to see that the decrease in pain (based on the pain scale) was drastic for the women who took the nitrous oxide.
3) The reason I like this analgesic option is because it gives pregnant women an option when it comes to childbirth. I know that in some circumstances nitrous oxide may not work or the birth is high-risk. Also, there are a good percent of women who are not fond of a spinal epidural because of possible complications (which is understandable). Using the nitrous oxide is another great option that can reduce fear in the woman during childbirth.
4) Overall, this was a great article and I think is a favorable option for women. I would like to see in the future a study done in the US. One thing I would be curious to see is how it affects the baby specifically. Would it make a difference if a baby is born full term compared to one born 2-3 weeks early.
It's funny that they're using laughing gas now during birth! (pun intended)
ReplyDeleteI've actually heard about this before and think it's a really cool technique. Since a majority of the population in America is heading toward more "natural" things in their household, when it comes to food, products, and home births, I wouldn't be surprised if in the next 5-10 years if this became as popular as epidurals in the hospital. I think it's interesting that one of the side effects of Nitrous Oxide is drowsiness. It reminded me of this birthing practice that I once heard where they would put woman in an almost sleep-like manner using morphine and scopolamine during childbirth. Overall I think that this is really a really cool new technique for birth.
I can see the overall benefits of using a lesser expensive means of relieving pain. In a money driven world I can see the incentive. However, the Nitrous Oxide crossing the placental membrane is no "laughing" matter. During childbirth, the potential risks associated with birth alone do not need to be emphasized with the addition of an analgesic. Immediately post-birth attachments are made to the mother by skin-to-skin contact. If the child is effected by the same analgesic as the mother, those bonds could be interrupted. I have not found current research to support this idea, however it is just something to keep in mind. All together this means of blocking pain appears to be without major complications.(1) It is a more effective, efficient, and economically beneficial overall.
ReplyDelete1. http://www.midwife.org/acnm/files/acnmlibrarydata/uploadfilename/000000000080/nitrous_oxide_12_09.pdf
The use of Nitrous oxide seems beneficial. If the prices are lower, the woman is in control of her own body, and the side effects are controlled, then this seems like a good alternative to use. The child being exposed to the world for the first time would probably rather be under the use of this gas too. Everyone benefits!
ReplyDeleteThis was a very interesting and informative article. Nitrous Oxide seems to be a very effective drug, since it is being used in most European countries and Canada. If the drug is cost effective and works efficiently, I believe it will the top choice for its kind very soon. The only worry about Nitrous Oxide is its ability to cross the placental membrane. This can be a major issue, especially since we do not know if it causes any side effects. Also, since a study to determine its side effects cannot be done easily it makes it difficult to determine the drug’s effectiveness.
ReplyDeleteIt is often said that if something isn’t broken, then do not fix it; however, this is not the case with pain relief during childbirth. The current method involves the use of an epidural to “block” the pain of the contraction and Pitocin to increase contraction strength. Pitocin, which increases the length and strength of contractions, leads to more pain than non-Pitocin labor scenarios (1). Most women then get an epidural, which can cause a loss of feeling in the bottom half of the body, inhibiting the woman’s ability to push when necessary, and often leading to the use of more Pitocin. The Pitocin-epidural-Pitocin regimen has been referred to as the “Pitocin cycle” (2). This has led to a lot of controversy surrounding the use of Pitocin and epidurals during labor (3). Some studies have even suggested that epidurals may have a negative effect on an infant’s ability to breastfeed (4). If this is the case, then current methods of pain relief during labor need to be reevaluated.
ReplyDeleteThe use of nitrous oxide seems promising since no studies have suggested any negative effects on the mother or infant; however, the fact that nitrous oxide crosses the placental barrier is cause for concern. Many people have suggested the epidurals can cause lethargy in newborns, causing delayed bonding with their mother (4-6). If nitrous oxide has the ability to cross the placental barrier and cause lethargy, it could lead to decreased bonding between mother and fetus. Although this has not been observed, it is worth further study. Overall, the data has suggested that this is a safe alternative to the currently controversial epidural, and may be a safer method for women who want the “natural” birth without the overwhelming pain.
1. http://www.childbirth.org/articles/pit.html
2. http://www.dssnv.com/#!the-pitocin-cycle/c1ays
3. http://abcnews.go.com/Health/study-pitocin-harm-babies/story?id=19148043
4. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3622113/
5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3080614/
6. http://sarahbuckley.com/epidurals-risks-and-concerns-for-mother-and-baby
Pain during childbirth can be difficult to manage. The safety of the baby must always be of the highest priority except in cases where the mother's life is at risk. This is why epidurals have been used so extensively. There is minimal risk to the baby and it can be an effective method for pain management. However, the use of nitrous oxide poses potential risks to the baby. This is why it should be used as a last resort and not as another option for pain management. The effects of nitrous oxide on neonates and infants is not fully understood. While it is believed to be safe, the complexity of neurodevelopment makes it difficult to study the outcomes of neonates and infants who receive nitrous oxide. This was one of the major shortcomings of the journal article mentioned in the blog. It did not adequately address the risks nitrous oxide may pose to the normal development of the neonates involved. This is one of the reasons I want to study the effects of several general anesthetics on the effect of neurodevelopment on neonates and infants that require surgery. This avoids the ethical dilemmas of exposing infants to something that is potentially detrimental to their development.
ReplyDeleteI think that this may be quite a reasonable alternative for an epidural. In my own conversations with various women I have found that there are often complications with the administration of an epidural and I have heard few instances where there has been any with nitrous oxide. My own love for "old" remedies does bias my interest in some ways but I believe that if it is not only cheaper but can be as effective with less risk it would be the better solution. I do have some concerns in regards to the effect it will have on a fetus, even if the exposure is limited to the period of delivery (as some deliveries can last quite long). The fact that it is popular in a wide range of countries does lend to the idea that any side-effects may be minimal, but, it would be wise to examine and read research done upon the subject.
ReplyDeleteThe use of Nitrous Oxide during childbirth seems like a great idea. However, as the saying goes, things that seem "too good to be true" probably are. It seems very alarming that this drug crosses the placental membrane. As some have already mentioned, a mother and newborn who are both affected by this gas would miss the critical bonding time that occurs immediately after birth. Even if this process is simply delayed, it may still have an effect on the mother and child. I would be interested to see a study on the effects of delayed bonding time. Many have mentioned that mothers who want a more "natural" birth may be interested in the use of nitrous oxide. I think many of these mothers would choose to forgo nitrous oxide if they were informed that it would affect their child as well. Although I have my doubts about this topic, it would provide many benefits. Maybe with further research we will find that the use of nitrous oxide really does not have any lasting effects. In that case, it would be a great alternative to implement.
ReplyDeleteFrom the research presented here, nitrous oxide seems to be a very beneficial option for women in the birthing process. Living organically has definitely become more than a temporary fad, and many cultures are pushing for a more natural and holistic lifestyle. The areas of pregnancy and childbirth can definitely be included in this. Nitrous oxide provides women with an alternative to an epidural which is not only more expensive but also less user-friendly: When using laughing gas, a mother is able to regulate its amount and thus, its influence. Obviously, the safety of the child should be a top priority as well. For this reason (and although other countries are using this technique successfully and regularly), research should continue for safety reasons.
ReplyDeleteWe're all familiar with the scenario in which the mother is in agony and the father is standing over her traumatized because he's never seen his wife look so furious...his hand is turning blue since her grasp is so tight and she's yelling at him for doing this to her. At this moment I'm sure this woman (and her husband) would love to have some laughing gas. Provided that nitrous oxide is a safe method for reducing pain during child birth, this sounds like a great advancement in obstetrics. I'm some what surprised that this method hasn't been utilized in the US already. It seems logical to chose this method over epidurals due to the ease of treatment and lower cost. The perception of pain versus the cure of actual pain doesn't seem to be an issue. The main reason that women want epidurals during the birthing process is so that they don't feel pain, not necessarily so that their body doesn't feel pain. If this method doesn't have any unwanted affects for the baby, then this seems like the way to go. (Unless you're just one of those hardcore women who refuse pain killers...yikes!)
ReplyDeleteThere is not much I can say about this topic that has not already been commented on. I think that the use of nitrous oxide as a means to block the perception of pain by women during childbirth is an ingenious method. I particularly find that letting the mother control the amount is very beneficial. However, for some reason I can picture this scenario going awry . . . a midwife trips over some part of the laughing gas delivery system, accidentally yanking the mask off and exposing everyone in the room to laughing gas. The father starts the chain of laughter (something he'll probably get slapped for later) and then the midwifes and doctors catch on. That scenario eventually results in perhaps one of the most humorous births ever seen -- to onlookers, yes, but especially to those affected by the gas. Joking aside, the truth is, I believe that nitrous oxide is an excellent alternative to epidurals for helping women get through childbirth.
ReplyDeleteFor those women who would prefer a more natural approach that endorses Genesis 3:16 (To the woman he [God] said, “I will make your pains in childbearing very severe; with painful labor you will give birth to children."), I suggest James 1:2-3 and 1:12).
The use of nitrous oxide is a novel approach to treating pain associated with parturition. This is certainly a topic that must be explored in greater detail since it may provide a useful alternative to painful epidurals for the mother. One problem that immediately arises is that nitrous oxide can cross the placental membrane and travel into the fetus’s blood supply. This could potentially cause damaging effects to the brain and other neurological damage, as researcher M. R. Hirschi has suggested in several scientific articles. Although nitrous oxide seems beneficial in many ways, I personally advise against its use in childbirth until further studies regarding its influence on neonatal brain development have been conducted. A comprehensive review of existing studies-- including results from countries where nitrous oxide use in childbirth is legal-- is essential before nitrous oxide is widely incorporated into American OB/GYN clinics. I’m hoping that N2O proves to be a safer (and cheaper) alternative to current delivery techniques.
ReplyDeleteEven though I do agree that the use of nitrous oxide is a great alternative to decrease the pain during childbirth, other aspects beyond the cost and the sedative effects are overlooked through this procedure.
ReplyDeleteAccording to (http://www.childbirthconnection.org/article.asp?ck=10188#drawbacks), there are many drawbacks against using nitrous oxide being one of them hazy memory of labor, loss of consciousness and effects on the initial response of the newborn. I think this is something every mother should reflect upon and research before being medicated. There are many woman that do not regret going through natural labor due to our body's natural mechanism to block/forget that painful experience through the release of hormones such as oxytocin and endorphis(which are still produced when using nitrous oxide but not perceived as much due to the blockage to pain stimuli).
Other studies done last year suspect that nitrous oxide may have negative effects in the developing brain of the newborn due to its neurotoxicity.
(http://www.ncbi.nlm.nih.gov/pubmed/24961701)
According to the data presented, yet a cheaper alternative, nitrous oxide does not offer the necessary security to both the mother and the newborn to be a good and safe alternative to 'avoid' pain, more than the natural mechanism within our body would.
I have never been under NO2 gas before so I am unsure of its effectiveness in relieving pain but if it can relieve pain from childbirth, I imagine it works quite well. Epidurals come with risk such as nerve damage, bleeding, dropped blood pressure, and severe headaches. In addition, some woman are unable to receive an epidural due to taking blood thinners or by having an infection around the lumbar area of the back [1]. NO2 gas works fast, relieving pain within 3 to 4 minutes after inhalation, but an overdose of this gas can cause nausea, hallucinations, and loss of consciousness [2]. As long as administration of the NO2 gas is done with caution, the mother and child should be safe even if the NO2 crosses the placental barrier. If too much NO2 is administered, there could be a risk of the child being unconscious when born.
ReplyDelete1. http://americanpregnancy.org/labor-and-birth/epidural/
2. http://www.dentalfearcentral.org/help/sedation-dentistry/laughing-gas/
I think as long as N2O is safe for the baby, it should just depend on what the mother feels like taking. Some might hear about N2O crossing the placental barrier and automatically think that they're are going to be extreme side effects, especially if their child develops some sort of disorder later on in life. It could become the new "vaccine" debate. I think every women should have the option of choosing one or another, but definitely has to be notified of how the drug works before administration. Hopefully, this would protect the physician and hospital from lawsuits.
ReplyDeleteWhile scrolling through the different posts, this post immediately grasped my attention! I personally enjoy learning about female health and birth and delivery, and hope to become an OB/GYN one day. What a great way of turning pain into laughter, especially during such a beautiful event as child birth! The use of nitrous oxide (N2O) seems to be very beneficial — low costs, zero pain administration, and its function seems to not disturb other functions of the body it is administered into. Although epidural has been proven to work and cause minimal issues, there are individuals who choose to opt out of its use due to fear or other reasons. N2O as an anesthetic would allow these individuals to have some sort of pain relief during childbirth without the worries that are carried with the use of epidural. Also, it may be used in third world countries where women may not be able to afford epidural and opt to the less costly N2O gas to relieve their birthing pains. My only concern with the use of laughing gas as epidural is its effects on the child to be born. The article made it clear that the gas would be able to cross the placenta and reach the baby. Could that cause the child any danger or inconvenience?
ReplyDeleteI see no problem with this its safe and causes no harm to the mother or infant.N20 is a cheap options with low risk with it. If a mother wants to experience a more natural child birth this gives her the opportunity. Its also interesting that the mother get to administer the amount she wants so it gives her the ability to decide if the pain is to much and adjust it. The gas which also goes to the child would be the only question mark it doesn't seem that it would cause any damage to the infant but its something to keep an eye on. Its also something that could help the child because there are cases when the baby is to big and if you don't do a C-section you have to break the infants collarbone.
ReplyDeleteI don't see any problem in using nitrous oxide, rather than taking an epidermal. I do however think that it definitely depends on the patient, not only their medical history, but their preference as well. Of course there will be some instances when they want to take one option that some how conflicts with their health, in that case, you would need to override their autonomy. I know when I have a chid, I would want to weigh out the pros and cons of both an epidermal and nitrous oxide before I decide what I would like to be given. You also have to keep in mind the extremely small room for error in both circumstances. For instance, if you insert the epidermal into the wrong part of the spinal cord, your could permanently paralyze the patient. If you don't give the patient the right dosage of Nitrous Oxide, you could kill them. There is always good and bad.
ReplyDeleteThis is definitely interesting because I looked into this particular topic when I first started pre-med and didn't know where I wanted to take my career (still don't actually). One of the fields I looked into was the world of OBGYN. When I was looking into the different kinds of childbirth I came across this 20/20 special on "orgasmic births". In these births, the process was actually pleasurable instead of an episode of immense pain. However, for this to happen, there needs to be that immense stimulus to the brain cause by birth. I would be curious to see if using the NO2 would cause more of these pleasurable episodes because the stimulus would still be there (unlike in the epidural).
ReplyDeletehttps://www.youtube.com/watch?v=jxB9mnKYr4M
Push (scream) Push (scream) Push (baby cry)!!! This is what I envision when I think about labor. However, after reading this article, it seems that there may be less screaming and more laughing. From what this study shows, I don't know why the use of nitrous oxide instead of an epidural is not as widely used in the states as it is around the world. However, I look forward to its acceptance in the future. Unless further studies show detrimental side affects, I would definitely encourage my future spouse to use nitrous oxide as another form of pain management.
ReplyDeleteA person who is under the influence of "laughing gas" is usually not in control of their action. I know from personal experience of using nitrous oxide, I was could not control my emotions, speech, or behavior when I had my wisdom teeth removed. In reference to a women giving birth, does the woman have control of her body? Is she emotionally and cognitively stable and present? Those are the questions that I would like to see answered. But regardless, everyone needs a good laugh and nitrous oxide in the NICU might be the answer.
I believe laughing gas is great alternative to the old method used to alleviate the pain of childbirth. Obviously, it depends on what the mother prefers. Since consuming N20 makes patients lose control of their behavior, emotions and speech, it is possible the mother would prefer an epidermal. It would be interesting to see what effects it has on the baby, since this gas crosses the placental barrier and directly enters to fetus. Yet because this method has been deemed safe, without any negative effects on the mother or child, it makes perfect sense that this new method be implemented as the standard.
ReplyDeleteI personally love laughing gas so I wouldn't have any problem using it for other applications as well. What could further applications be for laughing gas?
this is Levi Lall. I don't know why my name didn't show up.
DeleteI have been in the room two times when my sister had her babies. With her first baby, her epidural was not done correctly so she went through much more pain than anticipated. With her second, she felt no pain, other than the epidural. Hearing about the use of N20, it sounds like a great alternative. With this use, there would not be the potential of nerve damage, nor improperly placing an epidural. My only concern would be how the mother would react to the laughing gas. I had my wisdom teeth removed I did not remember everything, which child birth is something I would want to remember.
ReplyDeleteThis is a brilliant alternative! There can be many epidural complications and I wonder why is not implemented yet as an option. Recently, one of my aunts had to go through labor and they tried putting the epidural 3 times and she was in a lot of pain in the meanwhile. It is used internationally, for example the UK uses it in a 60% of the time. According to the American College of Nurse-Midwives (ACNM), women should have access to a variety of measures to assist them in coping with the challenges of labor. Among these should be nitrous oxide (N2O) analgesia, which is commonly used in many other countries. The big question is why it has not been used. Epidurals are more expensive and they are nationally used, if the market declined I believe many companies would not be so happy about it. The reasons may vary, but women should know they have different options to chose from.
ReplyDeleteI believe nitrous oxide is the best analgesic option during childbirth and I wonder why it was replaced by epidurals. The basic advantage of nitrous oxide sedation is that it can help transform anxious patients into relaxed and fully co-operative patients by relieving the stress, fear and anxiety associated with labor. Also, nitrous oxide provides light sedation, meaning that the patient remains conscious being able to communicate with the midwives and respond to instructions. People with fear of needles (like me!!) will appreciate the fact that no shots are required for the administration of nitrous oxide.
ReplyDeleteThis was a really interesting article. My sister had a baby about 7 months ago and I remember watching her as she got her epidural. It appeared to be painful; not to mention that long needle! There are also a lot of negative side effects when getting an epidural. Using Nitrous oxide instead of an epidural seems to be a really great alternative. Not only are the mothers not completely numb from the waste down, but they also do not have to have a super long needle stuck in their spine. Over all it sounds better than an epidural.
ReplyDeleteVery interesting. As Jack has already mentioned about the orgasmic births, I knew about them and had many questions, some of which were answered while reading this article (surprisingly). I can see from the industry perspective why epidurals are used rather than the nitrous oxide ($$$). However I wonder though if there are not other reasons why epidurals are used most often as of now. There are many questions that I have regarding the use and administration of both drugs and their side affects. Most notably (at least that is different than my peers, since they have already pointed out many great questions, concerns, ideas, and thoughts) the concern of irony that I have is not very specific but is just the idea of "drugging" your child as it enters the world...It is just an interesting thought. But nonetheless, I like the idea of the nitrous oxide. The thought of having an enjoyable labor is much more appealing than that of just getting through it or going through it in pain. Why not have a first great, fun, safe, enjoyable moment with your child?
ReplyDeleteThis is a interesting read and topic. It makes me wonder about what other types of pain relief measures will be developed in the coming future. However, one of my concerns is in regards to the gas leading to sedation in the child. I have not read any longitudinal studies of the effects of this gas in children in the long term, so i as a future parent would b hesitant of opting for it without through knowledge of the effects on the unborn child. Although I have to admit the reduced price is a large bit of incitement.
ReplyDeleteI personally think this is a great idea for moms who want to take a more natural route, rather than going through with an epidural. I don't believe giving birth to be a laughing matter, but rather a joyful time bringing a child into the world. Laughing instead of screaming with pain is a much better alternative and would make the birthing process a lot less terrifying. Although there's the risk of the Nitrous Oxide passing through the placenta, I believe this is still a safer route concerning the well being of the mother and baby. Another thing I found interesting in an article I read, is that in a high concentration, it's a weak anesthetic. A low dosage makes it the perfect drug for anxiety and pain relief, according to this source:
ReplyDeleteUsing Nitrous Oxide During Labor: Benefits and Risks. (2015, August). Retrieved September 23, 2016, from http://americanpregnancy.org/labor-and-birth/nitrous-oxide-labor/
This article went through the pros and cons of using nitrous oxide during childbirth and I believe the good outweighed the minimal risks.
This topic was very interesting and new to me and I enjoyed the read.
I believe that this is a great idea as an alternative to an epidural. The pain that women experience during child birth is terrible and any type of medication to alleviate some of the pain would be a relief to women. NO2 seems to be a better option in a way that would block the pain even better than the average epidural. This is a great idea and should be tested and used in every day births.
ReplyDeleteI always find it fascinating reading about treatments and procedures that are found to be useful in unconventional areas. In this case, the use of nitrous oxide seems like a positive alternative to the long used epidural because of its cost and way that it behaves in regards to the pain receptors. Epidurals pose a treat to the mother during childbirth because it literally prevents any cognition of the pain being experienced, therefore the mother may be experiencing a complication and have no knowledge of it. Furthermore, the use of nitrous oxide provides a more natural birth that still allows for the perception of pain but alters the way the brain processes it. The only issue that I can see is that the nitrous oxide has the capability to pass through the placental wall and affect the baby without any understanding of the possible complications.
ReplyDeleteI found this article to be quite interesting. The concept of shifting from blocking pain to blocking the perception of the actual pain is quite unique. And it has the bonus of being a cheaper/safe alternative which increases its usefulness. Some might even look at this and think that it is quite a humorous improvement on subduing pain during child birth.
ReplyDeleteAlthough it has been widely used and there have been no complaints of significant adverse affects to the child following use of nitrous oxide, the fact that this gas crosses the placental still puts me a bit on edge. For the case of the mother, it seems that nitrous oxide is a much safer analgesic compared to an epidural. I would like to see a study that did a long term evaluation of the health of children who were birthed under the influence of nitrous oxide. Epidurals pose potential long term risks of cerebrospinal fluid leaks which may cause headaches later in life (although I think this has a simple fix). As well, epidurals may cause a drop in blood pressure, and the physician must be careful that the baby has adequate blood flow. When delivering the epidural, the physician must be very cautious when messing around the epidural space. Given the numerous amounts of side effects that are associated with epidurals, and the relative few associated with nitrous oxide, as well as nitrous oxide being a cheaper medication, I feel that nitrous oxide would be a better move to make if the mother has a choice of analgesic.
ReplyDelete