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US Hospitals Starting to Offer Laughing Gas to Laboring Women


JumpyTheFrog
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http://www.theatlantic.com/health/archive/2014/07/using-laughing-gas-to-relieve-the-pain-of-childbirth/374124/

 

Although about half of women using laughing gas during childbirth in several countries, in 2011, only 1% of American hospitals had it as an option. As of 2014, we're up to a whopping 33 hospitals/birthing centers offering it. 

 

It's such a shame. I had two home births and used a TENS unit. If a nearby hospital with midwives offered laughing gas, I seriously would have considered it.

 

 

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Well you learn something new every day - I didn't know that hospitals in the USA didn't use it!  

 

In the UK it's absolutely standard; I don't think there's a midwife led unit or hospital that doesn't offer it, and you can also have it for a home birth.

 

I used a pool with gas & air at a midwife led unit (which is that standard of care here) for both my two, and it was great, although I think the pool was more important as pain relief.

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I had 'gas and air' for both my births (UK and Hong Kong). It certainly helped. Is that the same as laughing gas?

 

L

Yes, nitrous oxide. The only place I have seen it used in the US is dental offices. My sister had a baby in Scotland and they gave her "gas and air". Here in the US, the vast majority of women get an epidural. I'm glad to see this becoming an option. Did you find it helpful? Maybe I can convince my midwife to let me try.
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Yes, nitrous oxide. The only place I have seen it used in the US is dental offices. My sister had a baby in Scotland and they gave her "gas and air". Here in the US, the vast majority of women get an epidural. I'm glad to see this becoming an option. Did you find it helpful? Maybe I can convince my midwife to let me try.

It was helpful for a 'normal' birth (Hobbes).  I didn't have an epidural and it was doable.  

 

Calvin was induced, and the gas and air wasn't enough (for me).  I was glad of the epidural.

 

L

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Although about half of women using laughing gas during childbirth in several countries, in 2011, only 1% of American hospitals had it as an option. As of 2014, we're up to a whopping 33 hospitals/birthing centers offering it.

 

It's such a shame. I had two home births and used a TENS unit. If a nearby hospital with midwives offered laughing gas, I seriously would have considered it.

Laughing gas always makes me feel tipsy. I've only used it during dental procedures but I decline now after trying it a few times. It's probaby not a good feeling during labor.

 

Not that I'd know what labor feels like. I've always had to have c-sections with spinal blocks.

 

Also, does the nitrous oxide cross the placenta? Or perhaps it quickly moves through the baby's system once he/she is breathing? The anesthesiologist waited until my baby was born to give me a certain pain med because he was concerned about the baby.

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It was helpful for a 'normal' birth (Hobbes). I didn't have an epidural and it was doable.

 

Calvin was induced, and the gas and air wasn't enough (for me). I was glad of the epidural.

 

L

Hmm, I'll have to look into this more. I've had five births with nothing for pain relief other than using a tub through part of labor. I just don't think I can face doing it again--the last two the pushing phase was almost unbearable. But I don't know if gas would help with pushing. May just go for the epidural, but what I really love about natural birth is how great I feel as soon as the baby is out, no lingering effects like I hear about with epidurals.

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The article said it does cross the placenta but is removed from the body very quickly-within a few normal breaths. To me, it seems like it might be safer than epiduals, as far as drugs crossing the placenta.

 

I found it sad that one reason more hospitals aren't offering yet is because of turf wars over who would administer it.

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I would have gone for that. They gave me a shot of something. I can't recall the name of it, but it was awful. It didn't do squat for the pain, and I just felt like I was hallucinating or something.

Most likely Demerol. It is widely used, but LOTS of women have terrible reactions to it-feeling like they are drunk, hallucinating, terrible itching, etc.

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I had it for my last. It was great pretty much like Laura said. I've done the epi which didn't work well didn't wear off in time, one drug free and the last with gas. I still felt the pain but it felt like it was happening to someone else. You don't have to make an early decision I only had it for the end.

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I would have gone for that.  They gave me a shot of something.  I can't recall the name of it, but it was awful.  It didn't do squat for the pain, and I just felt like I was hallucinating or something.   I've had laughing gas in the dental office as a kid and don't recall any negative side affects. 

 

Was it Stadol?  I had it will my first dd.  It. was. horrible.

 

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I had it for my last. It was great pretty much like Laura said. I've done the epi which didn't work well didn't wear off in time, one drug free and the last with gas. I still felt the pain but it felt like it was happening to someone else. You don't have to make an early decision I only had it for the end.

If it made you feel detached did that make it harder to push? You say you had it for the end. Pushing is hardest for me and the part I really wish I could take the edge off of.

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Hmm, I'll have to look into this more. I've had five births with nothing for pain relief other than using a tub through part of labor. I just don't think I can face doing it again--the last two the pushing phase was almost unbearable. But I don't know if gas would help with pushing. May just go for the epidural, but what I really love about natural birth is how great I feel as soon as the baby is out, no lingering effects like I hear about with epidurals.

 

I was told to stop using it at the pushing stage.  So maybe it's not what you are hoping for.

 

L

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I had an epidural with my first and I hated it.  I need to keep some control and not being able to feel my lower half made me feel very much like a 'patient' instead of 'woman giving birth'.

 

I had stadol with all the rest (all induced).  It helped me rest during labor but, in the end, I was begging for death with each delivery.  Literally, I always end up telling DH that it is time for me to die.  Good times!!

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oh wow, I had no idea it wasn't available to you in the US.  It's just a standard thing here - it's in all the birthing rooms and even homebirthers can use it from a portable tank Midwives can carry.  It makes me vomit (more) so not so great for me, but it does work too. 

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I could still feel to push etc absolutely fine. It was ok to use while pushing although pushing is always pretty short for me. I actually can't believe you don't have it there. It's been around forever here...

 

My sis did say it made her crazy. She thought she'd already had the baby and couldn't understand why they still wanted her pushing.

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I was told to stop using it at the pushing stage.  So maybe it's not what you are hoping for.

 

L

  

I could still feel to push etc absolutely fine. It was ok to use while pushing although pushing is always pretty short for me. I actually can't believe you don't have it there. It's been around forever here...

My sis did say it made her crazy. She thought she'd already had the baby and couldn't understand why they still wanted her pushing.

Maybe different providers have different takes on whether to keep using gas or stop when pushing. It's definitely pushing that worries me; went fine with babies 1-3 but sheer agony with 4 and 5. After 4 I assumed it was worse because he was huge, but #5 was my second smallest and just as bad.

 

Sigh. I have a few months to figure out options. I have long but manageable labors, I hate feeling like I can get right to the end but can't handle pushing.

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Without personally looking up the medical pros and cons...  I support it!

I am pro-natural birth and have had 3 non-medicated births (after one epidural and one IV med birth.)  Loved them.

 

BUT, I am out of my mind terrified of dentists. To the point of provoking serious anxiety attacks in the past couple of years.  Gas took every ounce of fear away from me and allowed me to get through some serious work.

 

If gas is as "safe" (or safer) than other medical pain management, I think it's a great tool for women who fear labor pain.  And reversal is WAY simpler than an epi or IV if someone changes their mind.  I'm sure it's insanely cheaper, too!

I wonder how quickly it's accessible, because I'm thinking it could be really helpful in transition.

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And reversal is WAY simpler than an epi or IV if someone changes their mind.  I'm sure it's insanely cheaper, too!

 

 

It sounds like if the woman doesn't like it, the effect wears off within a few minutes.

 

One place (that I think allowed it to be administered by nurses instead of doctors) charged $15.

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Laughing gas always makes me feel tipsy. I've only used it during dental procedures but I decline now after trying it a few times. It's probaby not a good feeling during labor.

 

Not that I'd know what labor feels like. I've always had to have c-sections with spinal blocks.

 

Also, does the nitrous oxide cross the placenta? Or perhaps it quickly moves through the baby's system once he/she is breathing? The anesthesiologist waited until my baby was born to give me a certain pain med because he was concerned about the baby.

Yes, it does cross the placenta, but so does pitocin, demerol, stadol, and the drugs in the epidural. 

 

The article said it does cross the placenta but is removed from the body very quickly-within a few normal breaths. To me, it seems like it might be safer than epiduals, as far as drugs crossing the placenta.

 

I found it sad that one reason more hospitals aren't offering yet is because of turf wars over who would administer it.

Yep.  Epidurals are a hospital's bread and butter and most don't have any interest in reducing its use.  Also, if they don't have enough epidurals, they can't justify having an anesthesiologist dedicated full-time to labor/delivery.

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We have nitrous oxide in hospitals in ontario, and it is available for homebirth a upon request. I had natural births but did give the gas a try during my 3rd labor- I was dilating crazy fast and was starting to panic from the pain- I went from 2cm to birth in 45 minutes! I took a vigorous suck on the gas mask, passed out for a few seconds and woke up swearing about it not working- I do not swear- ever! It didn't really touch the pain so that was all I took.

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I an absolutely stunned! No wonder epi rates are high! It is standard here. I used it with my first 2 births and it was great. They didn't take it away from me at all, though I found I didn't need it so much during pushing. I found it took the edge off the pain. Babies had great apgars, no lingering effects. Great stuff, love the gas! I would have had it with my last 2 births, but #3 was too fast & #4 was at home.

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Yes, it does cross the placenta, but so does pitocin, demerol, stadol, and the drugs in the epidural.

 

Yep. Epidurals are a hospital's bread and butter and most don't have any interest in reducing its use. Also, if they don't have enough epidurals, they can't justify having an anesthesiologist dedicated full-time to labor/delivery.

For many hospitals, epidurals are the only way they can afford to keep an anesthesiologist on call round the clock. Birth is, from my understanding, a big part of keeping hospitals solvent.

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Wow, yep, it's standard here in Australia. I have used only gas for all 3 births now with no ill effects on me or baby.

 

I know some women hated it, felt sick, or just didn't like the dizzy feeling. For me, it didn't decrease the pain but it made the pain sort of distant from me which allowed me to focus inwardly on the urges of my body. I believe my good reaction to the gas is a part of the reason my transitions and pushing phases are very quick, because it allows me to be relatively calm and work consciously with my body. I have very quick, intense labours (was in the hospital a grand total of 40 minutes before birth this time). I use it during the end of dilation and throughout transition. In my experience it can be used during pushing as long as the woman is actively pushing. In my first birth it was taken away because I wasn't pushing effectively due to a few circumstances. In the second and third I had it right up until baby began crowning and then it was taken away (unless stated otherwise, the midwives take it so that you can experience the moment of birth without being under it's effects since at that point most women are in too much pain to think 'I am going to put this down now because it's almost over' lol).

 

If you have access to it I'd recommend any woman consider it. Make sure the midwife starts it low (I had one birth where it was turned right up, not so pleasant). Like I said, some really don't like the feeling or feel nauseous, but I personally think it is amazing and exactly what I need.

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Wow, count me among those who had no idea that it wasn't available as part of standard L&D in the States. Up here it's offered as one of the first options, and was even an option for my home birth, adminstered by midwives. I personally don't love it - the dizzy feeling makes me nauseous and didn't really do anything to stop the pain - but I know a lot of women who use it every time. Then again, I haven't tried it since my first, maybe if I have another I'll give it another shot.

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I saw them using it on "Ask the Midwife", and wondered (after visiting the university of google) why it's not offered here. I'm glad women are getting more options - particularly cheaper, more readily reverseable ones.

I remember seeing it on Call the Midwife and wondering why we don't do it because it seems like a good way to manage pain for those who want some relief but not quite lower limb paralysis. I assumed there must be some good reason that it became "outdated," but it sounds like there's not and it's just the US.

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Yes, that's a standard option here, too (Canada).  It's usually a first line offering, from what I understand.  If it isn't enough, they can offer more, but anecdotally, most of the women with whom I've discussed birth stories here have had no more than the gas and air, if they were able to deliver vaginally and if they weren't induced. 

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I was pondering this topic earlier in my pregnancy as I home birth and my last birth was horrifically painful. As in I really should have had pain meds and have seriously considered going to the hospital this time(I'm a midwife for the record :/ )I've done it without meds 6 times and there was just something not right last time.

 

Anyways, for those ladies that have used it especially if you haven't for one birth or more, did it make you loopy or out of it at the moment of birth? That is one thing I really wouldn't like. It's a moot point as ya not available for home birth anyways but I am curious.

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i wasn't out of it too much. Still aware of my body and what was going on. I actually felt more in control because the pain wasn't overwhelming any more. Especially during transition. Didn't really use it during pushing so it was well worn off before moment of birth. I also found it helped me control my breathing and focus, especially with my first when I was induced. Had her with no epi.

 

I'm just stunned it isn't an option! A large proportion of the women I know give birth vaginally and use it.

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Anyways, for those ladies that have used it especially if you haven't for one birth or more, did it make you loopy or out of it at the moment of birth? That is one thing I really wouldn't like. It's a moot point as ya not available for home birth anyways but I am curious.

 

Like I said, my midwife would remove it when we got to the 'baby is about to be born' stage. I have always done the last 2 or 3 contractions/pushes without it. It wears off really quickly, the main 'high' stage is gone within two or three normal breaths, though you may feel a little bit 'floaty' for a little longer than that, for me I was completely normal within 2-3 minutes (I have had it while not in labour a few times, so am using that for reference). Again, get them to start low. I am not sure how it's administered there, but I have always been given a mouthpiece to hold, and I just self-administer as soon as I feel the twinges of a contraction starting, and stop breathing through the tube as soon as the 'peak' passes.

 

Hope that helps a little. Maybe you can go to canada for a 'home' birth with gas! :D

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It did make it worse!  Who in heck came up with that idea?  Must have been a man.  I have never heard of a woman saying they had that drug and that it helped. 

I actually had Stadol with my first and it was WONDERFUL.  It still hurt, but I didn't care.  No hallucinations or anything weird like that.  And by the time it got bad enough that I cared again, I got an epidural.  Actually, I had epidurals with all three, but that first one was the easiest to get because the Stadol had me relaxed enough.  With my other two births, the hospital didn't have Stadol on hand.

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Anyways, for those ladies that have used it especially if you haven't for one birth or more, did it make you loopy or out of it at the moment of birth? That is one thing I really wouldn't like. It's a moot point as ya not available for home birth anyways but I am curious.

 

I stopped using it a bit before birth.  The effects wear off pretty fast, even within labour, so I wouldn't think it would be a problem.

 

For a non-induced birth, I much preferred it to an epidural.

 

L

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Maybe different providers have different takes on whether to keep using gas or stop when pushing. It's definitely pushing that worries me; went fine with babies 1-3 but sheer agony with 4 and 5. After 4 I assumed it was worse because he was huge, but #5 was my second smallest and just as bad.

 

Sigh. I have a few months to figure out options. I have long but manageable labors, I hate feeling like I can get right to the end but can't handle pushing.

This is me too. The only reason I had epidural for my first was because I thought I still had ages to go.

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Didn't make me feel loopy, as I had only a couple of breaths of it and it wears off almost immediately. I've had one drug free and one with gas and there is no difference except a feeling of thank goodness I have the strength to get through this now with the gas.

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I have never heard of laughing gas used during labor, period. This is news to me. I did a natural birth and am expecting baby #2. I want to say I'll do it again, but I guess I'll see when the time comes.

While I've heard of it I thought it had gone out of use 50+ years ago and was considered outdated. I'm stunned to hear all the reports of it being used by midwives and at home births where normally the aim is for meds-free births. I had a water birth and I still could have used some help in the pain-management department ;)

 

Has anyone here ever used it in dental situations? I'm curious to know whether it would be effective at quelling that anxiety or whether it would complicate things. Do they dose by weight?

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http://www.theatlantic.com/health/archive/2014/07/using-laughing-gas-to-relieve-the-pain-of-childbirth/374124/

 

Although about half of women using laughing gas during childbirth in several countries, in 2011, only 1% of American hospitals had it as an option. As of 2014, we're up to a whopping 33 hospitals/birthing centers offering it.

 

It's such a shame. I had two home births and used a TENS unit. If a nearby hospital with midwives offered laughing gas, I seriously would have considered it.

I begged and cried for a tens machine for my bad back during my back labors. Felt like someone was slowly scooping my vertebrates out with a dull melon baller.

 

Laughing gas in the dental office is highly annoying to me. That's about the only affect it has. I strongly dislike the feeling of being out of it or whatever. But I wouldn't have any issue with it working for someone else.

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Sigh. So the only way I'll get my hands on this stuff is by having dental work or giving birth. Which to choose, which to choose?

 

Al I know is that I've had it for dental work and I freaking loved it. I would have loved it for labor. I had to make due with crushing my dh's legs and hands and screaming. I think "gas and air" would have been more fun. Pretty sure dh would have liked for me to have an alternative to using his body parts and deafening him.

 

I'd like to see "gas and air" made available to homeschooling parents for those particularly pesky lessons. Wine has carbs.

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Has anyone here ever used it in dental situations? I'm curious to know whether it would be effective at quelling that anxiety or whether it would complicate things. Do they dose by weight?

I have a couple times. Once was for wisdom teeth extraction. I knew exactly what was going on and could feel everything (not pain due to lidocaine injections) but I simply did not care. At one point the dentist really pushed and twisted hard to grind out a tooth, and he asked me if I was okay. I remember telling him that I was fine and he was more than welcome to pull every tooth in my mouth cause I didn't mind it a bit. He laughed and said that I was a "fun one." I didn't know what he meant and didn't care. I was in my happy place.

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laughing gas never worked for me.  I went through 2 canisters of the stuff when I was having dd14.  She was a vacuum extraction with major tearing so they gave me the gas to use while they sucked her out and stitched me back together.  The only thing it did was give me a hoarse voice.  I still felt everything and there was no laughing going on, let me tell you

DD6 has had it for dental work.  She had a nose thing put on with a safe flow of laughing gas and got all her cavities done no problem.  She quite liked that dentist.  She did not like the next time when we were sent elsewhere and she was put under to have dental work done.  The laughing gas was much better

 

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Oh gas and air....one of the only pleasure about giving birth...well except for the baby. I had an Epi with my first and it was the stuff nightmares are made of..I swore never to do it again.

 

Used the gas only for my next two and had awesome births. You only need to suck it in when you are having the contraction. There is no real skill to it. I didn't have a mask either it was just plastic tubing you sucked on...or bit down on which is also very helpful. It wears off very quickly...within a few breaths.

 

I'm sad I won't be having more babies...just so I can use it again. LOL.

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