Gas and Air in Labour
In the UK Gas and Air (Also known as Laughing Gas or Entinox- it’s 50% oxygen, 50% nitrous oxide) is one of the most commonly used methods of pharmacological pain relief. How do you know if it’s right for you?
Gas and Air can be used at Home, on a Birth Centre or on a Labour Ward. It is a tasteless, odourless gas that is inhaled, usually through a mouth piece that you can place in an out of your mouth as required. You can exhale through it too so no need to remove between breaths! (example below).
Gas and Air works by reducing the level of discomfort of your surges, whilst allowing you to remain mobile and feel sensation as normal.
What are the benefits of using Gas and Air?
Research has shown gas and air to be an effective method of pain relief when compared to a placebo of 100% oxygen. In terms of ‘how much’ pain relief it provides, studies have show it is comparable to opioids (such as pethedine) without the unwanted side effects.
Many women like to use gas and air because it gives them control over their own pain relief. You are in control of when, how much and how long you breathe it in for. Many women find it helps them focus their breathing and provides a welcome distraction during labour.
Another benefit of gas and air, is that it is a very ‘short lived’ method of pain relief. Once you stop breathing it in, it’s out of your system in a matter of seconds. Meaning if you try it, and decide you don’t like it, you can simply stop using it!
It can also be used at other points in the birth process, such as whilst having stitches or undergoing a procedure in pregnancy.
The best available current research has shown that Gas and Air has no harmful side effects for your baby.
And what about the risks?
For some women gas and air can make them feel nauseous or cause them to vomit.
Some women report feeling ‘spacey’ or ‘out of it’, which is a state they don’t feel comfortable in. (For others this sensation is welcomed!)
How do you use it?
For Gas and Air to be most effective, you need to start inhaling it around 30 seconds before your surge begins, so that it has time to build up in your system before the peak of the surge. Breathe deeply and slowly, in and out through your mouth. You breathe both in and out through the mouthpiece, which you can remove at the end of the surge. It’s pretty simple and your midwife will show you how! After a couple of surges you’ll have the hang of it!
Whether or not you use gas and air in labour isn’t something you have to make any hard and fast decisions on until you get there! But if you have an initial preference either way, it might be something you wish to include in your birth plan.
REFERENCES
Collado V, Nicolas E, Faulks D, Hennequin M. A review of the safety of 50% nitrous oxide/oxygen in conscious sedation. Expert Opin Drug Saf 2007;6:559–71.
Declercq, E. R., Sakala, C., Corry, M. P., et al. (2013). Listening to mothers III: pregnancy and birth. New York (NY): Childbirth Connection; 2013.
Hellams, A., Sprague, T., Saldanha, C., et al. (2018). Nitrous oxide for labor analgesia. JAAPA. 2018 Jan;31(1):41-44.
Klomp, T., van Poppel, M., Jones, L., et al. (2012). Inhaled analgesia for pain management in labour. Cochrane Database of Systematic Reviews, Issue 9. Art. No.: CD009351.
Likis, F. E, Andrews, J. C, Collins, M. R, et al. (2014). Nitrous oxide for the management of labor pain: a systematic review. Anesth Analg;118:153–67.
Onody, P., Gil, P. and Hennequin, M. Safety of inhalation of a 50% nitrous oxide/oxygen premix: a prospective survey of 35 828 administrations. Drug Saf. 2006;29(7):633-40.
Richardson, M. G., Lopez, B. M. and Baysinger, C. L (2017). Should nitrous oxide be used for laboring patients? Anesthesiol Clin. 2017 Mar;35(1):125-143.
Sanders, R. D, Weimann, J. and Maze, M. (2008). Biologic effects of nitrous oxide: a mechanistic and toxicologic review. Anesthesiology;109:707–22.