When Megan DiMambro walked into the Birthplace at North Shore Medical Center (NSMC) this past June, her birthing plan was the same as it had been with her first child: “Take things one step at a time and, if possible, give birth naturally.” While an epidural had been necessary with her first delivery, this time she was armed with knowledge about a new pain management option being offered at the Birthplace, nitrous oxide.
Nitrous oxide, or laughing gas, is self-administered by the patient using a mask inhaler giving them complete control during labor. A patient simply takes a few breaths of the nitrous oxide at the beginning of a contraction to help alleviate the pain, and within a minute it leaves her system.
That was precisely what the 35-year-old Salem resident was looking for.
“It was a small step away from natural birth,” said DiMambro. “It was the help I needed to take the edge off during a contraction but didn’t leave me feeling out of it. I was completely in control the entire time.”
Unlike an epidural, nitrous oxide can be administered within minutes of a patient choosing to use it. Nitrous oxide is ideal for patients early in labor before they get an epidural, for patients who do not want an epidural or for patients who are too close to delivery to get an epidural.
“Every woman experiences labor differently, which is why it is important that we have various coping options to meet their needs,” said NSMC midwife, Mary Collari, C.N.M. “By offering nitrous oxide at the Birthplace not only are we improving the labor experience, but we also give patients the choice of having a medicine that has limited effects on them and their baby, allowing them to bond sooner.”
In addition to having little to no side effects on the patient or baby, nitrous oxide also allows patients more opportunity for movement during the delivery process.
DiMambro, who has now experienced childbirth with both an epidural and nitrous, says, “A day after labor my first time around, I was not feeling the way I did with this delivery. I just feel better.”
That was also the case for the newest addition to the DiMambro family, Isabel. “She came out and was completely alert and calm, and I honestly feel the nitrous contributed to that,” said DiMambro about her new bundle of joy.
While the recovery was smoother on nitrous oxide for DiMambro, she does not pretend that it provides the same level of pain relief as an epidural.
“If people are looking to not feel their labor, then nitrous oxide may not be the best option,” she said. “I was looking to fully experience my labor and just have enough of the edge taken off, which made nitrous the right choice for me.”
“Often times, women start labor unsure about whether they want an epidural,” said Nikolai Gonzales, M.D., NSMC Chief of Obstetrics Anesthesia. “Fortunately, the NSMC Birthplace offers many pharmacologic and nonpharmacologic pain management options in addition to epidurals and nitrous oxide, including a supportive birth environment, touch and massage, maternal positioning, relaxation and breathing techniques, birthing balls, continuous labor support, ambulation, hydrotherapy, heat therapy, and IV medications.”
An unanticipated benefit to nitrous oxide discovered by the Birthplace staff is that it can also be used during vaginal repairs and the manual extraction of the placenta. “Typically in patients who forego an epidural these can be very uncomfortable procedures, sometimes requiring pain medication that is sedating or anesthesia in the operating room,” said Kristen Cotter, M.D., NSMC obstetrician and gynecologist. “Nitrous allows us to perform these procedures in the patient’s suite and she is back to bonding with her baby a minute later.”
“I felt I could really own my labor, because I was in control,” said DiMambro. “At the end of it all, I was happy that I experienced this delivery the way that I did.”