Laughing gas, the technique for a painless birth

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Catherine Le Nevez
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  • 1 What is laughing gas 
  • 2 What Laughing Gas is for 
  • 3 How and when to administer laughing gas 
  • 4 Laughing gas and side effects
  • 5 Laughing gas and delivery times 
  • 6 Laughing gas and preventive tests 
  • 7 Contraindications to laughing gas 
  • 8 The differences with the epidural 

For a painless birth, every woman would come to terms with the devil, of this we are sure. All future mothers are scared, also because of tales of friends and relatives that seem to see the hour to list all the smallest details of their experience, even the most commonplace. Yet, birth is not such a "dramatic" event for everyone. Also because there are several ways to relieve the pain of contractions. Today we are talking about an alternative method, not yet widespread in Del Paese, but which gives good results. It is the so-called nitrous oxide, more commonly called laughing gas. 

What is Laughing Gas 

The name should certainly not be misleading. Do not think that, by inhaling this gas, you will face labor and delivery laughing out loud. It would be wonderful, of course, but the purpose is another: to feel less pain. And that's what nitrous oxide does. It is mixed 50% with oxygen and administered to the parturient through a mask. 

In our country, not all hospitals offer this possibility: it is still a novelty and is available a bit patchy in the area. On the other hand, laughing gas has been in use abroad for quite some time. In Britain, for example, it entered midwifery practice as early as the 50s and was used by 50-60% of women. In Australia it is a very popular method: about half of women in labor have used it. 

Nitrous oxide has been used in dentistry for some time to induce a state of deep relaxation in patients. It is therefore suitable for those who are afraid of the dentist's chair. And there are not a few ...

What is laughing gas for 

Laughing gas has analgesic and anxiolytic properties. The function is therefore double. On the one hand, it is able to decrease the painful sensation. On the other hand, it relaxes the mother, makes her feel less anxiety and therefore allows her to face labor and delivery with greater serenity. 

Nitrous oxide acts in the central nervous system. It attenuates the pain centers and, at the same time, releases endorphins, hormones directly involved in well-being. This gas gives a slight feeling of numbness, even if the woman remains alert and participatory throughout the time. And it could not be otherwise because it is she who has to manage herself. Plus, it has a slightly euphoric effect. Hence the expression laughing gas. 

How and when to administer laughing gas 

Typically, administration begins when the contractions become strong and close together. This is usually the time when the woman needs the most support because she begins to feel tired. So, if we consider the stages of childbirth, nitrous oxide is offered from half of the dilating one onwards. There are also those who ask for it early. 

It is the parturient who manages the administration of the gas, assisted by the midwife. To be truly effective, laughing gas is inhaled about 30 seconds before the contraction sets in and until it stops. The reason is simple: it is the moment when the pain reaches its peak and this is where it must be best managed. 

The mask is not fixed to the head, but must be removed when the gas is not inhaled. It is activated only by the mother's breathing. Gas has a very fast effect: less than a minute. 

Laughing gas and side effects

You may be wondering if there are any effects on the fetus. The answer is no. No problem for the baby at birth, not even a respiratory one. Laughing gas is harmless to the fetus. 

No particular adverse events have been reported for the mother. Sometimes nausea, dizziness, drowsiness may occur, but these symptoms disappear if the administration of nitrous oxide is stopped. However, there are no consequences on breathing, thrusting capacity, blood circulation, heartbeat or other functions of the organism. 

Laughing gas and delivery times 

One might think that the use of this substance may somehow slow down the progression of labor and delivery. On the other hand, there seems to be no lengthening of the times. Therefore, it does not affect the total duration of the birth.

Furthermore, numerous studies show that the use of caesarean section does not increase, nor does it increase the use of instruments such as the suction cup (which, in any case, is used less and less today). Finally, its use does not affect the presence of meconium in the amniotic fluid, the fetal heartbeat and blood loss after childbirth. 

The effects of the gas stop as soon as the inhalation is stopped. 

Laughing gas and preventive tests 

If the hospital where you decide to give birth provides childbirth analgesia with laughing gas, you will not need to undergo preventive examinations. This is a big difference from methods such as epidural anesthesia for which an anesthetic visit is mandatory. Laughing gas can only be administered in the presence of the midwife. It is therefore not essential that there is a gynecologist and anesthetist. 

It is however advisable that, during the last visits, the gynecologist explains this technique to the pregnant woman, so as to prepare her for this eventuality as well. Like all medical procedures, informed consent must be signed. 

Contraindications to laughing gas 

This procedure is indicated for all women who have had a physiological pregnancy. Contraindications concern some pathological conditions, but they are quite rare. In any case, your doctor will decide if it is appropriate to use this gas or if it is better to think about different techniques for childbirth analgesia. 

The differences with the epidural 

Usually, epidural anesthesia is the best known and most practiced technique of childbirth analgesia. It is also the most effective, while laughing gas does not allow for the same pain control. We can say that it is a slightly sweeter method. 

The epidural is the administration of anesthetic drugs through a small catheter placed between the vertebrae of the lumbar spine. In this way, the nerve roots that “carry” the painful perception are anesthetized. The advantage is that of a drastic decrease in pain. Furthermore, thanks to the possibility of increasing the dose of the drugs, the effect is prolonged throughout labor and delivery. 

The key difference between epidural and laughing gas is that the former eliminates pain, while the latter only relieves it. On the other hand, however, nitrous oxide allows for a less medicalized, even more natural, birth. 

However, it is possible to integrate the two techniques. For example, while waiting for labor to be well underway to proceed with an epidural, nitrous oxide can be used to feel the contractions a little less.  

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