Labour in the US: Now a laughing matter!

Did you know that if you’re having a baby in the US “gas and air” isn’t on your list of pain relief options? I didn’t, until it hit the news this week. The Daily Mail has the full story if you’d like to read it. What we call “gas and air” is actually Entonox, a mixture of nitrous oxide and oxygen. This is the same “laughing gas” that’s used to great comedic effect in many a US sitcom.

Most women I know here at least attempted to use Entonox during labour. Apparently 50-60% of women who give birth in the UK use it. I haven’t been able to find any statistics on it for Ireland, but I’d imagine it’s similar here. I tried it myself when I was getting close to the pushing stage and was starting to feel like the labour pains were too much. I gave up after a few contractions because it was interfering with my ability to concentrate on my Gentlebirth breathing, and I wasn’t finding it much use. Little Man was born very shortly after that, so it’s obvious now looking back that I was going through the transition phase during those few contractions when I felt everything suddenly intensify. At the time though, having a pain relief option like Entonox on hand was fantastic. I had coped very well to that point without pain relief, and given that I was experiencing an urge to push when I asked for the gas and air, it’s highly unlikely an epidural would have been an option had I decided to get one at that point.

I also used Entonox while I was getting stitches afterwards. There was no handing it back to the lovely midwife then – oh no! I sucked down that gas like my life depended on it. It made me feel deliciously woozy, which was much better than feeling being sewn up! (Shivers!) And as soon as the stitches were done, I put down the gas and air and after a few breaths of normal air I felt my head clear, and just ten minutes later I felt like myself again.

You always hear it said that no two labours are the same. That’s exactly the reason why I was delighted to hear that this pain relief option is making a comeback in the US. Apparently it faded from use because epidurals took over. So from the brief research that I did into birthing practices in the US, it seems that in many places there you have just two options – an epidural or nothing. Some women get by with absolutely no pain relief because they don’t need it, or they choose not to have any, or circumstances don’t allow for it. Other women want or need an epidural, and by all accounts it is a fantastic pain relief option. But it has its drawbacks – it may not be available immediately, it may limit mobility, and there can be some side effects. Personally I was worried about the increased risk of medical intervention, and so I was hoping to avoid an epidural if I could. In my birth plan, I made it clear that I wasn’t totally opposed to the idea of getting one if I needed it, I just wanted to see how I got on first. Here’s what I had written under pain relief:

Pain Relief

• I would like to try relaxation, breathing, and acupressure techniques for as long as possible; then gas and air, and an epidural in that order, if needed.
• I do not want any kind of anaesthesia offered to me during labour, though I would like it available if I specifically request it.
• I will want local anesthesia for repair of tears or of episiotomy.

Now it’s worth mentioning that during the big event, this birth plan didn’t make it out of my bag – but it didn’t matter. It had helped me think about how I felt about different aspects and options during childbirth.

But from my (non-medical, non-expert) point-of-view, providing a woman with options to suit the needs of her particular labour is the key to helping her have a positive labour experience. So a middle-ground pain relief option like Entonox is so important to help with that. A few puffs of gas might be enough to get a woman through the final few contractions before baby is born, as was my experience. Or gas and air might be a vital coping tool to someone in the early stages of labour who is waiting to receive an epidural.

Personally I’d love to see more options available to all of us – like the option to labour in water if you wish, or information on natural pain relief techniques like acupressure to be mentioned alongside the discussion of pain medications in antenatal classes. But for now, I’m glad to see one more option being made available to women in the US.