Nitrous Oxide, a Pain Management Alternative

As your due date approaches, you may want to learn about the low intervention options for pain relief. Nitrous oxide is one form of alternative pain management the Sky Ridge Birth Place now offers.

What is Nitrous Oxide?

Nitrous oxide is a colorless gas with a sweetish odor that occurs naturally in the atmosphere and is a greenhouse gas. In high concentrations, nitrous oxide is a weak anesthetic. In low doses, however, it is an anxiolytic (a drug used for anxiety relief) and an analgesic (a drug used for pain relief). According to the American College of Nurse-Midwives (ACNM), “Research has supported the reasonable efficacy, safety, and unique and beneficial qualities of N2O as an analgesic for labor and its use as a widely accepted component of quality maternity care” (2011).

Am I eligible?

If you would like to use nitrous oxide, a member of our team will come to your room to assess you. A few reasons why you may not be able to use nitrous oxide include:

  • Have received a dose of narcotics in the past two hours.
  • Cannot hold your own face mask.
  • Pernicious anemia.
  • B12 deficiency for which you take B12 supplements.

How does it work?

Once you and your care team have agreed to use nitrous oxide, a member of the anesthesia team will visit your room, set it up and review how to use it with you. You will self-administer the nitrous by holding your own mask and inhaling 45 seconds before a contraction for the greatest effect when you are at the peak of your contraction. No additional baby monitoring is necessary, and you may get out of bed as long as you are steady on your feet. 

What are the benefits of nitrous oxide during labor?

According to the Journal of Midwifery & Women’s Health, “Nitrous oxide labor analgesia is safe for the mother, fetus, and neonate and can be made safe for caregivers. It is simple to administer, does not interfere with the release and function of endogenous oxytocin, and has no adverse effects on the normal physiology and progress of labor.”

  • By not disrupting the release of oxytocin, nitrous oxide does not affect infant alertness during the early bonding period between a mother and her newborn.
  • It does not affect breastfeeding.
  • It does not increase the need for neonatal resuscitation.
  • In the doses given during labor, nitrous oxide is not a strong analgesic. Women who use nitrous oxide during labor may still have an awareness of labor pain. However, many women find it helps them relax and decreases their perception of labor pain.
  • It is self-administered, so not only can a woman decide how much to use, but she can also decide if she wants to stop using it and try another method of pain relief instead.
  • Nitrous oxide can be easily discontinued, and its effects disappear within five minutes.

Does nitrous oxide have any side effects?

There are no known side effects for your baby. However, you may experience nausea or unsteadiness. As soon as you stop breathing the gas, the nitrous effect is gone within a breath or two.

Do I have to choose between either using nitrous oxide or having an epidural?

You may use nitrous first and then move to a different pain relief method, such as an epidural. However, nitrous cannot be used with intravenous narcotics.

Is there an extra charge for nitrous oxide?

No, your insurance will be billed for an anesthesia consult, which is the same process if you decided to have an epidural.

For more information, call 720-225-4111.


American College of Nurse Midwives. (2011). Nitrous oxide for labor analgesia. Retrieved from 

Rooks, J. P. (2011). Safety and risks of nitrous oxide labor analgesia: A review. Journal of Midwifery & Women’s Health, 56 (6). Retrieved from