Should I Use Gas and Air for Labour?

In many countries, gas and air is commonly used as a pain coping strategy during childbirth. Gas and air doesn’t eliminate the pain of contractions, but eases anxiety and tension. But be warned, nitrous oxide has some serious side effects!

In this article we will learn what gas and air is, when it is used and discuss any contraindications. Let’s get started!

Should I Use Gas and Air for Labour?

What is Gas and Air?

“Gas and Air” is colorless, odorless and comprised of 50% oxygen and 50% nitrous oxide. This mixture is called Entonox and is manufactured by BOC Healthcare.

The Administration of Gas and Air

Gas and air is given through a mask or mouthpiece. During labor, before and during each contraction, a woman breaths Entonox to cope with the pain of contractions. As a contraction begins, a woman simultaneously breaths slowly and deeply into the mask to get the full effect of the medication.

How is Gas and Air Helpful?

Gas and air does not eliminate the pain of labor but helps women feel more relaxed and less uptight about the sensations of labor.

If a woman is fearful about childbirth she will begin to feel tense and uptight. The more tense and uptight she feels, the more painful her labor will be. The more painful her labor is, the more fearful she will be… and so on. This cyclical behavior is called the “fear tension pain cycle”.

Gas and air is helpful to short circuit the “fear tension pain cycle”.

Where Can Women Find It?

As previously noted, the use of gas and air is not common in the United States, but is quite popular in Europe and Canada. The United States has not followed suit, and for now much prefers the heavy use of epidurals.

In fact, I have never personally witnessed the use of gas and air, but have only read about it and seen it on tv (shout out Call the Midwife!).

(Note: If you are in the US check with your local hospital to see if gas and air is available to patients. It’s available at certain hospitals, but definitely not everywhere.)

(source)

Does Gas and Air Really Work?

I found an interesting study where the laboring women and their care providers both believed she was breathing Entonox, but only half of them actually were. Surprisingly, there were no statistically significant differences in pain with nitrous oxide compared with the administration compressed air. (source)

Pain relief in both groups were almost identical!

Having no personal experience with gas and air, it’s not fair for me to draw conclusions, but the study has me wondering if breathing deeply and slowly is just as effective as gas and air.

Who Shouldn’t Use Gas and Air?

Investigating who should and shouldn’t use gas and air led me to some VERY interesting information. It turns out that women with MTHFR should not use gas and air (nitrous oxide) ever, including while in labor (source) and here’s why.

Nitrous oxide does something funny to the body’s B12 – it totally wipes it out. And this is not an unknown phenomena!

“Nitrous oxide is known to interfere with vitamin B12 and folate metabolism. …Nitrous oxide should only be used with full precautionary consideration and close monitoring. Particular precautions should be taken in pediatric patients with underlying vitamin B12 deficiency (genetic or environmental) and conditions related to vitamin B12 deficiency.” (source)

Depleting the body of vitamin B12 isn’t good for anybody, but in a person with MTHFR this creates an even bigger problem. B12 and the MTHFR enzyme are key to the methylation process and if you are lacking just one of them, your methylation cycle does not work.

Basically gas and air would cause a women with MTHFR to have even more of a problem with the methylation process than she already does.

Lest you think that MTHFR does not affect you, I have seen statistics that around 40% of the population has a variance of this genetic mutation. If you don’t have it, someone you know does!

(By the way, I have the homozygous C677T MTHFR mutation. Woot.)

What is Methylation?

Methylation is a very important process that happens at the cellular level and takes place one billion times per second! Methylation is involved with processes of the brain, gut, detoxification and even regulates gene expression. It’s a big deal! (If reading more about methylation sounds fascinating to you, check out this article.)

Symptoms of Vitamin B12 Deficiency

According to WebMD, these are some of the symptoms of a vitamin B12 deficiency.

• Weakness, tiredness, or lightheadedness
• Heart palpitations and shortness of breath
• Pale skin
• A smooth tongue
• Constipation, diarrhea, a loss of appetite, or gas
• Nerve problems like numbness or tingling, muscle weakness, and problems walking
• Vision loss
• Mental problems like depression, memory loss, or behavioral changes

Vitamin B12 deficiency and an interruption in the methylation process can create big problems!

In my opinion, because most people do not know if they are deficient in B12 or have gene mutations like MTHFR, unless B12 and MTHFR screenings happen prior to use, it would make sense that the blanket use of nitrous oxide is contraindicated.

Does Gas and Air Affect the Baby?

Most websites say that nitrous oxide is harmless to an unborn baby. However, if it’s depleting a woman’s B12 stores (which as we now know is an even bigger problem for those with MTHFR) the same thing is happening to the unborn baby.

This study shows that anesthetics like nitrous aren’t good for a child’s growing brain.

I’m sure more research is needed, but from what I’m gathering Entonox isn’t good for a new baby’s brain.

Alternatives

Ok, Lindsey, so gas and air may not be the best choice, but what are my other options?

I’m glad you asked! As a doula and childbirth educator, I am a big fan of non-pharmacological methods of pain coping throughout labor. They work quite well!

Here are a few of my favorite methods of relieving pain during a natural childbirth.

• Hire a doula
• Take a quality childbirth class
• Breath awareness
• Labor at home as long as possible
• Ignore early labor
• Massage
• Eat and drink freely throughout labor
• Hydrotherapy
• Aromatherapy
• Change positions
• Lots of encouragement, especially during transition
• Consider alternative birthing venues such as a birth center or home

I could go on and on. But I’ll stop there for today. 😉

Leave a Comment

Please leave a comment and let me know what you think about nitrous oxide in labor. Do you have any experience with it? What other options for pain relief would you recommend as an alternative?