Is Using Nitrous Oxide for Labor Pain Dangerous?

I recently published a blog about the availability of Nitrous Oxide (NO2) on labor and delivery at Morristown Medical Center and Our Birthing Center. Everything I had read said that Nitrous oxide was safe for both mother and baby as it has been used for labor and delivery for many years.

A concerned reader asked if we had read an article that stated dangerous effects of Nitrous Oxide especially for women who “have one or more of the C667T variant or a combination of the C677T + A1298C (like me). Single A1298C does not predispose much risk; however, two A1298C variants do.”

This was very concerning to me and a little suspicious. I certainly do not wish to offer a medication to my clients that will substantially affect their health or their babies’ health. I have helped women give birth without pain medication for years and I can continue to do so. I was just so excited at the idea of having something to offer that would help a woman through tough parts of labor but still maintaining her ability to move, urinate and push. Nitrous Oxide seemed the perfect solution.

I was also suspicious because of the many years of data that supports the use of Nitrous Oxide for laboring women. I honestly don’t believe that it would still be in use if it caused lifelong health problems. And there is no drug without some potential side effects.   So I asked Dr. Hendrieka Fitzpatrick, a Family Practice physician who is board certified in Functional Medicine, her opinion on the article. She says the following:

The attached article is not medically accurate. Nitrous Oxide may be toxic after prolonged exposure (more than 6 hours continuously) and only at doses high enough to cause general anesthesia. No one uses it for general anesthesia anymore. All of the medical dangers are prolonged exposure at higher than 50% concentration. It is nontoxic to patients using it for conscious sedation (meaning the person is able to respond and interact). It could interrupt methylation at high doses in someone who is B12 deficient (this is rare, the lab range is about 300-900). The blood level of 300 is very unlikely in pregnant or young people. There is a lot of speculation in the “natural” community about MTHFR which is a Single Nucleotide Polymorphism (SNP). This means that in the gene, in 1 or both alleles, there is an error in the replication of the gene but most of what is written is speculation.  Fifty percent or more of Americans have one or the other MTHFR SNP. Both B12 and blood homocysteine levels need to be below normal before the SNP has significance at all and it is very unlikely to have both levels low in well-nourished pregnant people. The short answer is this. NO2 is a safe way to consciously sedate people. Checking B12 is fine but not necessary because it will very rarely be lower than 300! ”

I expect that our clients will continue to have medication-free births most of the time but if they need some assistance, they now have the option to use “laughing gas.”

Circumstances When Nitrous Oxide is Helpful:

1. Needle-phobic women may use the NO2 for blood draws and IV placements
2. For pelvic exams
3. To help tolerate labor until anesthesia can place the epidural catheter
4. While waiting for access to the birth pool
5. During Transition
6. Some women hate pushing so much they won’t do it. The baby would certainly be delivered eventually, but using laughing gas could make the delivery much more pleasant
7. For repair of vaginal lacerations

We are looking forward to having another pain management option for our clients. Nitrous Oxide is a tried and true method for safe and effective relief of pain and anxiety in labor.