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Laughing gas in delivery rooms? More area hospitals say yes

Lizzy Lester holds her 11-pound son, Sylas Spencer, born Tuesday at Tampa General Hospital, which just began offering nitrous oxide. Lester opted for it and said it made the pain tolerable.

SKIP O’ROURKE | Times

Lizzy Lester holds her 11-pound son, Sylas Spencer, born Tuesday at Tampa General Hospital, which just began offering nitrous oxide. Lester opted for it and said it made the pain tolerable.

TAMPA — Pregnant with her third child, Lizzy Lester knew she wanted a natural, unmedicated delivery. But she jumped at an option to take the edge off the labor pains: nitrous oxide, or laughing gas.

So the medical staff at Tampa General Hospital wheeled in a bedside device that let Lester breathe the gas through a face mask when she felt she needed it. And did she need it: Baby Sylas Spencer came into the world Tuesday tipping 11 pounds.

"I never felt high. It just made it more tolerable," said Lester, 31, cradling Sylas, whose head was too big for the hospital-issued newborn hat.

Laughing gas doesn't kill pain as an epidural injection does. But, like Lester, many women report that it helps them care less about the pain. Experts say nitrous oxide is cleared from the mother's body through her lungs, so it's also safe for the baby.

Though the gas has been widely used for decades in Europe, Australia and Canada, it didn't catch on in the United States. That's starting to change.

Just in the past few years, midwifery groups have helped spearhead the use of nitrous oxide in an estimated 30 hospitals and birthing centers as an option to help women cope with the pain of childbirth.

Locally, TGH started offering nitrous oxide in delivery rooms this week. Morton Plant Hospital in Clearwater has offered it since June, and Mease Countryside Hospital is scheduled to start doing so Wednesday, a spokeswoman said. St. Joseph's Hospital in Tampa is considering using it as well.

Mary O'Meara, the Tampa midwife who successfully lobbied TGH to offer the gas, saw it used routinely when she worked at a London hospital early in her career. She thinks the timing was right to extend the option to patients here, particularly as new medical devices for self-administering the gas have come on the market.

"The patients are asking for it," said O'Meara, president of Women's Health Care, which is on the TGH campus. "We want to give the mothers options."

Most American women giving birth opt for an epidural, a sometimes-painful spinal injection that offers significant relief but may leave many patients confined to their beds.

O'Meara emphasized that the gas isn't a replacement for an epidural; indeed, some women may request both. But the nitrous oxide can help tide the mother over until she decides if she needs an epidural. And, perhaps most important, the patient administers the nitrous oxide herself.

"The mother feels in control," she said.

Doctors groups have been slow to embrace the use of nitrous oxide, saying there is not enough safety data. The American Congress of Obstetricians and Gynecologists, for instance, has taken no position on it.

But O'Meara said she found that local physicians were open to the use of nitrous oxide once they heard more about it. Some of them have even indicated they want to look into using it for procedures such as inserting an IUD that can cause pain but don't warrant heavy sedation.

At St. Joseph's Children's Hospital, doctors offer nitrous oxide for outpatient procedures like joint injections or spinal taps to decrease anxiety and help children feel relaxed.

Dr. Cathy Lynch, associate vice president for women's health and professor of obstetrics and gynecology at the USF Morsani College of Medicine, said she began hearing more about nitrous oxide as device makers perfected the machines used to deliver the gas.

She said patients may not find the gas particularly helpful over a very long induction. But it's ideal for patients who can't get an epidural for medical reasons or because they are so far along in labor that they can't get the injection.

This week, Lynch had a patient at TGH who came in hoping she would not need an epidural. The labor was slow going until the woman's water broke. Though the pain kicked in, she told Lynch she wanted to stick with the nitrous oxide as long as she could.

"Once she took a couple of breaths, she kind of focused on me and the nurse and followed the instructions of how to push past the pain to get the baby out," said Lynch. The patient never asked for the epidural.

Lester, the new mother of Sylas, said she had nonmedicated deliveries for her first two children, and believed she could do it with Sylas. Her other children — now ages 6 and 8 — each weighed around 3 pounds lighter than their new baby brother. She believes the laughing gas helped make the pain bearable.

"I'm glad we chose it," she said, "because we didn't know he'd be this big."

Contact Jodie Tillman at jtillman@tampabay.com or (813) 226-3374. Follow @JTillmanTimes.

Laughing gas in delivery rooms? More area hospitals say yes 08/28/14 [Last modified: Thursday, August 28, 2014 9:10pm]
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