A pain management method that's more than 100 years old is again becoming a popular choice among women in labor.

Nitrous oxide, commonly known as laughing gas, was popular in the 1960's before the days of epidurals and IV medication.

“I’m a dental assistant so we use nitrous a lot in our office and sometimes it helps just enough to calm your nerves so it’s nice to have that option," said Jessica Cook, a soon-to-be mother of two.

Jessica and her husband Greg waited nine years for their first child. His birth did not go as planned.

“I went in prepared for a natural birth. My whole goal was natural birth for that one. Found out last minute it was going to be a C-section and I was nervous about it because I didn’t want to use medication," said Cook.

The C-section forced Cook to have a medicated birth. For the birth of her second child, she wants to keep it as natural as possible. However, she may use nitrous.

“I think more than anything just for my nerves. Not so much the pain. Just the anxiety," said Cook. 

Dr. Kimberly Fortner delivers hundreds of babies a month and said more women are looking for ways to have a mildly medicated birth.

"As we look at impact on the neo-natal and impact on moms' desires, we’ve swung back to say maybe there’s a use somewhere in the middle," said Fortner.

Nitrous is not as effective as an epidural or IV pain medication. Fortner said that's because the medication is mild  and women are using it in different ways. 

"I've seen women who decided to do no medication and then only use it for pushing or for times when they're a little bit more anxious or uncomfortable. Some women will use nitrous just to get their IV started, and I've seen women who are happy to have the option and then moved on to an epidural," she said.
Epidurals or other regional anesthesia are still the most popular pain relief in the United States. Fortner said some women are attracted to nitrous because it gives them more control in the delivery room.
“One of the other benefits of nitrous is that the woman is in control. She drives. When she starts it, she drives. She controls how many breaths she takes and she is in control of when she stops," Fortner said.
Even though the woman controls how much medication she gets, there is no risk of overdose.
Nurse Abby Polos said the majority of women she sees are very open to the idea of nitrous and enjoy it during labor. Occasionally, some women will laugh throughout labor.
"Yes, they do. I think it surprises people especially in early labor how effective it is and how much euphoria it gives them because they don’t expect to feel that way during labor," said Polos.
Polos wheels in the portable nitrous unit and explains how the process goes for laboring moms.
“It blends the oxygen and the nitrous equally and runs it through this (machine) and sends it out to the patient so they’re in total control of it," she said.
Polos pulls out two rubber tubes and a face mask. Patients breathe the nitrous in and out through the mask, so no one else in the room is at risk for being exposed.
"It only provides nitrous to her when she breathes deep through this. It only provides it when she's taking a breath from it," she said.
Patients can take as much nitrous as they need. Unlike an epidural or IV pain medication, its effects are not long lasting.
"If you stop IV pain medication, the effect is residual for 30 minutes to 2-3 hours. With an epidural sort of a very similar thing," said Fortner.
Fortner explains the effects of nitrous last about five minutes. The medication does not affect the newborn.
"There’s no effect on the neo-nat. In fact, it doesn’t suppress any of their APGAR scores. Even if she takes a breath in her last few pushes - meaning if she takes a breath of the nitrous in her last few pushes - right before she delivers, by the time the baby is delivered the effects have worn off,” said Fortner.
Like all medication, there are side effects of nitrous.
“Some women can have nausea. It's not extreme," said Fortner.
UT Medical Center is the only hospital in East Tennessee that offers nitrous. They say the cost of it is completely dependent on insurance.
For more information on UT Medical Centers birthing centers, click here.