New way to have a happy birthday is a gas

Union Leader Correspondent
January 16. 2014 10:58PM

Monadnock Community Hospital spokesman Jana Lothrop shows off the Peterborough hospital's nitrous oxide equipment in the maternity unit's tub room. (MEGHAN PIERCE/Union Leader Correspondent)

PETERBOROUGH — Monadnock Community Hospital has joined a handful of other hospitals across the country offering nitrous oxide, or laughing gas, as an option for pain management during labor.

"We've been using it since October and it's been very well-received and a pretty popular choice," said Elizabeth Kester, MCH's nurse manager of Obstetrics and Women's Health. "We were the first in the state, actually the first in New England."

Kester first learned about the use of nitrous for woman in labor at a conference a few years ago. Kester, Dr. Fletcher Wilson, the chief of obstetrics, and Dr. John Labranche, chief of the anesthesiology department, devised policies and procedures for nitrous administration, and the hospital purchased two FDA-approved nitrous oxide delivery systems from Canadian-based Pro Nox last year.

The gas is self-administered by the patient, who holds the mouthpiece to her face. If she feels sleepy, the mask will naturally drop away. If it makes her feel nauseous or light-headed, which can be side effects, she can put the mouthpiece down and take a deep breath.

This is not the "laughing gas" you would receive in a dentist's office, Kester said.

"In the labor room, it's a blend of 50 percent nitrous and 50 percent oxygen. So it's not considered anesthesia when it's used at that blend," Kester said.

First-time mom Melissa Lake of Keene thought nitrous oxide would be a good alternative to an epidural, which blocks all feeling below the waist and makes it difficult for a woman to know when to push.

"I wanted to be there completely for my birth and it allowed me to do that and it allowed me to relax so I could enjoy the whole experience," said Lake, whose daughter Brynn, was born Oct. 25.

Because she didn't have an epidural, Lake said she was able to move around the room or sit on the birthing ball. After 3 and 1/2 hours of pushing, she decided to stop the nitrous and take a half-dose of a narcotic to manage the pain at the end of her labor.

Jennifer Fritz of Fitzwilliam had her third child, Jackson, at MCH on Nov. 13. In the past, she had forgone an epidural and narcotics, but decided to try nitrous.

"It just took an edge off some of the pain during the contractions," Fritz said. "I would try it again."

Kester said since nitrous has been offered at MCH, about 70 percent of woman in labor have used it at some point. Some may use it for 15 minutes, others six hours. Most who have used it have done so for about 3 to 4 hours.

"Women have said, 'I knew I was having a contraction, but I just didn't care,'" Kester said. "And it's fast. As fast as you take the inhalation is as fast as you feel relief."

She added: "The sense of control that it gives women is the number one benefit."

Kester said she receives several phones calls a day from hospitals across the country interested in MCH's use and policies for nitrous.

"As much as I like being among the first and few, it really should be an option available to all woman, not just the ones lucky enough to live around us," she said.


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