How to use gas effectively in labour

Thinking about using gas (nitrous oxide) in labour? Learn how to get the most from it first.
Thinking about using gas (nitrous oxide) in labour? Learn how to get the most from it first. Photo: Getty Images

As a doctor who's worked in obstetrics and gynaecology, I often get asked whether I think 'gas' – nitrous oxide – is a good pain relief option in labour.

Many women say they used it during previous labours and that it didn't work for them.

Others say they tried it and hated it.

Despite hearing all that, when it came time for me to give birth I was really open to the idea of using gas myself.

This is because I found that lots of women who had tried gas in previous labours had done so ineffectively. They only started breathing the gas just as a contraction was at its most painful.

Using gas this way meant they suffered all the side effects of the gas – light-headedness, nausea, feeling woozy or 'out of it', and sometimes even vomiting – without any of its benefits (that is, pain relief).

Obstetrician and gynaecologist Dr Michael van der Griend, from North Shore Private Hospital, recommends gas as a "first line" approach to pain relief in labour.

Firstly, he says, it's safe for both mother and baby.

Yes, he concedes, you may feel a bit 'yuck' when using it. But unlike many other pain relief options, he says he's not aware of any other side effects.

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Besides, these yuck feelings often pass after you've used it for a few contractions.

Another benefit of gas is that it's dose-adjustable.

This means the 'strength' can be turned down (or up) as you need, so if you're feeling sick, you can try a lower dose for the next contraction.

Besides, if you really don't like it, you can stop using it and it will be out of your system within minutes.

Next, unlike an epidural (which, once in, keeps you pretty much bed-bound), the gas machine is portable. This means you can move around the room while using it – and even take it to the bath if you want.

Another benefit I found was that the gas made me feel like I was in charge of my own pain relief.

Once I tell people all those positives, they want to know how to use gas properly.

Firstly, you need to start breathing through the mouthpiece right at the beginning of each contraction.

This is because it takes a while for the gas to reach its peak effectiveness. It also takes a while for a contraction to be at its strongest - and most painful - too.

"So if you get the timing right the gas should be hitting the mark when the contraction is at its peak," explains Dr van der Griend.

Next, you need to breathe strongly and slowly through your mouth.

While you may think you'll get 'more' pain relief by breathing faster, Dr van der Griend warns that hyperventilating will just increase your chances of passing out.

To be honest, I found the slow breathing in itself really calming. I know some people find these benefits just from breathing deeply in labour with no gas (and all the more power to them!), but personally I liked knowing that my breathing was leading to an external source of pain relief.

While I didn't just rely on gas throughout my labours (here's where I give a shout out to the TENS machine and pethidine), I was so glad I gave it a try.

My biggest problem, apart from the initial wooziness, was the dependence I developed on the gas.

I must admit I became a bit like Tom Hanks in Castaway; my Wilson, of course, was the gas.

I dragged that machine with me everywhere I went, and became very reluctant to part with it ... especially as I knew that towards the end of labour I would need to do just that.

You see, in order to push effectively you need to be able to hold your breath and 'bear down' – and, as Dr van der Griend explains, "Trying to do that whilst sucking on the gas is ineffective".

In my third labour I have vague memories of my midwife actually tearing the gas out of my hands when it was time to push. While at any other moment in my labour I would have growled at her for stealing my beloved gas (Wilson! Wiiiiilllsooon!), the idea of meeting my baby was motivation enough for me to focus on making that moment happen.

And when I welcomed my beautiful baby girl five minutes later, my love for Wilson (ahem, gas), was long forgotten.

So yes, if you're considering your options for pain relief in labour, I think gas can be really helpful.