Humor will not be tolerated!! -Portia

NerdGirl, I haven't seen nitrous used for any labors here--as someone who's seen it used, what do you think the overall experience is like? Is it like the dentist, where you get kind of loopy and weird? Do you think it provides good pain control, or just "good enough?" Those would be my main concerns as someone who's only seen it used for dental procedures.

One thing I've heard consistently from patients who have gone through childbirth with and without an epidural is that the times they had the epidural were the times that they felt able to fully enjoy the experience without being distracted by pain. And I gotta say, I love it when the epidural's still working and a new mom can totally ignore us fixing her third-degree tear because there's no pain or discomfort to distract her from those first few minutes with the baby in her arms. Anyway, I'm not sure that I'd want to give up any mental faculties to the nitrous, or to be distracted by any more pain than I'd have to be. What do you think as someone who's seen it used?

NerdGirl wrote:I just think it's interesting that there are so many differences in the way birth happens in the US vs Canada.

Right, but the end product is also very different (a baby American vs. a baby Canadian ).

Along those same lines, I suspect that nitrous oxide triggers full-blown socialism!

Eirene - I haven't ever actually seen it used dentally, but from my understanding of how dentists use it, it's a bit different from how it's used in labor. It's not used continuously. There's like a little mouth piece with valve so that it only flows when you inhale it through your mouth, and most women only use it while they are having a contraction. So in between contractions the effects wear off. Most of them don't get too loopy, more just relaxed. But definitely less out of it than, say, someone who has had procedural sedation with fentanyl and midazolam, for example. They're pretty mentally there in between contractions and almost everyone I've seen who used it really likes it. And it's also really popular with moms who are worried about using things that effect the baby are comfortable with nitrous, but not with any other form of pain relief.

And from what I've seen the pain control seems to be pretty similar to what it is with an epidural. I'm not sure if epidurals are done differently in the US, but here they are almost always patient controlled (like they put the catheter in and hook it up to a pump and the mom can press a button when she wants more epidural). So some people are pretty frozen with an epidural, but most don't actually press the button all that much because they don't like the shivering and what not that happens. So that's why I think I've seen a lot of patients with epidurals that seem to have about as much pain with pushing as the patients without. By that point they just aren't pressing the button anymore. And actually, a lot of moms here choose not to even have an epidural. It's definitely a minority who even want it.

And as far as fixing tears, I was in a kind of a weird high-risk setting, so it was always a while before we got around to fixing the tears (like people were having babies with known heart problems, or twins, or the moms had bleeding disorders and had a postpartum hemorrhage or something). So by the time it was time to fix the tear, if they did have an epidural, it had worn off. Although they could just press the button again, but sometimes we just froze the perineum, and sometimes if it was a bigger tear we put in a pudendal nerve block. I have not ever seen a 3rd or 4th degree tear, but apparently we take those to the OR to fix, sometimes under a general anesthetic. It doesn't happen very often though. Actually a lot of the deliveries I saw only ended up with first degree tears. And I've only seen one episiotomy. That was a pretty unusual situation, though, and most OBs here basically never do them. And interestingly enough, the one mom I saw who didn't tear at all had the biggest baby I've ever seen and shoulder dystocia. That was pretty surprising.

And Katya, shhhh!!! You aren't supposed to let the secret out!! Of course nitrous oxide is the cause of socialism, but we like to keep that quiet.

NerdGirl wrote:And Katya, shhhh!!! You aren't supposed to let the secret out!! Of course nitrous oxide is the cause of socialism, but we like to keep that quiet.

[Shudder] And I came that close to socialism.

When I was a teenager I read about how to make laughing gas (nitrous oxide) since one didn't just buy bottles of laughing gas off the shelf. So, for some laughs, I decided to make some. I found, however, that the chemical supply stores wouldn't sell the key ingredient to me. I even went back with my 21 year old brother, and they wouldn't sell it to him, either. Now I know it was a right-wing conspiracy.

Oh, the dangers we unknowingly run in the ignorance of youth. I might have become a socialist.