Laughing into labour
When the pangs of labour come on, it’s good to know your pain relief options. Discuss your feelings about pain relief with your medical team; your ante-natal classes will cover this too, so by the time you’re almost due, you should have a fairly good idea of what you think you want.
What’s really important is that you reserve the right to change your mind. Some women have higher pain thresholds than others, some seem to have naturally easier labours than others. Whatever the reasons, the outcome that you and your medics want is a happy, healthy mother and baby at the end of it.
While you may write a birth plan that describes a birth with no pain relief (see our website on how to put together a birth plan), you may end up with gas and air, pethidine and an epidural. At each stage, you can make decisions based on how you feel and the expert advice that your Obstetrician and Midwife give you. They will explain why they think you might need to move to a different form of pain control and how it will help. As long as it’s not a real emergency, there will be time to consider it and make a decision, backed up by the wishes on your birth plan and with the support of your birth partner.
In this feature, we examine the most common early form of pain control in labour, gas and air. Also known as Entonox, or laughing gas, this gas has no taste or smell and is composed of half oxygen, half nitrous oxide. It arrives at your bedside in a canister or tubes from a central supply (if you are having a home birth, your midwife will bing a canister) and you will be given a mouth piece to use. It is up to you how you use it, how much you take and when, so you can feel in control of your labour.
When do I use it?
In very early labour, especially while still at home, you should try to avoid pain relief, as you’ll need to save this for later. Walking around, a back rub from your partner, a warm bath, breathing exercises you learned at ante-natal classes and sitting on a birthing ball can all help take the edge off early contractions.
Once you are in hospital or your midwife has arrived and the contractions are coming on stronger and closer together, it may be time to try out the gas and air.
How does it work?
The combination of oxygen and nitrous oxide works to help you feel more relaxed, a little light headed. This will help take the edge off contractions, yet you’re still in control and able to feel what your body is doing.
It may take a little while to get the hang of it. Put the mouth piece between your lips or teeth and take several deep, slow breaths. When you feel a bit light headed, stop. You can keep the mouth piece in while you breathe out, as it has a valve that allows your carbon dioxide to escape. This is good because we often want to cling to something – perhaps the head of the bed or the back of a chair – when a contraction is upon us, which leaves no hands free.
The best time to use it is as soon as you feel a contraction coming on, as it takes around 30 seconds for the effect to take hold. Get your birth partner to help with this – and if they have been beside you with a stopwatch timing your contractions, they can be useful here – they can estimate when the next contraction is due and get the mouth piece ready for you to take from them.
The good points
There are many advantages to gas and air as a pain relief option. You are very much in control of it, so it can really help you feel in control. It’s perhaps best used in conjunction with breathing exercises, as your attention is very much focussed on your breathing anyway. Don’t start off with some deep, effective breaths without the drug and then suck and gasp at the mouth piece – use the two things in complement to each other. The gas is not harmful to your baby and it will not build up in your system, nor will it interfere with the progress of your labour. You can even use it in a birthing pool.
Things to be aware of
Gas and air is only a mild form of pain relief, so you may find that as your contractions get stronger, you need to move to something else. That’s fine and if it gets you through a portion of your labour with no side effects, that’s great. It makes some women feel drowsy and others feel sick though – some throw up. If you find this is not working for you, talk to your midwife about moving to another form of pain relief.
It can be a little hard to coordinate – if, each time you have a contraction, you want to be on all fours, or kneeling with your hands on the headboard of the bed, it can be quite tricky to juggle the mouth piece too. That’s where your birth partner can truly come into his or her own, helping you nd it or even holding it for you each time and helping you remember how to breathe most effectively.
Your mouth can feel very dry using it and so it’s useful to know to bring water and other drinks and perhaps some boiled sweets and lip salve to take away the feeling between contractions.
◗ Breathe deeply and rhythmically
◗ Breathe in and out into the mouth piece
◗ Use it as soon as you feel a contraction You should not
◗ Start to use it when your contraction is at its most painful
◗ Use it between contractions
◗ Keep using it if you feel sick