Epidural Anesthesia


An epidural is a method for delivering pain relief drugs or local anesthesia through a catheter placed in the small of the back, just outside the spinal canal. An advantage of the epidural is that it allows most women to fully participate in the birth experience continue to feel touch and pressure while relieving most, if not all, of the pain of labor.

In most cases, the nurse anesthetist will start the epidural when cervical dilation is four to five centimerters. Under certain circumstances, it may be desirable to place the epidural earlier. Benefits of epidural anesthesia include:

•  Allows you to rest if your labor is prolonged.

•  Some women have a more positive birth experience, by reducing the discomfort of childbirth.

•  When other types of coping mechanisms are no longer helping, an epidural can help you deal with exhaustion, irritability, and fatigue. An epidural can allow you to rest, relax, get focused, and give you the strength to move forward as an active participant in your birth experience.


Nitrous Oxide


In the United States, the most common pharmacological forms of pain analgesia for labor have been narcotics and local anesthetics through an epidural. Nonetheless, in recent years, there has been a growing awareness of the benefits of using nitrous oxide for pain during labor.

Benefits of Nitrous Oxide

  • According to the Journal of Midwifery & Women’s Health, “Nitrous oxide labor analgesia is safe for the mother, fetus, and neonate and can be made safe for caregivers. It is simple to administer, does not interfere with the release and function of endogenous oxytocin, and has no adverse effects on the normal physiology and progress of labor” (Rooks, 2011).

  • By not disrupting the release of oxytocin, nitrous oxide does not affect infant alertness during the early bonding period between a mother and her newborn.

  • It does not affect breastfeeding.

  • It does not increase the need for neonatal resuscitation.

  • In the doses given during labor, nitrous oxide is not a strong analgesic. Women who use nitrous oxide during labor may still have an awareness of labor pain. However, many women find it helps them relax and decreases their perception of labor pain.

  • Because it is self-administered, not only can a woman decide how much to use, but she can also decide if she wants to stop using it and try another method of pain relief instead. Nitrous oxide can be easily discontinued, and its effects disappear within five minutes after cessation.

While there are many benefits of using nitrous oxide during labor, there are some risks to be aware of. For example, side effects may include sedation, dizziness, nausea and vomiting. Although nitrous oxide is self-administered it still requires a physician order. We encourage you to discuss this option with your provider.