Midwife Connection

by Cassie Moore, ACNM Writer and Editor

One of my favorite aspects of my job is speaking with midwives and other health care professionals who are engaged and passionate about what they do. Last week, I talked with Michelle Collins, CNM, PhD(c), RNC, about how she and others at Vanderbilt University Medical Center in Nashville recently began providing nitrous oxide as a pain relief option for their clients.

Michelle, who is an assistant professor of nursing in the nurse-midwifery specialty at Vanderbilt, told me that she had first seen laboring women using nitrous oxide for pain relief in England, where she worked at St. Mary’s Hospital in London. 

Having given birth just about 18 months ago, I was really curious about what nitrous does for laboring women. Does it really make you giggle? Does it affect the baby? Collins told me that nitrous tends to dull or take the edge off contractions, but doesn’t make clients numb; they can still feel contractions and the urge to push. It’s self-administered, so the client can decide how frequently she uses it. And—what seems like the biggest benefit to me—nitrous acts as an anxiolytic, so it really cuts down on the anxiety and fear that laboring moms may have. Plus, evidence shows nitrous is not harmful to mothers, babies, or health care workers in the concentration used for labor.

Michelle and I agreed that if I get pregnant again, I’ll have to return to my home state of Tennessee and waddle on over to Vanderbilt, because nitrous sounds like a pain relief option I want to try. When I gave birth last year, I wanted to avoid an epidural, narcotics, and other interventions. However, I did have quite a bit of fear, anxiety, and pain, and I could have really used something to help me relax.

And nitrous doesn’t have to be used instead of an epidural—it’s very versatile and can be used in earlier stages of labor to delay an epidural, or it can be used for patients who are receiving an epidural but are scared of needles, or it can be used for pain relief after the baby is born if a midwife has to sew up a laceration or perform other potentially painful tasks. 

Are you interested in using nitrous oxide at your practice? Check out the N2O During Labor listserv to learn more from Michelle and others who work with nitrous oxide. Here’s a longer Slate article that delves into the history of nitrous oxide.

Stay tuned to future issues of Quickening for a longer article about nitrous oxide and the process Michelle went through to bring it to Vandy.

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