What it is
Nitrous oxide is self-administered — you hold the mask and inhale as a contraction begins so peak effect meets peak pain. It doesn't remove pain but softens it and reduces anxiety. Widely used in the UK, Canada, and Australia; growing in US hospitals.
Evidence review links
Each link opens the full review on the publisher's site in a new tab.
Possible benefits
- Fast onset and offset (30 seconds)Review sources ↓
- Doesn't affect the baby or your ability to move and pushReview sources ↓
- Self-controlled — you decide doseReview sources ↓
- Can be used with other methodsReview sources ↓
Possible risks
- Nausea, dizziness, or dysphoria in some peopleReview sources ↓
- Doesn't provide strong pain relief — better as a coping toolReview sources ↓
Alternatives
- IV opioids for stronger short-term reliefReview sources ↓
- Epidural for continuous regional anesthesiaReview sources ↓
- Non-pharmacologic (hydrotherapy, TENS, movement)Review sources ↓
Current evidence
ACNM Position Statement (2010, updated) and multiple observational studies support safety and satisfaction. ACOG considers it a reasonable option.
Where the evidence is clear · where people may choose differently
For most topics, guidelines from ACOG, WHO, and other major bodies broadly agree on the core safety points (when to act in an emergency, informed-consent standards, monitoring baselines). Where reasonable people — and even guidelines — differ tends to be around thresholds (when to start or stop something), preferences (comfort, environment, support), and values (how you weigh small risks against benefits). Use the questions below to explore those pieces with your care team.
Educational only. Your care team can help you weigh what applies to your specific situation.
Related evidence topics
- Pain Management OptionsAn overview of non-pharmacologic and pharmacologic comfort options.
- Epidural AnesthesiaRegional anesthesia delivered through a small catheter in the lower back to numb pain from the waist down during labor.
- IV Opioids in LaborShort-acting opioid medications (fentanyl, remifentanil, nalbuphine, morphine) given by IV or push for pain relief during labor.
Questions to ask your care team
- ?Is nitrous available on the unit?
- ?Can I use it with an epidural or IV opioids?
- ?How is it different from what my grandmother had?
Universal questions (works for any decision)
A short BRAIN-style set you can bring to any conversation about interventions, monitoring, or care decisions.
- ?Why are you recommending this now — is it urgent, routine, or optional?
- ?What happens if we wait an hour (or longer) before deciding?
- ?What signs would tell us this is working — or that we need to change course?
- ?What are the alternatives, including doing nothing?
- ?What would you recommend if this were your family?
- ?What would change your recommendation?
Sources & provenance
Tap a source to open the original guideline or review in a new tab.
- ACNM Position Statement: Nitrous Oxide for Labor Analgesia — ACNM
- AWHONN: Nitrous Oxide for Labor Analgesia — AWHONN
Plain-language paraphrase. Re-verify before publish.
Last reviewed: 2026-07-03
Further reading — canonical references
Read the source material directly. Each link opens the publisher's own current guidance in a new tab — cross-check what we summarize against what they say.
Tier 1 · Clinical guidelines
Tier 2 · Systematic reviews
Educational only. Guidelines evolve — the linked publisher pages will reflect newer guidance than any static snapshot.
Version history — v1.0.0
v1.0.0 · 2026-07-03 · LlaMamma editors
Initial nitrous oxide topic.
New guidance from ACOG, WHO, Evidence Based Birth, or other listed sources is recorded here and can be updated remotely without a new app release.