The anxiety of new moms likely knows no bounds, but in the midst of labor at Mercy Regional Medical Center, there’s a new option to help take the edge off – laughing gas, aka nitrous oxide.
The Family Birthing Center at Mercy started offering nitrous oxide, an odorless gas, this spring to help ease anxiety and, in some cases, help avoid an epidural, said Jenn Cioppa, manager of the birth center.
Offering nitrous oxide is one of the most recent changes the center has made to improve care for patients. The center has also adopted new technologies to monitor fetuses during labor and to detect illness right after birth, the birthing center staff said.
The new tools help better serve the approximately 900 infants expected to be delivered at Mercy this year to moms with a variety of expectations for their labor.
“We want to give everybody the options that they want,” Cioppa said.
Some moms may want a completely natural birth, some a water birth and others may want an epidural that will provide more pain relief, the staff at the birthing center said.
Patients can also choose between an obstetrician and a certified nurse-midwife to provide care during pregnancy and labor at Mercy.
Since it was introduced, the nitrous oxide has allowed about half the patients who have used it to give birth without an epidural, Cioppa said.
The nitrous oxide won’t take away a patient’s pain, but it can help patients to relax, Cioppa said. The gas is commonly used in dental offices and wears off in minutes, she said. Patients use nitrous oxide during each contraction up until the point of delivery, she said.
The gas is widely used in other countries, such as Canada and Australia, and awareness about its effectiveness has been growing in the U.S., according to the American Pregnancy Association.
Labor pain can be intense even for those who have a pain tolerance, so all women can choose to have an epidural during their labor even if it wasn’t part of their original plan, said Jennifer Hyson, director of women’s services. An epidural provides regional anesthesia to the lower half of the body by blocking nerve impulses in that area, according to the American Pregnancy Association.
“We just try to tell them to keep an open mind,” she said.
The Family Birthing Center works with quite a few women who are interested in giving birth without an epidural, Cioppa said.
Giving birth without an epidural offers more freedom of movement and can allow women to labor in a position of their choice, such as in a squat or on their hands and knees, said Megan Riddle, a certified nurse-midwife with Southwest Midwives.
“Traditionally, women didn’t have to be on their backs,” she said.
An epidural immobilizes women during birth, so they have to lie mostly on their backs, Riddle said. Epidurals can also increase the amount of time a woman spends in labor because it decreases their sensation, she said.
The nitrous oxide option has been well-received among Riddle’s patients, she said.
“They are all really excited about having the opportunity to have nitrous,” she said.
In recent months, the birthing center also started using new wireless fetal monitors, part of the Novii Wireless Patch System, because they allow more freedom of movement during labor, Cioppa said. The monitors are adhered to a woman’s abdomen with patches and have worked well, she said.
The monitors are needed to track a fetus’s heartbeat, the mother’s heart rate and contractions, she said. Higher risk patients must be monitored continuously through their labor.
The waterproof monitors allow women to walk around or spend time in a jacuzzi tub during labor, which can last for many hours, she said.
“A lot of women don’t want to be tied down to the bed,” said Claire Barnard, a registered nurse with the birthing center.
Traditionally, mothers had to lie on the bed with a monitor resting on their tummy, Cioppa said. Newer monitors at Mercy required mothers to carry a purse-like device.
Once a child is born, staff will screen the child for conditions such as hearing loss, congenital heart disease and other conditions. The staff also monitors a child’s bilirubin levels because at high levels, the naturally-occurring compound can cross the blood-brain barrier and cause seizures and long-term brain problems, said Dr. Jessica Marsh with Pediatric Partners of the Southwest.
Bilirubin is a compound made during the breakdown of red blood cells and it can turn a child’s skin yellow.
A new tool introduced in the last year at the birthing center checks bilirubin levels when it is placed on a child’s skin, eliminating the need for blood samples. The transcutaneous bilirubin measurements rely on light waves, according to its manufacturer, Philips.
The new tool is part of a general trend to use less invasive procedures in pediatrics when possible, Marsh said.
While the birthing center is embracing new technology, it is not fundamentally changing how the center works with patients, Hyson said.
“We don’t bring people in and rush them through their labor and delivery process. We really do function as a true birth center where people are helping with decisions in their care,” she said.