Why is nitrous oxide for pain relief unavailable to most women giving birth in the United States when it is available in so many other countries?
This is the question posed by Judith Rooks, CNM, MS, MPH, a well-known midwifery author, epidemiologist, and researcher.
As Ms. Rooks notes in her editorial in the March 2008 edition of the journal Birth, “most U.S. women also lack access to many non-pharmacologic methods to cope with labor pain that, although less effective than epidural analgesia, provide sufficient and satisfactory pain relief to a significant proportion of the women who use them during labor.” American women might be surprised to learn that “nitrous oxide is used by the majority of women in many countries that are relatively similar to the U.S. in general socioeconomic and medical standards,” including 48 percent of the women who gave birth in Finland (2005), 46 percent of those who gave birth in New South Wales, (2004), forty-three percent of women birthing in British Columbia, (2004-5, either alone or with other agents), and fully half of all women birthing in the U.K. (2000).
So what happened here, where nitrous oxide was once commonly used in hospitals around the country? Ms. Rooks faults “the evolving epidural monoculture in some hospital obstetric units” where the options for women have become, effectively, an epidural or nothing, perhaps a bit of synthetic narcotic (usually promoted by the nursing staff to get the patient through until she can have her epidural).
The complete editorial, entitled “Nitrous Oxide for Pain in Labor–Why Not in the United States?” can be found in Birth, Volume 34 Issue 1 Page 3-5, March 2007. You can contact Ms. Rooks at 2706 SW English Court, Portland, Oregon97201, USA.
To subscribe to Ms. Rooks listserve for individuals interested in the use of nitrous oxide for pain relief in labor, send her an email at jprooks1 (followed by an ampersand, no space, followed by) comcast.net.