The joy of giving birth is often overshadowed for some women by the pain of labor, but according to a new study, inhaled pain relief medications appear to be a safe and effective choice for reducing pain in the first stages of labor.
Researchers at the Cochrane Collaboration, a respected international research group, reviewed 26 separate studies that involved nearly three thousand women. They found the inhaled pain medications were effective, easy to administer and provided pain relief within one minute. They were also less invasive than other pain relief methods, such as epidurals and nerve blocks.
“Women in labor who need pain relief should not only have access to invasive methods such as an epidural, which may have considerable side effects, but other means of pain relief as well,” they wrote.
Another advantage to inhaling a mixture of oxygen, and either a flurane derivative or nitrous oxide, was that it enables the mother to remain awake and experience childbirth.
Women who inhaled nitrous oxide gas did have side effects, such as nausea, vomiting, dizziness and drowsiness. Fluranes provided more pain relief than nitrous oxide and had fewer side effects, but they can only be administered under the supervision of a trained analgesia professional. Nitrous oxide can be administered by midwives.
“This is probably the main reason why flurane use is not widespread and also why little research is done on this form of inhaled analgesia for the management of labor pain,” said lead author Trudy Klomp, who works at the Department of Midwifery Science and the EMGO Institute for Health and Care Research at VU University Medical Center in Amsterdam.
The researchers say a more widespread use of nitrous oxide could help many women who do not have any option for pain relief, but when an anesthesiologist in available, flurane is the preferred gas to use.
“We need to apply some caution to these findings as there was a lot of variation in the analyses of pain intensity and of pain relief between the studies and some of the trials involved small numbers of women,” said Klomp.
“But despite these limitations, inhaled analgesia’s ability to significantly reduce pain intensity and increase pain relief indicates that it can help women in labor, particularly those who want pain relief but do not want more intensive forms such as epidurals.”
The authors called for more trials to be conducted that involve larger numbers of women and look particularly at which forms of anesthetic give a woman a greater sense of control in labor, satisfaction with the whole childbirth experience and ease in moving on to breastfeeding.
Another recent study by the Cochrane Collaboration found that epidurals are more effective in relieving pain during childbirth, but come with more side effects for mother and child. Drug-free pain relief methods also work and with fewer side effects, but more research is needed on their effectiveness.