The Development of a Protocol To Offer Nitrous Oxide in Labor

Pain management in labor and delivery is challenging. The current literature supports the practice of administering an epidural for complete pain relief followed by intravenous opioids as an alternative. The use of either of these two modalities can result in a negative response for both the woman and her newborn. Adverse effects range from newborn respiratory depression to prolonged second stage of labor possibly resulting in operative delivery for the woman. Nitrous oxide has been deemed a safe anxiolytic, anesthetic, and analgesic option. At a large community hospital in Southern California, nitrous oxide has not been part of the routine care. This DNP project was the development of a protocol for implementing nitrous oxide for laboring women to ensure pain relief and a better birth experience.