If you’ve watched labour on television, you’ve probably seen someone enthusiastically breathing into a gas and air mouthpiece while shouting, laughing or saying something memorable!
While these scenes can be entertaining, they don’t always give a realistic picture of one of the most commonly used forms of pain relief in labour.
Gas and air (known medically as Entonox) has been used safely in maternity care for many years. It’s available in almost every birth setting, including at home, in midwifery-led birth centres and on labour wards, and many people find it helps them cope with the intensity of contractions.
Like all pain relief options, it won’t be the right choice for everyone, but understanding how it works can help you decide whether you’d like it to be part of your labour toolkit.
What Is Gas and Air?
Gas and Air is actually offically called Entonox, a 50:50 mixture of oxygen and nitrous oxide.
You breathe it in through a mouthpiece or mask that only you use during labour.
Unlike some other forms of pain relief, it doesn’t remove pain completely. Instead, many people describe it as helping to “take the edge off” contractions, making them feel more manageable and helping them stay calm and focused.
Some people also find it helps them develop a steady breathing rhythm during labour.
How Does It Work?
Gas and air works very quickly.
As you breathe it in, it enters your bloodstream through your lungs. Once you stop breathing it, it also leaves your body quickly, which means its effects wear off within a minute or two.
Because you’re in control of when you use it, you can decide whether you want it for every contraction or only at certain points during labour.
When Can I Use Gas and Air?
One of the advantages of Entonox is its flexibility.
It can be used:
- during labour
- during induction of labour
- while having vaginal examinations
- during procedures such as stitches after birth if needed.
If you’re planning a home birth, your midwife will usually bring Entonox with them.
How Do I Get the Best Effect?
Gas and air works best if you start breathing it as soon as you feel a contraction beginning.
It usually takes around 30 seconds to reach its full effect, so starting early means it’s working when the contraction becomes strongest.
Try taking slow, deep breaths through the mouthpiece until the contraction eases.
Like anything new, it can take a few contractions to get the timing right, so don’t worry if it feels a little unfamiliar at first.
How Effective Is It?
Everyone experiences labour differently, so there’s no single answer.
Some people use gas and air throughout labour and find it provides enough relief on its own.
Others prefer to combine it with movement, water, massage or breathing techniques, or decide later that they’d like stronger pain relief.
There is no right or wrong choice. You can change your mind at any point during labour, and your midwife will support whatever feels right for you.
Are There Any Side Effects?
Most side effects are mild and disappear quickly once you stop using the gas.
You might experience:
- feeling light-headed
- dizziness
- tingling in your hands or face
- a dry mouth
- nausea.
Keeping a bottle of water nearby or sucking on ice chips can help with a dry mouth.
Because the effects wear off so quickly, most people feel back to normal within a minute or two after stopping.
Current evidence shows that Entonox is safe for most people during labour and does not cause drowsiness in your baby.
Why Do Some People Laugh?
Every midwife has stories about memorable gas and air moments!
Some people become very chatty, some laugh, some become incredibly relaxed, while others simply become very focused on their breathing.
Many people don’t experience any of these effects at all.
However it affects you, there’s no need to feel embarrassed. Labour wards have heard it all before, and nothing you say is likely to surprise your midwife.
The Benefits of Gas and Air
Many people choose gas and air because it:
✔ Works quickly
✔ Wears off quickly
✔ Allows you to stay in control
✔ Can be used alongside other pain relief
✔ Doesn’t stop you moving around if you feel able
✔ Can be used in a birth pool or bath (following local guidance)
✔ Is available in almost every birth setting
✔ Can be used at different stages of labour.
Things to Consider
Gas and air isn’t the strongest form of pain relief.Some people find it gives them enough relief throughout labour, while others choose to move on to stronger options such as opioids or an epidural.You may also experience mild dizziness or nausea while using it.Like every aspect of labour, what works well for one person may not work as well for another.
A Midwife’s Top Tip
Don’t wait until the contraction is at its strongest before picking up the mouthpiece. Start breathing the gas as soon as you notice the contraction beginning. It takes a little practice, but getting the timing right often makes a big difference to how effective it feels.
Want to Learn More About Pain Relief?
Our Complete Antenatal Course explores all of the pain relief options available during labour—from movement and breathing techniques to water, TENS, gas and air, opioids and epidurals.The course is self-directed, allowing you to learn at your own pace, with ongoing support from experienced midwives by email or Zoom whenever questions come up.
Our aim isn’t to tell you which option to choose, but to help you understand your choices so you can make the decisions that feel right for you.
And Finally…
We know there’s a long-running joke that birth partners like to “test” the gas and air while the midwife isn’t looking…Let’s just say… after looking after thousands of births, we’re usually very good at spotting when someone other than the labouring person has been using it!
Best to save it for the person doing the hard work.
References
- NICE Guideline NG190. Intrapartum care for healthy women and babies.
- NHS England. Pain relief in labour.
- Royal College of Obstetricians and Gynaecologists (RCOG). Pain relief during labour.
- Royal College of Midwives (RCM). Supporting informed choice during labour.
- World Health Organization (WHO). WHO recommendations: intrapartum care for a positive childbirth experience.
- PIF TICK. Making health information trustworthy.