Gas at homebirths in the US.... - Page 4

[3cuties]

Very helpful!

[elizaMM]

Update: My local guy at Airgas says the FDA does not acknowledge 50% Nitrous/ 50% Oxygen as a drug in the U.S., therefore, they can not sell it. However, Dentists buy 100% Nitrous and have a contraption that mixes it with Oxygen (02, I believe). He is going to send me some info on this mixer contraption (probably expensive :-/). Also cost of 100% N2O.

They will sell 100% Nitrous to a licensed professional. He figures since my CNMs have Prescribing authority for Narcotics, they should be able to Prescribe and purchase N2O.

Their company policy is that they will sell to a clinic or hospital, not to an individual.

Air Gas's number: 800-637-9353.

More later!

[3cuties]

Eliza you are amazing!

[Mama2Xander]

I used to be an RN in L&D here (in Canada) and it was very commonly used, but hardly anyone said it helped them.

I would say in my experience the reaction tended to be (from most common to least common):
1. Didn't make the mom feel gross but didn't help either
2. Made the mom feel so gross she didn't care if it helped or not
3. Found it somewhat helpful at the time, but afterwards said it was actually the act of focusing on breathing in and out through the mask that was helpful, not the gas itself
4. Found the gas itself helpful (a very small percentage, in my experience)

I am not saying this to try to get into a debate, just that I would be cautious of going to a ton of trouble and spending a ton of money on something which may not be super effective (trying to word this politely here )

My other logistical concern would be safe collection and disposal of the exhaled gas. I guess it is just collected into another canister? But seriously, it is important to do this properly, because it definitely CAN affect the people around the labouring woman if she isn't careful to breathe it back into the mask with a tight seal around her face.

[Viola]

Originally Posted by Nan'sMom

One reason I wouldn't want to use it is that people can sometimes have "bad trips" on it. A friend described a childhood dental experience using nitrous oxide as a nightmarish experience she still remembers vividly years later.

Not debating it's obstetrical use here, just sharing experience. I had two friends who had bad experiences with nitrous oxide at the dentist. The second story I heard while relating the first one. The one person had a paranoid delusion and was convinced the dentist and hygienist were trying to kill her. The second story was nothing like that, it was actually kind of odd, involving increasing forgetfulness and confusion to the point of requiring hospitalization.

I received nitrous oxide for dental work as a child, but it didn't seem to do anything for me. Maybe the dose was really low, but I never got the point of it since I still needed the novocaine, and it didn't alter how I was feeling in any way that I was aware of at the time.

I imagine it's like anything else, and results will vary. It sounds like it could have benefits in childbirth settings and that is worth exploring.

[elizaMM]

Viola & Xander's Ma: Thanks for your anecdotes.

Sadly, I think I'm abandoning ship.

My midwife(s) were trying to be open, but they really aren't comfortable with it. They say its only used in hospitals in Europe, and they're not interested in being pioneers. I thought it WAS used in homebirths in Europe, but I just don't have the energy to keep researching at this point.

I did get some more information from the local Air Gas dude though:


***********
The nitrous oxide is part number NS USPE and they cost $38.00 to fill and also $4.50 monthly rent. The oxygen part number is OX USPEA and it costs $18.50 to fill and monthly rent of $4.50 each cylinder. (I think these are for "E" size cylinders, whatever those are.)


$20.00 delivery charge and a fuel surcharge of $12.60 per delivery. The fuel surcharges go up and down based on the price of diesel fuel.

Otherwise, all they need is a state license number to deliver to the Birth Center.


But you still need a mixer or "flowmeter". Airgas offers two, one has manual flow controls and you set the flow for each gas. The second unit automatically mixes the gases for the proper flow. They are $3,500 & $3,800 (respectively?). They include disposable masks that "evacuates residual gas that's not inhaled". Also they include a "scavenger flowmeter". I don't know if that means it prevents exposure of other people around mama to the Nitrous or what.


**********


Expensive, as anticipated. But I was also told that there are smaller units designed for ambulances that are probably cheaper. No info on them though.

If anyone wants more info on the flowmeter/mixer things w/o dealing w/ Air Gas, PM me and I can send a pdf flyer.

While I'm giving up, I encourage y'all not to. I have found no evidence that having N2O at a home birth is illegal or impossible. Just not possible in my situation. The more we try the sooner this option will be available to all our laboring sisters.

As far as I can tell all you need to get it in the US is: a willing, licensed professional (that can prescribe drugs), and a little cash on hand (unless your willing professional is a dentist) for the two tanks of gas, a mixer, and probably a pulse oximeter. Then there is still the concern about exhaled nitrous. It sounds like hospitals have a method for "scavenging" it. It isn't clear to me how important that is.

3cuties good luck!!!

Never doubt that one person can change the world....:

[debsagos]

Just to let you know.......gas and air is often used at homebirths in the UK.

I am a homebirth midwife here and have a couple of canisters in my backroom right now.

we do NOT assess blood oxygen levels during use......just observing the mother using it is sufficient ..... it is entirely self administered.

It helps some women enormously but i find hardly ANY of my clients feel the need to use it!

HTH...

Debs xx

[elizaMM]

That IS interesting Deb. Thanks for sharing.

What do you do when your midwife (CNM with a great reputation) keeps saying things that are inconsistent with what you've learned elsewhere?

:-/

[3cuties]

Eliza -- just wondering if you did give up your search?