Southern medical journal
August 3, 2026 · via Europe PMC
Use of Nitrous Oxide during Labor in an Academic Medical Center in a Rural State.
Hope B, Du R, Magann EF, White A.
AI summary — for doctors, generated from the abstract only
A retrospective study at a rural academic medical center found that women managed by certified nurse midwives, and Hispanic women relative to other racial/ethnic groups, were significantly more likely to continue using nitrous oxide for labor pain management until delivery.
What was studied
A retrospective cohort study of 267 women who selected nitrous oxide for labor pain relief at an academic medical center in a rural state (January 2020-July 2023), examining demographic and clinical factors associated with continued nitrous oxide use through delivery.
Key findings
- Care by a certified nurse midwife (versus a physician) was significantly associated with continued nitrous oxide use (adjusted OR 2.45, 95% CI 1.22-4.89, P=0.0115).
- Relative to Hispanic patients, non-Hispanic White women (aOR 0.27, 95% CI 0.11-0.68) and non-Hispanic Black women (aOR 0.39, 95% CI 0.16-0.93) had significantly lower odds of remaining on nitrous oxide; maternal age, gestational age, marital status, insurance type, and parity were not significantly associated with continued use.
Clinical relevance
This may be relevant to labor and delivery providers and institutions considering pain management options, suggesting that provider type (midwife-led care) and patient race/ethnicity are associated with nitrous oxide continuation, which could inform patient counseling and highlight the potential of nitrous oxide to support patient autonomy during labor.
Who should care
Limitations
Single-center retrospective study limited to women who already selected nitrous oxide, so findings describe factors associated with continuation rather than initial choice; the authors explicitly note further research is needed to clarify nitrous oxide's role in labor pain management overall.
Midwife-led care and Hispanic ethnicity were associated with higher rates of continued nitrous oxide use during labor at this rural academic center, highlighting provider and demographic factors that may influence this pain management choice.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objectives
This study examined the use of inhaled nitrous oxide as a pain management option during labor. Nitrous oxide offers a noninvasive, self-administered pain relief option that allows patients greater autonomy compared with other methods such as epidural analgesia or intravenous opioids. Its effectiveness and patient satisfaction remain a debated topic, however, with mixed results from previous studies. The primary aim of this cohort study was to analyze nitrous oxide utilization by focusing on identifying factors influencing its continued use during labor.
Methods
This was a retrospective cohort study of information collected from patient charts of those who used nitrous oxide between January 1, 2020 and July 1, 2023. Demographic and clinical characteristics were reviewed to assess patterns in continued nitrous oxide usage.
Results
There were 267 women who selected nitrous oxide for pain relief during labor. The study showed that the type of healthcare provider (certified nurse midwives vs doctors of medicine) (adjusted odds ratio [aOR] 2.45, 95% confidence interval [CI] 1.22-4.89, P=0.0115), and race relative to Hispanic patients, that non-Hispanic White women had a lower odds of remaining on nitrous oxide (aOR 0.27, 95% CI 0.11-0.68), as did non-Hispanic Black women (aOR 0.39, 95% CI 0.16-0.93) were significantly associated with continued nitrous oxide use during labor. The factors of maternal age, gestational age (term vs preterm), marital status, type of insurance, and parity were not significantly associated.
Conclusions
Women who selected and continued using nitrous oxide until delivery were more likely to have a certified nurse midwife managing their labor/delivery and were more likely to be Hispanic. The study underscores the potential use of nitrous oxide to enhance patient autonomy during labor. Further research is needed to clarify the use of nitrous oxide for pain management during labor.
DOI
10.14423/smj.0000000000002001
PMID
42550939
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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