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A qualitative analysis of parturients’ experiences using nitrous oxide for labor analgesia: It is not just about pain relief
Author(s) -
Richardson Michael G.,
Raymond Britany L.,
Baysinger Curtis L.,
Kook Bradley T.,
Chestnut David H.
Publication year - 2019
Publication title -
birth
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.233
H-Index - 83
eISSN - 1523-536X
pISSN - 0730-7659
DOI - 10.1111/birt.12374
Subject(s) - nitrous oxide , analgesic , anesthesia , medicine , respite care , aromatherapy , population , psychology , nursing , alternative medicine , environmental health , pathology
Background A vast majority of women who choose nitrous oxide for labor report high satisfaction despite variable analgesic effectiveness. We analyzed comments provided by women who used nitrous oxide for labor, to identify determinants of satisfaction in this population, and to better understand reasons for continuing with nitrous oxide despite variable analgesic effectiveness. Methods We conducted qualitative content analysis of comments in a quality improvement database of routine follow‐up assessments of women who delivered vaginally, using nitrous oxide as the sole labor analgesic. An inductive grounded approach was used and emergent themes and subthemes were identified. Results Of 6507 vaginal deliveries over 34 months in 2011‐2014, 753 (12%) used nitrous oxide as their sole analgesic. Analysis of 264 clarifying comments yielded six emergent themes. Parturients cited nonanalgesic benefits of nitrous oxide use (relaxation, distraction, focus on breathing), as well as partial analgesic effects that they deemed to be sufficient, or consistent with their expectations. Numerous women described their nitrous oxide experience as consistent with their birth plan, including 14 who equated it with natural childbirth. Several comments described nitrous oxide as a vital component of the parturients’ birth experience. Some described using nitrous oxide when neuraxial analgesia was not possible. Side effects were identified, as were difficulties using the apparatus/mask. Analysis highlighted importance of timely administration upon request and attention to technical aspects. Conclusions Among parturients who choose nitrous oxide as their sole labor analgesic, determinants of satisfaction are more variable than previously understood, and extend beyond analgesia.