Here is the answer I got from Mike Civitello, who works for a company that is in the process of seeking FDA approval for new equipment for providing N2O for labor analgesia.

Judith

………

We have several hospitals that are already using our equipment in Ohio – Pediatric though. We also have current equipment at the Cleveland Clinic being used for a clinical trial – which we are hoping gets published in the next year. They are conducting a study comparing the use of N20 versus another commonly used drug for chronic pain treatments.

Parker Hannifin (Porter parent company) has a relationship with the Cleveland Clinic – and I’m sure we could get our new equipment to any of their affiliated hospitals. We will be looking for a few highly respected institutions like Cleveland Clinic, Vanderbilt, etc to start using the new equipment in hopes of studies and papers getting published – along with the educational opportunities that would be presented.

New equipment is not going to be available by December 5 though.

I’m going to try and find out more about Magee this week – will share info as I get it.

Mike Civitello, Product Sales Manager
Porter Instrument Division
Parker Hannifin Corporation

I am sure my midwife (midwives) will be ready to go, if I ask. We meet again this Wednesday and I will let them know of the journal article and your suggestion to get the approval and training. Very exciting! I have so many questions I hope they can answer them. I went on-line to Anesthesiology Journal publications and found some encouraging research and articles.

I just wish we could know the FDA timeline for approvals!!!

I won’t give up hope that it all might be accomplished in just 6 weeks!
Looking forward to your information. Thank you, again, Judith.
~Maura

I sent a copy of your message to a representative of a company that is in the process of seeking FDA approval for new equipment to provide nitrous oxide labor analgesia. I asked him to let me know if any hospitals or birth centers in Cleveland are in line to buy the new equipment when it is approved by FDA. I should hear from him tomorrow and will let you know. Please go ahead and ask the midwives at the Cleveland Clinic to go through their internal process of getting approvals and getting the necessary training. A review of the Safety and Risks of Nitrous Oxide Labor Analgesia is coming out in the next issue of the Journal of Midwifery & Women’s Health is available on-line in advance of publication. I can get a copy of it for you if that would help.

Judith Rooks

I am so very excited to find these postings and so very thankful to you for being such an advocate.

I am pregnant with my 7th child. The first 2 were with an epidural. Wanting a natural birth since the first child, I was determined to do it! I switched to a group of midwives with a week to go on my third child and what a difference. My last four were natural births. I know I do not want to go back to an epidural, but do need something to “take the edge off” (as I am a typical redhead in that I have an extremely low pain threshold).

Would you be able to tell me if you have had any contact with my hospital here? I deliver at Hillcrest Hospital in Cleveland, Ohio. It is part of the Cleveland Clinic. One of my midwives has been trying to encourage N2O here and you may know her.

I am very willing and interested in contacting the hospital hierarchy via a request letter and will ask my CNM for assistance in doing so. I will use the advice you have given here in previous posts as well.

I am due to deliver December 5th. So I really only have 6 weeks left to accomplish this. I just hope it is not too late!

Please advise! Would you like me to contact you on email?
Thank you again for all your work and in advance for your support.

I believe that a company that specializes in making medical equipment
will soon get FDA approval to begin to produce and sell a new version of
the equipment needed to use nitrous oxide for labor analgesia. The FDA
procedure for getting this approval is complicated and can take a long
time, but a big company is putting substantial effort into this. They
previously told me that they hope to have it by the end of this year. It
could take a little longer, but new equipment should be available in time for your birth. Right now only 5 US hospitals are using it, to my knowledge. They are:

University of California at San Francisco [UCSF] Moffitt Hospital in San Francisco
University of Washington [UW] Medical Center in Seattle
Vanderbilt University Hospital in Nashville
St. Joseph Regional Medical Center [SJRMC] in Lewiston, Idaho
Okanogan Douglas District Hospital in the Methow Valley of Washington State

However, an ever-expanding group of hospitals are ready to buy the new equipment when it becomes available and will start using it shortly thereafter. Where do you live, Brittany? I can probably tell you if any hospital in your area is in line to buy and start using the new equipment?

Keep in mind though that you need to know about all kinds of ways to deal with labor pain before you go into labor. Labor pain is unique to every woman. You may want to use nitrous oxide and find that you really need an epidural. Or you may find, as my step-daughter did recently, that she could get by without anything more than access to a warm tub, preparation through reading of ways to self-manage pain, and the support of her husband, a great doula, and a very good nurse, although there were a few short periods when she would have liked to use nitrous oxide if it had been available. My point is that, although you need to educate yourself and think through various scenarios, you won’t know what you need until the time comes. She was elated that she was able to give birth to her first child (at age 43) with support, her personal strength, and warm water. There are many advantages to being able to avoid an epidural if you can. You can’t count on that though, and you can’t count on a epidural either. You may have pain when it is too early to start an epidural; nitrous oxide is a good way to get through until you can have an epidural, and by then you may just want to stay with nitrous. Or you may not get to the hospital until it is really too late to have an epidural placed and begin to take effect before the baby is born. Or you could be among the percent of women, at least 10%, maybe higher, for whom an epidural isn’t really very effective for one reason or another.

If I know where you live, and can tell you whether it is likely that a hospital near you will be using nitrous oxide labor analgesia when you are ready to have your baby.

Congratulations on your pregnancy and your intent to learn more about labor analgesia choices.

Judith Rooks

I am currently 5 months pregnant with my first child. My husband and I will be moving near Goldsboro, NC in about a month. Not only am I nervous about giving birth for the first time, but I’m moving to a new place with only 2 months to find a new doctor and try to build a trusting relationship with him/her. I’ve always been interested in alternative methods of pain relief. I first read of the possibility of nitrous oxide about 2 months ago, but have only found 2 hospitals that offer it for laboring women (neither of which is close to Goldsboro, NC). I was wondering if you have a list of hospitals that do offer it, or even another website or source I could use? Thank you!

Thanks for the information. I’ll definitely bookmark this for reference.

The N2Oduringlabor is now open to anyone, no need to be invited or added by me. The website url is http://health.groups.yahoo.com/group/N2Oduringlabor/. Click on it and follow the instructions to join. When you join you will see a light blue sidebar on the left side of the website home page. Clicking on “Messages” takes you to a space where many of messages sent to members of the listserv are preserved and can be read. Some are more important than others. Mickey Gilmore, CNM, MsN, helps me with the listserv and goes through the messages from time to time to remove the less informative messages. Most of those that are available here either have some important information or are fairly new. Each message was assigned a number when it was received. Number 1 is the oldest message, number 287 was the oldest the last time I checked. But there are not that many messages there now. Although many messages that are no longer relevant and don’t provide new, interesting, or unique information have been deleted, the message that are there retain there original numbers; there are gaps in the sequence. Once you find a message that you may want to return you, note the number; that message will always have the same number. I just went through some of the oldest ones and deleted some more. I should do it again for all of them, and I will, but if you are serious about doing something about nitrous oxide, it would not be a waste of time to just click through them. Click on messages. At the top of the first message shown is a line that allows you to choose between Newest, Newer, Older and Oldest . I started with oldest, then went to older, etc. As soon as you click on one and read it, you can click on “next” to go to the next one. Some of the messages from me are sort of a compendium of information about a particular subject.

If you click on the “Files” heading on the light-blue side bar on the home page you will enter the part of the website that has important documents. Some of them were also sent as messages. If you click on one, it will show up on your desktop.

If you have any trouble joining or opening any of the documents, please let me know.

Judith Rooks