Minnesota Birth Center Offers Nitrous Oxide in Labor

Nitrous Image.2The Minnesota Birth Center is excited to announce that we are offering self-administered nitrous oxide for pain relief in labor.  As fans of “Call the Midwife” on PBS have learned, nitrous oxide is used around the world for pain control in labor and is slowly being re-introduced in the USA.  Nitrous oxide has a long history of safety for mothers and babies. The World Health Organization (WHO) lists nitrous as one of the hundred most essential medications. MBC’s new director, Kerry Dixon, CNM, CPM, has experience using nitrous oxide for laboring mothers in New Zealand, where it has been used for more than 50 years.  Nitrous oxide is available at our Minneapolis location and will also offered at our newest birth center opening in St Paul in April.  For further questions, please contact Minnesota Birth Center at 612-545-5311 or visit our website.

For more information on Nitrous Oxide, read the American College of Nurse-Midwives (ACNM) position statement

FAQs About Nitrous Oxide or “Laughing Gas” in Labor

-What is it exactly? Nitrous oxide use is a mixture of 50% nitrous-oxide gas and 50% oxygen that is inhaled through a self administered mask or a mouthpiece.

-I think I have heard of it? Nitrous is more well known for use in dental offices, or pre-op for surgeries, especially in pediatrics like at Children’s Hospitals and Clinics of Minnesota. Most people identify of it as “laughing gas.”

Did you know? Nitrous is the most commonly used pain relief for labor in the developed world including in: Canada, UK, Scandinavia, Australia and New Zealand. In the countries listed it is used by 40-60% of all laboring women.

– How does it work? You hold your own mask or mouthpiece and begin to inhale the gas mixture about 30 seconds before a contraction begins. Starting to inhale before a contraction begins helps the gas to reach its peak effect at about the same time as the contraction reaches its peak, providing the greatest relief. This way you determine how much or how often you need to use nitrous for pain relief.

– Will the midwives or nurses be administering nitrous? No; different from dental or pre-op; the nitrous is self administered by the laboring woman, who breathes it in when she feels the need. Once you decide you want to use it, your provider will prescribe it. Then the provider or nurse will come to your room, set it up, and review how to use it.

– Does it have any side effects? Some women have reported nausea after prolonged use; medication to help ease the nausea is available if that happens. It can also cause some unsteadiness with movement, which is why there should always be a family member or staff person in the room, in case you need assistance.

– Can I still be out bed and use nitrous? Yes; you may be out of bed and use the nitrous. As long as you are steady on your feet, you may be up and about. In fact, you are encouraged to find a position that works for you!

Can I be in the waterbirth pool or on a birth ball and still use nitrous? Yes; as long as you do not feel dizzy it is acceptable to use this way.

– Is there any extra monitoring required? No; if you are eligible to have intermittent fetal monitoring, no extra monitoring required while nitrous oxide is being used.

– Can I use nitrous and have intravenous narcotics at the same time? No, the combination of narcotics and nitrous can slow your breathing so they would not be used together.

– Are there any reasons I could not use it? Yes: you cannot use it if you:

1) cannot hold your own facemask or mouthpiece;

2) have received a dose of narcotic in the past 2 hours;

3) have a B12 deficiency for which you take B12 supplements;

4) have one of a very few other rare medical conditions.

– Are there any effects on baby? No, there are no known effects on the baby; nitrous is the only pain relief method used for labor that is cleared from the body through the lungs, so as soon as you stop breathing it in, the nitrous effect is gone within a breath or two.

What other procedures could I use nitrous oxide with? During the repair of a laceration, or during an uncommon, but painful treatment, of the manual removal of your placenta. Also, in some facilities nitrous can be used during blood draws or IV placement.

– While there is still a limited number of hospitals and birth centers in the USA that offer this option for pain relief to laboring women, we anticipate this to change as consumers and providers become aware of this safe, low-cost, effective choice! We are so happy that the Minnesota Birth Center is one of the leaders in Minnesota offering this to women who choose our service.

 

Kerry Dixon, CNM, Director of Midwifery Services

Kerry2Minnesota Birth Center (MBC) is thrilled to announce that Kerry Dixon, CNM is our new Director of Midwifery Services. She comes to MBC with a robust résumé that spans homes, hospitals and continents. We are truly thrilled to have Kerry leading the birth center and can’t wait for each of you to meet her!

What professional experience did you have prior to working at the MN Birth Center?
I started out as a doula before we had that specific “title” and was part of the original group of women who created the Childbirth Collective. I became a Traditional Midwife in 1994, under the guidance of Minnesota’s beloved “spiritual midwives.” When the Certified Professional Midwife credential became available in the USA, I applied for that and then chose to be a Licensed Midwife through the Minnesota Board of Medical Practice. I attended homebirths primarily in the Twin Cities, but my territory was anywhere a couple hours from my home. I have stories of driving to places like Star Prairie, WI during a blizzard and being snowed in for a day afterwards to walking down my street in the middle of the night to attend the birth of a fifth baby, after helping welcome older siblings in the same way.

When I decided to expand my scope-of-practice, it meant becoming a Registered Nurse, then a Certified Nurse-Midwife. I happily practiced as full-scope, hospital-based midwife in the East Metro for several years with a fantastic nurse-midwifery service known for their support of normal birth.  I especially enjoyed caring for families from a variety of backgrounds.

Being a CNM opened up doors for teaching and practicing as a midwife in Pakistan, China, Rwanda, as well as New Zealand where I am a Registered Midwife. Interestingly, NZ requires that all their midwives be trained to work outside of hospitals as well as inside. Being both a CPM and CNM meant that for once, my combined and less common background was recognized as an asset!

What brought you to MBC?
Most recently I was working as a midwife/mentor overseas caring for women in challenging situations. Overuse or underuse of technology and other conditions contributed to the morbidity and mortality of mothers and babies. It made my heart hurt as there were many times I was powerless to make immediate changes.  Joining the MBC team is a dream job! To be part of a small, intimate practice, supporting out-of-hospital birth, but with an integrated plan for easy transfer for medical needs is exactly why I became a midwife in the first place. Containing costs, reforming healthcare while improving outcomes is a worthy commitment of MBC initiated by Dr. Steve Calvin. Minnesota Birth Center’s fine reputation and statistics are also what I look forward to contributing towards as well.

What is your birth philosophy?
I have had many wise women and men mentors for birth who have planted pearls of truth that guide my work. I still believe that we can make the world better one baby at a time.

What inspires you professionally?
The work by many unknown people throughout time, who knew that some things were just “right” like breastfeeding, delayed cord-clamping, skin-to-skin, that science later proved was beneficial. I am grateful to those who contribute to evidence-based research guiding us to provide safe care for mothers and babies. With the Internet we can have important conversations on a global level and we must be willing to learn from each other.

What is the main piece of advice you like to share with pregnant mamas?
Learn, question and take what you need and discard the rest. You are the expert and love your baby more than anyone else, so find your own voice. What works for some mothers does not work for others.

What are your interests outside of work?
My first degree is in Art, so I appreciate doing things with my hands, creating. I love books and movies. I especially like foreign films with subtitles, listening to their accents. Many times I look at maps and imagine places that I want to visit or work in some day.

Do you have a family? Tell us about them?
My husband and I are the parents of children born between 1984 and 2002. We have 4 by birth and 2 by blessing. With the addition of the last two we became a multi-cultural family. I have semi-jokingly said having six children, was a “hazard” of being a midwife. Being with families during the most significant moments of their lives, being allowed to be part of their miracles…inspired me.

What is the craziest thing you have done?
See question above. 😉

Get To Know Natalie

Natalie2We are thrilled to introduce Natalie Jacobson-Dunlop who joined Minnesota Birth Center as a Certified Nurse Midwife this fall.  Below she shares her approach to practicing midwifery and a glimpse into her personal life.

What professional experience did you have prior to working at the MN Birth Center?
I have worked in women’s healthcare since 2000, providing a variety of services including teaching childbirth education and fertility awareness classes, helping women conceive with intrauterine inseminations, proving gynecologic care to women across the lifespan and providing obstetric care to low and high risk women. The majority of my obstetric experience has been as a Nurse Midwife in the hospital setting, but I have worked as a Nurse-Midwife’s assistant providing care to mothers delivering their babies at home in the Chicago area. I have also traveled to Temixco, Mexico and caught several babies with a traditional midwife at her birth center.

What brought you to MBC?
After nearly 20 years of living away from Minneapolis, we finally succumbed to the gravitational pull of family and moved back to be closer to them.  I searched for just the right place to practice midwifery and was delighted to discover the Minnesota Birth Center (MBC).  The philosophy of the MBC, to provide high quality individualized care and to minimize unnecessary healthcare interventions, is completely in line with my own. I am thrilled to be a member of the MBC team.

What is your birth philosophy?
I have always been passionate about woman and family-centered care. I believe women who are in a welcoming and comfortable environment and who are active participants in their healthcare, are able to process, grow, and evolve into empowered women and mothers. I also believe that providing a nurturing and safe space for women to give birth allows them to relax and feel uninhibited, enabling them to embrace their experience and make it their own. This then creates a peaceful and gentle environment into which babies can be born.

What inspires you professionally?
I feel honored to have shared in many momentous and transformative experiences in women’s lives. In particular, the transition to parenthood can be both overwhelming and empowering. Witnessing the depth of power and strength women possess in giving birth, and the subsequent transformation of who each woman and her family becomes, is a constant inspiration to me.

What is the main piece of advice you like to share with pregnant mamas?
Trust your body and the processes we go through as mothers. Remaining open and present in the moment both during birth and subsequently as a parent can help protect against feelings of fear and being overwhelmed. Becoming a mother is both challenging and beautiful. Be kind to yourself and accept help. Remember that a woman who takes care of herself is able to be a better mother and partner.

What are your interests outside of work?
Since my kids are still young, my life basically consists of being a mother and a midwife. When I am not at work I am with my little crew, going on walks, making art, cooking, and reading books. I love to eat good food, and occasionally have time to make more intricate dishes. My extended family all live n the Minneapolis area, and we get together as often as we can manage. I used to make art and hope at some point in the future my life will allow for that again. Our wheel and kiln have been sitting idly in our basement and I would love an opportunity to put them to good use again.

Do you have a family? Tell us about them?
I have a loving, supportive husband who is an amazing father to our three children: Meera and Emma who are six (twins, yes), and Emil who is just under two years old. Parenthood has been a humbling and joyous experience for me. Each of my kids are unique, vibrant individuals who, moment to moment, seem to have an innate ability to either create total mayhem or a beautiful sweet harmony. I feel so lucky to be their mom and am grateful for what they have taught me.

What is the craziest thing you have done?
Sit on a live crocodile while I was in Paga, Ghana.