There's No Need for Supplemental Oxygen During Labor, Study Finds

woman with an oxygen mask on

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Key Takeaways

  • Providing supplemental oxygen during labor has been recommended since the 1960s.
  • Hospitals typically supply oxygen to regulate the baby’s heart rate and prevent complications.
  • A recent study points to it being unnecessary.

Women have been receiving supplemental oxygen during childbirth for over 50 years, a practice recommended by the American College of Obstetricians and Gynecologists to aid a fetus in distress. A new study published in JAMA Pediatrics casts doubt on the usefulness of this practice.

The analysis reviewed existing oxygen studies, and found no significant benefits for babies delivered with oxygen compared to those who were delivered without it. 

The Study

Researchers reviewed the data from 16 studies that took place between 1982-2020. The analysis of 2,052 births included an evaluation of pH level, NICU admissions, and Apgar scores—a measure that evaluates newborn health the first few minutes after birth. Babies are scored based on their heart rate, respiration, and anything else that could indicate poor health.

Even though two-thirds of women are given oxygen, it benefits some, but not everyone. According to the study's lead researcher, Nandini Raghuraman, MD, "Overall, the studies produced mixed results. Fetal monitoring can indicate a possible abnormal issue such as oxygen deprivation, but about 80% of the time, women giving birth fall into an intermediate category, in which cases are not completely benign but also not high-risk. And in cases such as these, supplementing oxygen offers no additional benefits.”

Nandini Raghuraman, MD

Comparing the health of the babies whose mothers received oxygen and those whose mothers didn't, we found that the differences were essentially zero.

— Nandini Raghuraman, MD

Not only is supplemental oxygen potentially unnecessary, but it may also add another expense to the exorbitant fees associated with childbirth. Raghuraman takes the study findings into account in her own work at Barnes-Jewish Hospital, where she delivers babies. She explains, “We’re being more judicious about giving supplemental oxygen to women during labor.”

While this practice does increase oxygen transfer to babies, it is not “significant,” leading Raghuraman and another researcher to the conclusion that it is safe to discontinue. For women undergoing caesarian sections, more research is needed to determine if oxygen is necessary, as well as if using oxygen for a long period of time can be harmful.

What's the Point of Supplemental Oxygen? 

Renee Wellenstein
, DO, OB/GYN, and functional medicine doctor from New York, explains that she is a firm believer in using oxygen. “Oxygen for laboring women may be of significant benefit and certainly can be of no harm if a non-reassuring fetal heart rate pattern is present," says Wellenstein.

Renee Wellenstein, OB/GYN

While a number of factors can be the cause of fetal heart rate decelerations during labor, the basic concept is that there is a problem with adequate blood supply to the fetus that may be correctable simply by administering oxygen to the laboring woman.

— Renee Wellenstein, OB/GYN

Wellenstein continues, "While a number of factors can be the cause of fetal heart rate decelerations during labor, the basic concept is that there is a problem with adequate blood supply to the fetus that may be correctable simply by administering oxygen to the laboring woman and increasing the oxygen concentration in the maternal blood supply to the fetus.” 

During delivery, the baby’s heart rate and mother’s contractions are monitored. If the baby’s heart rate seems to be erratic or distressed, oxygen is administered in an attempt to rectify it. A mask also is put on moms to correct hypoxia, low blood oxygen that can be fatal and/or lead to developmental complications for babies.

Wellenstein believes that oxygen can make delivery less traumatic. “It is a worthy effort if it remedies the problem causing the non-reassuring fetal heart rate pattern and saving the mother from an assisted vaginal delivery-using a vacuum or forceps, or C-section." 

What This Means for You

While researchers found no significant benefit attributed to using oxygen during delivery, there are very few studies that point to any sort of harm from having mom breathe from a mask instead of “room air.” This information shouldn't deter you from using supplemental oxygen, just know that it's not medically mandatory.

1 Source
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  1. Raghuraman N, Temming LA, Doering MM, et al. Maternal oxygen supplementation compared with room air for intrauterine resuscitation: a systematic review and meta-analysisJAMA Pediatr. Published January 4, 2021. doi:10.1001/jamapediatrics.2020.5351