A new interest in self-administered nitrous oxide for labor analgesia has emerged in recent years in the United States. It has been used widely in Europe for decades, with favorable results. The American College of Nurse-Midwives published a position statement in 2010 supporting the practice of self-administered nitrous oxide as an additional analgesia choice for laboring women. Recent literature on this subject has been directed toward midwives, obstetricians and/or anesthesiologists, with little emphasis for labor and delivery nurses. This article presents highlights of nursing care for women using self-administered nitrous oxide during labor and birth.