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Original poster

Entonox has been suspended in some hospitals

117 replies

Soubriquet · 25/02/2023 07:24

link

It’s a hard one. I mean, on one hand I feel for hospital staff. No they shouldn’t have to be exposed to something that can cause health problems now it’s being documented. But labouring women also need pain relief and not every alternative works.

Oramorph did nothing for me
Pethadine made me sleepy
I wasn’t allowed a water birth
Epidural is known to need more interference.

I do hope a compromise is made somewhere

OP posts:
picklemewalnuts · 25/02/2023 11:13

Standing up for gas and air- it was brilliant. Had it for post birth investigations and stitching. It relaxed me and separated me slightly from what was going on.
Perhaps it's different from person to person. I totally get why kids abuse it.

But obviously can't be used unless staff are protected.

AgeingDoc · 25/02/2023 11:18

Olivia199 · 25/02/2023 10:53

Sadly not true everywhere. My risk assessment stated I couldn't work in areas using radioactive material but was absolutely fine to carry on in anesthetics. I requested a reduction in peads lists as the use of sevo via an open mask (while they're wiggling and breaking any hope of a seal) obviously increases the amount I'm inhaling. They were somewhat happy with that. But I most certainly continued to work in anaesthetics throughout my pregnancy until some non clinical time at the very end of my third trimester due to covid. Same went for all my colleagues and occupational health agreed there was no need to be isolated from the use of gasses throughout pregnant. Including first trimester.

Show quote history

What is this "risk assessment" of which you speak?!😂
Obviously I'm older, but nobody ever did any kind of risk assessment when I was pregnant to my knowledge and there were no adjustments in my work whatsoever. There were no adjustments made for pregnant doctors anywhere that I worked. It was almost like they expected us all to be...I don't know...men, maybe?
Mind you, I was also never offered any moving and handling training until the last few years of my career, which was after the decades of lifting patients in theatre and after my obviously not connected at all discectomy and spinal fusion.
In my experience, the NHS has blatant disregard for the health and safety of most of it's workforce and puts sticking plasters on the problem with so called "staff well being" programmes, whilst roundly ignoring the root causes of the problem.
I really miss treating patients, and many of my immediate colleagues but I don't miss being an employee at all. Both my physical and mental health have improved dramatically since I retired.

kenne · 25/02/2023 11:18

Pain relief is important health provision. Calling it "women's comfort" is minimising it, like it's a fluffy cushion or something.

Staff must be protected, of course. It's unacceptable that this risk has been known for so long and the steps haven't been taken to improve ventilation and make it safe.

Epidurals and morphine based drugs have potentially serious side effects for mothers and babies , so removing gas and air is effectively leaving labouring women without safe pain relief.

For me gas and air worked wonderfully as pain relief. It was not "minimal." It was vital and amazingly effective and I dread to think how traumatic my experience of childbirth would have been if I had been denied access to gas and air.

Interested in this thread?

Then you might like threads about these subjects:

Antenatal & postnatal General health
Rainbowshit · 25/02/2023 11:21

UWhatNow · 25/02/2023 11:05

‘Gas and air’ has always struck me as a pretty piss poor cheap choice for women in pain tbh. You may as well give them a stick between the teeth.

In America where people pay for and expect a decent standard of healthcare, epidurals are routine. That’s because they’re the Rolls Royce of pain relief in labour. That’s what would be in place if men gave birth but no, British women have been fobbed off with third rate, cheap as chips gas and air since the 1950s.

That’s the scandal.

Epidurals are offered too. I had no desire to have an epidural. Gas and air worked perfectly well for me.

Rainbowshit · 25/02/2023 11:21

kenne · 25/02/2023 11:18

Pain relief is important health provision. Calling it "women's comfort" is minimising it, like it's a fluffy cushion or something.

Staff must be protected, of course. It's unacceptable that this risk has been known for so long and the steps haven't been taken to improve ventilation and make it safe.

Epidurals and morphine based drugs have potentially serious side effects for mothers and babies , so removing gas and air is effectively leaving labouring women without safe pain relief.

For me gas and air worked wonderfully as pain relief. It was not "minimal." It was vital and amazingly effective and I dread to think how traumatic my experience of childbirth would have been if I had been denied access to gas and air.

Agree with all of this.

RosaBonheur · 25/02/2023 11:30

Most French hospitals don't have entonox, because nearly all labouring women have an epidural. They consider that there is no need for gas and air when real pain relief is available. They don't have higher rates of instrumental delivery or C-sections.

I suspect that the NHS encourages scare stories about epidurals which aren't evidence based and promotes "natural" childbirth because it is cheaper than staffing maternity units with dedicated anaesthetists and giving all labouring women access to proper pain relief. And it seems their own staff are paying for it with their health too.

Namechange828492 · 25/02/2023 11:33

I had an epidural which i really hated and 2nd time g&a which was great. If it's not safe for midwives it must not be used.

supercalifragilistic123 · 25/02/2023 11:37

This has been coming for a long time. I'm sorry for labouring women who will no longer have access to gas and air but the health of staff has to come first.

Many countries in Europe and of course the US don't use G+A for this reason.

Hopefully they'll find a new, better form of pain relief for labour.

CjCreggsFish · 25/02/2023 11:42

kenne · 25/02/2023 11:18

Pain relief is important health provision. Calling it "women's comfort" is minimising it, like it's a fluffy cushion or something.

Staff must be protected, of course. It's unacceptable that this risk has been known for so long and the steps haven't been taken to improve ventilation and make it safe.

Epidurals and morphine based drugs have potentially serious side effects for mothers and babies , so removing gas and air is effectively leaving labouring women without safe pain relief.

For me gas and air worked wonderfully as pain relief. It was not "minimal." It was vital and amazingly effective and I dread to think how traumatic my experience of childbirth would have been if I had been denied access to gas and air.

So as long as you are ok you're happy for staff to be infertile and have miscarriages? Cool cool

Saffronpotatoes67 · 25/02/2023 11:44

RosaBonheur · 25/02/2023 11:30

Most French hospitals don't have entonox, because nearly all labouring women have an epidural. They consider that there is no need for gas and air when real pain relief is available. They don't have higher rates of instrumental delivery or C-sections.

I suspect that the NHS encourages scare stories about epidurals which aren't evidence based and promotes "natural" childbirth because it is cheaper than staffing maternity units with dedicated anaesthetists and giving all labouring women access to proper pain relief. And it seems their own staff are paying for it with their health too.

Great post! One hundred per cent this! ^^

Barannca · 25/02/2023 11:44

in America where people pay for and expect a decent standard of healthcare, epidurals are routine
Women can chose an epidural in the UK if they want one but many chose not to for valid reasons.

RosaBonheur · 25/02/2023 11:48

Barannca · 25/02/2023 11:44

in America where people pay for and expect a decent standard of healthcare, epidurals are routine
Women can chose an epidural in the UK if they want one but many chose not to for valid reasons.

Many women in the UK choose not to have an epidural because they have been fed a load of absolute cock about it increasing the risk of instrumental delivery and emergency C-sections, and about natural childbirth being preferable.

And many women in the UK who ask for an epidural are told it's too early, or too late, or they're being a wuss and don't need one, or just kept waiting until they're already pushing and it really is too late.

Jedstre · 25/02/2023 11:53

I had no idea about the issues around Entonox and the risks to staff.

Newcastle hospitals are using a machine designed to collect and destroy residual nitrous oxide from exhaled gas and air. It’s very much touted as being better for the environment with one mention of benefits to staff by reducing exposure. I’ve got no idea how widely this is being used in the department or how costly it would be for other Trusts to move to this technology (if it is indeed as safe as the article is suggesting)

www.newcastle-hospitals.nhs.uk/news/newcastle-hospitals-become-first-in-the-uk-to-use-climate-friendly-gas-and-air-during-labour/

OntarioBagnet · 25/02/2023 11:54

Soubriquet · 25/02/2023 11:00

Entonox for home birth is still ok as there is decent ventilation

Show quote history

I’m not sure opening a window is sufficient. What about in the winter when the labouring woman says shut the window it’s cold? I think home birth is worse as definitely no scavenger system.

Toffeeappler · 25/02/2023 12:03

CjCreggsFish · 25/02/2023 11:42

So as long as you are ok you're happy for staff to be infertile and have miscarriages? Cool cool

Show quote history

This is a false dichotomy.

It is entirely possible for staff to be kept safe AND women to have access to a wide range of effective pain relief, but most NHS Trusts are either sweeping the issue under the proverbial carpet by not protecting staff and/or penalising women in pain by removing options, rather than spending the proper money required to make labour units safely ventilated.

Misogyny within healthcare is rampant; this is just one example. Please see the issue for what it is and stop attacking women for wanting proper care when there is a fix available- it costs but surely we are worth it.

DrSalome · 25/02/2023 12:06

Oh gosh. Terrible if staff are being exposed to damaging chemicals, and obviously not acceptable. But I'm shuddering at the thought of birth without gas and air. None of the other options allow you to actually birth in a relatively natural way.

kenne · 25/02/2023 12:10

@CjCreggsFish I don't think you read my post too carefully if that's what you think

AgeingDoc · 25/02/2023 12:14

it costs but surely we are worth it
But is the planet not also "worth it"?
That's the main reason why other countries don't use nitrous oxide and the environmental effects aren't negated by better ventilation.
As an anaesthetist I stopped using nitrous oxide in all but a few specific circumstances over a decade ago and many of my younger colleagues have never used it at all. It's a useful drug, but it has significant downsides and I think it's only a matter of time before it becomes obsolete.

Toffeeappler · 25/02/2023 12:19

AgeingDoc · 25/02/2023 12:14

it costs but surely we are worth it
But is the planet not also "worth it"?
That's the main reason why other countries don't use nitrous oxide and the environmental effects aren't negated by better ventilation.
As an anaesthetist I stopped using nitrous oxide in all but a few specific circumstances over a decade ago and many of my younger colleagues have never used it at all. It's a useful drug, but it has significant downsides and I think it's only a matter of time before it becomes obsolete.

Ok. I assume then you actively campaign for greater / quicker access to other forms of pain relief for labouring women at each stage of labour?

RosaBonheur · 25/02/2023 12:20

DrSalome · 25/02/2023 12:06

Oh gosh. Terrible if staff are being exposed to damaging chemicals, and obviously not acceptable. But I'm shuddering at the thought of birth without gas and air. None of the other options allow you to actually birth in a relatively natural way.

What do you mean by giving birth in a relatively natural way?

fyn · 25/02/2023 12:21

@RosaBonheur exactly, I asked for an epidural with my first because gas and air did absolutely nothing at all for me. It took three hours for the anaesthetist to arrive after the midwife made me have a bloody paracetamol first, then diamorphine. By the time they got the needle in my back the baby started to come.

With my second it was an induction and I told every midwife that came in the door that I wanted an epidural repeatedly. They said, ‘oh you won’t need one, I know you can do it without’. Thankfully I was insistent because I was in labour for nearly two days and was exhausted. I dread to imagine two days without it. Epidural isn’t a real option, they try to put you off at every turn.

kenne · 25/02/2023 12:22

AgeingDoc · 25/02/2023 12:14

it costs but surely we are worth it
But is the planet not also "worth it"?
That's the main reason why other countries don't use nitrous oxide and the environmental effects aren't negated by better ventilation.
As an anaesthetist I stopped using nitrous oxide in all but a few specific circumstances over a decade ago and many of my younger colleagues have never used it at all. It's a useful drug, but it has significant downsides and I think it's only a matter of time before it becomes obsolete.

There's a link up thread to a unit that neutralises the exhaled gas and makes it environmentally friendly (as well as safe for staff).

I'd rather they looked for solutions that don't involve removing pain relief for women in labour.

Mummyof287 · 25/02/2023 12:27

endofthelinefinally · 25/02/2023 08:05

Expiration, leaks and tanks cause the highest ambient levels, piped systems are apparently better. That was what the 1980s reserch concluded. It was in the BMA. I can't remember exact details but I looked it up when 3 of us miscarried at 12, 13 and 14 weeks. At work on the labour ward. In a 6 week period.

So they knew about the risks in the 1980s, yet only now in 2023 are they taking action....wtf?!?!

Original poster
Soubriquet · 25/02/2023 12:32

I agree that if they are stopping entonox, they need to stop telling women they can “cope with out an epidural”.

However, I also know there is staffing issues when it comes to administering them. So there needs to be a compromise here

OP posts:
DrSalome · 25/02/2023 12:35

@RosaBonheur I was labouring for a long time and wanted to stay on my feet and moving around, that's what I meant by natural. Possibly not the best term (and not what everyone wants obviously) but it was crucial for me, and only possible because of gas and air.