Entonox has been suspended in some hospitals

[Soubriquet]

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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

I was too scared to have an epidural for 1st and after hearing the negative effects of pethadine just had gas and air.I had a very difficult labour.After i had to have a spinal block for stiches, so may aswell have had the epidural tbh!
They were very reluctant to let me have an epidural for 2nd baby, pushing me to have pethidine instead.I declined that and eventually got the epidural, which whilst horrific when it was administered (I think they gave it too late as I was in so much pain I could barely sit still) once took effect was a game changer! Pushed baby out with literally no pain, and had a much more positive low stress birth.

I didn't know anything about this. When I finally got gas and air, post 7cm, I took a long breath in then breathed it out without the mask like I had during ECV, and the midwife kind of shouted at me that I had to keep the mask on without giving me any reason and I was wound up and probably non co-operative. I now wonder if she was trying to minimise risk to others and I hope I didn't cause anyone any harm, think I was on it for about 10 hours before the epidural turned up.

If there's an increased risk to others from not using the mask constantly then they really should communicate that in birth planning, NCT courses etc, so you know how to use it properly when the time comes as during labour is not a good time for taking on new and emotional information.

Pethodine and Entonox are not pain relief.

Hospital trusts need to be held accountable for all the deaths of unborn children and fertility issues that they have knowingly caused.

My trust regularly tests what staff are exposed to, we found 2 rooms were incredibly high. They invested in better scavenger systems and ventilation. It’s still tested regularly and is all good now.

There's no reason why you can't do that with a well dosed epidural.

In my first labour I had an epidural which completely took away the contraction pain but left me still able to feel everything else. I didn't go wandering off down the corridors but I was able to get into different positions on the Swiss ball, and stand up to lean on the bed and circle my hips during contractions. I ended up having an EMCS for unrelated reasons (was heading that way even before the epidural in retrospect).

In my second labour I spent all night moving around, getting into different positions, in and out of the bath tub, circling my hips, music, essential oils, dim light, the works. I then had an epidural at about 9:30am and asked the anaesthetist not to put too strong a dose in because I wanted to remain mobile. I then lay down on the bed for an hour to have a nap. The doctor came back to examine me an hour later, after which point I was planning to get up and start moving around again, but in that time I had fully dilated and was almost ready to push. I could still feel the (almost painless) contractions, getting lower and lower down, and then I started to feel enormous pressure in my pelvis, then I got the uncontrollable urge to push. I only pushed for about five minutes in the end.

So I've never given birth without an epidural, but during my VBAC I did and felt all the things you're not supposed to be able to do or feel after an epidural. Except the pain.

Not my field, I leave obstetric matters to those who have interest and expertise in them. But there will be alternatives, and clinging to "but we've always done it that way" doesn't help get them.
I was brought up believing that nitrous oxide was an integral part of a general anaesthetic. Yes, it had some downsides but you couldn't really do without it so tough luck. I was very sceptical when people started talking about not using it and initially it was only a few whippersnappers or the odd hippie who didn't. It took a lot to persuade me to join them. But it's mainstream not to use nitrous now and even this old dog learned new tricks late on in her career.
Large parts of the developed world have done away with nitrous oxide already and they seem to manage ok. It will happen here eventually - it's bound to. Spending a fortune on reducing the risks of nitrous at this stage strikes me as being a bit like companies developing better diesel when the writing is clearly on the wall for the internal combustion engine. It might be a help short term but it's not the answer ultimately. So yes, it would be better to put that money and effort into developing alternatives in my opinion.* *

@RosaBonheur gosh that does sound pretty good! I wasn't in hospital though, so no epidural available. And I had zero pain when crowning though I realise that was very lucky.

@DrSalome Obviously a non hospital birth is a different kettle of fish, but I think women in the UK are encouraged to believe a lot of things about epidurals which aren't necessarily true to put them off asking for one. Because if everyone had one, the NHS would need to invest more in anaesthetists.

When I moved to France I was scared of giving birth here because I knew there was no gas and air so it would be epidural or nothing and I believed all the scare stories I'd heard about epidurals. But I've come to realise that the overwhelming majority of women I know who have given birth here have had straightforward vaginal births under epidural. The only French woman I know who has had a very traumatic birth was induced and the pessary worked so fast that she went from zero dilation to pushing in 20 minutes and didn't have time for the epidural. But out of the women I know who have given birth in the UK, quite a few have had traumatic births.

Here here. Was just about to post the same. Women are fed a line about ‘natural’ being wholesome and heroic to save the NHS money.

I've had three births in a country that doesn't use gas and air.

The first was a long labour and I was encouraged to have an epidural. It worked like a dream pain relief-wise but my labour rushed ahead and then stalled after having it. I ended up with a syntocin drip, an episiotomy and a ventouse, and a PPH (all managed very well so I had a quick recovery and didn't feel traumatised). I've no idea of the role of the epidural in all that but I found the complete switching off of the pain a bit disorientating and I decided I wouldn't have one again. The next two were completely without pain relief, one of those also a ventouse. That happened half an hour after arriving at the hospital (I hadn't realised how far on I was) and the third was very fast indeed (though I was already in the hospital as being induced) so although they were very painful they were quick enough not to have been too bad. I don't know how I'd have felt had they been more drawn out, but I'm not at all sure an epidural is always the answer and I certainly wouldn't have wanted to feel it was a matter of course.

Given these risks (which I also had no idea about), I just don't feel G&A is acceptable to use, though.

The country where DD was born only gave the option of gas and air if you went private. None of the public hospitals used it. Fortunately she came out fairly quickly so the need to have an epidural never arose.

I have never heard of this issue before. It must be very worrying for female HCPs.

I can't believe this isn't widely known. It's an absolute scandal. I had no idea. Like others I had three entenox only births which was all I needed, epidural was never even uttered.

My child bearing days are over now but I think I'd feel very uncomfortable using G&A now armed with this new information despite the fact I fell in love with the stuff 😅

The thought that staff are put at risk with no choice but to deal with it is appalling. It sounds like an overhaul is long overdue.

Ah see they ARE on top of the paperwork.. think how many incidents they can get away with by saying "we did a risk assessment". Essentially it's printed off the trust net and the same for everyone. They give you a copy and that's it done. Responsibility out of their hands as they've done the paperwork.
Similar to us, no adjustments made other than here and there when I asked to swap lists with colleagues. (A longer case being very much appreciated here and there!)
It's similar now with manual handling. It's a tick box every year so when things happen, it isn't on them because "the staff have had training". I love my role but have to agree with the observation that as a whole, we are hardly seen as human, let alone treated as such.

It must be very worrying for female HCPs
There's also at least one study (albeit an old one) demonstrating an increased rate of reproductive problems in the female partners of male anaesthetic staff. Obviously it's more of a concern for women, and a high proportion of the at risk staff are female, but men are at risk too. Maybe it would have been taken more seriously earlier on if more men realised?
But there are quite a few very good reasons for change, and better late than never.

@Girasoli I gave birth in Italy and it's not used at all but I don't know if it's because of this. I got the impression that it was down to (Catholic) cultural reasons as well as a desire to save money! I wasn't given any pain relief the first time I gave birth (induced - ouch!) Second time round I had a csection and still wasn't given any pain relief until I complained and was given 2 paracetamol!

Perfect example of the lack of care the NHS towards its staff and the lack of interest and investment in women's healthcare. Absolutely outrageous.

Bloody well hope it’s not taken from my local hospital. I’ve needed it so many times and it always works for me. Infact I had some 2 weeks ago for a colonoscopy.

I agree health staff mustn’t be put at risk but there are some very dismissive conments on this thread about the use of gas and air which I think are unpleasant. Although it doesn’t work for everyone, for many women it really does facilitate a good birthing experience.

Absolutely, steps should be taken so it can be a choice for women again, as soon as possible, but until that’s been done suspension seems like the right decision.

I personally found it did nothing except make me feel sick (so frankly was worse than nothing!) but many women feel it’s important so it should be available for them if they think it’s going to make a difference.

It’s banned in the Middle East too. The UK must be one of the only countries left still offering this?

Respect the need to ban it for the staffs sake but I want that gas and air I'll labour in the car park outside

Not in my Trust!

I wasn't aware of the risk presented by entonox to hospital staff until relatively recently and by then had already used it extensively for two out of my three births.

Obviously staff must be kept safe and it is beyond frustrating that so little seems to have been done when apparently the risk has been known about in some circles for a long time. Staff are exposed to the gas daily, and not just in obstetrics.

I had just about all forms of pain relief one way or another while giving birth.

1. Pethidine - only just took the edge off for a while and probably was what made that DD1 so sluggish to start feeding after birth (midwives said that).

2. Epidural for ages worked only down my right hand side and left a huge window of agony down the left. That went on for hours (with me having to rely on entonox) until for some reason a top up suddenly worked and all pain stopped. I had this with two epidurals administered about seven years years apart (births of DD1 and DD3).

For DD2's birth there wasn't time for an epidural or anything else by the time I felt the need as the delivery was so close. So entonox it was.

Obviously money needs to be put in here to find and set up solutions, and it does seem that there might be some solutions out there. Good luck getting this government to spend money on anything though.

I was induced with both my DS and was told l was only allowed entonox for painrelief due to my medical history. If l needed a section, it would have been under GA.

Thankfully it was very effective for me and l laboured really well with it.

Dh is an Endoscopist, they use Entonox every day in his unit. He says the air exchange system is apparently “good enough”. They don’t actually have a scavenging system. I’ve just asked him if anyone ever checks the levels, he says no.

hmm.. worrying.