To think women should be free to choose whatever pain relief in labour suits them without having to consider the environment

[FannyCann]

A colleague brought this article in to work today and it made me furious.

Apparently if women in labour would base their choice of analgesia in labour on the environment they should choose an epidural which has a far lower carbon footprint.
Using Entonox for four hours is the equivalent of driving 850 miles whilst an epidural is equivalent to just four.

It just reads like male doctors scolding women for wanting a simple safe form of pain relief when instead they could burn up manpower resources by demanding epidurals. They haven't considered where all the anaesthetists are meant to come from to provide epidurals for all!

Three female obstetric anaesthetists quite rightly responded in the letters that mothers shouldn't be guilt tripped about their choice of analgesia in labour.

Gas and air in labour ‘harms the planet’.

https://www.thetimes.co.uk/article/3d011450-e354-11ec-8bdd-c253e043f5f0?shareToken=3d20235d87acf65d1bda38d59ef587e11_

I recall a male midwife writing something to the effect that western women didn't know how lucky they were using multiple gallons of water for a water birth whilst in Africa women walked miles every day to carry a small pot of water back to the home for cooking and drinking.

What a surprise that it was a bloke.

In a situation like this, the onus is on scientists to come up with equally effective and more environmentally friendly pain relief, not on women to just suffer for the good of the world.

Yes. My midwife said “the anaesthetist is passing, if you want one let me know”.
I had been induced perhaps 3 or 4 hours previously. Was finding it all quite painful but it wasn’t unbearable.

This was 2016. It was the right decision for me. I had no idea they were so hard to come by for so many people!

I absolutely agree women should be entitled to whatever pain relief they want, and should not feel guilty. There are lots of things we could do better on with the environment without subjecting women to even more suffering in birth.

That said, I don’t have a problem with the information being out there. Not so women can have their choices restricted, but it might be relevant to certain women in what choices they make. For most, I suspect it’s irrelevant but I don’t think it was wrong to do a study on it.

I think it greatly depends on how this fits in with the overall environmental objectives of any medical/hospital organisation surely?

I have no idea how this relates or contributes to the carbon footprint of a regular NHS hospital and doubt many do either. If it's significant in achieving targets then it's not unreasonable. If it's not significant, it's still not unreasonable to consider the environment but unreasonable if other aspects have greater impacts and they're not being addressed.

Sadly, choice of pain relief doesn't trump how bad a chemical may be. Especially when thousands of babies are born every year. If it's genuinely bad to produce/use then it'll be outlawed and rightly so. If this is just some blokes being dicks to women then it'll come out.

The piece mentioned some new bit of kit which destroyed the exhaled nitrous oxide rather than venting it. That sounds like a good way forward.

When we start doing operations on mens balls without pain relief, then I will take this seriously.

Women seem to be expected to put up with pain generally.

I did too, my epidural failed after the first (glorious) dose so had to use gas and air as well as the 2 or 3 more epidural doses I had, for 25 hours plus maybe a couple of hours after the birth because I had a pph and them sorting that out was more painful than most of the labour, then they forgot to take it off me.
That's probably a lot of driving miles but I don't drive at all so maybe it's balanced out.

They do, but it always seems to be women who have the most pressure on them to change their behaviour - eg sanitary protection too.

Nobody will tell men that they should choose different pain relief for the sake of the environment.

Anyway I drive a hybrid, not a full petrol car so I suspect over the life of the car so far I've offset the gas and air when having ds.

Having a baby is bad for the environment, and condoms are throw-away so maybe we just need to have less sex?

There are easy wins for the environment but pain relief is not one of them.

I get very pissed off with individual "save the planet" propaganda.

It's governments and companies who should be changing their ways. The difference I can make is marginal. I'm not going to make my life less comfortable until I see large organisations doing something that may damage their profits but will save the planet.

Women seem to be expected to put up with pain generally

yes and by other women. See also painful periods and slagging off other women for being "too posh to push".

That said, I don’t have a problem with the information being out there. Not so women can have their choices restricted, but it might be relevant to certain women in what choices they make. For most, I suspect it’s irrelevant but I don’t think it was wrong to do a study on it.

Yes it's fine to look at the use of medical gases generally and their impact, and regarding entonox in maternity I had thought the scavenging systems were widely used not so much for environmental reasons but for health and safety to protect midwives from breathing it in continuously as they care for their patients but maybe I thought wrong?

It was the tone of the article that annoyed me as it really felt like men scolding women for their choices. It's also ridiculous to suggest that women should choose epidurals instead of entonox to protect the environment due to the other factors relating to epidurals including requiring more anaesthetists, closer monitoring, increased intervention. By all means look at the impact of entonox but don't tell women they should have an epidural instead. Although epidurals are generally very safe they are not without risk and entonox is very safe and simple to use.

My mother who had 4 children (of which I'm one of them) was always told, while she was in labour, to "offer it up". When she enquired as to what she was to be offering up and to whom, it was her pain and to God.
This was in the 1960's and '70's in good old Catholic Ireland.

I agree with the OP - if a woman needs pain relief, give her the pain relief. End of.

🤣

I heard this a few years ago and I refused gas and air as a result. So I have no problem with the information being available. It's not like I was forced to make that choice.

Ended up having an emergency spinal and would definitely consider an epidural in future.

In France they don't use gas and air because they think it's a complete waste of time. They don't understand why anyone would bother with it when proper pain relief is available. Having had an excellent epidural in labour, and then some very underwhelming gas and air in A&E a few months later, I'm inclined to agree.

That would have meant I was allowed no pain relief at all in labour as my blood condition means I can't have epidural or any of the opiates.

Fear not, science is already on the case so that medical use of entonox can continue with reduced harm to the planet; www.medclair.com/en/mdu

Yeah if women were really that bothered about the environment, they wouldn't be having a baby in the first place!!

I was going to try and say something serious, but on reflection offsetting is def the way forward.

So many twats we can all stop visiting AND be supporting labouring mothers. This needs to be a world-wide campaign!

Yes, there's a cultural context here that's very troubling.

I didn't read it as an attack on women in labour, more just comparing the environmental impacts of different substances, which is interesting. I think though if somemanone had told me to think of the environment whilst in labour, then I would refer him back to @thelastshadowpuppet's question about the carbon footprint of a broken nose.

My understanding is that the wastage of nitrous oxide by NHS causes far more environmental damage that the actual usage.
So they can fix that before recommending that women have additional procedures with higher risk to 'save the planet'

sustainablehealthcare.org.uk/what-we-do/sustainable-specialties/anaesthetics/nitrous-oxide-project

Surely a drop in the ocean compared the environmental impact of adding a new human to the planet!

No-one would expect men to undergo a major painful event like childbirth without pain relief.

You get this with asthma inhalers too. I take the one my consultant recommends for my difficult to control asthma. I need it to live. There's always someone who wants to wring their hands over the environmental impact of them though.

What’s the carbon footprint of a patient being put under general anaesthesia? Surely men having genitourinary surgery could have an epidural instead? Think of the savings.