Irish women worried about carbon footprint of ‘laughing gas’ used during childbirth

The bedside mix of oxygen and nitrous oxide is one of the commonest forms of pain relief during birth but Irish mothers are concerned about the mixture due to its carbon footprint.

Nitrous oxide — commonly called laughing gas — accounts for the largest carbon footprint of anaesthetic gas, with a global warming potential of around 265 times of carbon dioxide.

A new study of maternity staff and postnatal women at the Coombe Hospital in Dublin, found knowledge of the greenhouse effect of the potent gas used in labour was low.

Researchers said the carbon footprint associated with the average amount of nitrous oxide used per delivery was equivalent to driving approximately 1,500km in a typical petrol-engine passenger vehicle.

The study, published in the European Journal Of Anaesthesiology, involved 100 women who had given birth two days earlier and 50 health staff in the Dublin hospital.

“After receiving information, 46pc of patients were more inclined to seek epidural or request it earlier (54pc) to limit their nitrous-oxide use,” the study said. It found 51pc would choose an alternative painkiller to avoid nitrous oxide altogether.

“Overwhelmingly, 99pc believed they had the right to know about these harmful effects when choosing an analgesic option,” researchers said.

The study said climate change was the single biggest global health-threat of the 21st century.

“Nitrous oxide accounts for the largest carbon footprint among our use of anaesthetic gas. Despite recent curtailment of its use, it remains extensively employed as an analgesic for women in labour,” they said.

The study said about 4.4pc of net greenhouse gas emissions were attributable to healthcare activities.

They said inhaled anaesthetic agents such as nitrous oxide, sevoflurane and isoflurane accounted for up to 5pc our healthcare carbon footprint.​

Nitrous oxide was “the single most important contributor towards stratospheric ozone depletion today, and in addition, accounts for approximately 6pc of all anthropogenic global warming”, the study said.

In contrast to the high carbon-footprint of gas nitrous oxide, four hours of pain relief with an epidural is equivalent to driving 7km while two injections of morphine were equal to driving 500m, the Association of Anaesthetics said, .

Despite the reduction in nitrous oxide use within anaesthetic theatre practice in recent years, the researchers said it continued to be employed extensively during labour.

The research said Entonox, a mixture of 50pc oxygen and 50pc nitrous oxide, was used by up to 75pc of women as a painkiller during labour.

In 2021, more than 8,000 deliveries took place in the Coombe with 41pc involving an epidural, but data on nitrous oxide-assisted deliveries was not recorded.

A total of 100 post-natal women who underwent vaginal delivery in the labour ward completed the survey on their knowledge of the environmental effect of the gas in 2021.

“Regarding their concern for the environment, 82pc of participants rated their degree of concern as moderate to extreme, while only 5pc claimed to have no concern at all,” the study said.

In all, 89pc of women opted for some form of painkiller, it said.

The HSE said it would reflect on the findings and engage with the hospital as required.

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