April 14, 2004

Entonox research

A large package of information arrived for me today from our UK office. It contained a number of research papers, reports and package insert information regarding the use of Entonox (nitrous oxide and oxygen), the “gas” often used for easing labour pain.

The information has been gathered by a British midwife who is concerned that midwives are offering labouring women this gas, unaware of the implications for themselves. This midwife, who wants to remain anonymous at this point, has herself experienced unwanted effects from the gas, and feels that her employers are not taking her concerns seriously. She has embarked on a mammoth effort to uncover everything that she can about the uses and effects of this drug, and has forwarded copies to me so that I can write it up for publication in a suitable midwifery journal. She wants her colleagues warned of the health risks of being exposed to nitrous oxide on a regular basis, as happens in British labour wards (and many Australian ones as well).

At the same time, the makers in Britain, BOC Gases, have begun an advertising campaign to promote its use. It is hard to imagine why this might be necessary, because it is a staple measure for managing pain in all British hospitals, and is even used at home births and during water births. Apparently they feel that midwives are not using it correctly, and recommend that women be encouraged to start breathing it before the contractions start, rather than waiting for the contraction to begin, as has been the practice to date. This would mean that women would inhale a larger quantity of the gas, in anticipation of contractions. It would also mean that the air in the room would have a greater level of gas circulating, from the machine itself and also from the exhalations of the labouring woman.

It will take me some time to sift through this interesting material and to pull and article together. Whilst I am concerned about the effects that this drug has on midwives (and who only receive it indirectly) the effects on the woman using it, and her unborn baby also need to be exposed. The lack of research on the effects on newborns has been the basis of statements that “it is safe” for the unborn, but in my mind this is a false claim. Just because there is no research does not prove safety, it proves that we don’t know, because no investigations have ever been undertaken.

I am looking forward to sifting through this pile of information, and to checking the various websites that have also been suggested as useful sources of background details. This is one project that will go to the top of my “urgent” list. I will keep you posted.

Posted by andrea at April 14, 2004 08:06 AM