Gas and air cut off in some hospitals for expectant mothers

Mothers-to-be will find it harder to get pain relief gas as hospitals suspend its use over concerns about the safety of midwives.

A hospital in Essex has become one of the latest to ban pregnant women from inhaling nitrous oxide over fears medical staff are being exposed to high levels for prolonged periods.

The tasteless and odorless gas has been used as a labor pain reliever for more than a century and became widely available to women in labor in the early 20th century. While safe in small amounts, long-term exposure to unsafe levels can be dangerous, leading to infertility, vitamin B12 deficiency, and nerve damage.

In January, The Princess Alexandra Hospital in Harlow, Essex, suspended the use of the gas, depriving expectant mothers of vital pain relief, such as Amy Fudis.

Ms Fantis, a hairdresser, told the Sunday Times that the gas withdrawal was causing her anxiety and described it as “madness”.

“It’s not available to everyone and I might not get it. My birth can only be 40 minutes. It’s a stress you don’t need. I understand they need to protect midwives, but to take it away seems crazy. It’s the poor moms who pay the price,” she said.

Other hospitals shut off natural gas

The gas, given under the trade name Entonox, is mixed with oxygen and is more commonly known as gas and air. It is breathed in through a mask or mouthpiece as contractions begin and takes 15 to 20 seconds to work. While it doesn’t take away all the pain, it can make it more bearable.

Dr Alex Field, head of department, consultant obstetrician and gynaecologist, at Princess Alexandra Hospital NHS Trust, was quoted by The Guardian in late January as saying: “We have temporarily suspended the use of Entonox across the maternity unit to protect obstetric and medical our team.”

The hospital follows others in suspending the gas amid the discovery of nitrous oxide levels 50 times above the safe limit, such as Watford General Hospital.

The Queen Elizabeth Hospital in King’s Lynn was also found to have high levels of nitrous oxide due to poor ventilation in some rooms.

The findings came in a BBC investigation which found 11 notifications to Health and Safety between August 2018 and December 2022 from seven NHS trusts and one private hospital in relation to nitrous oxide – almost all of them involved maternity units.

Installation of air cleaners

Because nitrous oxide is heavier than air it collects in clouds, usually at ground level, experts say. Midwives may be exposed to long hours of nitrous oxide-laden air in rooms with closed doors to ensure the laboring woman’s privacy.

One way to break this is to install air cleaners, which Watford General has now done.

Princess Alexandra Hospital has also bought machines, which take exhaled gas and break it down into nitrogen and oxygen, but only three are available, the paper said.

Ipswich Hospital has turned the gas back on after installing new ventilation units.

An NHS England spokesman said: “NHS England is working with Trusts where gas and air supplies have been affected due to different and localized issues – this is not a widespread issue and patients should continue to access services as normal.”

West Hertfordshire Teaching Hospitals NHS Trust chief nurse Tracey Carter said: “Maternity safety champions and the estate team have been closely monitoring nitric oxide levels since we became aware of the issue in October 2021. Our estate infrastructure means that we cannot put a mechanical ventilation system in place, but we have installed machines that effectively remove waste anesthetic gas from the delivery rooms to ensure safety for patients and staff.”

BOC, which supplies nitrous oxide to Princess Alexandra Hospital, has been contacted for comment.

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