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Risks of exposure to Entonox

I have started reading the research regarding the use of Entonox and its impact on care givers, in preparation for writing an article for publication. It is clear that there is increasing concern about the impact of exposure to this chemical (Nitrous Oxide) by midwives, with evidence from several studies revealing that the majority of midwives, where Entonox is used, have chronic levels in their system, even when they are not directly exposed through contact with women using it in labour. It seems that Entonox does not disperse easily in the air, and tends to form “clouds”, especially in areas that are not well ventilated such as many labour rooms. Once I have the full article written I will publish it on our Web site and let you know when it is available.

None of the research studies that I have read mention the potential impact of Entonox and Nitrous Oxide on women and babies, although the package inserts available from BOC Gases (the major manufacturer of this product around the world) state that there are potential hazards for the woman and her unborn baby. It seems that once again, the pregnanct woman and her child are invisible.....

One alarming note that I read in the information supplied by BOC Gases states forcefully that Nitrous Oxide and Entonox should NEVER be carried in a car because of the risk of leaks and the potential to cause a fire if there is an ignition source. This is something that British midwives will need to note carefully because they routinely take Entonox to home births, transporting it with their other equipment in the boots of their cars.

Of course, none of this will be of any interest to midwives in Europe or the Americas. Nitrous Oxide has never been used in obstetric or maternity care in those countries. Which begs the question, if women don’t have it available (especially in home births) they manage in other ways. This would seem an obvious solution to the potential problem for midwives of exposure to this chemical s well - just say “Entonox is not available” and use other safer means to ease labour pain, such as water, heat etc. A simple solution?

Posted by andrea at July 19, 2004 11:58 AM

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