Hi Mummies
I got the from the weekly email that I subcribe from BabyCentre. Good knowledge for those who intend to do natural birth without epi.
What is Entonox?
Entonox, or gas and air, is a colourless and odourless gas made up of half oxygen and half nitrous oxide, or laughing gas, as it is commonly known. It has a calming effect and takes the edge off labour pain, rather than blocking it out completely.
Gas and air should be available wherever you choose to give birth, including in birth centres and at home (NCCWCH 2007). Most hospitals pump gas and air to the labour wards from a central supply, so it's always available when you want it.
If you're in a smaller hospital or a birth centre without a central supply, or if you're having a home birth, your midwife can bring gas and air to you in portable cylinders.
When and how should I use it?
You can have gas and air whenever you want in labour. You breathe it in through a mask or mouthpiece:
1. Simply bring the mask up to your face or put the mouthpiece between your lips or teeth.
2. Keep it there as you breathe deeply and evenly. The mask or mouthpiece has a two-way valve that releases the gas and air for you to breathe in and takes away the carbon dioxide you breathe out.
3. Continue to breathe deeply until you start to feel a little light-headed. Take the mask or mouthpiece away from your face.
4. Within a few seconds, you will feel perfectly normal again.
You'll need a bit of practice to get the timing right. It takes at least 30 seconds of breathing for the gas to build up in your bloodstream to give you some benefit (Millns and Eagland nd). You may not get the full benefit until you've been breathing it deeply for about a minute (MIDIRS 2008).
Start breathing the gas and air the very second you feel a contraction beginning. If you wait until the contraction really hurts, and then start breathing, it will take effect between contractions.
What are the advantages of gas and air?
- It is flexible and quick-acting.
- It is easy to use.
- It is under your control.
- It doesn't stay in your system. As soon as you stop breathing it in, the gas and air in your system is cleared by your lungs and any side effects will stop too (MIDIRS 2008, Millns and Eagland nd).
- It takes the edge off contractions.
- It's safe for your baby (NCCWCH 2007, Millns and Eagland nd).
- Your baby doesn't require extra monitoring while you're using it.
- If you want to labour in a birth pool or in the bath, you can use it while you're in the water.
What are the disadvantages of gas and air?
- It is only a mild painkiller.
- It may make you feel light-headed or sick (NCCWCH 2007).
- It dries out your mouth if you use it for long periods (Millns and Eagland nd).
- Keeping hold of the mask or mouthpiece may stop you from moving around and getting into a comfortable position (MIDIRS 2008).
- It may take a while to get the timing right so that it's effective at the peak of your contractions (MIDIRS 2008).
- If used with painkilling drug pethidine, it may make you feel even more drowsy (Millns and Eagland nd).
Gas and air is perfectly safe for you to use during labour. However, there have been concerns about the safety of people who are exposed to a lot of nitrous oxide in their work (Henderson et al 2003). In large quantities, nitrous oxide can interfere with the body's levels of B vitamins and with cell development (Robertson 2006). If you work as a midwife, you need to be aware of how long you are exposed to nitrous oxide, particularly if you are planning to get pregnant yourself.
Questions for your midwife
It's best to ask your midwife these questions before you go into labour! Or you could make sure your partner is briefed with them in advance.
Ask whether the mouthpiece or mask and breathing tube are new or have been properly cleaned before you use it. Check whether the hospital uses filters to protect against infections. The Association of Anaesthetists of Great Britain and Ireland recommends that disposable fittings are used, so that each person gets a new set, or that reusable equipment is cleaned thoroughly to reduce the spread of infection (AAGBI 2008).
If you're having a home birth, ask your midwife when she arrives to check that the mouthpiece, valve section and breathing tube are all in working order and that she has enough canisters for your labour (Home Birth Reference Site 2002).
Useful tips
You'll probably be given gas and air through a mouthpiece. However, if you're offered a rubber facemask, and the rubber makes you feel queasy, ask to swap to a mouthpiece. It's quick and easy to do.
Have lots of sips of water in between contractions to keep your mouth moist.
When you're pushing your baby out in the second stage of labour, you may find it easier to concentrate without using gas and air. Or you could have a little gas and air at the beginning of each contraction, but then put the mouthpiece to one side, and PUSH!
Don't feel bad if gas and air isn't enough to help you cope with contractions. Try something else. Using gas and air doesn't prevent you from having any other drugs for pain relief.
Source:
http://www.babycentre.co.uk/pregnancy/labourandbirth/painrelief/entonox/
