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Pregnant Swedes in labour gas ban outrage

Pregnant Swedes in labour gas ban outrage

Published: 10 Mar 2012 13:23 GMT+01:00
Updated: 10 Mar 2012 13:23 GMT+01:00

Use of laughing gas during labour may soon be no more than a memory for women giving birth in Sweden. Gävleborg hospital, in northeastern Sweden, is first to cut off the use of nitrous oxide as pain relief.

"It feels like a slap in the face," said pregnant Lina Forslund to newspaper Aftonbladet.

Nitrous oxide, or laughing gas, is to be phased out, hopefully by 2014, because of its damaging effect on the environment and on the hospital's staff and patients.

"Research has shown that patients with a shortage of vitamin B can suffer lasting neurological damage from nitrous oxide. It's also a question of our work environment. Laughing gas causes documented higher frequencies of miscarriage and deformities," Ingegerd Lantz, head of Gävleborg's gynaecological section, explained to Aftonbladet.

"It's also about the environment around us. Nitrous oxide remains in our atmosphere for 150 years before being broken down," she continued.

Pregnant Lina Forslund told the paper that she understands the hospital's reason for discontinuing their use of nitrous oxide.

"But I'm selfish. I don't want to be in pain giving birth," she said to Aftonbladet.

Ingegerd Lantz recommends other methods of pain relief, among them epidural anaesthesia and relaxation exercises.

Lina Forslund is unconvinced, however.

"I feel insecure. I've used laughing gas for my two previous births, since that was the only thing there was time for. Laughing gas is what you can control. I don't want to give birth without it, it's wonderful and I really don't want to be without it."

"But if that's how it's going to be, I'll have to live with it. I guess I'll have to bring along a schnaps instead," she added.

The Local/cg (news@thelocal.se)

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Your comments about this article

15:05 March 10, 2012 by johnny1939
Relaxation exercises.....my foot!!!!!!!
15:13 March 10, 2012 by krrodman
Welcome to the 20th century, Sweden.

The deleterious effects of nitrous are well know. Here is a short list:

1. Bone marrow suppression

2. Neurologic complications

3. Environmental disaster. 300 times more destructive than carbon dioxide at depleting the ozone.

4. Increased incidence of nausea and vomiting.

In an obstetrical suite, the nitrous would not only impact on the mother and child, but the hospital staff would be exposed to low levels of nitrous on a daily basis.

Most anesthesiologists in the USA have stopped using nitrous entirely - no less in a pregnant mother - because of its safety profile and environmental impact. It is inconceivable to me that Sweden would allow a child in-utero to be exposed to nitrous. In my hospital, as soon as we learn that an operating room nurse is pregnant, we do not allow her into an operating room in which she may be exposed to nitrous.

Shameful
16:44 March 10, 2012 by Miss Kitten
Meh, screw the environment! Who cares about the baby? SHE doesn't want to be without it. She's selfish and proud of it.

Cry me a river, hon. Didn't anyone tell you that giving birth is painful.
16:49 March 10, 2012 by Opinionfool
"Research has shown that patients with a shortage of vitamin B can suffer lasting neurological damage from nitrous oxide."

RIght so one group of patients may develop postnatal issues. Surely the appropriate tactic is to treat the vitamin B deficiency first.

"It's also a question of our work environment. Laughing gas causes documented higher frequencies of miscarriage and deformities,"

Maybe better ways of delivering the NO2 to the vitamin B-enriched patient only could be sort. The use of face masks rather that nasal tubes maybe. Put a sensor in the mask so it shuts off when not over the gravid's face.

" I don't want to be in pain giving birth," there are other "natural" methods such as TENS. Like gas it does not work for all but it only affects the woman in labour.
18:15 March 10, 2012 by registererer
krodman: No offense, but what the hell are you talking about? "300 times more destructive than carbon dioxide at depleting the ozone"???

There is absolutely no relationship between the depletion of the ozone layer and carbon dioxide. Nitric Oxide? Sure. Nitrous Oxide? Sure. Chlorine? Sure. Bromine? Sure. Hydroxyl? Sure. CO2? CFLs? Sure.

Carbon dioxide? Not even remotely. Although of course CO2 is implicated in the greenhouse effect, that is totally unrelated to the ozone layer.
19:02 March 10, 2012 by krrodman
@registererer

Sorry, but I was so shocked about the Nitrous that I misspoke. Nitrous is both a depleter of the ozone (http://www.sciencedaily.com/releases/2009/08/090827141344.htm) as well as a very potent greenhouse gas.

@Opinionfool

Nitrous interferes with both folate and B12 metabolism by binding methionine sythetase. Taking excess folate and B12 can mitigate the effects of nitrous oxide. Neurologic problems from nitrous were first identified in dentists who were subjected to constant low level exposure in their offices. While scavenging operating rooms helps, as would using masks with automatic shut off valves, it would not eliminate the problem because the mother, as she exhales, becomes a constant source of nitrous oxide which is released unchanged from the body.
20:11 March 10, 2012 by gpafledthis
It's a PLOT !! To make swedes stop having babies to make room for the browning of sweden- just import your babies !!
09:26 March 11, 2012 by hipersons1
http://www.huffingtonpost.com/2011/02/14/laughing-gas-childbirth_n_822657.html

in contrast
13:41 March 11, 2012 by terriergirl
A lot of ladies have a whiff of the gas, realise that it is a distraction rather than pain relief, and ask for diamorphine. Given all the other environmental issues we have to contend with, a few women using only gas and air through their labours is nothing. Get a grip and let them have their gas.

And, yes, we know giving birth is painful, but that does not mean women should just put up with pain. I can only assume that the earlier commenter has never given birth!
14:12 March 11, 2012 by krrodman
@Terriergirl,

The intent is not to deprive women of pain relief during childbirth. Quite the contrary, the point is to provide women with the best possible pain relief which would be an epidural for labor pain.

My understanding is that the countries that still allow anesthesia gases such as nitrous to be administered during labor are countries in which there are an insufficient number of anesthesiologists.

The standard in the United States is for an epidural to be placed within 30 minutes 24/7/365. We are a typical small anesthesia group in the USA with 7 anesthesiologists. Every night of the year we have 2 MDS on call - one for surgical emergencies and one for obstetrics. The work load is high but we provide a high level of service.

What is the standard wait time in Sweden for a labor epidural? Are labor epidurals available within 30 minutes 24/7/365? Is nitrous used because epidurals are not readily available?
16:54 March 11, 2012 by terriergirl
Yes, but sometimes it is enough to 'take the edge' off the pain with gas and air. I have friends who have found gas and air provided enough relief/pain control in their labours and would not have wanted the loss of movement of an epidural. Myself, I found gas and air to be totally useless (and don't get me started on the TENS machine) but I am glad I had the chance to try these milder methods of pain control before stepping up to something stronger.

My first experience of birth in the UK was an 18 hour induction with no offer of an epidural. The midwives were very pro gas and air and, as a first timer, I did not ask for an epidural as I assumed the staff would suggest it if they thought necessary.

If I have a fourth child I'll book in with you in the USA !
18:55 March 11, 2012 by johan rebel
"But I'm selfish. I don't want to be in pain giving birth,"

Well then, how about just not giving birth at all? What a certified moron!
20:02 March 11, 2012 by johnny1939
yea, yea why go through that horrible ordeal anyway...wish that I had not and then they turn bad on you.......
21:52 March 11, 2012 by krrodman
@Terriergirl

First and foremost, it would be a pleasure to help you with an epidural should you need one in the future.

As for the present, one of the OB nurses that I work with on a daily basis was a midwife in the UK before moving to the States. She is marvelous and dedicated, as is every midwife that I have ever met. As she tell it, patients often had to make due without an epidural in the UK for lack of an anesthesiologist. Which brings us right back to my original question. Is gas used in Sweden for lack of available anesthesiologists?
08:47 March 12, 2012 by karex
#10 You probably hit the nail on the head. If you need an anesthesealogist on a weekend or in the middle of the night, or during a fika break, you will have to do without. If you are having a heart attack, you will die. It's budget medicine at its best. The aim is not to save patients but money. And that includes not paying overtime.
09:38 March 12, 2012 by Gretchen
@ Krrodman, karex, I can only agree with you, it seems that in Sweden saving money is the first priority when it comes to medical care and a lack of anestesiologists is likely. Tasks are here carried out by nurses or so called "under-nurses" that in other countries would require a doctor, so it could be that not enough specialists are present.
11:18 March 13, 2012 by libertarianism
A google search of "brist anestesi" suggests there is a shortage of anesthesiologists. In fact, the national anesthesiologists group SFAI (Svensk förening för anestesi och intensivvård) described the shortage as "dangerous" and cited it as direct cause for longer wait-times for surgery, as well as the shortage of available places within intensive care. These problems are attributed to a lack of planning which focused on short-term economic goals. SFAI also described the current education system as inadequate and lacking, and thus contributing to a shortage of qualified anesthesiologists.

sfai.se/files/Remissvar_SFAI_Kompetensochansvar2010.pdf
13:39 March 16, 2012 by Amber Dawn
Also keep in mind the epidurals they give in Sweden are not full epidurals like are often administered in the US.
23:22 March 17, 2012 by Token-not-found
Couldn't you find a more repulsive picture than that?
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