Greenpeace and obstetricians have questioned a scientific report warning pregnant women to consider alternatives to nitrous oxide as pain relief during childbirth because of the environmental impact of its emissions.
A report in Australasian Anaesthesia notes that while nitrous oxide – known as laughing gas when used as an anesthetic – is an effective method of pain relief during labor, the gas represents 7% of global emissions, according to the World Meteorological Organization. Carbon dioxide and methane account for 66% and 16%, respectively.
The report’s authors found that using nitrous oxide as pain relief during four-hour labor creates a carbon footprint equivalent to driving an average car for 1,500km. In contrast, an epidural is equivalent to driving 6km.
The report explores methods to capture and destroy waste from nitrous oxide and suggests that pregnant women consider alternatives, such as epidurals, acupuncture, massaging, and hypnobirthing, to manage their pain during labor.
Ultimately, the authors argue, educating patients about the emissions impact of nitrous oxide could lead to them choosing an alternative.
“While it may be innocuous for the pregnant woman and unborn baby, that is certainly not the case for the environment,” the report states, noting its use should ultimately continue in some capacity due to its convenience and safety.
A Greenpeace spokesperson said that the health sector accounts for about 7% of Australia’s emissions and that while it was important for all industries to assess their climate impact, the focus should be on the worst polluters, such as the energy sector.
“Rapid phase-out of coal and gas, by far the biggest climate culprits, is the fastest and most effective way to tackle the climate crisis, rather than focusing on the relatively low emissions from obstetric medicine,” the spokesperson said.
Associate Prof Gino Pecoraro, president of Australia’s National Association of Specialist Obstetricians and Gynaecologists, said that while some pregnant women might be concerned about the environmental impact of their childbirth, alternative pain relief such as epidurals is not available at every hospital, especially outside of capital cities.
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He added that nitrous oxide could be a more attractive pain relief option as it doesn’t restrict walking or movement ability to the extent epidurals do.
“If you’re in rip-roaring pain during labor, carbon footprint might not be what you most want to discuss,” Pecoraro said. “During childbirth, some women wouldn’t care how many coal-fired power stations are needed to reduce pain.”
Pecoraro said that, ultimately, it was important to offer as many different options for pain relief during labor as possible, as other methods are effective for other women.
“If pregnant women in labor were denied a proven safe and effective pain relieving method, I’d think we’d be going down the wrong path,” Pecoraro said.
Dr. Marilla Druitt, an obstetrician-gynecologist and researcher, cautioned that calculating an epidural’s carbon footprint would require considering that people often drive to perform and receive them.
“Does that figure include the anesthetist driving to the hospital or the woman who wants an epidural which has to travel 200km to the nearest place it’s offered?”
“Nitrous oxide is safe and easy and cheap, and you can keep walking around, you’re not pinned to the bed with drips in your arm … and I’d imagine [nitrous oxide] is available in every birthing facility in the country.”
Druitt said pain relief during pregnancy should be “all about choice”, and it was important for information about nitrous oxide’s emissions to be raised by experts and discussed well in advance of labor.
“I talk to my patients and encourage them to give everything a go because they will only know at the time what is right for them.
“Pregnant women don’t need to be picked on given all the contributors to global warming,” she said.
Druitt added that there were other hidden causes of emissions that the health industry should address first, claiming half of the hospital emissions come from wasted food.