**Update September 2023***
GAS AND AIR IS NOW BACK IN USE AT EAST SURREY HOSPITAL
** August 2023**
UPDATE There are now plans in place for the suspension of Gas and Air to be lifted by the end of September, no solid date yet but I will update here if a date is published.
**July 2023**
It has been announced on July 5th 2023 that for the time being Gas and Air at East Surrey Hospital has been banned for use in the hospital due to concerns over staff health.
This is an ever changing issue but in this post I will clarify as much as possible for families due in the next couple of months, what this means for you.
**July 25th Update – there is still no change, gas and air is still suspended at East Surrey Hospital
Why has the use of Gas and Air at East Surrey Hospital been suspended?
This is a nationwide issue but has been effecting different hospitals at different times.
Long story short, gas and air is a very safe to use during labour, however there has been some evidence that a very long term prolonged exposure to gas and air can have an impact on your health. The evidence is a little unclear but it seems like it effects the level of B12 in those exposed. The main concern around this is for the health of the midwives spending long shifts continuously exposed to residual levels of gas and air in the atmosphere.
East Surrey Hospital has now had extensive testing and this has shown that the amount of gas and air in the air in the birth centre and delivery suite is significantly above the desired threshold. In order to reduce the exposure for midwives East Surrey Hospital has had to ban the use of Gas and Air in the hospital until they can arrange suitable ventilation in the birth centre and the labour ward.
However, as homes tend to be better or at least more easily ventilated, gas and air is still available when having a home birth.
What does this leave as my pain relief options during labour at East Surrey Hospital?
Your pain relief options change dependant on your birth location.
If you are having a home birth via the team at East Surrey Hospital/SASH maternity then you are able to use:
- TENS (this is something you will need to buy or hire yourself)
- Birth pools (this is something you will need to buy or hire yourself)
- Gas and Air
If you are going to the birth centre then you have the options for:
- TENS (this will be something you need to provide for yourself currently)
- Birth Pool (all rooms at the SASH birth centre have pools available)
- Pethadine
- Oramorph
If you give birth on delivery suite then your options are:
- TENS (again something you need to provide yourself)
- Birth pool (one of the 9 rooms have a birth so it is not a guarantee that this will be available)
- Oramoprh
- Pethedine
- Remifentanil (this is a newer option which used to only be available to those unable to have an epidural but in light of the removal of gas and air is being rolled out to be available to everyone)
- Epidural
For more information about all these options the hospital recommend checking out the Labour Pain website for great information on how these options works and I highly recommend the AIMs website to give great evidence based and balanced information on all of these pain relief options.
I don’t want to use strong medications so what are my options now I can’t have Gas and Air?
There are a few different approaches to this.
- Consider your birth preparation, obviously I have a bias here, but doing a hypnobirthing course, learning how your birth works and techniques to keep yourself calm and as comfortable as possible can make a huge difference to the type of pain relief you end up wanting or feeling like you need during labour. There is lots of evidence that shows that hypnobirthing reduces the use of epidural and other strong painkillers.
- Consider a home birth. For many families, they assume that homebirth is a less safe option, however, this is completely untrue. There has been lots of evidence to support the fact that home birth is just as safe for baby as giving birth in a hospital, and actually there is lots of evidence that home birth is safer for the labouring mum than giving birth in a hospital. Gas and air is still available with the homebirth service and homebirth is safe so it might be worth doing more research into this and chatting with the homebirth team directly about your options here.
- Learn ways to make your own pain killers. And no, I’m not talking about making a labour and delivery version of Breaking Bad! Our bodies produce a hormone called Endorphins in response to pain and we can produce lots of this during labour. Endorphins are natures Morphine without any of the potentially unpleasant side effects of medicinal opioids. There are a couple of ways you are able to produce more endorphins to create better in built pain relief and keep you more comfortable
- Combs – using a simple plastic hair comb, and squeezing it in your pain both sends the message to your brain to produce more endorphins but also puts pressure on an acupressure point in the palm of your hand which reduces pains.
- Massage – either a really firm pressure massage in your back, or a very tingly gentle massage done by your birth partner running their finger tips over your skin on your arms/chest/back will send messages to your brain to produce more endorphins
- TENS machine. These are something you can hire or purchase. They consist of pads which go on your back attached to a machine which sends mild electrical signals to your back. This works in two ways, primarily it tells the brain to produce more endorphins but secondly, they have a boost button which you press during a contraction which intensifies the sensation from the TENS machine and creates a distraction from the sensation of the contraction your are experiencing. This can be a really helpful tool in labour and has the benefit of being something you have at home to use in early labour before heading to the hospital if there is where you plan to give birth.
- Use water – birth pools are a great form of comfort during labour and has an excellent result in making women feel more comfortable labour. Getting in the pool may take the edge off of your contractions in a way that allows you to cope with your breathing techniques
- Learn breathing techniques. Whether you commit to a full hypnobirthing course or not, using breathing techniques during contracts WILL make you calmer and more comfortable. Our instinct when feeling pain is to hold our breath. This works directly against your contractions, making you tense, making less oxygen available for you, your muscles and your baby and making the contraction more painful. Using breathing techniques to keep you breathing, calm and focused during your contractions will support you throughout.
- Plan for other pain reliefs. Research your remaining pain relief options. If you fully understand the tools you have available to you, you will be able to use them to the best of your abilities. For example, if you learn about and understand the impact having an epidural with potentially slowing your labour down and making the 2nd stage (pushing stage) of labour more difficult increasing your risk of needing medical intervention then the more you are able to put in safe guards against these negatives such as having a lower dose epidural so you are able remain as mobile as possible, have the dose reduced as labour progresses so you are able to feel again and more better for the pushing stage, putting things in place to keep your natural birthing hormones high will all help you avoid as many of the possible risks of an epidural as possible.
- Finally, you do have the option of self referring yourself to a different hospital, at this moment of publishing (6/7/23) the other surrounding hospitals do all have gas and air available, however, this ban on gas and air is a national issue and the policy around this could change at other surround hospitals at any time so do double check with the other possible hospitals you are considering.
If you would like to arrange a chat with me about your options for labouring now just complete this contact form and I will arrange a time for us to have a proper talk free of charge.
