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You're Having A Laugh
Gas & Air (Entonox)
Member Name: sandemp
Gas & Air (Entonox)
Advantages: You're in control, doesn't affect baby
Disadvantages: Dry mouth, not the strongest pain relief
There's no doubting that labour is called labour for a reason, it's hard work and can also be extremely painful. I've given birth to five children and with three of those the only pain relief I used was Gas and Air, otherwise known as Entonox. On the scale of things I would consider Entonox to be a mild to moderate method of pain relief, with only nothing at all and TENS being milder and then Pethadine and epidurals being stronger. In fact Entonox is normally the first pain relief offered to most labouring women as it is not only quite effective but is also safe (and possibly even beneficial) to the baby.
==You're Having Laugh==
Entonox is a colourless, odourless, tasteless gas comprising of equal quantities of Oxygen and Nitrous Oxide (otherwise known as laughing gas). Nitrous Oxide itself was first used as an analgesic (pain killer) by a dentist in 1844, but is was soon discovered that if it wasn't mixed with oxygen then patients would become hypoxic (not enough Oxygen) and so today it is mixed with oxygen at high pressure and the normal mix is 50% nitrous oxide and 50% oxygen (there's approximately 21% oxygen in the air).
In the maternity wards I've been in there have been two different ways of delivering the Entonox, via a large gas cylinder or a wall connection, to either a mask or mouthpiece. Either way, you simply breathe as normal (yeah right, I'm in labour) and the Entonox then enters the bloodstream via the lungs. Entonox is a fast acting and yet short lived analgesic, taking effect in about thirty seconds but leaving the body within a minute. This means that it's just about the safest form of pain relief, as if you do take too much and begin to pass out, you can't physically hold the mouthpiece to your mouth and it will leave your system very quickly. The fact it's short lived also means that if you don't get on with it for any reason, then it will clear your system quickly meaning other pain relief can be used. In fact it can also be used in conjunction with other pain relief such as Pethadine. The addition of Oxygen in the mix can also be beneficial to the baby, especially as the labouring woman's breathing can become quite erratic.
==The Gas And Me==
Although I have used Gas and Air with all of my labours, I'm now going to focus on my last labour in April 2010, although I may add a few anecdotes from the other four. The first thing to point out here, is that I was induced a week early due to severe Symphis Pubis Dysfunction and after having my waters broken it was discovered that the baby had passed meconium, which was a sign of possible distress, meaning I spent the whole labour on the bed strapped to a monitor. The second thing to note is that it was a very short but intense labour, that did get extremely painful very quickly. The third and final point is that the monitor didn't actually word very well meaning it was hard to tell just how strong the contractions were and there was no warning of them starting (I'll explain why this is relevant in a bit).
I did pretty well for the first hour after my waters were broken, getting by just by practising my breathing exercises, concentrating on the nice deep breathes was enough to distract me from the pain. But then it started getting a bit harder, well a lot harder actually, I would have preferred to have been up and walking about at this point, but because I was being constantly monitored I had to stay put. So when the midwife asked me if I wanted the Gas and Air I jumped at the chance as I knew that while it wouldn't completely kill the pain it would make it easy to deal with.
This time around I was given a mouthpiece to use, in the past I used a mask and if I'm honest I prefer the mouthpiece, it was just so easy to clamp it between my teeth (and the action of biting down helped too). Having used gas and air before, I knew that I had to start taking this at the beginning of the contraction before it got to painful, this is because it takes time to take effect. Within thirty seconds of start to breathe the gas and air in, my head would start to feel woozy and while the pain didn't actually go away, I felt so out of myself that I didn't care about the pain. It was almost like watching someone else going through the pain. My partner has often asked me what the gas and air feels like, and I think that a comment I made half way through my labour says it all really. "I feel stoned", that's almost exactly what it feels like, the effect is very much like having smoked a joint, or drunk too much alcohol. Your limbs feel heavy, your speech slurs and you feel like you're in a bubble which makes everyone else's voices seem far away. Well that's how it feels for me anyway.
I'm not going to say that gas and air made my labour pain free, because it certainly didn't, it was still very painful. But what it did do is make it far easier to deal with the pain, right up until I was almost ready to push and begging for an epidural. (But as I said it was a very short and intense labour). Personally I think there are two reasons why this works so well for me. Firstly the actual effect of the Entonox on me disconnects me from the pain and secondly I find using the entonox encourages me to concentrate more on my breathing.
So far I've only been positive about entonox, but there are a few down sides. Although the gas is tasteless, it does still have a drying effect on my mouth, meaning that I made sure that I always had some water to sip. Entonox can also make you feel sick, just like too much alcohol or weed, whenever this happened I would simply stop taking it for a couple of contractions and because it leaves the system so quickly I'd soon start feeling better. Another downside is that if you don't take this correctly them it won't work. You do need to start breathing it in when the contraction first starts rather than when it gets painful, it really does take practise to get the timing right. But hey, by number five I knew exactly what to do.
I've used entonox in all of my labours, the first of which was over 20 years ago. With that labour I used it alone for the first six hours and then had Pethadine as well, but that was more because it was the early hours and I needed some rest. With my second child, I used just gas and air and she was back to back which means a far more painful labour, but it just went to show that if you get the technique right then entonox can help you get through ten hours of hell (although I did also have a fantastic, supportive midwife). My third labour was a little different as he was seven weeks early and I had been given Pethadine in the hope that it would help me relax and stop the labour progressing. This meant that as the delivery drew near, the Pethadine was just starting to wear off, so I still had a lot of pain at the height of each contraction, but couldn't feel the start of the contraction so I was relying on the monitor to help me work out when to start taking the gas and air. My fourth labour was a breeze, I hardly had time to even start taking gas and air let alone anything else and I've already told you about my fifth labour.
What I love about entonox is that I was in control of my pain relief, and it's so easy to feel out of control while in labour so that bit of control also helped me to cope. I also like that because it's portable it is carried on ambulances, meaning that if you go into labour and it progresses quickly there is a safe form of pain relief available. Talking about safe, I love how this is safe for both myself and my babies and doesn't have any life-threatening side-effects, unlike Pethadine that can make a newborn drowsy. I even like the fact that if I ever decided to have another baby and go down the home birth route (something I'm seriously considering), entonox is a form of pain relief that can be used. It can even be used if I ever decided to have a water birth.
What I don't like about entonox is how dry it makes my mouth, I do always need to make sure I have drinks to sip in labour. I also must admit that I'm not that keen on it coming in canisters, especially as when I had a long labour I managed to go through three and it took time for them to be replaced. I really don't think there's anything I don't like, although the stoned feeling might be off-putting for some.
Whether you call it Entonox or Gas and Air, this is a safe pain relief for those in labour. For me it's the best pain relief available, one that makes it a lot easier to cope with labour and yet one that doesn't leave me or the baby feeling drowsy. I know it's not for everyone, but it's surely something worth considering if you feel you can't cope with no pain relief. Only do make sure that you ask the midwife to show you how to use it correctly as without the correct technique you won't get the full benefit. Hope this has helped you decide whether this is the pain relief for you and good luck with your labour.
Summary: Pain relief you control