Views of people who have given birth on the environmental and occupational exposure risks of nitrous oxide for labour analgesia: an interview-based qualitative study.

INTRODUCTION A 50:50 nitrous oxide/oxygen mix is commonly used for labour analgesia in the UK; however, nitrous oxide is associated with comparatively high environmental impact and potential exposure risks to staff if appropriate measures are not taken. Reduction of the impact of nitrous oxide in line with net zero emissions targets would require widespread changes in the way nitrous oxide is administered or in the availability of alternative options for labour analgesia. The aims of this qualitative study were to understand nitrous oxide use from the perspective of the parturient in the context of concerns regarding the environment and occupational exposure, and to provide evidence to guide the development of patient-centred nitrous oxide mitigation strategies. METHODS We conducted semi-structured interviews with participants who had used nitrous oxide for labour analgesia. Participants were recruited purposively. Data were analysed using reflexive thematic analysis. RESULTS We conducted 12 interviews and identified three themes: nitrous oxide is the default for labour analgesia in the UK; mitigating nitrous oxide harm depends on personal priorities; and institutions have a responsibility to mitigate nitrous oxide harm. Participants viewed nitrous oxide as a safe option, readily available in the context of limited choices for labour analgesia. They would be interested to know about the environmental risk of nitrous oxide, though this would not necessarily influence their choice to use it. They were less interested in its occupational risks and considered institutions, rather than individuals in labour, to have a responsibility to mitigate these. Though they felt that investment in reducing NHS emissions is important, participants also felt there may be other more pressing financial priorities. DISCUSSION This study provides evidence to support the development of strategies to reduce nitrous oxide emissions, which consider the views of people who have used nitrous oxide for labour analgesia.