Mothers denied gas and air in labour say their births were traumatic

Theo was born after being induced, with the labour lasting for an hour and ten minutes

When Leigh Milner gave birth to her baby boy last month she was expecting "all the pain relief" but ended up with just paracetamol and describes her labour as absolutely unbearable.

The BBC journalist delivered her son Theo at the Princess Alexandra Hospital in Harlow, one of several that have recently suspended gas and air due to fears midwives and doctors have been exposed to unsafe levels.

Leigh was warned beforehand that gas and air wouldn't be available but said she was promised she could have other pain relief.

Leigh and her husband Chris welcomed baby Theo on 1 February

However, her labour progressed very quickly after being induced due to pre-eclampsia, and doctors said there was no time for an epidural - an injection in the back to stop feeling pain - or anything else.

"I desperately needed something to take the edge off," the 33-year-old says.

"My whole body was shaking. I kept begging for pain relief but the only thing they said they could give me was paracetamol. The pain was so much that I was in and out of consciousness.

"It felt like a Victorian birth and it shouldn't have. From start to finish, that day was an absolute mess."

Leigh believes mothers need more clarity and support amid confusing advice from hospitals

The hospital has since put three temporary gas and air units in place but when Cheryl Lake, 39, gave birth to her daughter, Sophie, at the hospital on 13 February the one in her room wasn't working.

"My two midwives were absolutely fantastic but they can only work with the resources they have got," she says.

Cheryl wasn't able to have gas and air during her labour with her daughter Sophie

Permanent gas and air units are being fitted soon at the hospital, Giuseppe Labriola, director of midwifery, says.

"We also have a designated helpline in place for women and people who are due to give birth to call with any queries they have," he adds.

The NHS maternity survey for 2022 shows 76% of women used gas and air, also known as nitrous oxide, during their labour.

Kirsty Old, 33, from Ipswich, wanted to use it during the delivery of her third child, Hallie, in December.

The day before she was due to be induced, Kirsty spotted a local newspaper story on Facebook which suggested Ipswich Hospital had suspended its use.

Kirsty only found out that gas and air wasn't available while she was being induced

"The lack of communication was unbelievable. No-one had mentioned this to me during my pregnancy. During my induction, I asked if it was true and the midwife said 'yes but you can have pethidine instead or an epidural', but that wasn't what I wanted," she says.

Kirsty had previously used pethidine in labour and had a bad reaction. She did not want an epidural because she wanted to be mobile throughout labour and "know what was happening to my body".

Kirsty feels like the hospital's communication about her labour options was poor

But 15 hours in to the labour she was in "so much pain and was so tired" she asked for one.

"I'm still quite cross about it. I don't feel like I had the birth experience I wanted. I had a lovely labour with just gas and air with my second child but this was taken away from me," the 33-year-old adds.

Kirsty with her husband, Ian, and other children, Elodie and Ezra

Dr Giles Thorpe, chief nurse at East Suffolk and North Essex NHS Foundation Trust, which runs Ipswich Hospital, said he was sorry to hear about Kirsty's experience.

Gas and air was reinstated last month, he said, but the trust appreciates it was a "very frustrating and anxious time" for mothers.

"As soon as we were aware of the issue we shared information on our website, social media channels and through local media in order to reach as many people as quickly as we could".

Gas and air, also known by its brand name Entonox, is harmless to women and babies in small doses but long-term exposure can affect vitamin B12 levels, leading to potential nerve damage and anaemia.

Several other hospital trusts have temporarily suspended its use in maternity units over the last few months, including:

• Peterborough City Hospital and Hinchingbrooke Hospital in Huntingdon

• The Norfolk and Norwich University Hospital and The Queen Elizabeth Hospital in King's Lynn which have suspended it in certain rooms

• Basildon University Hospital in Essex, where tests found levels at 3,000 parts per million (ppm) compared to the safe limit of 100ppm

• The William Harvey Hospital in Ashford, Kent

• Watford General Hospital recorded levels of almost 5,000ppm but did not suspend gas and air, instead it installed machines to remove gas from delivery rooms

Val Willcox, from the National Childbirth Trust, believes many pregnant women are worried and anxious about the issue.

"Hospital trusts need to urgently look into how to make the environment in maternity wards and birth centres safer, so that midwives are protected and women in labour have more choices around pain relief," she added.

The health of midwives must be protected, says author Leah Hazard

Midwife and author Leah Hazard says she feels sympathy for women denied the use of gas and air, but the health of midwives must be protected.

"We want birthing women to have access to a wide range of pain relief options, but staff also have the right to safe working conditions.

"Midwives especially over the last few years with Covid have been exposed to such dangerous environments at work. It is unfortunately having a knock-on effect on women but it is a basic safety at work issue and it needs to be addressed."

The Royal College of Midwives (RCM) believes the issue has arisen because of poor ventilation in delivery suites and labour wards.

In January it said its members at Basildon Hospital were considering legal action after being exposed to almost 30 times the legal workplace exposure limit for nitrous oxide.

Dr Suzanne Tyler, the RCM's executive director, says many of the buildings that house maternity services are not fit for purpose.

"We know of crumbling walls, ceilings being held up by props and even sewage flowing onto wards. We need to see proper investment in maternity services, including the bricks and mortar," she adds.

In new guidance to trusts last week, NHS England said hospitals should only suspend gas and air as "a last resort".

"Where there is no other option but to remove this provision, there must be clear communication with all service users who may be affected, with alternative options explained to support informed patient choice," it said.

For Leigh and many other women the guidance comes too late but she hopes other mothers won't have to go through the traumatic experience she did.

"Yes I have a healthy baby boy but your mental health matters too and you shouldn't have to sacrifice that to give birth," she adds.