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Benchmarking nitrous oxide use in maternity care: Clinical audit and consumer perspectives

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      Introduction and Aim

      Nitrous oxide is commonly used by women in Australia to enhance comfort during labour and birth. The evidence on the prevalence and usefulness of nitrous oxide during labour and for obstetric procedural analgesia is limited. The aim of this study was to audit the use of nitrous oxide (N2O) within a tertiary and secondary Australian maternity unit and then explore women’s perspectives on its use.

      Methods

      In the first study phase, a prospective clinical audit was conducted between May 2021 and September 2021, collecting point of care data for n=183 cases. For the second study phase, a survey was undertaken by consenting women who had used N2O, n=137.

      Results

      Multiparous women were more likely to indicate that N2O was useful for them during labour compared with primiparous women (95% vs 80% CI 95% p=0.009). Women were more likely to indicate that N2O was effective at point of care if they had higher concentrations of N2O. In the postnatal survey, women indicated that N2O was easy to use, had minimal side effects and facilitated their sense of control owing to the need for active maternal inhalation. Women who were prepared for what to expect from N2O administration were enthusiastic about its perceived effectiveness. Some reflected that they were unaware of the anticipated effects of the drug, which impacted their willingness to persist with its use.

      Conclusion

      This novel study provides the first ever benchmarking of nitrous oxide use in the maternity setting in Australia. Consumer perspectives captured at both point of care and in a postnatal survey add strength to these findings; which have utility for parent education, midwifery education and provide a foundation for further research into the use of nitrous oxide in maternity care globally.
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