Vaginal Birth

Gas and air for labour- What if it’s not available?

It's been widely reported in the media that gas and air, or Entonox, is not available in some hospitals. Here's what it is and why some hospitals are currently unable to provide it.

What is ‘gas and air’?

Entonox or ‘gas and air’ is nitrous oxide gas mixed with oxygen. It is also known as ‘laughing gas’, or just ‘gas’. Entonox is the brand name that it is known by. It is odourless and tastless and has been used as a labour aid since the beginning of the 20th century.

If you are birthing at home, the midwife would bring a cylinder of gas and air. If birthing in hospital or at a birthing centre, it would usually be fed through a pipe that comes out of the wall. A mouthpiece or a mask is connected by a tube to the gas supply. When you want to use the gas and air, you hold the mouthpiece or mask to your mouth and inhale and exhale deeply through your mouth. It can be used anywhere in the room, including whilst in a birthing pool.


When do you use it?

Ideally you would take in a deep breathe of gas and air as you start to feel your waves (contractions) building, inhaling and exhaling deeply throughout. Many people say it helps to ‘take the edge off’ as you have something calming to focus on as your body carries on with the birthing of baby! As your wave (contraction) starts to fade, you can simply take the mouthpiece or mask away and breathe normally.

It’s a good idea for your birthing partner to have water or an energising drink ready with a straw as it can dry your mouth out quite a lot!

They can hold the mouthpiece or mask until you are ready to use it again.


What are the benefits?

  • By encouraging rhythmic, deep breathing, it helps the mind and body to relax and relieve tension in the body
  • It can be used at any stage of labour
  • It doesn’t have known side effects on parent or baby
  • It doesn’t stay in your system for very long
  • You have control over how much you use


What are the risks?

  • It can make you feel nauseous or ‘too’ light headed. If it does, then you simply stop using it and those symptoms should subside within a few minutes
  • Too much emphasis can be put on the ‘pain relieving’ benefits. It’s best to approach using gas and air as an option in your toolbox to try if you would like to- but know that everyone will feel the benefits in different ways
  • People with some medical conditions are advised against using it
  • It might not be available on the day


What if it isn’t available?

Up until recently, gas and air has been a readily available comfort measure / pain relieving option in all birth settings. However, a risk to staff in hospitals has been identified when they are exposed to Entonox for long periods of time. Parents and babies are safe as the exposure time is very low. Therefore hospitals with inadequate ventilation systems are having to stop the supply until they can improve the systems or instal air purifiers which some are already doing.

We recommend doing 2 things:

  1. Check with your midwife or call your labour ward/birth centre as you enter your due time to get an update on its availability so that you know if you are likely to be able to access it on the day.
  2. Focus on the controllables and let go of the uncontrollables. It’s a concept that we centre our whole course around. When we focus on what’s OUT of our control, it’s likely we will feel tense, anxious and stressed which isn’t helpful for going into labour. When we focus on what we CAN control, we feel much more content and safe which is much more helpful for a birthing body as the hormones we produce when we are in this mindset support the birthing process. So what can you control? Here are a few suggestions to get you started:
  • Your environment. Think about your five senses. How can you make the room around you feel familiar and cosy? Whether it’s listening to relaxation audios/music, having a warm bath/using a pool, spraying a familiar calming scent in the air/on your pillow or dimming the lighting/switching it off and putting on battery powered fairy lights… think spa-like! These simple adjustments can help the mind feel safe and secure and have a huge impact on your comfort levels as your body relaxes in a soothing environment (just as it might in a spa). Check out this video on our Instagram account for inspiration!
  • Positioning. Remember this: UFO. Upright, forward, open. Gravity is yours and baby’s best friend during labour, so being in a position that helps baby move down just makes sense. If you need to lie down or have a rest, then use a peanut ball or a few pillows to prevent your bottom being pushed up from being flat on your back. Here is what we mean on this video.
  • Your breathing. Yes, gas and air helps with breathing but you can still focus on taking deep breaths without it too. Focus on filling your lungs and visualise oxygen reaching all the way to baby, filling their lungs too. Remember, you are doing this together!
  • TENS machines. These are a great non-medicalised option (and therefore no risk of side effects) to have in your toolkit. The key is to start using it as soon as you start feeling regular tightenings (even if they are mild) as the sensations of the TENS need to build up with your waves (contractions). People often put it on too late and are then led to believe it didn’t help so much. You can buy one from Boots for £29.99 here.
  • Water. Check out this blog post for everything you need to know about using water/birthing pools as a comfort measure. Even if not using a pool, a shower could be really tension reliving and soothing.
  • Hydration and sugar. Keeping up your energy is crucial. Birth is a high endurance activity (so to speak!) and so you need to be fuelled and hydrated at all times. Easy to chew sweets (like jelly babies) or something easy to swallow like honey (don’t forget to pack a spoon!) are perfect. Check out this video to see why honey is such a great birth bag essential. You can also make your own energy/isotonic drink, see how here. 
  • Medicalised pain relief. We talk through EVERY option on Mindful Birth antenatal/hypnobirthing courses so that you can make informed decisions on the day. Opioid pain relief and an epidural are also options so educate yourself on the benefits and risks so that you can decide what’s best for you on the day.
  • Your birth rights. If you need advice about your rights in your maternity care, the Birth Rights advice email service is here for you. Birth Rights recently posted this on the gas and air suspension.


We are here for you every step of the way with our online Parent Hub subscription and award-winning antenatal hypnobirthing courses:





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