Sustainability of Entonox in obstetrics: A qualitative study

Catherine Kelly, Pavan Raju, Tim Smith, Evridriki Fioratou

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
110 Downloads (Pure)


Background/Aims Nitrous oxide is a potent greenhouse gas widely used in childbirth in the form of Entonox. In this study, its use was investigated because of its negative climate effect. The study aimed to identify and investigate midwives use of Entonox in the labour ward of a tertiary Scottish hospital. Methods This qualitative service evaluation was conducted using semi-structured interviews with 10 midwives and an environmental sustainability manager. Thematic analysis using combined deductive and inductive approaches were used to analyse the data. Results Deductive analysis revealed all six work systems factors from the system engineering initiative for patient safety framework to be pertinent to Entonox use in the labour ward, with specific influences and perceived outcomes of Entonox use found through inductive analysis. Conclusions A reduction in Entonox use would be difficult, but changes have been recommended to raise awareness among healthcare staff of Entonox risks and create a more environmentally sustainable work system.

Original languageEnglish
Pages (from-to)74-80
Number of pages7
JournalBritish Journal of Midwifery
Issue number2
Publication statusPublished - 1 Feb 2023


  • Childbirth
  • Entonox
  • Human factors
  • Midwifery
  • Sustainability

ASJC Scopus subject areas

  • Maternity and Midwifery


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