Author Archives: Tricia Calilung

  1. How Anxiety can Affect Pregnancy: Advice for Midwives

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    Pregnancy is a time of excitement, anticipation, and, at times, anxiety. While some degree of worry is common during pregnancy, excessive anxiety and chronic stress may have adverse effects on maternal, foetal and neonatal outcomes. As health professionals entrusted with the care of pregnant women, midwives and obstetricians need to be aware of the potential impact of anxiety and stress on pregnancy. In this blog post, we will explore the signs, symptoms and causes of pregnancy-related anxiety, its effects on maternal and neonatal outcomes, and evidence-based strategies for managing anxiety in pregnant women. 


    Pregnancy anxiety refers to excessive worry, apprehension or fear about pregnancy, childbirth, or the health and well-being of the foetus and the mother. It may manifest in various forms, such as fear of miscarriage or stillbirth, anxiety about the delivery process, obsessive thoughts about harm to the baby, or feeling overwhelmed and unprepared for motherhood. It is estimated that about 15% of pregnant women experience clinically significant anxiety, and many more may have mild to moderate symptoms. 


    Anxiety during pregnancy has been associated with several adverse outcomes, such as preterm birth, low birth weight, preeclampsia, gestational diabetes, and postpartum depression. Chronic stress and anxiety may also affect the foetal brain development, the mother-child bonding process, and the long-term mental health of the child. The exact mechanisms by which anxiety affects pregnancy outcomes are not fully understood, but it is thought that stress hormones and immune system dysregulation may play a role. 


    As midwives and obstetricians, you play a critical role in identifying and managing pregnancy anxiety. Some evidence-based strategies for supporting pregnant women with anxiety include: 


    Screening for anxiety using validated tools such as the Edinburgh Postnatal Depression Scale (EPDS) or the Generalised Anxiety Disorder Scale (GAD-7) 


    Providing psychoeducation on the nature of anxiety and its effects on pregnancy 


    Referring women with clinically significant anxiety to specialist mental health services for further assessment and treatment 


    Offering non-pharmacological interventions, such as cognitive-behavioral therapy (CBT), mindfulness-based stress reduction (MBSR), yoga, or relaxation techniques. 


    Collaborating with other health professionals, such as psychologists, perinatal mental health nurses, or social workers, to provide holistic care for the pregnant woman. 



    Pregnancy anxiety is a common and potentially serious condition that can affect maternal and neonatal outcomes. Midwives and obstetricians need to be aware of the signs and symptoms of anxiety, and be equipped with evidence-based strategies for managing it. By providing appropriate assessment, referral, and support, you can help pregnant women to reduce their anxiety and promote better pregnancy outcomes. 

  2. Is Entonox Safe to Use During Labour?

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    As a midwife or obstetrician, you’ve likely been asked by many pregnant women whether or not entonox (commonly nas gas and air is safe to use during labour. You may have even seen news articles or social media posts claiming that it can be risky. So, what’s the truth? In this blog post, we’ll take a closer look at the safety of entonox and whether or not it’s a viable option for pain relief during labour.


    Firstly, let’s start with some basic information about entonox. Entonox, , is a mixture of 50% oxygen and 50% nitrous oxide. It’s a popular form of pain relief for women in labour, as it can help to reduce anxiety and alleviate pain without affecting the progress of the labour. Entonox is self-administered by the woman in labour, using a mask or mouthpiece provided by the healthcare provider.


    So, is entonox safe to use during labour? The short answer is yes. Entonox is a safe and effective form of pain relief for most women in labour. It has been used for decades in maternity units around the world and has a long history of being a safe option. In fact, according to the Royal College of Obstetricians and Gynaecologists (RCOG), entonox has no known harmful effects on the woman or the baby.


    However, like any form of pain relief, entonox does come with some potential side effects. The most common side effect is dizziness or feeling lightheaded, which can be exacerbated if the woman hyperventilates while inhaling the gas and air. Other less common side effects include nausea, vomiting, and difficulty concentrating. It’s important for healthcare providers to monitor the woman’s oxygen saturation levels while she’s using entonox, as prolonged use can lead to hypoxia.


    It’s worth noting that entonox may not be suitable for women with certain health conditions, such as severe asthma or B12 deficiency. Additionally, some women may not feel that entonox is effective enough to manage their pain and may require additional pain relief such as epidural anesthesia. As with any form of pain relief, the healthcare provider should discuss the risks and benefits of entonox with the woman before she makes a decision about whether or not to use it.


    In conclusion, entonox is a safe and effective form of pain relief for most women in labour. It has minimal side effects and a long history of use in maternity units around the world. However, as with any form of pain relief, it’s important for healthcare providers to assess the woman’s suitability for entonox and monitor her closely while she’s using it. By providing accurate information about the safety and effectiveness of entonox, midwives and obstetricians can help women make informed decisions about their pain relief options during labour.


    If you are a health care worker and have any concerns about exposure, please be advised by the links below


    Entonox exposure: are you at risk? | RCN Magazine | Royal College of Nursing

    Entonox safety in workplace (1) – RCM


    The information found anywhere on this website, including but not limited to text, graphics, images and any other material therewith is for information purposes only. No material on this website is intended to be a substitute for professional personalised medical advice, diagnosis or treatment. By providing the information contained herein we are not diagnosing, treating, curing, mitigating or preventing any type of disease or medical condition. Always seek the advice from a registered health care professional if you have any questions regarding any medical concerns or conditions. Do not disregard professional medical advice or delay in seeking it because of something you have read on this website. 

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