A survey of Australian midwives: Experts in nitrous oxide administration within the peripartum setting.

PROBLEM:There is little documented evidence of midwives' perspectives regarding the use of nitrous oxide in the peripartum period. BACKGROUND:Nitrous oxide is an inhaled gas used widely in the peripartum period; usually offered and managed by midwives. AIM:Explore midwives' knowledge, perceptions, and practices of facilitating women's use of nitrous oxide in the peripartum period. METHODS:An exploratory cross-sectional survey design was used. Quantitative data were analysed using descriptive and inferential statistics; open-ended responses underwent template analysis. FINDINGS:Midwives (n = 121) working in three Australian settings reported regularly recommending the use of nitrous oxide and high levels of knowledge and confidence supporting its use. There was a significant association between midwifery experience, and perspectives on women's capacity to use nitrous effectively (p = 0.004); and desire for refresher education (p < 0.001). Midwives working in continuity models were more likely to support women using nitrous oxide in any situation (p = 0.039). DISCUSSION:Midwives demonstrated expertise in facilitating nitrous oxide use, citing utility to relieve anxiety and distract women from pain or discomfort. Nitrous oxide was identified as an important adjunct to the provision of supportive care requiring midwifery therapeutic presence. CONCLUSION:This study provides novel insight into midwives' support of nitrous oxide use in the peripartum setting revealing high levels of knowledge and confidence. Recognition of this unique expertise held by midwives is important to ensure transfer and development of professional knowledge and skills and emphasises the need for midwifery leadership in clinical service provision, planning and policy.