The carbon footprint of different modes of birth in the UK and the
Netherlands: an exploratory study using life cycle assessment
Abstract
Objective: To compare the carbon footprint of caesarean and
vaginal birth. Design: Life cycle assessment. Setting:
Tertiary maternity units and home births in the UK and the Netherlands
Methods: A life cycle assessment, including: equipment use,
energy, analgesia, hospital stay, waste, sterilisation and laundry, was
conducted using primary data combined with data from published sources.
Main Outcome Measures: ‘Carbon footprint’ (in kgCO
2e) Results: Excluding analgesia, the carbon
footprint of a caesarean birth in the UK was 31.21 kgCO
2e, compared with 12.47 kgCO 2e for
vaginal birth in hospital and 7.63 kgCO 2e at home. In
the Netherlands the carbon footprint of a caesarean was higher (32.96
kgCO 2e), but lower for vaginal birth in hospital and
home (10.74 and 6.27 kgCO 2e respectively). Emissions
associated with analgesia for vaginal birth were: 0.08 kgCO
2e (opioid analgesia), 0.75 kgCO 2e
(remifentanil), 1.2 kgCO 2e (epidural) and 237.33 kgCO
2e (nitrous oxide with oxygen). Differences in analgesia
use resulted in a lower average carbon footprint for vaginal birth in
the Netherlands than the UK (11.64 vs. 193.26 kgCO 2e).
Conclusion: The carbon footprint of a caesarean is higher than
for vaginal birth if analgesia is excluded, but this is very sensitive
to the analgesia used; use of nitrous oxide with oxygen multiplies the
carbon footprint of vaginal birth 25-fold. Alternative methods of pain
relief or nitrous oxide destruction systems would lead to a substantial
improvement in carbon footprint. Although clinical need and maternal
choice are paramount, protocols should consider the environmental impact
of different choices.