Abstract：
OBJECTIVE: To compare the carbon footprint of caesarean and vaginal birth.
METHODS: Life cycle assessment (LCA).
METHODS: Tertiary maternity units and home births in the UK and the Netherlands.
METHODS: Birthing women.
METHODS: A cradle-to-grave LCA using openLCA software to model the carbon footprint of different modes of delivery in the UK and the Netherlands.
METHODS: \'Carbon footprint\' (in kgCO2 equivalents [kgCO2 e]).
RESULTS: Excluding analgesia, the carbon footprint of a caesarean birth in the UK was 31.21 kgCO2 e, compared with 12.47 kgCO2 e for vaginal birth in hospital and 7.63 kgCO2 e at home. In the Netherlands the carbon footprint of a caesarean was higher (32.96 kgCO2 e), but lower for vaginal birth in hospital and home (10.74 and 6.27 kgCO2 e, respectively). Emissions associated with analgesia for vaginal birth ranged from 0.08 kgCO2 e (with opioid analgesia) to 237.33 kgCO2 e (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 versus 193.26 kgCO2 e).
CONCLUSIONS: The carbon footprint of a caesarean is higher than for a 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.
METHODS: Life cycle assessment (LCA).
METHODS: Tertiary maternity units and home births in the UK and the Netherlands.
METHODS: Birthing women.
METHODS: A cradle-to-grave LCA using openLCA software to model the carbon footprint of different modes of delivery in the UK and the Netherlands.
METHODS: \'Carbon footprint\' (in kgCO2 equivalents [kgCO2 e]).
RESULTS: Excluding analgesia, the carbon footprint of a caesarean birth in the UK was 31.21 kgCO2 e, compared with 12.47 kgCO2 e for vaginal birth in hospital and 7.63 kgCO2 e at home. In the Netherlands the carbon footprint of a caesarean was higher (32.96 kgCO2 e), but lower for vaginal birth in hospital and home (10.74 and 6.27 kgCO2 e, respectively). Emissions associated with analgesia for vaginal birth ranged from 0.08 kgCO2 e (with opioid analgesia) to 237.33 kgCO2 e (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 versus 193.26 kgCO2 e).
CONCLUSIONS: The carbon footprint of a caesarean is higher than for a 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.
摘要：
目的：比较剖宫产和阴道分娩的碳足迹。
方法：生命周期评估（LCA）。
方法：英国和荷兰的三级产妇单位和家庭分娩。
方法：分娩妇女。
方法：使用openLCA软件对英国和荷兰不同交付方式的碳足迹进行建模的从摇篮到坟墓的LCA。
方法：\'碳足迹\'（单位：kgCO2当量[kgCO2e]）。
结果：不包括镇痛，英国剖腹产的碳足迹为31.21kgCO2e，相比之下，医院阴道分娩为12.47kgCO2e，家里为7.63kgCO2e。在荷兰，剖腹产的碳足迹更高（32.96kgCO2e），但在医院和家庭中阴道分娩较低(10.74和6.27kgCO2e，分别)。与阴道分娩镇痛相关的排放量从0.08kgCO2e（阿片类药物镇痛）到237.33kgCO2e（一氧化二氮和氧气）。镇痛使用的差异导致荷兰阴道分娩的平均碳足迹低于英国（11.64对193.26kgCO2e）。
结论：如果排除镇痛，剖腹产的碳足迹高于阴道分娩，但这对所用的镇痛非常敏感；一氧化二氮和氧气的使用将阴道分娩的碳足迹增加了25倍。缓解疼痛或一氧化二氮破坏系统的替代方法将导致碳足迹的实质性改善。尽管临床需要和母亲的选择是最重要的，协议应考虑不同选择对环境的影响。
方法：生命周期评估（LCA）。
方法：英国和荷兰的三级产妇单位和家庭分娩。
方法：分娩妇女。
方法：使用openLCA软件对英国和荷兰不同交付方式的碳足迹进行建模的从摇篮到坟墓的LCA。
方法：\'碳足迹\'（单位：kgCO2当量[kgCO2e]）。
结果：不包括镇痛，英国剖腹产的碳足迹为31.21kgCO2e，相比之下，医院阴道分娩为12.47kgCO2e，家里为7.63kgCO2e。在荷兰，剖腹产的碳足迹更高（32.96kgCO2e），但在医院和家庭中阴道分娩较低(10.74和6.27kgCO2e，分别)。与阴道分娩镇痛相关的排放量从0.08kgCO2e（阿片类药物镇痛）到237.33kgCO2e（一氧化二氮和氧气）。镇痛使用的差异导致荷兰阴道分娩的平均碳足迹低于英国（11.64对193.26kgCO2e）。
结论：如果排除镇痛，剖腹产的碳足迹高于阴道分娩，但这对所用的镇痛非常敏感；一氧化二氮和氧气的使用将阴道分娩的碳足迹增加了25倍。缓解疼痛或一氧化二氮破坏系统的替代方法将导致碳足迹的实质性改善。尽管临床需要和母亲的选择是最重要的，协议应考虑不同选择对环境的影响。
