Green Doctors: Suitable Cases for Treatment

On climate, a lot of medicos are out there on the nuttiest end of the doom spectrum. But I had no idea their hysteria could even out-do and embarrass Greenpeace, The Guardian and Tim Flannery’s Climate Council.

Last month three anaesthetists published a peer-reviewed paper in Australasian Anaesthesia  discouraging birthing mothers from using nitrous oxide for pain relief. The trio warn, “While it may be innocuous for the pregnant woman and unborn baby, that is certainly not the case for the environment.”

About 200,000 Australian pregnant women per year choose the help of nitrous oxide.[1] The learned paper wants them to use more climate-friendly pain-killers, and/or epidurals, hypnobirthing, massage, acupuncture, and Tens — elaborate equipment called “Transcutaneous electric nerve stimulator”. They’re all costlier, but hang the expense.

I hasten to add that two of the trio of authors are females, albeit gung-ho for purported planetary healing. Dr Alice Gynther is from Western Health Melbourne and Fiona Pearson from Sunderland Royal Hospital UK. The lone male Forbes McGain of Western Health is a stalwart of Doctors for the Environment Australia (DEA). I’ll chart DEA’s extremism later in the course of my obstetric odyssey.[2]

These three mothers’ helpers write

By educating medical staff and pregnant women about the carbon impact of N2O, ensuring that it is delivered and used as efficiently as possible and considering the use of more carbon-friendly alternatives, we can reduce GHG emissions from the labour ward and help to mitigate the effects of climate change. Ensuring that midwifery, obstetric and anaesthetic staff are aware of the environmental impact of N2O is crucial…

In order to support women’s autonomy and help them make informed choices regarding their labour analgesia [pain reduction], we have a duty to explain the risks and benefits of the different analgesic options. As climate change is a threat to public health, the carbon footprint of [nitrous oxide] is arguably a ‘risk’ worthy of inclusion in such discussions. Ideally such discussions would occur during antenatal classes, that is, well prior to childbirth itself. This knowledge, coupled with the lack of good evidence for nitrous oxide’s analgesic efficacy, may reduce the number of women choosing to use it for labour…

 I can picture the scene at the doctor’s.

Woke medico: Good morning Alice! How about saving some greenhouse warming via an epidural?

Mother-to-be Alice: Dr Wittgenstein, I actually came here to talk about the risk of pre-eclampsia to my baby. How self-centred of me! What do the climate scientists models’ predict for 2050-2100? What can I and my baby do personally to offset China’s 12 billion annual tonnes of emissions, which I understand are accelerating?

Woke medico: No pain, no gain. You go, girl!

The reports’ authors say nitrous oxide is only 7 per cent of all “long-lived” greenhouse gases, and only 1 per cent of that 7 per cent is from women reducing their distress in labour.[3] But being sciencey types, the authors work out how much global warming is created by Victorian women in labour using nitrous oxide. Their model involves a 70kg woman starting with 4cm cervical dilation. First-timers average 5.5 hours and others 4.5 hours. They suck nitrous oxide for 60 seconds per contraction and have three contractions each 10 minutes, hence 18 minutes on the gas per hour. Then the authors add the extra greenhouse damage like

♦ Coal-fired Victorian electricity (75% of output) used to power the medical pumps

♦ Making of mouthpiece, needles, syringes, tubing and contents, sterile single-use drapes, gown and gloves and

♦ Incineration of clinical waste products

Their dreadful conclusion is that emissions-wise, Mrs 70kg might as well have driven an average-polluting car almost 1500km. An epidural equated with just six kilometres breezing along the boulevard in an econobox Barina.

Not all medicos are obsessed about global warming. The green/Left Guardian quotes Gino Pecoraro, president of the Association of Specialist Obstetricians and Gynaecologists: “During childbirth, some women wouldn’t care how many coal-fired power stations are needed to reduce their pain. If pregnant women in labour were denied a proven safe and effective pain relieving method, I’d think we’d be going down the wrong path.”

 The Guardian quotes Greenpeace types (of all people): “Rapid phase out of coal and gas, by far the biggest climate culprits, is the fastest and most effective way to tackle the climate crisis, rather than focusing on the relatively low emissions from obstetric medicine.”

Flannery’s Climate Council also prefers banning coal, oil and gas first before chasing down emissions from behind the drapes in labour wards. In a fleeting flash of sanity, the Council says, “No individual mother should be made to feel guilty about her choice of pain relief.” But it continued, “Parents could do more to protect their child’s health, their wallets and the climate by doing simple things like getting gas out of their homes.” I didn’t realise swapping out gas heaters for electrics was a “simple thing” and a friend down the road says it cost him $6-7000.
The Guardian piece by journalist Isabelle Oderberg finished,

I don’t see anyone asking men queuing up from colonoscopies or transurethral resections of the prostate to give a Tens machine or massage a go. They’re knocked out quicker than you can say ‘Bob’s your uncle’.

While the report in itself may not be “incorrect” in any way [all climate propaganda is good propaganda. TT], it feels like the lowest hanging, cheap-as-chips fruit. Context is everything and, in a world where people who aren’t men [I think she means “women”] are fighting for their right to be treated with care, equality and compassion, the release of this report in this way was deeply ill-advised and made for painful reading.

WHILE our anaesthetist trio finds innumerable fringe studies about alleged health impacts of global warming, they haven’t caught up with a report last February by Britain’s Office for National Statistics that warming in England and Wales alone in the past 20 years can be credited with a net 550,000-plus lives saved. That’s because mortality from cold outweighs by around ten-fold any mortality from heat.[4] Extrapolate the England/Wales result to northern Europe, Asia and America and global warming is a giant health benefit to humanity, even without considering the boon to agriculture.[5]

Noted climate blogger Joanne Nova sums up all this fuss, a little unkindly, as “Junk models meets junk research, junk journals, and junk reporting.” Her commenters also show some robust common-sense. Like Annie, for instance:

Carrying a growing baby and giving birth is perhaps the most rewarding and frightening and triumphant moment in the lives of many women and I feel that using that to score points about Greenhouse gases is sick.

It is evil to suggest denying pain relief at what can be an extremely frightening and painful time for women. How can this ugliness be allowed to continue in a supposedly civil society?

And another:

What? No information on how much Nitrous the MEN will need when they give birth? It’ll be a LOT!”

I’ve mentioned that the paper’s co-author Dr McGain is a stalwart of the Doctors for the Environment Australia (DEA). Of all the global-warming groups among medicos, DEA seems the loopiest about “preventing catastrophic climate change” and the alleged perils of “the current market society”.

DEA teams flung their weight behind the Teal candidates in five electorates to oust Morrison’s conservatives last month, putting “Climate Action Now” signs on their Teslas in Wentworth “at their own cost to raise awareness” and running a “picnic party for our planet” in Boothby (Adelaide). They’ve been advised by a “Scientific Committee” featuring Nobelist Peter Doherty at one end and the ABC’s once-was-medico Dr Norman Swan at the other.

Back in 2019 DEA was already

♦ declaring a climate “health emergency”

♦ demanding a ban on new oil, gas and coal-seam fields[6] and

♦ pronouncing that “Climate change is killing people.”[7]

It campaigned for the demolition of the Port Augusta coal-fired power station, which happened, but DEA’s pipedream of substituting solar thermal energy fell to bits after failing to secure finance. DEA has also striven to lock coal-seam gas in the ground. It gave 100 per cent credence to a report, “Lethal Power”, by Greenpeace activists that coal-fired power plant emissions are killing 373-1310 citizens a year. In a revealing aside, Greenpeace added that the health damage equated to $15.40 per megawatt hour, or about a quarter of the value of electricity’s then-cost. Oh boy, that means that only three years ago our electricity was costing $60 per megawatt hour, compared with $130-200  on recent 2023 futures contracts.

One DEA enthusiast, a Dr Kimberley Humphrey, bewails that “the rate of suicide among young people is also increasing with the threat of global warming and this needs to be prevented by young people able to see we are doing something to save the planet.” If activists would cease scaring the daylights out of little Billy and Sally, the kids might have less incentive to self-harm.

DEA now expresses some Schadenfreude that our health sector “is responsible for a whopping 7 per cent of Australia’s carbon emissions.” Maybe we should dispense with health services by 2030, along with fossil fuels, to save our perspiring planet.

Tony Thomas’ latest essay collection “Foot Soldier in the Culture Wars” ($29.95) is available from publisher ConnorCourt

[1] In the Joan Kirner Hospital labour ward (Melbourne, Australia) in 2020, 62 per cent of women used the gas

[2] The following seven colleges have declared their ridiculous “climate emergencies”, along with 2300 individual medicos:

* Royal Australian College of General Practitioners (RACGP)

* Royal Australian College of Physicians (RACP)

* Australian College of Emergency Medicine (ACEM)

* Royal Australian and New Zealand College of Psychiatrists (RANZCP)

* Australian College of Rural and Remote Medicine (ACRRM)

* College of Intensive Care Medicine (CICM)

* Australian & New Zealand College of Anaesthetists (ANZCA)

[3] From the paper: “More than 1 per cent of worldwide GHG

emissions resulting from N2O are anaesthetic in origin, which is a substantial figure, given that a total of 40 per cent of global N2O is anthropogenic.”

[4] Even in India, cold deaths outweigh heat deaths by 7-to-1

[5] In another recent study, titled “Global, regional, and national burden of mortality associated with non-optimal ambient temperatures from 2000 to 2019: a three-stage modelling study,” 68 scientists representing universities and research institutes in 33 countries spanning all regions of the world, concluded that as the earth modestly warms, deaths caused by non-optimum temperatures are declining by tens of thousands of people each year.

[6] In today’s real world, PM Albanese’s Resources Minister Madeleine King vows never to put a limit on how much coal Australia will export, with Australia possibly still exporting coal to Asian trading partners past 2050, and Labor is scrambling to protect two big aluminium smelters from grid crises. 

[7] From the 2019 DEA media kit: “Interview and photo opportunities — Doctors in scrubs, surgical masks and stethoscopes will gather to issue the Climate Emergency declaration on Saturday 6 April at the Menzies Research Institute, 17 Liverpool Street, Hobart at 10:20 am.”