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THE HEALTH OF BARKING
and an unkindness to tell these harrowing stories and deal with it as such : snub those
who start to scare others in this silly way.
The relaxed, confident attitude of mind is most important but it is not the only
thing, of course, which can be done to make childbirth less painful. The child can
be born under general anaesthesia (when the mother is quite unconscious) or under
analgesia (when the mother is awake but feels no pain). The trouble is that, in
general, the more effective the method, the greater the risk to mother and child.
The search for an agent at once fully effective, absolutely safe, and simple to
administer goes on. Ever since Queen Victoria was given chloroform during
childbirth, experiments have been made and our store of knowledge has grown but
we have not yet found the perfect drug.
One of the best measures is to use the Mlnnitt Gas and Air Apparatus. This
can be used in the home as well as in hospitals because it is portable and midwives
can use it alone after they have been trained in its use. It is safe and it is simple,
but it is not always fully effective in pain prevention, also, though portable, it is
heavy. Nevertheless, it is a very valuable weapon against pain in childbirth.
At the end of 1946, you had 8 midwives in domiciliary practice and 6 of these
held the certificate in gas and air analgesia administration.
Not all cases require this relief but during the year it was administered
to 304 mothers. Since July, 1946, training in gas and air analgesia is to form part
of the training of all midwives.
It looks to me as if the policy of the future will be that every birth shall be attended
both by the midwife and the doctor. When this policy is fully operative, its wisdom
will be tested by the Maternal and Infantile Mortality figures. Comment before
these become available would be premature but it would, of course, simplify the
problem of pain in childbirth.
Before the pregnancy becomes advanced, the midwife calls at the mother's home
and advises upon its suitability for domiciliary confinement. A set of the special
equipment needed at the time of the baby's delivery is given free to each mother.
It will be interesting to watch the development of the Maternity Services in
the future. In the past many of these services have grown up as part of the Public
Health Departments. Pregnancy and delivery have been looked upon as normal
functions and treated as such save only in those cases where it has been necessary
to treat them otherwise by reason of some definite abnormality.
So far as I can see the modern tendency, quite apart from recent legislation,
has been for this work more and more to fall into the hands of specialists. This is
an excellent idea so far as abnormal cases are concerned, but I doubt very much
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