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The Health of Barking
doctors thought about it. She was a little shy at asking the doctor a direct question
on the matter—it was unfortunate that she did not ask because a lot of people
attending the clinics have an altogether wrong notion about what is done in Barking
with regard to analgesia.
A large number of people have a vague idea that doctors generally, owing to their
intense conservatism and for other reasons, are opposed to analgesia in midwifery.
This, of course, is not so. What doctors are vitally interested in is finding out what
is the safest way of bringing about analgesia.
It is now 35 to 40 years ago that I was called upon to write the notes on the
delivery of a baby under what was then spoken of in general terms as " twilight
sleep " and even now I remember writing up that the colour of the baby when
born was not healthy. What did happen, I suppose, under this form of analgesia,
was that the baby was longer being delivered than would otherwise have been
the case, and it suffered more than was normal.
Then there came in a vogue for chloroform capsules, which the patient could
break on her own and inhale. I myself have tried the use of chloroform, but
there is a lot to be said against its introduction into general use. A search is still
going on for the ideal analgesia which must at one and the same time be efficient
and safe.
At this stage we in Barking use gas and air, the same sort of gas that is used
in dentistry, and of the 518 confinements on the district, gas and air was used in
317 cases.
We do not like the midwife using gas and air unless the doctor has examined
the patient and said it is quite safe, and we do not like the midwife to use the
apparatus if the patient has had bronchitis between the date of the doctor signing
the certificate and the date the woman is confined.
At the Barking Hospital trilene is used, which is an analgesia that has come
into use more recently than gas and air, but at this stage it is not considered safe
to be used generally on the district, although perhaps a technique may be developed
which will enable it to be so used in the near future.
With all this new work going on we must not forget that some of the older
work is quite useful and that drugs which have been known for a very long time
can be used and still do give a large measure of relief.
The ideal analgesia will be one which makes the patients unconscious of
pain ; it will be safe, and it will be without detriment to the child about to be born.
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