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47
Most of the midwives employed by the Essex County Nursing
Association have already taken the approved course of instruction.
Only three are not qualified to administer gas and air, but it would
presumably be desirable that all the midwives practising in the
Borough should attend a course of instruction.
When the question of the actual administration of gas and
air analgesia arises, some arrangement will require to be made by
which two midwives, or a midwife and a pupil, are available for
each case desiring analgesia.
In the report on 'A National Maternity Service' prepared in
1944 by a Committee on behalf of the Council of the Royal College
of Obstetricians and Gynaecologists there is a section on the relief
of pain. The report states that it is the duty of the medical attendant
and midwife to relieve the pain of labour as thoroughly as
possible, bearing in mind that their efforts in this direction must
not be allowed to jeopardise the safety of the mother or child.
The concluding paragraph reads: "We would stress that much
more thorough and varied training than has hitherto been given is
necessary for doctors and midwives, within their respective scopes,
in the methods and drugs used for relieving the pain of labour;
for we have no doubt that the widespread use of anaesthetics and
analgesics by unskilled administrators results in maternal and
neonatal deaths and stillbirths."
The cost of the apparatus for the administration of gas and
air analgesia (weighing some 28 lbs.) is £26 10s. 0d.
A further amendment of Rule 10, Sec. 3, was made by the
Central Midwives Board in September, 1945. This section refers
to the second person who must be present at the time of administration
of gas and air analgesia by the midwife in charge of the case.
The section now reads:—
"One other person, being any person acceptable to the
patient, who in the opinion of the midwife is suitable for the
purpose, is present at the time of the administration in addition
to the midwife in charge of the case."
so that it is no longer necessary for this second person to have had
any training.