Analgesia and anesthesia and their bearing upon the problem of shortened labor

Abstract

I T IS very interesting to note the reaction of members of the medical profession toward the question of painless labor at various times during the last two or three decades. There was the period during which either nothing was given to relieve pain or merely a little chloroform as the head was being born and when in national obstetrical society meetings there was bitter opposition to proposals for relief of pain, all kinds of arguments, some quite silly, being made against such proposals. In years following, a continually increasing number of obstetricians had a more or less favorable attitude toward painless labor and instead of opposition there were efforts to develop new methods for relief. Many were suggested, perhaps in most cases too much stress being laid upon the individual procedure, even to the extent of making it a fad for the laity. Much that is disgusting has been published in lay journals. More recently we have heard renewed opposition to painless labor in medical circles. Bad results of childbirth have been attributed to analgesia and anesthesia, when in reality they were due to bad judgment or technique of poorly trained physicians. Unfortunately this has been quoted in lay journals, all to give the laity a very wrong impression of the real facts and values. Through all these years my associates and I have continued, unswayed by these discussions, to relieve all pain of labor and delivery, from start to finish, to the fullest extent of our ability to do so. Painless labor is not an experiment nor has it been considered such at the Cleveland Maternity Hospital during the last twenty or twenty-five years. From the results obtained in a, very large number of cases we have no doubt as to the safety and effectiveness of our relief methods and have never had any hesitancy about continuing them but have rather been amazed at groundless arguments against such procedures. It would seem that in spite of some unfavorable opinion the real question today is not whether to make labor painless but how to do this in the best way. The chief mistake of those who have advocated any particular method has been the attempt to make of it a means of conducting the ent.ire labor painlessly. For example one may advocate morphinescopolamine, colonic ether, paraldehyde, the various barbiturates or avertin as if any one of these were a method in itself sufficient. No one