Orders of the Day — Analgesia in Childbirth Bill

Part of the debate – in the House of Commons at 12:00 am on 4 March 1949.

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Photo of Squadron Leader Samuel Segal Squadron Leader Samuel Segal , Preston 12:00, 4 March 1949

My hon. Friend says that these figures have no relevance. My view is that they point to the desperate necessity of having this Bill passed into law for the benefit of the vast majority of our expectant mothers who have not the access to skilled medical help which the wives of doctors or married women doctors have at their disposal.

Another striking figure was contained in this report. These women were asked how many of them actually thought that administration of an analgesic was necessary in the confinement. The figures here are even more significant. No less than 92 per cent. thought that analgesia was necessary in their confinement. Only 4 per cent. said categorically that they thought that it was unnecessary. Having read out those figures I turn to a further set of figures quoted in the "British Medical Journal" of the same issue, wherein it is stated that in the Metropolitan Boroughs only 5 per cent. of mothers confined at home, and 48 per cent. of those confined in hospital, were given relief. Let us think of the degree of dread which must encompass the minds of the 95 per cent. of mothers confined in their own homes.

A great deal has been said this afternoon about the difficulties of the Minnitt apparatus and the difficulties of its portability. Whereas it may be available in hospital it is certainly difficult to make it available in the majority of homes. Parenthetically, I should like to say that the granting of a motorcar to every midwife in the country should not be required by reason of the need to transport the Minnitt apparatus to the home of the mother who is undergoing confinement, but should be granted as of right to every midwife in the country regardless of this issue of analgesia in childbirth.

Another set of figures in the same report is also significant. Not only did 92 per cent. think that analgesia was necessary, but 25 per cent. actually stated that they wanted more analgesia than they actually received. This same report goes on to ask that the reasons for this should be sought: Are obstetricians disinterested in obstetric analgesia? Could more effective drugs have been given? Did the mothers react abnormally? These are highly technical questions which should be left to the medical profession to decide for itself. But when the report proceeds to ask whether obstetricians—that is, the specialist in the carrying out of confinements—are disinterested in obstetric analgesia, surely we can ask ourselves to what extent the ordinary general practitioner, so harassed with a heavy round of other patients to visit may be found to be—whatever the reasons—disinterested in administering analgesia in an obstetric case? He knows, and it is no fault of his, that the more analgesia he administers the longer the confinement may possibly take. With a number of other cases to attend, perhaps even more urgent than that of a woman in childbirth, he knows that he cannot give the necessary time and care to her case which he would like to give.

The corollary is equally true. When a doctor in attendance on a case finds that he is not pressed for time, and that he can concentrate entirely on the one case in hand, there is nothing that can equal the satisfaction the doctor receives, that deep inner self-satisfaction, that feeling that he has delivered a woman of a baby with as near a complete absence of pain as possible. There is a very real satisfaction in the happiness which he sees in the mother, even the degree of the absence of trauma in the child through the mother having had a normal steady confinement, which has not had to be interrupted because of the doctor being hard pressed. I have found in my own experience that it is one of the deepest and most profound types of satisfaction that a doctor can ever derive from his own medical practice. I only wish that doctors in our country today were sufficiently numerous and sufficiently unduly pressed for time so that they could devote to every confinement which they attend that degree of care and patience necessary both in the interests of the mother and the child.

If very often the doctor finds problems in the administration of an analgesic, to what extent would the midwives find it difficult? They are sometimes left in remote districts with the sole responsibility for the confinement on their hands. Every doctor realises what an enormous amount of research work still has to be done on this subject. But that is no excuse for administering at least some form of analgesia under proper safeguards, however imperfect that it may be, so that the mother should know in advance that she can be absolutely assured of some form of relief, even if it is nothing more than providing her with a free supply of chloroform capsules which she can crush in the folds of a handkerchief and inhale from time to time when she feels a severe pain coming on. It may well be a far from perfect form of analgesia, but it is a tremendous source of psyohological comfort and relief to the patient to know that she has within her grasp means of relieving at least the greatest severity of the pain which she is undergoing.

We reached the stage many years ago when doctors were entitled to a free supply of ampoules of N.A.B. for the treatment of syphilis. Surely now doctors and midwives all over the country should feel that they may have available an unlimited supply of these chloroform capsules or some other simple, self-administered analgesic to be used with a degree of discretion and restraint, and that the patient herself should know that there is some form of relief. Every midwife in the country should be able, long before the confinement, to assure the expectant mother that there will be some form of analgesia made available at the time of confinement.

There are a great many other points upon which one would like to dwell, but these few points alone may serve to show how deeply many doctors feel about the issues dealt with by this Bill. To my mind there is no excuse whatever for the Government not giving their fullest support to the Bill, and seeing to it that it will become in the very near future a directive to every single local authority and every midwife in the country. I believe that if we could remove the dread of the mother in childbirth we should go a long way to promoting the happiness and welfare of both mothers and children in tens of thousands of homes all over the country.