The opinion that painless childbirth should be freely available to all women on demand was expressed yesterday at the World Congress of Anaesthesiologists in London. Before long, it was suggested, doctors would be under pressure from women to introduce new techniques which, on economic grounds and because of manpower shortage, were not at present obtainable generally.
The method particularly recommended for many women by the anaesthetists was epidural analgesia, which has been most successfully used at the Westminster Hospital and some other centres for some years. It is probably available to less than one per cent of mothers in Britain.
It works by cutting off the pathway of pain along the nerves by means of a small injection in the back and introducing drugs into the small space just outside the fluid area of the spinal cord.
Quiet wards
Mr. Roger de Vere, consultant obstetrician at the Westminster Hospital, said epidural anaesthesia was ideal in that it was safe for mother and baby, and it did not complicate the obstetric situation, and it did not reduce the cooperation of the mother.
"Mothers like it", he said. "We have not had one who, with their second child, refused it." It made labour dignified, the wards quiet and peaceful, contrasting with "the rather rough and tumble effort that may occur with morphine and pethidine, which may cause confusion".
It had been objected that an assisted delivery was more often necessary with this method, particularly with first babies: but he did not think this was a disadvantage. One major difficulty was that 40 per cent of women were delivered at home, the vast majority by midwives. If epidural analgesia was to be universally applied to those who wanted it there would have to be a vast increase in the number of anaesthetists and obstetricians, because normal deliveries would have to be made by doctors.
Less mortality
Professor John Bonica, Professor of Anaesthesia at the Washington University, said childbirth was painful in spite of claims to the contrary. In some instances the pain was minimal, in some moderate, in some severe.
"I think that today women deserve and should receive ample relief, which should be related to their needs", he said.
Dr. John Wyman, consultant anaesthetist at Westminster Hospital, said epidural analgesia completely abolished pain. There was full retention of all mental faculties and the mother was "present at her own child's birth".
