The Matron's Manual of Midwifery, and the Diseases of Women During Pregnancy and in Childbed / Being a Familiar and Practical Treatise, More Especially Intended for the Instruction of Females Themselves, but Adapted Also for Popular Use among Students and Practitioners of Medicine

by Frederick Hollick

APPENDIX.

ON PREVENTING PAIN IN CHILDBIRTH.

USE OF CHLOROFORM IN MIDWIFERY.

AN ENQUIRY INTO THE UTILITY AND PROPRIETY OF PREVENTING THE PAIN AND SUFFERING WHICH USUALLY ATTENDS CHILDBIRTH, WITH AN ACCOUNT OF THE MEANS TO BE EMPLOYED FOR THAT PURPOSE.

In the preface to this work I remarked that a great part, and, perhaps, nearly the whole, of the suffering and danger to which parturient females are exposed, arises, undoubtedly, from their bad physical education and mode of life; and that, in a more rational state of existence, it was probable that both would be so slight as to excite no apprehension. This improved state of things is much to be desired, and should, of course, be striven for by all friends of humanity. But, in the mean time, it is proper to consider whether there are any means by which those now living can be relieved in their hours of distress. The agony which many females endure at this time is so great that there are few circumstances under which relief is more needed, or would be more acceptable; and I, for one, cannot subscribe to the doctrine that such relief would be improper, unless it prove to be injurious. There are some persons, I know, who say that this suffering has been ordained for woman, and that it ought to be endured. This notion, I think, needs no refutation, it being just as unreasonable as to say that the sick should be allowed to suffer and die without assistance, because their condition has been ordained. There are others, and men of science, too, who think that the pains of childbirth are necessary to its safe accomplishment, and that they are also valuable in a moral point of view. This opinion will be examined by and by, and the facts on which it is founded, carefully analyzed; but it is first necessary to state the means of prevention usually employed, and to note their mode of action, and effects.

Some years ago, a celebrated physiologist, who supposed that the chief cause of pain and difficulty in labor was the size and hardness of the child's bones, advanced the theory that if these bones were less developed, and softer, the pain and difficulty would be materially lessened, if not entirely removed. He proposed, therefore, since the hardness of the bones is caused by the deposition of lime in them, which is derived, of course, from the blood of the mother, that she should avoid taking anything to eat or drink, during pregnancy, that contained lime. This, he supposed, would keep the bones of the child soft till after birth, and so allow them to give way and crush together during delivery, and thus prevent the suffering and difficulty usually experienced. It was also thought that the bones of the mother would be partially softened at the same time, and give way a little, so as to facilitate the process still more.

I am not aware, however, that this theory has ever succeeded in practice, either in the human species or in the lower animals, though frequently tried. Nature will work on her own plan, and will develop the bones of the fœtus, while in the womb, to a certain extent, providing she has the means to do so; and if these are withheld, she is very likely to suspend its development altogether, rather than send it forth imperfect. I have known cases where everything was withheld, for the whole period, that contained a particle of lime, and yet the child's bones were as hard at birth as in any other case; the material being, probably, taken from the bones of the mother, which might be thus weakened, and made liable to displacement, without any good result whatever. It is also a question whether such a course, supposing it to succeed, might not be dangerous in another way, by causing an imperfection in the child which its future growth could not overcome. I have known some cases where this practice appeared to have caused abortion from imperfect development, and several others in which there was too much reason to fear that the child was injured, though safely born. As this is, therefore, at best, a very uncertain and ineffective process, and is also, probably, dangerous to the mother or child, or both, it does not appear to me worthy of further attention, and I merely allude to it in order to make the present sketch of such means complete.

The other means are such as do not interfere, in any way, with the natural processes, but merely prevent sensation or feeling at the time of delivery. Mesmerism has been recommended, and, in some few instances, tried, for this purpose, but its success has either been so small, or its action so uncertain, that no dependance can be placed upon it, notwithstanding many persons assert its power. Opium and other powerful drugs have also been given, but so much of them is required, at that time, to produce a sufficient effect, that their use becomes dangerous. Other substances, in the form of vapour, or gas, have also been used, the effects of which only last for a short time, and are not, generally speaking, at all dangerous. Among them may be mentioned nitrous oxide, or laughing gas, carbonic acid, sulphuric ether, and chloric ether, all of which were first employed in severe surgical operations.