Barnett, R.; (2007) Obstetric anaesthesia and analgesia in England and Wales 1945-1975. Doctoral thesis , University of London.

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Abstract

This thesis addresses the history of obstetric anaesthesia and analgesia in England and Wales between 1945 and 1975. It is based on an analysis of archival material from the Ministry of Health Department for Health and Social Security, the Central Midwives Board, the Medical Research Council, the Royal College of Obstetricians and Gynaecologists, the Obstetric Anaesthetists' Association and the National Birthday Trust Fund. Other sources used include the popular and medical press, British governmental publications, oral history interviews and a prosopography of the Obstetric Anaesthetists' Association. In this period the management and elimination of the pain of childbirth became the subject of great interest not only for mothers and anaesthetists, but also for obstetricians, midwives, clinical scientists, healthcare administrators, politicians and the press. Broadly speaking, existing work on the history of obstetric anaesthesia and analgesia treats this subject in two contrasting ways. Practitioner-historians of anaesthesia have characterised it as one of co operation between mothers and medical practitioners, but many historians of obstetrics and midw ifery have preferred to emphasise the role of obstetric anaesthetists in medicalising and hospitalising birth. This thesis places the development of obstetric anaesthesia and analgesia in the context of three related narratives. These narratives emerged in the first half of the twentieth century, but after 1948 operated within wider debates over the centralisation and hospitalisation of state healthcare under the NHS. First, the emergence and consolidation of anaesthesia as a hospital- based clinical speciality. Second, the demographic shift from home to hospital birth. Third, arguments over the role of midwives in birth. It uses four case-studies to explore these narratives: the Analgesia in Childbirth Bill, 1949 the development of new analgesics for use by unsupervised midwives obstetric anaesthesia and analgesia in the governmental Reports on Confidential Enquiries into Maternal Deaths and the early history of the Obstetric Anaesthetists' Association and its role in debates over epidural analgesia.

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