THE B.M.A. AND MIDWIVES should like to thank Mr. D.
C. Macdonald for his letter, in which he confirms my statement that the B.M.A. is a voluntary organisation to which a certain number of doctors and dentists belong, and I am grateful to him for emphasising the fact that the organisation is more " limited " than my letter might suggest, in that only those dentists are allowed membership who have a medical as well as a dental qualifica- tion. I mention these facts because so many members of the general public mistake the activities and powers of the B.M.A. for those of the General Medical Council, the latter, of course, being the only body which has authority over every medical Practitioner, while the former only has authority over its own members.
In regard to the use of anaesthetics by midwives, I am afraid I must strongly disagree with Mr. Macdonald's attitude to this question.
His statement that "it is often in the early stages of chloro- form anaesthesia that the risk is greatest " is very clever—I hardly like to say naive—for it is thoroughly well established that while this statement is very true in cases of minor and major operations, the one great exception is a woman in child- birth. A normal woman in labour can obtain very great help and relief from pain by the administration of faint traces of chloroform—in fact, one can arrange for them to administer it to themselves by means of a simple apparatus which auto- matically cuts off the supply of chloroform vapour as soon as
they lose consciousness, and this can be done with absolute safety.
The modem trained midwife is a fine and intelligent type of woman, and is perfectly capable of arranging such apparatus as mentioned above. Moreover, we must bear in mind that by far the majority of women in labour are attended by quali- fied midwives only. Are all these mothers to be denied the relief a simple anaesthetic could give them merely because a doctor is not present?
Fortunately for the women of this country, the answer to this question does not rest with the B.M.A., and I hope that in the near future the Central Midwives Board will take steps to prevent their nurses from being treated as if they were devoid of average intelligence where simple and safe anaes- thetics are concerned.—Yours faithfully,
z Sussex Place, Slough, Bucks. H. TUDOR EDMUNDS.
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