Medicine: Pangless Childbirth

Continuous caudal anesthesia for childbirth (TIME, June 12, 1943) is potentially so hazardous that only an expert in a hospital can use it, and he must be on hand every minute to see that all goes well. This has prevented its use by: 1) busy doctors, 2) country doctors, 3) doctors who have not had a chance to study the method. Last week University of California doctors were well beyond their 100th delivery with a new, simpler kind of childbirth anesthesia which may turn out to be readily usable by any obstetrician. It is billed as “safe, simple and without sequelae [bad aftereffects] . . . done without elaborate equipment or extensive technical training.”

The new method is called paravertebral sympathetic nerve block. It is sponsored by Dr. Shiras (“Skipper”) Jarvis of the University, who is now somewhere in the Pacific with the Navy. Procedure: wait until labor pains are seven minutes apart then block the nerves which conduct pain from the uterus to the brain. This is done by inserting a needle beside the lower spine and injecting a local anesthetic (usually procaine, a cocaine substitute) into the nerve channel which serves the uterus. As labor progresses, nerves farther down are blocked and finally the mother, who until then has been fully conscious, may be given a few whiffs of laughing gas (an anesthetic) if she wants it.

Doctors who have tried the method find that the mothers’ muscle tone remains good, so that delivery is spontaneous, babies are not dopey, labor is shortened. One objection: the injection is 8 to 12 cm. (3⅛ in. to 4¾ in.) deep and some skeptics insist that not every doctor can learn to make it.