The Introduction of Anesthesia in Obstetrics

News of the introduction of ether anesthesia in surgery by the dentist W. T. C. Morton in Boston reached Europe on December 1, 1846, and on December 19 James Robinson, an English dentist, became the first in Great Britain to anesthetize a patient with ether.  The practice was quickly adopted by British surgeons for surgical operations; however, anesthesia was not used in childbirth in either Europe or the United States until January 19, 1847, when James Young Simpson, professor of midwifery at the University of Edinburgh, etherized a laboring woman afflicted with a severely contracted pelvis.

The following month Simpson wrote Notes on the Inhalation of Sulphuric Ether in the Practice of Midwifery. This 11-page paper was his first on the practice of anesthesia—recording the obstetric cases in which he had successfully used ether. These included “the operation of turning, in cases of the employment of the long and of the short forceps, as well as in several instances in which the labour was of a natural type” (p. 3). He concluded by addressing the objections of contemporary obstetricians and the lay public as to the propriety of alleviating the pains of childbirth:

“I have stated that the question which I have been repeatedly asked is this—will we ever be ‘justified’ in using the vapour of ether to assuage the pains of natural labour? . . . I believe that the question will require to be quite changed in its character. For, instead of determining in relation to it whether we shall be ‘justified’ in using this agent under the circumstances named, it will become, on the other hand, necessary to determine whether on any grounds, moral or medical, a professional man could deem himself ‘justified’ in withholding, and not using any such safe means (as we at present pre-suppose this to be), provided he had the power by it of assuaging the pangs and anguish of the last stage of natural labour” (p. 11).

Simpson published his paper in the Monthly Journal of Medical Science issued from Edinburgh. There appear to be two issues of the offprint of Simpson’s paper:  one with a statement on the title reading “Extracted from 75th No. of the Monthly Journal of Medical Science, published Feb. 24, 1847,” and the other reading “Extracted from the Monthly Journal of Medical Science for March 1847.”