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John C. Hirst, M.D.
JAMA. 1938;111(16):1459. doi:10.1001/jama.1938.72790420001010.
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Safe and effective amnesia and analgesia in labor must be based on individualization of each parturient patient, which in turn must depend on accurate, frequent and complete observations permanently recorded. Otherwise the patient will either be deprived of relief or, with the fetus, will be subjected to unwarranted and possibly dangerous or even fatal depression. With almost universal adoption of sedation of some sort in hospital practice, the obstetrician assumes greatly increased responsibility even in the simplest confinements and should obligate himself to show evidence of adequate personal attention to the progress of labor, not only to justify his policy of conservatism or interference, as the case may be, but also to establish a foundation for the choice of hypnotic as well as for the time, amount and method of administration, particularly in complicated labors.

In spite of these obvious truths, most labor records, even in large maternities, favor incomplete


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