Changes

With that, births went from being normal, everyday events, to illness-centered events requiring medical intervention. Once natural, with the dawn of medicine, childbirth became pathologized.

Though most women gave birth at home before the 19th century, the 20th century gave rise to maternity hospitals and more women gave birth with physicians in attendance. Dr. Joseph DeLee, author of the most frequently used obstetric textbook of the time ''Principles and Practice of Obstetrics'', argued that childbirth was a process from which few women emerged unscathed. He believed that physicians needed to maintain control over the labor and delivery process through active protocols and medical interventions <ref name="test">Lynette A. Ament, ''Professional Issues in Midwifery'' (Sudbury: Jones and Bartlett Publishers, 2007), p. 23. </ref> Specialist obstetricians should sedate women at the onset of labor, allow the cervix to dilate, give ether during the second stage of labor, cut an episiotomy, deliver the baby with forceps, extract the placenta, give medications for the uterus to contract and repair the episiotomy.

Twilight Sleep emerged at the beginning of the 20th century in this context. It was one of the most extreme measures available designed to allow doctors to remain in complete control during the childbirth process. In Twilight Sleep, mothers were drugged with morphine and scolpolamine--rendering them effectively unconscious throughout the birth process. This allowed the doctor to maintain control, but also had the additional benefit of rendering the childbirth painless. When the mother regained consciousness, she would have her child in hand, and no recollection of the delivery process.

Twilight Sleep was the product of two German physicians--Dr. Bernhardt Kronig and Dr. Karl Gauss. They developed the procedure in 1906 to alleviate the pain of childbirth. Their development did not occur in a vacuum. Twilight sleep "contributed to changing childbirth from an at home process to a hospital procedure and increased the use of anesthetics in obstetrics," and it was developed several years after Dr. Richard von Steinbüchel suggested the use of scopolamine as an anesthetic for childbirth.<ref>Jessica Pollesche, "Twilight Sleep," The Embryo Project, 2018 [https://embryo.asu.edu/pages/twilight-sleep].</ref>

Morphine, a derivative of opium, was a well-known, powerful, (and addictive) narcotic with analgesic properties, and scopolamine was a "preanesthetic agent" that produced drowsiness, amnesia, and euphoria.<ref>William C. Shiel, Jr. "What is Twilight Sleep in Obstetrics?" MedicineNet, 2018 [https://www.medicinenet.com/twilight_sleep_in_obstetrics/ask.htm].</ref> As medicine became a more organized and professional field, women increasingly asked for anesthetics during the childbirth process. Physicians were responding to these demands. When Dr. von Steinbüchel suggested the use of scopolamine (in conjunction with morphine) he wasn't hoping to render women unconscious, just to reduce pain.

Twilight Sleep was popular because it was thought to be a modern medical intervention, but also because it offered the potential for "painless" childbirth. However, the process was not ''actually'' painless. Women just had no memory of the pain. Their bodies still responded to pain and they still screamed, thrashed, and moved even while in a semi-zombie state. Pregnant women undergoing Twilight Sleep were thus restrained and placed in dark rooms while delivering.

Twilight Sleep soon became widely available in the US in 1914. However, its rise was short-lived. American physicians were not as well-versed in the proper dosages as more women demanded the procedure than physicians and nurses who were trained the administer them. In late 1915, Francis Carmody, a leading advocate for Twilight Sleep in the US, died while during Twilight Sleep--though others would later say the death was unrelated to the procedure itself.

Though Twilight Sleep fell in popularity, it was still available. In 1958, however, an article called "Cruelty in Maternity Wards" by ''Ladies Home Journal'' exposed some of the violence that was occurring in modern American delivery rooms. The author described the leather restraints and screaming that the women under the influence had no memory of. Some have described this as an important moment in the history of childbirth, as it was, after this encouraged for fathers to be present at deliveries where they had been absent before. This was also true for the women. When they were administered this particular drug cocktail, they, too, were absent from the childbirth experience.

====References====

*Mark Sloan, ''Birth Day: A Pediatrician Explores the Science, the History, and the Wonder of Childbirth.''

*Paul Starr, ''The Social Transformation of American Medicine''.