Birth and ‘twilight sleep’ (1915)

The article below offers a perspective on childbirth from the year 1915, when there were far fewer pain relief options than there are today — as well as much less understanding of (and appreciation for) the process of labor and delivery.

The very same month that this article was published, however, an advocate for Twilight Sleep during birth — Frances X Carmody — died while delivering her third child… and people started to realize that maybe the method really wasn’t as great as they thought.

To find out more about Mrs Carmody and the changing attitudes about birth here: A Quick History of Medication in Maternal Health Care (and the Business of Being Born).

Mother of ‘twilight sleep’ baby brings message to “martyrs of motherhood”

by Mary Boyd, President of the Twilight Sleep Ass’n of New York

Two years ago, I did not myself know what twilight sleep was. I did not even know that there was such a thing as twilight sleep.

When I went to Freiburg two years ago to have my child, I found that the Freiburg way was called “Dämmerschlaf,” which roughly translated means “twilight sleep.”

Twilight sleep, I found from my experience, is easier for the doctor than for the mother to describe, for the period of my “twilight” is a period of ten hours just wiped out of my life.

I remember the nurse stooping over me with the hypodermic needle, and I remember waking up in the same dim room with the same quiet nurses passing to and fro. I was frightened because the labor had stopped and I thought that something was the matter, so when the nurse came to me I told her that labor had stopped. She laughed, stepped to a table and brought me my baby. I had brought him into the world entirely by my own efforts and even with some of the expressions of pain that a woman in consciousness uses, but I knew nothing of what I had been doing!

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Many elements go to produce twilight sleep. The sleep itself is not unconsciousness or even semi-consciousness; it is simply instantaneous forgetfulness of pain. One moment you see the mother crying in pain; the next she will be sleeping so soundly that you cannot believe she is the same woman.

The drug element in twilight sleep is at first a tiny dose of copolamin, together with a small dose of morphine. Then the scopolamine is repeated in still tinier doses, but no more morphine is used. The scopolamine is only repeated when, by the so-called “memory test,” the doctor finds that the mother is remembering some of the things that happen about her and may soon remember the pain.

Quite as important as the drugs are the “psychic” elements in twilight sleep. These are a mind undisturbed by fear and a quiet, dim room, where sight and hearing and touch are especially protected from disturbance.

These are what enable the mother to drift dreamily into the twilight, even under a very tiny dose of the narcotic. This is what doctors had done with scopolamine-morphine before Prof Bernhard Kronig and his assistant Dr Carl Gauss, by years of patient labor, worked out the twilight sleep at Freiburg. If you hear doctors today criticize twilight sleep, you can know that it is these doctors own overdosing in past years before twilight sleep was known. They either do not know or do not choose to know the difference between their own use of scopolamine-morphine and the Freiburg twilight sleep.

Under twilight sleep, as used in Freiburg on 5,000 cases and in America on at least 1,000, there have been no injuries to either the course of labor, the mother or the child.

Quite the reverse; for, as I shall show in later articles, not only have mothers been given ease and comfort in childbirth by twilight sleep, but labor has been made more normal by twilight sleep, and mother and child have been protected by it from some of the dangers and injuries of birth.

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Photo: Six tagged babies lying in a crib in a room in a hospital in Chicago, Illinois (1912; DN-0009511, Chicago Daily News negatives collection, Chicago History Museum)

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