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15 Crazy Truths About Twilight Sleep

Childbirth used to be something that was considered natural. Women gave birth in bed at home with other village women or  midwives nearby. Regardless, these women had seen many births and knew what to do. Yes, there were unfortunate accidents where babies, mothers or both died when complications arose. In most cases, however, everyone was alright. The problem was the pain of childbirth. As time went on, women wanted relief from this pain, and with it came the beginning of medicine and the advent of drugs. They hoped to have this miracle delivery that would be pain free.

In the late 1880’s women began demanding a birth called “Twilight Sleep," or "Dammerschlaf ” in German, meaning "painless childbirth." It was brought about by the injection of morphine and scopolamine to relieve the pain of childbirth. Women fell asleep and did not remember the labor. But in many cases, women died or were not the same for years due to the drugs administered. The controversies about this practice would go on for years. Here are 15 crazy truths about twilight sleep:

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15 Erased Memory Of Birth Altogether

While it may seem crazy, one of the two drugs used to ease the pain of birth actually erased the memory of it entirely. The drug of choice was scopolamine. It's derived from nightshade plants. It caused the person to become semi-conscious and experience a form of amnesia, in other words, cause them to forget what happened. The other drug that was used was morphine. This helped with pain management. However, sometimes patients still experienced pain and would cry for hours. While they wouldn't remember it, they would still be suffering anyway. Therefore, that pain free birth that women talked of was really just an inability to remember what had happened to them. Sometimes in horrible flashbacks, parts of the traumatic events would come back. Many women shared stories of the horror they experienced during this time years later.

14 Women Became Uninhibited And Psychotic

There were some upper class women in Germany reporting on the advantages of twilight sleep and their wonderful experiences with a painless childbirth. So some US women began to demand to try it and “take control” over the pain of labor, but all were not in agreement over this method’s effectiveness. The German doctors who began Dammerschlaf, Dr. Bernhardt Kronig and Dr. Karl Gauss, as well as other doctors in the United States, began seeing the horrible side effects from both drugs; delirium, psychotic behavior where women had to be restrained, shackled, and locked in special beds where they could not move. Many women cried for days until the birth happened. Some suffered terribly, even if many did not recall it - except in a few cases where they had traumatizing flashbacks. There were also side effects like decreased pulse, slower morphine induced contractions as that was the other drug introduced at the same time, and decreased respiration.

13 Dosing Made All The Difference

Doctors in Germany realized that the success cases they had, were due to being able to admit the women a good thirty days before delivery in order to examen them and administer the correct dosage of the two drugs needed to strike the right balance in having a painless child birth. They also stayed with the women once labor started, and though they would leave at times, doctors would be checking up on them regularly to make sure that they were not overdosing. Even in cases where all seemed well, there was always the risk of something going wrong. In the US, the doctors were not as numerous, and due to staff shortages were not able to adjust individual dosages according to the women’s bodies. They would sometimes just guess, and would also not be able to stay or check in on them regularly. It made for a more dangerous way to administer this procedure.

12 Labor Went On For Longer Than Necessary

In a lot of cases bot in Germany and the US, labor ended up going on longer than necessary. This produced exhausted women and often babies that were drug addled and lethargic. There were also more fetal and mother complications due to a longer labor which included longer recovery times for the mother, and difficulties for babies to settle and bond with the mother. As a result, women’s suffering was prolonged. They would self-harm, scream, and thrash around in their beds. They would be put in “cot-like” beds not to fall out and would sometimes have to lie in their own vomit and waste until labor ended. Medical staff that witnessed this were horrified. Eventually, in 1915, after the death of one of twilight sleep’s biggest US supporters, Francis Carmody, the procedure became less popular, a year after the demand for it in the US and Germany.

11 Risk Of Hemorrhage Was Great

Another horrible danger of this procedure was the risk of hemorrahage. All the thrashing around and moving out of control inflicted by the drugs, and the unpredictability of the contractions and labor under the drugs, put women in a real dangerous position. As most were given the same dosage in most twilight sleep clinics due to the low doctor-patient ratio, and the doctors leaving them in the care of nurses who were not trained, it was a scary  situation indeed. And even the doctors did not have the same training as those in the Freiburg clinic in Germany where the procedure was detailed and measured accordingly, and individual care was truly given to each woman that came in. Women were demanding it to try and get some control over the labor experience, though many doctors were against it after having seen how quickly things could escalate. Still, the public demand outweighed doctors' opinions.

10 Higher Risk Of Fetal Death

Ironically, what women most feared about a home birth was risk to themselves and their babies, and yes, there were cases of mother and infant mortality in home births. But the rate of mother and infant casualties was far greater with this new procedure. Anything from giving drug doses that were too high, leaving women alone for too long, other complications that would arise due to a depressed nervous system, anxiety due to the confusion brought upon by the drugs, and the restraints and straightjackets women had to wear to avoid hurting themselves and others, made deaths more common in a lot of cases unfortunately. Sometimes the stress on the heart or other organs produced problems in delivery, and with babies born with drug addled responses, they were sometimes too weak to respond to any intervention and became quite sick. Those that could not be saved would die.

9 Feminists Fought For The Right To Have Twilight Sleep

Unlike today where women continue the trend towards natural childbirth in a home or outside of a hospital setting that began in the 1960’s, most women who were feminist in nature argued for the opposite in the 19th century. It was thought that a medically-assisted birth would give women control over their pain management, and help their childbirth experience to be more like a vacation at a hotel than having a baby in all its ups and downs. They didn't want the pain or the memories of it, so they pushed doctors to adopt Twilight Sleep clinics and get access to it. This was especially the case with middle-class to upper middle-class women who were thought to be too gentile to deal with childbirth. Even women who were not for it were told by feminists to raise up their arms against the doctors who voiced concerns about this practice’s unpredictability and dangers. It was viewed as women taking control of their own pain management.

8  Contractions Slowed Down Due To Morphine

Having a painless birth is usually equated with having a quick delivery and contractions that come regularly and at a normal pace. However, with morphine making the contractions slower, many women’s labors were long, drawn out, and more painful. The body did not know how to measure and deal with these kind of artificial contractions. These also were the cause of a longer recovery time for mother and baby afterwards, as well as confusion, foggy memory, and for many women difficulties adjusting to motherhood afterwards. Baby absorbed these drugs too, and this was not good for their development either. It would be years later in the 1960s that women started advocating for drug-free births out of concern for the baby’s mental and physical health. Drugs have been known to have harmful effects on a baby's development, and now this is being taken much more seriously. Even with all of these problems, due to the demand and money to be made, many still pushed the clinics to continue with the twilight sleep method.

7 Had To Avoid Over Stimulation

Another side effect of the drug combination was a disorientation of where they were, and sensory overstimulation. In the German clinics where the dosages of the drugs were monitored individually, dark glasses were also given along with towels being placed on their heads, and ear plugs in their ears. This was to help with the feelings of overstimulation that would occur with the drugs, and help manage what they would do to the women’s bodies and nervous system. Even with all this, the experience was often scary for the women and for those who had to watch them suffer. But at least in some cases, these measures helped with the pain and discomfort. In US clinics, these additional measures were not done as no one knew that this could help women. It was crazy how much bruising, screaming and suffering women went through. Many would remember years later in flashbacks what had happened, and were not fortunate to have had the peaceful experience they had hoped for.

6 Newborns Born Depressed

Another side effect of the drug and many of the stresses the women’s bodies went through were depressed newborns. Many had feeding issues, cried a lot, continuously wailing, and were slower in their movements. Many were born breathing slower, and sometimes were even blue. The doctor would have to tap them on the back to get them breathing and crying, and for them to regain their color. This is still done today in hospital births, and this is where the process originated from. It also took babies longer for bonding because not only was there stress on their nervous system, but they were being kept away from their mothers right after the birth. Sometimes they were born with physical problems as well. This was not reported as much as the side effects to the mothers, but it was still apparent when medical staff observed babies born in this way.

5 Women Kept In Straight Jackets

This was one of the most horrific things to behold; women were put in straightjackets and bound up this way so as not to hurt themselves. Their arms and legs were shackled to cot-like beds that looked like cribs where they could not roll over or get out and harm themselves or others. There were marks on their arms and legs, and bruises all over their bodies due to this barbaric practice to ironically keep women from harming themselves. This obviously caused physical damage to their bodies requiring lots of healing, not to mention the psychological costs to the women when they remembered their experience. Their husbands or other family members were not allowed in, only medical personnel. They were the ones to witness this horror, and eventually, enough of them spoke up. It took a prominent lady dying for the procedure to begin falling out of favor.

4 Rarely Had Individualized Care

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In addition to the more personalized approach in Germany where doctors would admit women thirty days before their delivery and monitor the doses, they also sat with the women at the beginning of labor and would return every thirty minutes to monitor how the women were doing and what kind of adjustments were needed, if any, to make their experience as safe, pain free and pleasant as possible. This is why the German clinics had more success. The staff was also better trained and the patients were not outnumbering doctors as was the case in the US clinics. There were difficulties, but they were closely monitored, and  the procedure was therefore a little safer. In the US, the patients outnumbered doctors, therefore women went to the clinic very close to labor, if not already in labor. The dosage and observation was the same for all women regardless of their health, body shape or previous experience. This is why there were more problems in those circumstances.

3 Ward Was Class Divided

There was also the practice in many of the clinics that the ward be divided by class; upper class women were placed on one end and got the best care. They had more money and were thought to be more “fragile and delicate,” therefore deserving of gentle practices. The lower-class or working-class women, on the other hand, were thought to be able to handle pain and other side effects more intensely, and due to this horrible stereotyping, were not monitored as closely, if at all. Their discomfort was not looked upon as it was reserved for upper class or wealthy women. Doctors and staff that cared for both categories of women shared this terrible way of looking at things, and these women and their babies suffered more as a result.

2 Enhanced The Obstetrical Profession

Prior to twilight sleep, obstetricians were laughed at for practicing a profession deemed not real medicine. Giving birth was not considered a medical issue, but a natural physiological occurrence that midwives with no medical training could undertake. With the more complex procedures put in place for twilight sleep, it gave obstetricians a more professional stance on childbirth. They were able to take their place in this area. After this, the medicalization of birth started to grow in importance. Suddenly, doctors were needed to help women give birth. The administrating of drugs and monitoring meant that childbirth was now becoming medicalized and moved from the home domain into the hospitals. Slowly, more and more women began feeling comfortable giving birth in a specialized medical setting instead of at home with other women standing by. Birth became a medical procedure as any other even though for centuries it had been the natural way of doing things.

1 Led To Advent Of  Medicalized Births Today

Twilight sleep also helped lead to the medicalization of birth today and all the ways drugs have been used to help women handle the pain and discomfort in childbirth. It led to new methods and procedures that doctors can use such as forceps delivery, c-sections and any other childbirth experiences where baby is born through artificial means or with outside help. Some of these methods have literally saved women’s and their babies’ lives, while other times the birth could have gone just as smoothly at home or with a natural birth. It really depends on the woman and her particular labor and birth experience. Still, it's useful to have backup methods to help women who are having difficulty in childbirth. However, despite the traumas of twilight sleep, it's great that there has been a move back towards home births, birthing centers, and even natural childbirth methods in hospitals so women don't have to go through a hospital birth if they choose not to or don’t have to.

So there are some of the crazy truths about twilight sleep. As they say, truth is often stranger than fiction, and though it's hard to believe many of these things occurred two centuries ago, they did happen. Women have come a long way in having many options open to them in the birthing process, options that are safer and healthier. The most important thing they must remember to consider: theirs and their baby’s overall health and well-being.

Sources: Belly Belly, Supported Birth

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