Twilight Sleep and its Contributions in Shaping Perceptions of Childbirth

Twilight Sleep was a technique originally developed by physicians in Germany in the early 20th century as a novel way to address parturient women’s fear and aversion to pain endured during labor and childbirth. Using a combination of amnestic and analgesic agents such as scopolamine and morphine to synergistically suppress pregnant women’s memories, physicians Carl Gauss and Bernhard Krönig enabled women to give birth free of pain, or more accurately any memories of pain.

Despite widespread use throughout Europe, Twilight Sleep initially experienced less popularity and more resistance in the United States where doctors were wary of the potential health risks that Twilight Sleep brought upon women and infants. Some adverse effects caused by incorrect doses of scopolamine and morphine included hallucinations and uncontrolled thrashing in women and depressed respiration in infants. Thus, Twilight Sleep’s status as a vogue topic in obstetrics during the first half of the 20th century came about due to the work of affluent and educated American women. While lacking formal medical training, a subset of women became experts in the matter of Twilight Sleep by traveling to Germany to experience and investigate Twilight Sleep firsthand then disseminating their findings through published books and articles.

This thesis explores the impact of Twilight Sleep on women and physicians and their perceptions of childbirth. Twilight Sleep empowered women to take on a more active role in shaping the medical care they received rather than accepting that childbirth as a natural event associated with physical and mental trauma and high risk of mortality. For doctors, the debate regarding Twilight Sleep’s safety and efficacy affirmed a ubiquitous notion that childbirth ought to be seen as a pathological rather than natural event. By considering childbirth a medical condition that necessitated treatment, physicians had to evaluate their duties to their patients. In empowering women to be involved in making medical decisions and forcing physicians to balance their medical training with their patients’ needs, Twilight Sleep helped to establishing more reciprocal doctor-patient relationships.