Twilight sleep
[4][5][6] Because of how variable the scopolamine dosages are between patients, and the need for accurate assessment of performance on the memory test, the twilight sleep method required skillful, well-trained practitioners for proper execution.
[4] Anesthesia's use was popularized in 1853 by Queen Victoria’s decision to use chloroform for pain relief during the birth of her eighth child, Prince Leopold, Duke of Albany.
[3][9] The use of this combination to ease birth was first proposed by Austrian physician Richard von Steinbuchel in 1902, before being picked up and further developed by Carl Gauss and Bernhardt Kronig in Freiburg, Germany, beginning in 1903.
[8] They recorded preferred dosages and adverse side effects of scopolamine, which included slowed pulse, bradypnea, delirium, dilated pupils, flushed skin, and thirst.
[8] The Women's Clinic of the State University of Baden, where Gauss was a physician, had the city's lowest rates of maternal and neonatal mortality, further increasing the procedure's popularity.
[8] A June 1914 McClure's Magazine article titled, "Painless Childbirth" published by Marguerite Tracy and Constance Leupp about twilight sleep was instrumental in increasing awareness of the procedure in the United States.
[4] The article garnered a massive public response, prompting thousands of women to write the magazine asking for information about doctors able to perform the method.
Because the treatment's greatest popularity overlapped with World War I, women who advocated for the German technique were also accused of being disloyal to the United States.
The dosages of morphine and scopolamine needed to be precise to avoid overdose, and NYC hospitals typically lacked the private, quiet birthing rooms like those used in Freiburg for sensory isolation.
[7] At its peak, there was such demand from women for twilight sleep that many physicians who were not adequately trained in the technique felt that the success of their obstetric practices depended on offering it.
Twilight sleep spread in popularity in New York through a grassroots female-led campaign that was closely connected to the first-wave feminism movement.
[5][8] While twilight sleep began to wane in popularity after 1915, it permanently altered obstetric care and created irrevocable changes in the role of obstetricians in the United States.
