Pregnancy - Twilight Sleep and Painless Labor : Part 3

The Mother and Her Child
by William S. Sadler, M.D., Lena K. Sadler, M.D.

(Page 11 of 44)

4. That by lessening the dread of labor and the fear of painful childbirth, there will probably occur an increase in the birth rate of the so-called "higher classes of society" - the social circles which now show the lowest birth rates.

5. That it is of special value in the cases of certain neurotic women and those of low vital resistance; especially those patients suffering from certain forms of heart, respiratory, kidney, and other organic diseases.

6. Some authorities maintain that "twilight sleep" is of value even in threatened eclampsia, although they admit it tends to produce a rise in blood-pressure.

7. It is supposed to shorten the first stage of labor - by facilitating the dilation of the cervix - owing to the painless stretching; although the majority of its special advocates admit that it lengthens the second stage of labor, during which the patient must be very closely watched.

8. That even in those cases where the sense of pain is not entirely destroyed, the patient seems to possess little or no subsequent memory of any physical suffering or other disagreeable sensations.

9. That the method is of special value in sensitive, high-strung, nervous women of the "higher classes," who so habitually shun the rigors of child bearing - especially in the instance of their first child.

10. That the action of scopolamine is chiefly upon the central nervous system - the cerebrum - that it diminishes the perception of pain without apparently decreasing the contractile power of the uterus; labor may, therefore, proceed with little or no interruption, while the patient is quite oblivious to the accompanying pains.

11. That the physical and nervous exhaustion is quite entirely eliminated - especially in the case of the first labor - that patients who have had this method of anesthesia appear refreshed and quite themselves even the first day after labor.

12. That there is decidedly less "trauma" (appreciable injury) to the nervous system and therefore less "shock;" and that all this saving of nervous strain tends greatly to hasten convalescence.

13. And, finally, that "twilight sleep" does not interfere with the carrying out of any other therapeutic measures which may be deemed necessary for a successful termination of the labor.

Dangers of Twilight Sleep

While we are recounting the real and supposed advantages of "twilight sleep" - especially in certain selected cases - it will be wise to pause long enough to give the same careful consideration to the known and reputed dangers and drawbacks which are thought to attend this method of anesthesia in connection with labor cases.

We desire to state that these expressions, both for and against "twilight sleep," are not merely representative of our own experience and attitude; but that they also represent, as far as we are able to judge at the time of this writing, the consensus of opinion on the part of the most reliable and experienced observers and practitioners who have used and studied this method in both this country and Europe. The dangers and difficulties of "twilight sleep" may be summarized as follows:

1. That this method tends to weaken the mental resistance of many women; to lessen their natural courage and to decrease that commendable fortitude which is such a valuable feature of the character endowment of the normal woman.

2. That "twilight sleep" is essentially a hospital method and is, therefore, inaccessible to the vast majority of women belonging to the middle and lower classes of society, as well as to those women who live in rural communities.

3. That in fifteen or twenty percent, the method fails to produce the desired results - at least, when administered in amounts which are deemed safe.

4. That this method does decrease the baby's chances of living; that the second stage of labor is definitely prolonged; that from ten to fifteen percent of the babies are sufficiently under the influence of the anesthesia when born as to be unable to breathe or cry without artificial stimulus.

5. That it is a method requiring special training and experience; that it will be many years before the average practitioner will become proficient in its use; and that the older methods are probably far safer for the average physician.

6. That the method requires more care in its administration than can be expected outside of the hospital in order to avoid the dangers of fetal asphyxiation - which danger has led not a few obstetricians to abandon it.

7. That a satisfactory techniques is almost impossible of development; that every patient must be individualized; that the chief dangers are connected with the over dosage of morphine; that the method is not adaptable to the general practice of the average doctor.

About the Author

Dr. William S. Sadler M.D. was a well-known American psychiatrist and college teacher in the school of medicine at the University of Chicago. For over sixty years he practiced his profession in Chicago, thirty-three years being associated in practice with his wife, Dr Lena Kellogg Sadler. The doctors were pioneers in the research on the mysterious Urantia Papers.