Hanna Rion and The Weekly Dispatch's twilight sleep crusade.

The story of twilight sleep is an important, yet neglected, episode in the history of obstetric pain relief in Britain. One reason for its neglect in historical writing is that most of the discussion of the therapy took place in newspapers, particularly the Weekly Dispatch Using digitised newspapers, as well as medical journals, this article reconstructs the largely overlooked story of twilight sleep in Britain. Twilight sleep was comprised of two drugs, scopolamine and morphine, which acted together to remove the pain of labour, as well as memory of it. Twilight sleep gained popularity in 1915 in Britain, a year after it became popular in America, on which most scholarship has focused. One of the main advocates for the use of twilight sleep in Britain was Hanna Rion, who wrote a series of weekly articles in 1916 campaigning for its use. Rion's articles, and the response to them, show how the rise in popularity of twilight sleep reflected concerns about a declining birth rate amidst the backdrop of World War I. Through studying twilight sleep we see how women began to see themselves as consumers and shape medical practice, before the natural childbirth movement, which it has traditionally been attributed to. Therefore, twilight sleep provides us with the missing link in the story of obstetric anaesthetics, between the discovery of chloroform in 1847 and the natural childbirth movement in the 1930s.

Bearing the Pain: A Historic Review Exploring the Impact of Science and Culture on Pain Management for Childbirth in the United States.

Scientific advances over the past 150 years have influenced pain management practices during childbirth. Cultural attitudes about pain in childbirth have also affected these practices. The objective of this work is to examine the history of pain management in childbirth in the United States and explore the relationship between cultural attitudes and care practices. A historic review was chosen as the research method. Included were records that described pain management practices and records that explored the relationship between care practices and American cultural attitudes about pain in childbirth. The health science reference databases of CINAHL (EBSCO host), PubMed and the Cochrane Library were searched for English language articles. There were no limitations in years searched. Twenty-five primary records and 42 secondary records met inclusion criteria and were used in this work. Scientific developments as well as ever-changing cultural attitudes have greatly impacted pain management practices for childbirth in America. A highly complex and parallel, relationship exists between science and culture in regards to this history. To promote positive birth experiences for women, it is essential that obstetrical practices are congruent with cultural views regarding appropriate pain management in childbirth.

Recognizing the Chinese Pioneer of Neuraxial Labor Analgesia: Dr Guang-Bo Zhang and Her Unpublished Manuscript From More Than a Half-Century Ago.

Dr Guang-Bo Zhang was the first anesthesiologist to administer and study the effects of labor epidural analgesia in China. Between September 1963 and March 1964, she conducted an observational study evaluating the effects of neuraxial analgesia for laboring women. She presented her research and prepared an article; however, due to the Great Proletarian Cultural Revolution (Cultural Revolution), which began in 1966, her work went unpublished. She successfully preserved her unpublished article, notes, and slides throughout the Cultural Revolution by hiding them in a countryside location near Beijing. These 54-year-old, previously unpublished documents represent the first known clinical trial of neuraxial labor analgesia conducted in China.

The politics of female pain: women's citizenship, twilight sleep and the early birth control movement.

The medical intervention of 'twilight sleep', or the use of a scopolamine-morphine mixture to anaesthetise labouring women, caused a furore among doctors and early 20th-century feminists. Suffragists and women's rights advocates led the Twilight Sleep Association in a quest to encourage doctors and their female patients to widely embrace the practice. Activists felt the method revolutionised the notoriously dangerous and painful childbirth process for women, touting its benefits as the key to allowing women to control their birth experience at a time when the maternal mortality rate remained high despite medical advances in obstetrics. Yet many physicians attacked the practice as dangerous for patients and their babies and antithetical to the expectations for proper womanhood and motherly duty. Historians of women's health have rightly cited Twilight Sleep as the beginning of the medicalisation and depersonalisation of the childbirth process in the 20th century. This article instead repositions the feminist political arguments for the method as an important precursor for the rhetoric of the early birth control movement, led by Mary Ware Dennett (a former leader in the Twilight Sleep Association) and Margaret Sanger. Both Twilight Sleep and the birth control movement represent a distinct moment in the early 20th century wherein pain was deeply connected to politics and the rhetoric of equal rights. The two reformers emphasised in their publications and appeals to the public the vast social significance of reproductive pain-both physical and psychological. They contended that women's lack of control over both pregnancy and birth represented the greatest hindrance to women's fulfilment of their political rights and a danger to the healthy development of larger society. In their arguments for legal contraception, Dennett and Sanger placed women's pain front and centre as the primary reason for changing a law that hindered women's full participation in the public order.

Shifting understandings of labour pain in Canadian medical history.

While pain in childbirth is a universal, cross-cultural, biological reality, individual experiences and perceptions of this pain are historically and culturally specific. At the turn of the 20th century-a key period in terms of both the medicalisation of birth and the professionalisation of obstetrics in the Canadian context-Canadian physicians understood and conceptualised 'birth pangs' in a number of varying (and at times competing) ways. Throughout the 19th century, doctors emphasised the broader utility of pain as a diagnostic tool and a physiologically necessary part of the birthing process. With the advent of anaesthetics, including chloroform and ether, however, a growing subset of the medical profession simultaneously lauded the professional, physiological, and humanitarian benefits of pain relief. By the first decades of the 20th century, shifting understandings of labour pain-and particularly growing distinctions between 'pain' and 'contraction' in mainstream medical discourses-underscored the increasing use of obstetric anaesthesia. Drawing on a broad range of medical texts and professional literature, and focusing on a key historical moment when the introduction and adoption of a new medical technology opened up possibilities for professional debate, this paper unpacks both the micropolitics and the macropolitics of shifting understandings of labour pain in modern Canadian medical history.

An Early History of Anesthesia in Labor.

Fear of pain often overshadows childbirth, and each woman must decide whether to receive anesthesia to combat labor pain. Historically, this choice resulted in unintended consequences and marked the beginnings of medical interventions in labor and birth. The purpose of this article is to trace the use of anesthesia in childbirth from the mid-19th to the mid-20th centuries and to explore its influence on childbearing women and nurses.

The Psychoprophylactic Method of Painless Childbirth in Socialist Czechoslovakia: from State Propaganda to Activism of Enthusiasts.

This paper explores the history of the 'psychoprophylactic method of painless childbirth' in socialist Czechoslovakia, in particular, in the Czech and Moravian regions of the country, showing that it substantially differs from the course that the method took in other countries. This non-pharmacological method of pain relief originated in the USSR and became well known as the Lamaze method in western English-speaking countries. Use of the method in Czechoslovakia, however, followed a very different path from both the West, where its use was refined mainly outside the biomedical frame, and the USSR, where it ceased to be pursued as a scientific method in the 1950s after Stalin's death. The method was imported to Czechoslovakia in the early 1950s and it was politically promoted as Soviet science's gift to women. In the 1960s the method became widespread in practice but research on it diminished and, in the 1970s, its use declined too. However, in the 1980s, in the last decade of the Communist regime, the method resurfaced in the pages of Czechoslovak medical journals and underwent an exciting renaissance, having been reintroduced by a few enthusiastic individuals, most of them women. This article explores the background to the renewed interest in the method while providing insight into the wider social and political context that shaped socialist maternity and birth care in different periods.

Pain relief in childbirth: changing historical and feminist perspectives.

Pain during human childbirth is ubiquitous and severe. Opium and its derivatives constitute the oldest effective method of pain relief and have been used in childbirth for several thousand years, along with numerous folk medicines and remedies. Interference with childbirth pain has always been criticised by doctors and clergy. The 19th century saw the introduction of three much more effective approaches to childbirth pain; diethyl ether, chloroform and nitrous oxide. Access to pain relief was demanded by the first wave of feminist activists as a woman's right. They popularised the use of 'twilight sleep', a combination of morphine and scopolamine, which fell into disrepute as its adverse effects became known. From the 1960s, as epidural analgesia became more popular, a second wave of feminists took the opposite position, calling for a return to non-medicalised, female-controlled, 'natural' childbirth and, in some cases, valorising the importance of the pain experience as empowering for women. However, from the 1990s, a third wave of feminist thought has begun to emerge, revalidating a woman's right to choose a 'technological', pain-free birth, rather than a 'natural' one, and regarding this as a legitimate feminist position.

Parirás sin dolor: poder médico, género y política en las nuevas formas de atención del parto en la Argentina (1960-1980) / Without pain you will bring forth children: medical power, gender, and politics in new forms of assisted childbirth in Argentina (1960-1980)

Presenta los debates y reacciones que generaron en la Argentina los métodos difundidos en los años 1960 y 1980, conocidos como parto sin dolor, parto sin temor, parto psicoprofiláctico y parto sin violencia. Analiza las resistencias y apoyos a las primeras experiencias en el campo médico local y el papel de las mujeres en ellas. Indaga los significados de muchas de estas ideas en aquel contexto de movilización social, inestabilidad institucional, golpes militares, violencia, censura y represión, e importantes transformaciones en los roles y relaciones de género. Por último, plantea una reflexión sobre el lugar que ocupan las demandas por un embarazo y parto respetado en las políticas de sexualidad y reproducción y en el movimiento feminista.

The methods known as painless childbirth, childbirth without fear, psychoprophylaxis, and birth without violence were popularized in the 1960s and 1980s. The article examines discussions about these methods and reactions to them in Argentina and analyzes the resistance and support encountered in the local medical field when they were first tried out, along with the role played by women. It investigates the meanings of many of these ideas within the period's context of social mobilization, institutional instability, military coups, violence, censorship, and repression but also of major transformations in gender roles and relations. Lastly, it reflects on how demands for respected pregnancy and childbirth fit in with policies on sexuality and reproduction and with the feminist movement.

Parirás sin dolor: poder médico, género y política en las nuevas formas de atención del parto en la Argentina (1960-1980) / Without pain you will bring forth children: medical power, gender, and politics in new forms of assisted childbirth in Argentina (1960-1980)

Presenta los debates y reacciones que generaron en la Argentina los métodos difundidos en los años 1960 y 1980, conocidos como parto sin dolor, parto sin temor, parto psicoprofiláctico y parto sin violencia. Analiza las resistencias y apoyos a las primeras experiencias en el campo médico local y el papel de las mujeres en ellas. Indaga los significados de muchas de estas ideas en aquel contexto demovilización social, inestabilidad institucional, golpes militares, violencia, censura y represión, e importantes transformaciones en los roles y relaciones de género. Por último, plantea una reflexión sobre el lugar que ocupan las demandas por un embarazo y parto respetado en las políticas de sexualidad y reproducción y en el movimiento feminista. (AU)

[History of pain treatment from 1500 to 1900]. / Geschichte der Schmerztherapie 1500 bis 1900.

The history of pain treatment likely started in the cradle of mankind, as the experience of pain from many causes presumably had an aversive dimension comparable in its ranking to elementary sensations and motivations such as hunger, thirst, maintenance of body temperature, and sexuality-all vital for individual and genetic survival. Thus, pain certainly was among the drives to create social behavior and medicine-these functions still are inherent in pain. The period of history from 1500, as considered here, is dominated by the emergence of science. The exploration of the inside of the human body found the brain to be the seat of sensations, emotions, and behavior, and this progress included pain as well, slowly disabusing it from the magic elements and demons still inherent from early times. The rational phase of medicine began and also included new concepts of pain as first conceived by Descartes. The treatment and prevention of pain became a strong motive of medicine, with new approaches in drug treatment, physical applications such as electricity, and discoveries of psychosocial implementations. During the nineteenth century the most important breakthroughs in pain treatment included general and local anesthesia as well as analgesic drugs from morphine to anti-inflammatory agents. They succeeded in taking the terror out of the agonizing pain of surgery and dramatic courses of diseases. Today's natural extension of the medical success in controlling acute pain may be seen in the period of pain medicine aimed at understanding and preventing chronic pain.