Deliver Me from Pain: Anesthesia and Birth in America

290 Pages·2009·3.25 MB·English

by  Jacqueline H. Wolf

contents
Acknowledgments ix
introduction
“Terrible Torture”or “The Nicest Sensation I’ve Ever Had”?
Conflicting Perceptions ofLabor in U.S.History 1
1 Ether and Chloroform:The Question ofNecessity,
1840s through 1890s 13
2 Twilight Sleep:The Question ofProfessional Respect,
1890s through 1930s 44
3 Developing the Obstetric Anesthesia Arsenal:The Question ofSafety,
1900through 1960s 73
4 Giving Birth to the Baby Boomers:The Question ofConvenience,
1940s through 1960s 105
5 Natural Childbirth and Birth Reform:The Question ofAuthority,
1950s through 1980s 136
6 Epidural Anesthesia and Cesarean Section:The Question ofChoice,
1970s to the Present 168
Glossary ofMedical Terminology 197
Notes 205
Index 267
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acknowledgments
T
his book is the product ofpersonal experience as well as scholarship.I
owe a special debt to two ofmy oldest friends,Mary Ludden DeJong and
Estelle Carol,for introducing me to social birth almost thirty years ago.
I realize now that in attending the births ofthree oftheir six children (two home
births for Mary and one low-tech hospital birth for Estelle) and watching Mary
and Estelle closely as they labored,I internalized their casual attitudes.“So that’s
how you behave during birth,”I said to myselfas I watched first Mary and,sev-
eral years later,Estelle relax through contractions.By the time I was pregnant,
birth held no fear for me.I knew exactly what to expect and what to do,thanks
to these wonderful role models.(That is,to a point.Seeing Mary and Estelle give
birth without anesthesia and with barely a grimace was a little deceiving.I vividly
recall the moment Mary arrived to help me through my labor.I managed to open
one eye and with great difficulty gasp in the midst ofa contraction,“I can’t be-
lieve you’ve done this four times.”)
My interest in exploring the topic of this book stemmed from those events.
Having so enjoyed my birth experiences as both witness and eventually mother,
I looked forward to discussing birth physiology and the history ofbirth practices
with medical students,undergraduates,and graduates via the lectures and classes
I offer today through the departments of social medicine and history at Ohio
University.I was stunned to find that the young women attending my medical
school lectures and history classes met my enthusiasm for birth and birth prac-
tices not with keen interest but with wide-eyed horror.This I had not anticipated.
What happened to the passion and fearlessness with which women approached
childbirth? How had unbridled enthusiasm in the 1970s for women’s unique
strength and power during labor and birth been replaced in the late 1990s with
abject fear and a fervent wish to avoid every sensation ofbirth? Seeking answers
x Acknowledgments
to these questions set me on the path that became this book,and so I am grate-
ful to the students who taught me at least as much as I taught them.
I also owe special thanks to Sam Wilen,the kind ofattentive partner for whom
“husband-coached”childbirth was invented.Ifhe had left my side even momen-
tarily during my labor with our daughter,Cora,I would have lost control.His
voice carried me through.He also nurtured this book in many small ways,most
notably giving me hours ofvaluable writing time as the project neared comple-
tion by transcribing several ofthe oral history interview tapes with mothers and
physicians,translating mysterious words and acronyms like “parous”and “VBAC”
as “Paris??”and “V-Back??”
I could not have even begun researching and writing this book without the aid
ofseveral granting agencies.I was the fortunate recipient ofa multiyear National
Institutes ofHealth–National Library ofMedicine Publication Grant,two Ohio
University Research Challenge grants,an Ohio University College ofOsteopathic
Medicine Office ofResearch Direct Grant Award,and an Ohio University Research
Committee Award.
In the course ofmy research for this book,I interviewed several dozen moth-
ers and physicians who generously shared with me their varied and fascinating
birth experiences.I wish I could thank them each by name,but,alas,in the era of
HIPAA they must remain anonymous.As I prepared for these oral history inter-
views,Amanda Konradi,a sociologist formerly of Ohio University and now at
Loyola College ofMaryland,helped me (a historian accustomed to studying yel-
lowing documents rather than interviewing living people) to construct the ques-
tionnaires I used to probe the experiences ofmothers and doctors.
As I worked on this project,I met often with Katherine Jellison and Steven
Merritt Miner as the RRC (Ruthless Readers’ Club). We were each writing a
book—Katherine on the history of the American infatuation with the white
wedding,Steve on the experience ofthe Soviet people during World War II—and
our weekly critiques of each other’s work proved essential to our progress.
Katherine and Steve are colleagues in the best sense of that word;I am grateful
for their support, friendship, and unremitting constructive criticism. Steve
Rubenstein was also a valued member ofthe RRC,until he left Ohio University
for the University ofLiverpool.
Norman Gevitz,Janet Golden,Barbara Katz Rothman,my brother Robert V.
Wolf,and an anonymous reviewer for the Johns Hopkins University Press read
one version or another ofthis book (in Rob’s case several versions) and offered
many suggestions for improvement, almost all of which I gratefully incorpo-
rated.This book is far sounder thanks to their generous help.
Acknowledgments xi
I am also grateful to Donald Caton,Timothy R.B.Johnson,and Wanda Ron-
ner; each of these physicians gave this book an invaluable medical scan.Their
work and interest in the history of women’s health and medicine made their
input particularly helpful.Any errors that remain are,ofcourse,mine alone.
My brother Kevin Wolf,an actuary specializing in health care costs,was un-
stinting with his knowledge ofthe history ofthe health insurance industry and
maternity coverage.An Excel master,he also maintained the bar graph tracking
the annual rise ofthe cesarean section rate that appears in Chapter 6.My parents,
Herbert and Nancy Wolf, and my brother Glenn Wolf provided meals and a
touch ofhome during my numerous research visits to Chicago and Boston.
Jacqueline Wehmueller at the Johns Hopkins University Press has been a
dream editor,gently offering suggestions throughout the research,writing,and
production processes.Lois Crum,a freelance copy editor for Johns Hopkins,pro-
vided elegant wordsmithing and a sharp eye.
Thanks,too,to Linda Ross and Angela Cross for helping me find photographs
and to JeffBrown for his assistance with the book’s illustrations.
I owe many a “eureka!”moment to archivists.Special thanks to Debra Scar-
brough,Mary Hyde,and Pamela Van Hine of the American College of Obstetri-
cians and Gynecologists;Stacey Peeples ofthe Pennsylvania Hospital Historic Col-
lections;Susan Sacharski ofthe Northwestern Memorial Hospital archives;Patrick
Sim,Judy Robins,and Karen Bieterman ofthe Wood Library–Museum ofAnes-
thesiology;Russell Johnson and Marcia Meldrum ofthe UCLA Louise M.Darling
Biomedical Library History and Special Collections Division;Monica Ralston of
the Minnesota Historical Society;the late Archie Motley ofthe Chicago Historical
Society;Susan Rishworth ofthe American College ofSurgeons;Heidi Butler,for-
merly ofthe Rush University Medical Center Archives;Jack Eckert ofthe Count-
way Medical Library at Harvard University;Stephen Greenberg ofthe National Li-
brary of Medicine,History of Medicine Division;Kathy Jacob of the Schlesinger
Library;and Marian Taliaferro ofthe Association ofAmerican Medical Colleges.
My daughter,Cora Wilen,was three when I began to write my dissertation,
seven when I began to write my first book,and ten when my first book was pub-
lished.She is now a stunning seventeen and long accustomed to a mother who
spends every daylight hour ofevery weekend working in her study.Cora:Thanks
for being my occasional companion in that study,curled up on the floor reading
while I was writing.However you choose to give birth,I hope the births ofyour
children will be as wondrous an event in your life as your birth was for me.And
ifyour children are halfas magnificent as you are,your life will indeed be blessed.