Medicine 4

Childbirth

Most mothers since the beginning of time had given birth at home with midwives or other women in attendance. It was a long, painful and exhausting experience. Finally in the 1850s wealthy women were offered some relief from ether after it was used for Queen Victoria during her labor. Following the Queen’s lead ether, chloroform, and even laughing gas in the United States, were administered for decades to women able to afford delivery in a hospital. Because some doctors were better trained than others babies being born at home were likely to have had safer births without the effects of these gases.

Painless Childbirth

Page 1106 in our 1910 manuscript states that a method of “painless childbirth” had been developed by doctors, Bernard Kronig and Carl Gause, in Germany. Hallelujah! Just what every woman in the world had been hoping for. It sounded wonderful, even the name “Twilight Sleep” (Dämmerschlaf in German) was promising. Doctors from the US went to Germany to learn to use this new miracle combination of drugs that would herald childbirth without pain. Soon gas was out of favor and powerful drugs were in. 

Twilight sleep was said to be “especially suited to the requirement of nervous women.” I find it interesting that men were so sure what women needed in view of the fact that not one of them had passed a bowling-ball-sized human through their loins. To this day many men are inclined to have very strong opinions about a woman’s body and what she should be allowed to do with it, but back to the topic at hand. 

Twilight Sleep

Twilight Sleep was made up of a combination of morphine and scopolamine. Morphine is derived from opium and acts on the central nervous system, causing pain relief. Scopolamine comes from a mixture of nightshade plants. It causes patients to fall into a semi-conscious state resulting in amnesia.

Both drugs are still in use today, but not routinely with labor patients. Morphine is a powerful and useful pain reliever that can lead to opioid dependence in some situations. Scopolamine is used orally or by a transdermal patch to treat nausea, vomiting and motion sickness. You may have used or seen fellow passengers use these patches to prevent or combat seasickness.

Possible side effects from scopolamine listed today include the following:  drowsiness, disorientation, dry mouth, blurred vision, dilated pupils, confusion, hallucinations, difficulty urinating and rash.    https://medlineplus.gov/druginfo/meds/a682509.html

What is wrong with this picture? In retrospect, it does not seem a chemistry degree is necessary to foresee problems with this combination of drugs. The pain relief of morphine was a big plus for the laboring mother, however, it could depress respiration in the newborn leading to a life-threatening emergency. The scopolamine rendered the mother semiconscious during the painful childbirth experience, however, it caused amnesia. The mother usually remembered nothing of the experience including seeing her newborn for the first time nor hearing the first cries. The effects of this drug had significant potential to defer or even diminish bonding between mother and child. 

Both of these drugs crossed the placenta and depressed the fetus’s central nervous system. For decades babies would be born drugged, and unable to breathe normally. It is no wonder they were held upside-down and spanked to start them breathing. After over sixty years of Twilight Sleep administration, the practice was abandoned in the 1970s due to the harmful side effects. Unfortunately, this was after the birth of my two daughters and I am sure after many of you or your children were born. 

Lakshmipati G. (Care of the Medical Outpatient, (Preface) 1st ed. 2003. pp. vii–vii. Nama publication, Coimbatore, Tamilnadu) has said:  

“Half of what is true today will be proven to be incorrect in the next five years. Unfortunately we don’t know which half that is going to be.” 

Sadly, this is true even today. One only hopes that such truth will be proven in only a few years rather than the centuries or decades it has taken in the past. 

 An Art or a Science?

Whether the practice of medicine is an art or a science has been debated for centuries. Many, if not most, feel that it must include both. For a comprehensive discussion of this subject read Dr. Sadhu Charan Panda’s research. He is Editor, Journal of Community Medicine.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3190445/

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Change, does it occur too fast or too slowly? 

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 The Complete Guide to Prevention and Cure of Disease is still in print. If you are interested in reading all 20 medical books in one volume written over 100 years ago see: https://www.amazon.com/Library-Health-Twenty-Books-One-Scholl/dp/B007GNBQB6/ref=sr_1_10?s=books&ie=UTF8&qid=1516977599&sr=1-10&keywords=library+of+health+by+Scholl

Part 4 of 4

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Words Matter – II

If a child is told often, from a very young age, that he or she is limited (slow or weak) in some way, do you think the child will become an adult who believes he or she can accomplish anything of which it dreams? Or, will the child become an adult who is restricted and unsure of their capabilities? I believe what a child hears over and over has a significant impact on what the child sees as its potential.

When I was a nursing student I remember hearing that nurses and other caregivers talked to male and female newborns differently.  I didn’t have enough time as a student to fully appreciate this truth. Later though, when I began to teach OB (obstetrics) to nursing students, I rotated classes into and out of labor and delivery, newborn nursery and postpartum care. During three years of observation I indeed saw that what I had heard was true. It began as soon as the child slipped from their mother’s body and into the cold, bright and noisy delivery room.

From Day One

When a boy was delivered there was congratulatory talk, often booming loudly and as the boy infant began to cry everyone talked about his strong lusty voice. As he was wrapped in a blue blanket there were predictions of his first touchdown, layup or hole-in-one, whatever might please the proud father. When genitalia appeared without the external apparatus it was likely to result in hushed “ahhhhhs” as a pink blanket was held out to swaddle a baby girl. The remark most often heard was regarding her appearance using words like beautiful, dainty, maybe even predictions of her being a little “heartbreaker.” The love and gratefulness for a healthy newborn was not unequal, one not valued more than the other, but the words used were different.

Without a doubt the newborn would be referred to as “big” or “little” not according to the actual measurement of weight and length, but according to gender. There were exceptions, to be sure, if the child was a great deal smaller or larger than average, but nearly always a boy was referred to as “big bouncing” baby. A girl, even when over eight or nine pounds, was a “sweet little” girl.

This trend continued in the nursery while the newborn was bathed and examined and then transported back and forth to the mother’s room for feeding and bonding over the next hours of hospitalization. If you doubt this, I challenge you to listen carefully as your friends and family members discuss the babies in their lives. Observe the words that are used when the infant is spoken to and sung to and handled. It may seem insignificant at the time since the baby does not yet understand words, but the truth we need to remember is that this is just the beginning of a persistent message. Day after day a child is reminded that she is the “weaker sex,” to use an outdated term, and unable to do or be anything in the world to which she aspires. This is not intentional, not sinister, not done out of unequal love, but these facts do not dilute the message. Words matter, especially when repeated through years of developing a sense of who we are and what we are capable of achieving in life.

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Art by Pat Brooks