‘Mighty Glad to Gasp in the Gas’: Perceptions of Pain and the Traditional Timing of Obstetric Anesthesia

Abstract

Medical historians have long argued that while birth remained in the home women controlled the event. However, a detailed examination of the prevalent use of obstetric anesthesia beginning in the late 19th century indicates that parturients allowed physicians to define appropriate obstetric treatment even when home birth was still the norm and that this deference led to the use of obstetric anesthesia in a manner that made no physiological sense. For at least 70 years beginning in the 1890s, physicians did not anesthetize women during transition, the most painful portion of labor. Rather, they rendered women unconscious at the moment of birth. Physicians based this therapeutically useless but long sacrosanct medical practice on what they presumed women felt, given the disturbing way women looked at the moment of birth. Women accepted this practice because they were ignorant of the sensations of birth. Thus physicians’ and women’s perceptions of labor pain, rather than reality, have played a major historic role in shaping the administration of obstetric anesthesia.