A friend and I were talking about our experiences with giving birth to our eldest children, and the discussion naturally turned to pain relief. In discussing that, I had to ask whether the era of "twilight sleep" is truly a thing of the past.
For those who don't know about it, twilight sleep is when the mother is given an injection of morphine and scopolamine. The morphine was to deaden the pain and the scopolamine produced an amnesiac effect so she wouldn't remember the pain. This was the common practise from c1914-the 1940s or a little later. Unfortunately, it also had the effect of hampering bonding by removing the mother from the experience of birth. It also depressed the baby's central nervous system. And so the practise fell out of fashion.
Or did it? True, they no longer inject women with scopolamine to induce an amnesiac state, and morphine itself isn't usually used, but other opioid drugs such as pethidine or diamorphine are commonly used. My friend and I both received these injections: I was given pethidine (combined with an antiemetic) and she was given diamorphine. We agreed that the drugs didn't actually deaden the pain, but they made it so we couldn't truly respond to the pain. In my case, the antiemetic also made me incredibly drowsy. Both drugs cross the placenta and have a depressive effect on the baby's respiration, and may interfere with breastfeeding. This isn't sounding too different from twilight sleep.
I have to say that I also don't see the point of giving an amnesiac drug during labour. I won't say that I forgot the pain, but I didn't care about it once the child was born. The endorphins we get during labour are also quite powerful. A little support in a calm environment can go a long way, really. I'm not saying women shouldn't have access to pain relief if they want it, but let's make it pain relief that actually relieves pain instead of depressing our ability to respond to it, and pain relief that doesn't have the potential to interfere with/hamper breastfeeding or depress our babies' breathing.