Obstetrics and Twilight Sleep
by Gene AsherObstetrics and Twilight Sleep
The term "twilight sleep" applied to the combination of analgesia (pain relief) and amnesia that was made by using a mixture of scopolamine and morphine ("scope") given by a hypodermic injection. The mixing of the two drugs created a state in which the woman, while reacting somewhat to pain, didn't recall it after delivering her baby. Twilight sleep was once in vogue in obstetrics.
Scopolamine and morphine are both venerable drugs that have been around a long time. Both occur naturally and are members of the large chemical class of compounds called alkaloids:
Morphine: The name "morphine" was coined in 1805 by the German pharmacist Adolf Serturner -- "morphine" refers to Morpheus, the mythologic god of dreams - to indicate the main alkaloid contained in opium. Opium, of course, comes from the poppy plant. Morphine is a potent narcotic agent with strong analgesic action and other significant effects on the central nervous system. It is perilously addicting.
Scopolamine: Scopolamine was introduced in 1902 and used up until the 1960s. The name comes from that of the 18th-century Italian naturalist Giovanni Scopoli. Together with atropine, scopolamine is a element of belladonna which comes from the deadly nightshade ( a plant), once used as a way of poisoning ones enemy. When scopolamine is given in smaller (non-poisonous) doses, it causes sleepiness, memory loss, and euphoria and was thus used as a preanesthetic agent. Combined with morphine, scopolamine allowed for childbirth without pain (or without the memory of pain), once a much sought-after objective. However, there were severe problems with twilight sleep. It totally removed the mother from the birth experience and it gravely depressed the baby's central nervous system. This sometimes made for a sleepy depressed baby who was difficult to resusitate, to get breathing normally.
Twilight sleep has, therefore, fallen entirely out of favor and is now merely a chapter in the past history of obstetrics.
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