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A history of birthing

Yale Medicine Magazine, 2010 - Autumn


A physician and journalist traces the history of childbirth from Eden to the 20th century.

Among the many intriguing stories that Randi Hutter Epstein, M.D. ’90, recounts in her history of childbirth, the story of twilight sleep is among the most ironic. In the early 20th century, women seeking painless birth without the risks of chloroform anesthesia pushed for access to a German obstetrical innovation called “twilight sleep.” By mixing morphine and amnesia-producing scopolamine, doctors had reportedly lifted “the curse of Eve.” Women who chose twilight sleep still felt pain during childbirth; they just didn’t remember it afterward. And an innovation that these early feminists saw as liberating nevertheless entailed tying the woman hand and foot to a bed while she screamed and struggled through labor.

In her sweeping survey, Epstein begins in Eden and ends in a Yale clinic where a woman is having eggs extracted for freezing. Epstein also tells the story of how the inventor of the obstetrical forceps managed to keep the instrument’s design secret until the early 1700s. She describes how the 19th-century surgeon and “father of American gynecology,” J. Marion Sims, M.D., developed lifesaving surgery for vesicovaginal fistulae—then-common complications of traumatic childbirth—by testing his technique on slave women in Alabama between 1845 and 1849. Epstein also visits a sperm bank that accepts only nine in every 1,000 men who apply to sell their sperm. Epstein’s book provides a colorful history for readers curious about the social, religious, and economic factors that influence the management of childbirth.

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