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As fields of inquiry, obstetrics and gynecology have a relatively short history. While obstetrics and gynecology have been practiced since time immemorial, their shift from women-centered knowledge and common sense practices to science began in the 19th century. Before the 19th century, much of the knowledge of childbirth and delivery was passed through women, kin, and midwives. As medicine became an organized profession in the 19th century, much of its early history revolved around consolidating that knowledge into medical men’s hands.<ref>Pablo Mitchell, ''Coyote Nation: Sexuality, Race, and Conquest in Modernizing New Mexico, 1880-1920'' (Chicago: The University of Chicago Press, 2005), p. 122-148.</ref>
With that, births went from being normal, everyday events, to illness-centered events requiring medical intervention. Once natural, with the dawn of medicine, childbirth became pathologized.
Though most women gave birth at home before the 19th century, the 20th century gave rise to maternity hospitals and more women gave birth with physicians in attendance. Dr. Joseph DeLee, author of the most frequently used obstetric textbook of the time ''Principles and Practice of Obstetrics'', argued that childbirth was a process from which few women emerged unscathed. He believed that physicians needed to maintain control over the labor and delivery process through active protocols and medical interventions <ref name="test">Lynette A. Ament, ''Professional Issues in Midwifery'' (Sudbury: Jones and Bartlett Publishers, 2007), p. 23. </ref> Specialist obstetricians should sedate women at the onset of labor, allow the cervix to dilate, give ether during the second stage of labor, cut an episiotomy, deliver the baby with forceps, extract the placenta, give medications for the uterus to contract and repair the episiotomy. His article was published in the first issue of the ''American Journal of Obstetrics and Gynecology''. All of the interventions that DeLee prescribed did become routine. By 1920, most doctors believed that "normal" deliveries were rare, and that doctors needed to be present to prevent trouble, and by 1921, thirty to fifty percent of women gave birth in hospitals.<ref>Richard Wertz and Dorothy C. Wertz, ''Lying-In: A History of Childbirth in America'' (New Haven: Yale University Press, 1989)</ref>
Twilight Sleep emerged at the beginning of the 20th century in this context. It was one of the most extreme measures available designed to allow doctors to remain in complete control during the childbirth process. In Twilight Sleep, mothers were drugged with morphine and scolpolamine--rendering them effectively unconscious throughout the birth process. This allowed the doctor to maintain control, but also had the additional benefit of rendering the childbirth painless. When the mother regained consciousness, she would have her child in hand, and no recollection of the delivery process.
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==== Additional Sources ====*Stella Lehr, "A Possible Explanation of the Conflicting Reports on Twilight Sleep.” ''California State Journal of Medicine'' 8 (1915): 220–22. *Judith Pence Rooks, ''Midwifery and Childbirth in America''. *Mark Sloan, ''Birth Day: A Pediatrician Explores the Science, the History, and the Wonder of Childbirth.''*Paul Starr, ''The Social Transformation of American Medicine''.
