Lauren at Feministe has a really excellent post breaking it down for readers:
Let’s break out the Childbirth 101: As Betty is depicted, fifty years ago it was common for women to be given a drug that would induce “twilight sleep” during a hospital birthing procedure. The amnesic drug did not behave like a true analgesic pain killer, but instead induced a state of disorient that managed pain by making the mother forget the entire process of childbirth.
"Twilight sleep" (induced by a mixture of morphine and scopolamine) was introduced in the early part of this century to replace chloroform as an anesthetic during childbirth, and was advocated by medical professionals and women who thought it managed labor pain well and oddly enough, believed it produced healthy, intelligent babies. But when it became standard protocol in hospitals throughout the country in the 1930s, the kind of birth Betty went through became de rigeur. Aunt B wrote a graphic description of it here. Essentially, women like Betty were shackled or tied down and sometimes padded because during their hallucinations, they would thrash wildly or bang their heads, driven into a frenzy by the pain--which they were very much experiencing--and the effect of the narcotics in their system.
Incidentally, as several feminist bloggers have pointed out, the fact that Don and the other expectant fathers were always relegated to the waiting room was ostensibly because of gender roles or social customs. But this practice conveniently meant that women had no one to witness the awful side effects of procedure, or demand that it stop. So "Twilight Sleep" remained "the thing to do."
Maureen Corry, Executive Director of Childbirth Connection--a 91-year old nonprofit which in its current incarnation seeks to inform and educate women about their childbearing options--describes a friend giving birth in the 50s who refused Twilight Sleep and asked to breastfeed (Betty, like most women of her time, doesn't do this either) and was treated as if she was crazy. Lauren writes that her mother gave birth under the procedure. My own grandmother, who gave birth twice in the late 40s recalls a dismissive nurse, somewhat like the sadistic nurse in the "Mad Men" episode, arriving with a needle and injecting it over her protests, telling her it was what the doctors insisted upon. Neither my grandfather or her own mom were allowed in the room with her.
Another effect of "Twilight Sleep," besides the physical cruelty and pain, was a psychological sense of detachment for the new mom, a bizarre blank where the birth should have been, which was one of the triggers that led women to question the procedure. The backlash against procedure was already in effect by the time Betty gave birth, ten years after my grandmother. In the late 1940s, Childbirth Connection brought Grantly Dick-Read, British author of "Childbirth Without Fear" to speak to American women. "His premise was that women could have babies without going through the horrors of twilight sleep, screaming and writhing in pain," says Corry. "He felt women need to be educated and they could deal and cope with childbirth if trained to do so."
As Tina Cassidy reported in a piece about the history of pain
relief in childbirth, five years before Betty gave birth to Gene, Ladies Home Journal ran an expose:
In 1958, an article headlined "Cruelty in Maternity Wards" ran in Ladies' Home Journal, and described in detail the "tortures that go on in modern delivery rooms." A flood of women sent the magazine their own horror stories. "I've seen patients with no skin on their wrists from fighting the straps," a nurse from Canada wrote.
"Just let a few husbands in the delivery rooms and let them watch what goes on there," said one reader from Detroit. "That's all it will take — they'll change it!" An Indiana mom claimed, "The whole thing is a horrible nightmare."
Despite this rising awareness, "Twilight Sleep" didn't go out of vogue until the late 60s or early 70s--so Betty's experience is far from outside the realm of possibility. But by the mid-seventies, things had certainly changed. As Corry points out, Lamaze, started by a natural birth advocate who had studied Dick-Read's work, was "pretty widespread" at that point and epidurals, the current anesthetic, arrived midway through the decade. Like chloroform before it, "Twilight Sleep" went into the dustbin of history.
But more than being ushered out by medical advances, the practice ended because "Women were empowered to make the change," says Corry. "They wanted to birth in a way that gave them a sense of control, so they spoke out."
And the social upheaval of the 60s, which "Mad Men "is gingerly approaching, helped enable them to do so. "So many things were happening: women were being educated in math and science, they were coming out of school and working." says Corry. "It was the "our bodies, ourselves," era. Women's rights were coming into play. Birth control was available, which meant self-determination for women and the ability to control our reproductive health."
Indeed, it's telling that Roe was legalized around the same time as Lamaze was making major inroads-- as Rh Reality Check and its writers have long been documenting, the rights of expectant mothers and other reproductive rights come from the same place: acknowledging women as people and their right to control their reproduction as a a human right.
While today's birth have far less similarity to a torture chamber as they did in Betty Draper's day, today a similar lack of agency can affect women giving birth, particularly at hospitals, says Corry. Because of the insurance and medical system, doctors make more money by performing more procedures, which leads to what many feel is an over-medicalization and intervention-heavy birthing process from heavy epidurals to forced cesareans to women simply not being informed of their options. For some women in many areas of the country, laws or the lack of options in their region severely limit their ability to control the process.
Whether it's trying to have a vaginal birth after a cesarean (VBAC) or choosing to forgo drugs or have a natural birth, it can be difficult for women to figure out and speak up, particularly in an institutional setting. "It's challenging for a woman to get her hand on trustworthy information," says Corry. "How do you decide what's good for you, based on the best evidence rather than someone's opinion? Even the most motivated woman still has to deal with hospital protocols and staff who are used to intervening in birth."
Just as "Twilight Sleep" ended as a result of women's raised voices, so must the issues women still face in childbirth today. Even if it's not as melodramatic as morphine-induced hallucinations, feminist are fighting a medical system that reduces women's agency over their bodies by presenting alternatives and by arguing for systematic reform.
In this video, Mad Men creator Matt Weiner and January Jones, who plays Betty, talk about portraying "Twilight Sleep" on TV and about Don's experience in the waiting room.
