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What Is Twilight Sleep?

A twilight sleep-inspired sedation technique is often used for patients who are fearful of oral procedures.
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  • Written By: Lainie Petersen
  • Edited By: Melissa Wiley
  • Last Modified Date: 16 September 2014
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Historically associated with childbirth, the term twilight sleep is often used to describe a modality of anesthesia in which a patient who is undergoing any sort of painful procedure is given a cocktail of drugs that both minimizes pain and reduces consciousness of the event. In many cases, twilight sleep induces an amnesic condition so that the patient does not remember the procedure or any discomfort experienced after the anesthetic drugs wear off. This type of anesthesia was originally introduced in the area of obstetrics as a way of minimizing women's discomfort during childbirth. Although the original combination of drugs, morphine, and scopolamine is generally no longer used, other drugs that can have a similar painkilling and sedating effect are commonly offered to patients in a variety of medical and dental procedures.

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Around the turn of the 20th century, German doctors published information about their work in obstetrics anesthesia. The goal of twilight sleep was to reduce the stress and discomfort of the laboring woman and to enable her to completely forget the experience. After labor and delivery was completed, she could be presented with her new baby and not have any memory of the labor experience. Twilight sleep continued to be used for several decades in maternity wards despite undesirable side effects, such as causing women to behave so erratically that they required restraints. Some women also complained that, because they had no memory of giving birth, they felt disconnected from their children; babies born to mothers under the influence of twilight sleep drugs often developed breathing problems.

Eventually the trend toward so-called natural childbirth as well as new anesthetic techniques that allowed women to remain conscious while giving birth meant that twilight sleep was generally no longer used in obstetrics. Other medical practitioners, however, continue to use anesthetic techniques that work on a principle similar to twilight sleep. Sometimes known as modern intravenous sedation, IV sedation, or light sedation, it is typically indicated for individuals undergoing a painful medical procedure that does not mandate the use of more risky general anesthesia. In some cases, IV sedation is offered to patients who are fearful of undergoing a procedure that could be performed under local anesthesia, such as a tooth extraction.

The degree of unconsciousness experienced by individuals who undergo modern twilight sleep anesthesia varies considerably. In many cases, however, the individual will be able understand and respond to verbal instruction offered by health care professionals. For example, a person who is under the influence of IV sedation may be able to dress himself after a procedure and get into a wheelchair in order to be transported to a recovery room with minimal assistance. Yet this individual may have little or no memory of the procedure or any pain experienced.

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umbra21
Post 3

@MrsPramm - I don't know if that's actually the case. They had ways of knocking people out cold back then and would have been able to do that for a serious operation like a Cesarean.

I think it's more likely that it was just a symptom of how people saw women in general back then. They were seen as too fragile to experience the pain of childbirth and too unreasonable to make their own decisions when it came to medical care.

MrsPramm
Post 2

@Iluviaporos - In some ways I can kind of understand it though. You've got to remember that childbirth in history was fraught with danger for both the mother and the baby. If you refused the medication and then ended up in trouble, it wasn't like today where they could whip you into an operating theater and make sure you were numbed up enough within a few moments to deliver the baby.

Mothers will often die of shock if they don't have access to pain medication during a Cesarean, which is what happened routinely before they had any kind of anesthetic.

These days it's important for people to be given a choice. But we still wouldn't give people the choice to have an operation without anesthetic because it would be suicide. Without twilight sleep a childbirth could have easily turned into that.

lluviaporos
Post 1

They had a very interesting episode of the historical drama I watch where one of the mothers experienced this during childbirth. I don't remember them referring to it as twilight sleep, but at one point she commented to one of her friends who asked how it went, that she didn't really remember, like always.

The thing that would have terrified me was that this was completely outside of her control. It's not like today where you can ask to have a natural birth or ask to have painkillers. These women were forced to have twilight sleep during birth whether they wanted it or not.

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