Читать книгу The Mother and Her Child - Lena K. Sadler - Страница 110

While "twilight sleep" as a method of anesthesia is not altogether new, many of the claims made for it by recent advocates are more or less new; and, to enable the reader clearly to comprehend both the advantages and disadvantages of this method, both the favorable and unfavorable facts and contentions will be summarized in this connection. The favorable claims made for "twilight sleep" are:

1. That eighty to ninety per cent of all women who use this method can be carried through a practically painless labor.

2. That there is practically no danger to the mother (some degree of danger to the child is admitted by most of its champions) other than those commonly attendant on the older and better known methods in general use.

3. That "twilight sleep," being almost exclusively a hospital procedure, would result in more women going to the hospital for their confinement—if it were used more; and would, therefore, tend to bring about more careful supervision and individual care on the part of the attending obstetrician.

4. That by lessening the dread of labor and the fear of painful childbirth, there will probably occur an increase in the birth rate of the so-called "higher classes of society"—the social circles which now show the lowest birth rates.

5. That it is of special value in the cases of certain neurotic women and those of low vital resistance; especially those patients suffering from certain forms of heart, respiratory, kidney, and other organic diseases.

6. Some authorities maintain that "twilight sleep" is of value even in threatened eclampsia, although they admit it tends to produce a rise in blood-pressure.

7. It is supposed to shorten the first stage of labor—by facilitating the dilation of the cervix—owing to the painless stretching; although the majority of its special advocates admit that it lengthens the second stage of labor, during which the patient must be very closely watched.

8. That even in those cases where the sense of pain is not entirely destroyed, the patient seems to possess little or no subsequent memory of any physical suffering or other disagreeable sensations.

9. That the method is of special value in sensitive, high-strung, nervous women of the "higher classes," who so habitually shun the rigors of child bearing—especially in the instance of their first child.

10. That the action of scopolamin is chiefly upon the central nervous system—the cerebrum—that it diminishes the perception of pain without apparently decreasing the contractile power of the uterus; labor may, therefore, proceed with little or no interruption, while the patient is quite oblivious to the accompanying pains.

11. That the physical and nervous exhaustion is quite entirely eliminated—especially in the case of the first labor—that patients who have had this method of anesthesia appear refreshed and quite themselves even the first day after labor.

12. That there is decidedly less "trauma" (appreciable injury) to the nervous system and therefore less "shock;" and that all this saving of nervous strain tends greatly to hasten convalescence.

13. And, finally, that "twilight sleep" does not interfere with the carrying out of any other therapeutic measures which may be deemed necessary for a successful termination of the labor.