Dr. Jacqueline Wolf tells history, hazards of obstetric anesthesia

OU-COM historian of medicine publishes new book, Deliver Me From Pain

By Anita Martin

March 9, 2009

Practices in childbirth are driven less by medical innovation and more by socio-cultural forces—sometimes to the detriment of mothers and their babies, writes Jacqueline H. Wolf, Ph.D., in Deliver Me from Pain: Anesthesia and Birth in America. The book, published this month by The Johns Hopkins University Press, examines the development of, and common misconceptions surrounding, one obstetric practice: anesthesia.

In Deliver Me from Pain, Wolf, professor of social medicine, describes how obstetric anesthesia came to calm women’s anxiety about
birth despite the medical risks it posed to mothers and newborns.

As obstetric anesthesia first became common in the early 20^th century, the maternal death rate began to rise, in part because anesthetized women who could not push on their own required forceps, which increased the chances
of postpartum infections. Through the 1960s, mothers were frequently anesthetized to the point of unconsciousness, usually during the second, less painful stage of labor—often just as the baby was being born. 

“I wanted to understand why so many women were rendered lethargic, or even unconscious, during one of the most salient moments of their lives,” Wolf says.

Wolf argues that the popularity of obstetric anesthesia, based on its
perceived “convenience,” helped drive public approval of subsequent, often unnecessary—and sometimes dangerous—treatments. These include forceps, labor induction, episiotomy, electronic fetal monitoring and, most recently, Cesarean section, which studies have linked to the recent rise of the maternal mortality rate in the United States—the first such rise in more than
70 years.  

As American women make decisions about anesthesia today, Deliver Me from Pain offers insight into how women made this choice in the past and why each generation of mothers has made dramatically different decisions.

Wolf is the author of Don’t Kill Your Baby: Public Health and the Decline of Breastfeeding in the Nineteenth and Twentieth Centuries and the host of Health Vision, a weekly show on contemporary health and medicine airing on the PBS affiliate in Southeast Ohio. She has already begun work on her third book, about the history of Cesarean sections in the United States.