3 Anesthesiologists began focusing their efforts on reducing anesthesia-related adverse maternal and neonatal outcomes, including airway-associated morbidity and mortality. In the mid-twentieth century, general anesthesia for cesarean delivery gave rise to airway complications, including failed tracheal intubations, maternal aspiration, and Mendelsohn syndrome (aspiration pneumonitis). 2 In the early twentieth century, “twilight sleep,” a combination of morphine and scopolamine, became common, but was ultimately abandoned due to its depressant effects on the neonate. 2 Ultimately, the clinical use of ether and chloroform for labor analgesia was not driven by the scientific community, but by a shift in the social attitudes of patients who demanded it, persuaded by public rhetoric from feminist advocates. Women’s rights to request and receive labor pain relief was controversial-religious mores of the nineteenth century viewed pain, including labor pain, as divine punishment, and interference was considered sinful. The medical community expressed concerns about safety and toxicity. 1 While Simpson publicized this intervention as effective and innovative, he expressed reservations about its unknown effects on labor and the fetus. The “birth” of obstetric anesthesia began with the introduction of ether labor analgesia by obstetrician James Young Simpson in 1847.
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