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c h a p t e r o n e Ether and Chloroform The Question of Necessity, 1840s through 1890s O n April 7, 1847, Fanny Appleton Longfellow of Cambridge, Massachusetts , pregnant with her third child, became the first woman in the United States to inhale anesthesia while giving birth. Longfellow’s decision to use ether was not precipitous; indeed, finding a physician willing to administer the substance took considerable time and effort. Before the birth, her husband, the poet Henry Wadsworth Longfellow, consulted a host of doctors, all of whom denied his request. Each denounced obstetric anesthesia as unnecessary and dangerous.Undeterred,Henry persisted in his search for an amenable doctor.1 Ultimately he found Nathan Cooley Keep, a Boston physician specializing in dentistry, who agreed to dispense the desired ether. Keep later reported that Fanny’s labor was short and unproblematic. Five and a half hours after labor commenced, Keep began to administer ether, and Fanny sporadically inhaled it. She gave birth a brief thirty minutes later. At one point in this half-hour span, acutely aware of the experimental nature of his venture, Keep withheld the ether, despite Fanny’s protest, to ensure that the gas was not interfering with her labor. The action allayed his fears, for he saw no change in the frequency, duration, or strength of Fanny’s contractions. He noted, however, that in the absence of ether, “the distress of the patient was great.”2 In retrospect, both physician and patient were pleased with the experiment. In a letter to the editor of the Boston Medical and Surgical Journal, Keep termed the endeavor “highly satisfactory.” Fanny was elated: she said the birth was far superior to her two previous, unanesthetized ones and that under the influence of ether, she had never felt better or labored more comfortably. She pronounced ether “certainly the greatest blessing of this age” and declared herself “proud to be the pioneer to less suffering for poor weak womankind.” Henry’s brother joined the celebration by joking,“If you had asked your wife which she preferred, a boy or a girl, she would have replied,‘I will take ether.’”3 Social Change Hastens the Acceptance of Obstetric Anesthesia Notwithstanding the jubilation, it remains unclear why the Longfellows persisted in seeking a medical treatment that the vast majority of doctors considered reckless . Fanny’s previous births offer no clues, since Henry described those two labors as“pretty easy.”4 Perhaps Fanny’s pride in her ability to offer hope to“poor weak womankind” suggests the reason for the Longfellows’ dogged pursuit of ether. By the mid-nineteenth century,being a woman and being weak and unhealthy seemed to go hand in hand. The tendency of middle- and upper-class urban women to exhibit infirmity was so widespread that when Catherine Esther Beecher, a pioneer in women’s hygiene, asked women around the country to describe the health of the ten women they knew best, one Milwaukee woman provided the prototypical response: “Do not know one healthy woman in the place.”5 Characterizing birth as unbearable was a logical by-product of this cultural milieu. The development of ether in 1846 and the discovery one year later of the anesthetic properties of chloroform strengthened the tendency. News of the potential of obstetric anesthesia amplified the descriptions of agonizing labors as the possibility of painless childbirth was increasingly dangled before a susceptible audience of seemingly frail women and their concerned doctors.6 In the late nineteenth century, Cyrus Edson, commissioner of health of New York, exemplified the American tendency to describe birth in harsh terms by likening the suffering of laboring women to the agony of martyrs tortured during the Middle Ages. He contended that giving birth transformed vulnerable women into lifelong invalids and blamed girls’ increased access to formal education for the tragedy. Sitting in a classroom during puberty, he argued, drained girls’ strength, leaving little in reserve for childbirth in coming years.7 Other physicians elaborated on this argument, explaining that educational demands interfered with the proper growth of girls’ bodies. Frequent diagnoses of “structural disease of the ovaries” and “juvenile cervix” appeared in the medical record. Physicians theorized that boys were immune to underdeveloped reproductive systems because boys’ bodies developed slowly and evenly throughout adolescence. In contrast, girls’ bodies allegedly developed in a brief burst that could result in disaster if at that particular moment their overtaxed brains were monopolizing the...

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