ed--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.

DANGERS OF TWILIGHT SLEEP

While we are recounting the real and supposed advantages of "twilight
sleep"--especially in certain selected cases--it will be wise to pause
long enough to give the same careful consideration to the known and
reputed dangers and drawbacks which are thought to attend this method
of anesthesia in connection with labor cases.

We desire to state that these expressions, both for and against
"twilight sleep," are not merely representative of our own experience
and attitude; but that they also represent, as far as we are able to
judge at the time of this writing, the consensus of opinion on the
part of the most reliable and experienced observers and practitioners
who have used and studied this method in both this country and Europe.
The dangers and difficulties of "twilight sleep" may be summarized as
follows:

1. That this method tends to weaken the mental resistance of many
women; to lessen their natural courage and to decrease that
commendable fortitude which is such a valuable feature of the
character endowment of the normal woman.

2. That "twilight sleep" is essentially a hospital method and is,
therefore, inaccessible to the vast majority of women belonging to
the middle and lower classes of society, as well as to those women who
live in rural communities.

3. That in fifteen or twenty per cent, the method fails to produce the
desired results--at least, when administered in amounts which are
deemed safe.

4. That this method does decrease the baby's chances of living; that
the second stage of labor is definitely prolonged; that from ten to
fifteen per cent of the babies are sufficiently under the influence of
the anesthesia when born as to be unable to breathe or cry without
artificial stimulus.

5. That it is a method requiring special training and experience; that
it will be many years before the average practitioner will become