On Birth and Fog


Mad Men fans have been chattering about Betty’s “dream sequences” in the latest episode, “The Fog,” and at the risk of sounding pedantic I am compelled to clarify at least one thing about Betty’s dreams: They really aren’t dream sequences. Not like Tony Soprano’s.

Let’s break out the Childbirth 101: As Betty is depicted, fifty years ago it was common for women to be given a drug that would induce “twilight sleep” during a hospital birthing procedure. The amnesic drug did not behave like a true analgesic pain killer, but instead induced a state of disorient that managed pain by making the mother forget the entire process of childbirth. During the procedure, laboring women were, as a matter of course, shackled during regular childbirth.

As Aunt B. wrote last year:

I really thought it was what it sounded like, a light sedation that kept you kind of woozy and pain free while your husband was out in the waiting room passing out cigars and you both waited for the doctor to bring you the news that the baby had been born. And I assumed it fell out of favor because the women couldn’t help push or something.


America, during twilight sleep, women went bat-shit crazy from the drugs and the pain. They hurt their heads (and so women’s heads were wrapped in large gauzy Q-tip looking arrangements). They thrashed around and tried to claw at the doctors and so they were strapped to their gurneys, sometimes for days, in their own piss and shit.

Twilight sleep didn’t suppress pain; it suppressed the memory of pain. So the doctors could just do whatever and the women would not remember it and since it was ‘indecent’ for new fathers to be there, there was no one with the woman to advocate for her. Plus, and this is the part that just creeps me out, they used lamb’s wool on the restraints because it didn’t leave bruises and so the husbands stopped seeing bruises and stopped asking questions about what was being done to their wives.

This method of childbirth completely removed a mother from the birth experience, prevented her from being an agent in her own care, and the necessary isolation prevented the woman’s family from advocating for her while she labored. I spoke to my mom tonight and verified that she gave birth under twilight sleep with my sisters in 1963 and 1969, and she confirmed that you went to the hospital, were put in a delivery room alone, were given a shot, and woke up later with a baby in your arms.

All the exasperated talk about Betty’s helplessness in this episode is defunct since it’s not intended to be part of her overall characterization. Betty, like many women then, was unable to advocate for herself, or enlist anyone else to advocate for her. This kind of obstetric medicine quite literally rendered women helpless to manage their own minds and bodies.

And ironically, considering the era of the show, these drug-induced sequences are more aptly considered like acid trips than run of the mill dreams. It’s definitely more interesting to her storyline when you realize that Betty wouldn’t remember any of her socially and personally loaded hallucinations later.

For shots of the twilight sleep scenes from Mad Men, see the video footage here.

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39 comments for “On Birth and Fog

  1. K
    September 15, 2009 at 9:37 pm

    I don’t think you’re being pedantic at all–not in the way I normally consider the term, anyway. This was good solid information, and posting it is part of not letting history be forgotten. I say that as someone who doesn’t watch the show. But anytime you get the word out on women not being to blame for how they cope with the misogynist situations they/we MAGICALLY wind up in all the time, I cheer.

    I AM going to use not watching the show as an excuse not to raise my blood pressure with those Slate articles, though.

  2. September 15, 2009 at 9:45 pm

    Do you know the name of the drug, by any chance? Because the doctor states “Demerol”, at least at the beginning, and that’s not really an amnesiac, although it wouldn’t be totally unusual for it to cause hallucinations when the patient is under stress.

  3. September 15, 2009 at 9:46 pm
  4. September 15, 2009 at 9:46 pm

    There are two scenes where they deliver drugs (I didn’t link the first one). In one the nurse says she is going to put Betty into twilight sleep, and in the next scene when Betty is in hard labor (and in shackles, the scene I linked) the doctor orders Demerol.

  5. September 15, 2009 at 9:48 pm

    Oh! They actually said the words twilight sleep. I’m gonna go back to my cotton candy now.

  6. Nentuaby
    September 15, 2009 at 9:56 pm


    Ever since I took psychology core at university, I’ve been continually astonished every time somebody holds up the midcentury period as a golden age. Better to live without modern medicine entirely than the shit they got up to…

  7. Ugh
    September 15, 2009 at 9:56 pm

    Michael Crichton wrote about his time in a birthing hospital while he was a med student. He said that it was like a circle of hell. He could not get over how horrible and terrifying it was in the ward.

    Then he got taken to the ward with the unwed teenage mothers. They weren’t given drugs as a ‘punishment’. They were all fine. The breathed, they occasionally groaned, but it was nothing like the adult, married women.

  8. September 15, 2009 at 10:04 pm

    Okay, in the scene I linked Betty isn’t in shackles yet. In order,

    1) The nurse administers the twilight meds and Betty begins to hallucinate.

    2) In the next scene she is under the twilight sleep, begging for Don, and the doctor orders Demerol.

    3) In the third — and I lied, or I can’t find it online, she isn’t in shackles but she does have the wrap on her head — she is alone in the hospital bed, gives the “I’m just a housewife” line, and has the hallucination about her parents and Medger Evans.

  9. Azalea
    September 15, 2009 at 10:15 pm

    @ Ugh- teenage girl/first time mothers who were not given any kind of labor pain medication were ALL “just fine”? That’s amazing. know there are people who endure labor without much pain but that’s rare. Labor hurts and the pain has been severe enough to kill some women and girls. While I think the medicine given to most women now and then aren’t good and sometimes were detrimental, I don’t think many 1st time laborers who go through natural birth would say they were “just fine” even if they would do it again.

  10. Nentuaby
    September 15, 2009 at 10:45 pm


    A “mental scale calibration” issue, no doubt. Compared to women given nothing to kill pain, but given a drug that induces hallucination and strips away all coping mechanisms…

  11. Ugh
    September 15, 2009 at 10:45 pm

    He was only there as a student for one day, and he did describe the callousness of the faculty when dealing with the teenagers. However, he wrote about how the teenagers had stayed at a home for unwed mothers and learned from returning mothers about the birth experience, including the fact that they wouldn’t be getting drugs, and practiced breathing with each other.

    The irony was that the ‘punishment’ meted out for the teenagers was a blessing compared to hellish misery that the supposedly ‘good’ women went through. The nurses and doctors thought they were teaching the girls a lesson, when what they were actually doing was keeping the young girls from being further tortured by a harmful drug.

  12. GrannyT
    September 15, 2009 at 11:43 pm

    When my first baby was born in 1959, I had a local anesthetic and was awake, and my husband was present at the birth, but I had to fight for both. The first doctor that I went to said “a delivery room is no place for a woman”. He laughed, but he meant it. So I changed doctors. Later, when I described the birth to my mother, she was amazed… she had had three babies, but had never seen one take its first breath. The good old days were not that, and for that reason, I never watch Mad Men. Living through it was enough. Watching it on TV would be unendurable.

  13. evil_fizz
    September 16, 2009 at 12:25 am

    My grandmother gave birth to five children between 1947 and 1959. When I had my daughter, she wrote me a letter telling me about how she was the first woman at her hospital to give birth without being medicated. Her doctor was completely gobsmacked, but let her do it. My respect for her has increased by several orders of magnitude reading this.

  14. Bruce from Missouri
    September 16, 2009 at 1:03 am

    I’ve never heard of this before… Was it still the standard in the 1960’s? My siblings and I were born in 1963, 65, and 67, and my mom, and most other women that generation that have ever talked childbirth in front of me had epidurals, not twilight sleep.

  15. AnneThropologist
    September 16, 2009 at 8:56 am

    My mom gave birth to me in 1974, and she was put under twilight sleep with no choice. She was left alone in a room for 12 hours during “early labor,” with no support and no contact. Then they gave her the “shot” and she woke up to find I was already there. She describes it as hell.

    My siblings were born in the early ’80s, and she insisted on natural child birth for both. She says it was much less traumatic and less painful to do it that way.

    We forget how recent this shit is. When I was born in ’74, while my mom was still sedated, the nurse brought me out to “show” my father and my grandmother. She stood behind a red velvet cord and lifted me up – no one was aloowed to hold me or touch me because of the germs.

    My grandma still tells the story of how she stepped over the red velvet ropes and said, “I’ll take that, thank you very much!” and snatched me out of the nurse’s arms. Apparently, the nurse was too gobsmacked by my grandma’s lack of “decorum” to react.

  16. September 16, 2009 at 8:58 am

    My mother gave birth to her first in 1967 at age 18, and it was a complete nightmare. Whatever drug they gave her was absolute torture. She still remembers it, so I suppose it wasn’t twilight sleep. She hallucinated that she was in a concentration camp and that the doctors were trying to kill her. Understandable. She was in horrific labor for a day and a half. And she kept trying to run away. At one point my dad’s friend called a priest, because they (he and my dad) thought she was dying. Shows how little the doctors communicated with the family.

    She ultimately cussed the priest out and said “I’m not dying! All I want is a fucking piece of toast!”

    I love my mom.

  17. Wednesday
    September 16, 2009 at 9:01 am

    I had no idea that such a barbaric practice had ever happened, let alone been routine, in this country. (Which was pretty much my reaction when I learned about the shackling of female prisoners during labor. I suppose it’s some sort of progress that our country has moved on to shackling only “bad” women, instead of the “good” ones?)

    Also disturbing (albeit on a much lower level), the Wikipedia article on this topic mentions the emotional harm to the mother- “removal of the mother from the birth experience” and the physical harm to the baby, but none of the physical harms (bruises from shackles, etc) this practice inflicted on the mothers.

  18. emjaybee
    September 16, 2009 at 10:54 am

    Re laboring unmedicated; pain is also a mental experience, and your experience of pain is highly influenced by your mental state. Shackled and helpless labor pain is going to be worse than not being shackled and being allowed to move and breathe. Painkilling drugs in labor have mixed and sometimes unpredictable results, depending on the woman’s body and her feelings of fear, tension, or stress. And if they make her immobile, that slows down labor, and thus causes new problems, and increases her risks of c/section surgery and thus mortality risks.

    Just wanted to make clear that the benefits of natural or unmedicated birth can mitigate a lot of the physical pain (especially if you use water tubs, move around, and can make noise unhindered), and avoid many risks, which is why so many advocate for it–not because, like the nurses described we think women need or deserve pain in birth–quite the opposite.

    Before the modern era, women did not die of labor *pain*–they died of labor *complications*, such as infections, ruptures, pre-eclampsia, or breech babies that got stuck. Factors like malnutrition, which caused deformed hip bones and other problems, as well as unsanitary obstetrical practices by doctors or midwives ignorant of germ theory also killed many women.

  19. Gordon
    September 16, 2009 at 11:19 am

    Auguste asks which drugs were used. Several on-line sources I consulted claimed it was a combination of morphine (instead of demerol) and scopolamine, but I have no personal knowledge.

    The stories I heard from my same-age friends in the late 1960’s was pretty much the same as Bruce from Missouri. They had either epidurals or nothing. As I recall, their biggest complaint about hospital birth was usually the gallon-size enema, which I think was still standard procedure until the mid-1980’s.

  20. sonia
    September 16, 2009 at 11:43 am

    That was a weird time. It was also a time when frontal lobotomy was a recommended procedure for any and all conditions and the guy who popularized it got a Nobel prize in medicine for it.

  21. September 16, 2009 at 12:57 pm

    I am incredibly sad that we don’t get the channel MadMen is shown on, nor can it be found on-line (other than purchased for approximately “How much?!!?” per season). I am therefore *really* thankful for the reviews I’m finding on-line. Spoilery, but not so much so that I won’t enjoy watching the show when I *can* get my hands on it.

    My husband is so going to squirm during this episode, especially when I turn to him and go “yup, they really did that”. He has already done so with some of the blatant sexism. And since I have nothing really useful to add to the discussion, I’ll stop here. *grin*

  22. Kat
    September 16, 2009 at 2:27 pm

    My ex-mother-in-law had three children with this twilight drug. She has no recollection whatsoever of the childbirth experience. It was just as you described — she went into the hospital in labor, and woke up and had a baby placed in her arms. Three times. Later, when I was pregnant with her grandson, she seemed a little sad that she could not discuss childbirth with me, as her experience had such gaps.

    My own parents lost their first child after my mother’s doctor delayed care despite my mother telling him that something was wrong. She was labeled as a over-reactive first time mother. After that, my father was in the delivery room for all the births, and my mother didn’t take pain medications. She wasn’t necessarily a believer in natural childbirth, but she was hell bent not to lose control of the situation as had been her experience with the tragic first birth. At the time, it was completely unseemly for the father to be in there, but my normally not-very-progressive parents held firm on that. Pretty brave of them, when I think of it now.

  23. Kat
    September 16, 2009 at 2:29 pm

    Also, I have had that twilight drug, when I had to have a D&C. It was an extremely odd out-of-body sort of experience for me. I was aware of everything going on, but no pain. Or maybe there was pain but I couldn’t tell. Not sure. I can’t imagine giving birth that way.

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  25. September 18, 2009 at 1:30 pm

    I was born in 1957, under these circumstances also.

    I was put in “twilight sleep” for my colonoscopy… I remember looking up and seeing my multi-colored colon on a TV screen while they were doing it… I said “Ohh, how pretty” and they just laughed and laughed at me…and then, zzzz.

    Only memory I have of it.

  26. bethrjacobs
    September 19, 2009 at 3:20 pm

    I’m resubmitting this as it’s a serious issue and it was confirmed to me by a rape crisis teacher. And I don’t see it on screen yet.
    Ativan (Lorazepam),
    Is one it’s a “preoperative drug” commonly given before sedatives and also in mental wards as a “tranquilizer?”.It does not tranquilize but as the article above mentions it makes you “forget” Ativan (Lorazepam) Drug Information: Uses, Side Effects, Drug …
    Coincidentally there is a huge issue of rape by staff in mental wards….go figure.

  27. bethrjacobs
    September 19, 2009 at 3:41 pm

    AND THIS IS ALSO VERY INPORTANT ESPECIALLY FOR ABUSE CASES. http://www.google.com/search?sourceid=navclient&ie=UTF-8&rlz=1T4GGLL_en&q=post+hypnotic+drugs+ativan

    IE Ativan and other Lorazepam type drugs make you more easily hypnotized i.e. your rapist or abuser can not only make you forget your rape or torture but convince you that you liked and wanted it to happen.

    1. Ativan as a date rape drug
    Mar 10, 2009 … Originally Posted by Blender View Post. Ativan, or Lorazepam, is a strong sedative and has strong hypnotic effects, which makes it a good …
    community.thegooddrugsguide.com/27-ativan-date-rape-drug.html – Cached – Similar –

  28. HelluvaTime
    September 20, 2009 at 2:41 pm

    My mother had had 7 pregnancies thru the fifties & early sixties and had talked to me in detail over the years of her experiences and of all the various “pain control” methods that were used. She never had “natural” – scopalamine, twilight sleep, epidurals gone wrong, demerol…I heard it all from her.

    I delivered my child via natural childbirth in the mid-1980’s. That was a time when we women were aware & educated about how far we had come…and that we COULD advocate for ourselves throughout the pregnancy & childbirth process. I had a wonderful labor & delivery experience…yes, childbirth is painful and I had a an “easy” eight hour labor…but we are so fortunate to have choices today and control over this important process of giving birth. And to have family with us to advocate for us if needed.

    In the aftermath of the Madmen epi, it’s been eye-opening for me to see that women (and men ) today are so shocked to see Betty’s childbirth experience!~ It’s wonderful in a sense that today’s younger people are unaware of how it was for most women…but it’s also very important to NOT forget history – DO NOT take for granted how far we we have come, as women, as families, as people.

  29. cocoschomoco
    September 20, 2009 at 9:44 pm

    emjaybee had it right, Azalea, in that pain doesn’t kill women, labor complications do. It’s a little known fact in our fear-filled culture that childbirth isn’t actually something to fear (though you could argue that childbirth in a hospital is something to fear…).

    The saddest part about twilight sleep is that this shit is still happening to women these days – episiotomies are still routine with some doctors – I know of many women my age (I’m in my early thirties), who were cut without consent. VBACs (vaginal birth after cesarean) are banned from many hospitals in this country, despite proof that they are safer than repeat c-sections – women aren’t informed or even given the option of attemping one in many cases – they are denied, misinformed or flat-out lied to into repeat c-sections.

    Routine obstetric practices in the US are still figuratively tying women down in labor (and literally – something like 80% of all women are induced, which means being hooked up to many, many machines to track labor progress). Two really good books about the history and current state of maternity care are ” Birth: The Surprising History of How We Are Born” by Tina Cassidy and “Pushed” by Jennifer Block.

    As for past labor practices, my mom (as an unwed teenage mother) was induced with Pitocin and then strapped down and left to labor on her own for hours in the late 60s. Guess she didn’t qualify for the twilight sleep…

  30. Pencils
    September 20, 2009 at 10:26 pm

    I knew about twilight sleep but this episode still freaked me out. My mom had five kids between 1963 and 1971, never with twilight sleep. but then her OB was a woman, so that might have been the difference. With one of us, she was in terrible pain, telling the people there that her babies came fast–her first was born while she still had sand from Rockaway Beach on her (she went into labor on the beach)–but no one was listening to her, and she felt such relief when she heard the fast tap-tap-tap of her approaching doctor’s high heels on the tile floor. She only had epidurals, as far as I know, although a couple of births were too fast for anything. I had an epidural during my first birth a year ago, and, damn, I was READY and desperate for it! I thought I knew pain, as I have chronic pancreatic disease, but that was bad. Everyone’s birth experience is different, and even each birth is different. Or, at least, every modern birth is different, the twilight sleep ones sound eerily the same in the women’s’ non-recollections.

  31. September 22, 2009 at 10:39 am
  32. M
    September 24, 2009 at 3:27 pm

    The key to me is that “we are so fortunate to have choices today and control over this important process of giving birth.” And that includes having the choice to receive pain-killing medication and medical help during childbirth if you DO want it.

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