Conceptualizing Childbirth Pain in Medical Texts and Personal Narratives in Early America

Historical scholarship on pain and childbearing in America has focused primarily on pharmacological developments and medical debates that began in the 1840s surrounding anesthetized childbirth. Prior to this period, childbearing women and their practitioners left few extensive discussions of pain, but recognition of it was woven through both women's personal writings and published medical texts. A close reading of these sources reveals two distinct conceptualizations of childbirth pain. Women focused on the lived experience of pain and represented it as the cumulative effect of the processes of childbirth. They made it clear that the fear of pain, as well as death and debility, defined their attitudes toward childbearing. Women described labor and delivery comprehensively as a "fiery trial"; rather than differentiate specific kinds of pain, they tended to broadly evaluate the impact of pain as part of their assessment of the aftermath of birth. Pain colored their entire outlook on childbearing. Physicians, on the other hand, did not tend to write about pain as a part of lived experience. They either largely avoided the subject in their medical texts or they sought to understand its anatomical location and function. Physicians hoped to understand whether pain served a useful purpose in the process of labor, a question that would ultimately come to bear in debates about anesthesia. In their published writings, most physicians showed little interest in investigating ways to measure, articulate, or manage women's experiences of pain, for they envisioned pain less as a human experience and more as a physiological function that needed to be understood in relation to other processes. These different ways of conceptualizing pain can provide useful context for understanding women's eagerness for anesthesia and the intense debates over its usefulness that preoccupied medical practitioners in the second half of the nineteenth century.