"When I Think of It I Awfully Dread It": Conceptualizing Childbirth Pain in Early America.

The emergence of obstetric anesthesia in the second half of the nineteenth century was preceded by a transformation in the medical conceptualization of women's pain. In the eighteenth and early nineteenth centuries, physicians described pain in physiological terms as natural and unproblematic, but in the second half of the nineteenth century they adopted a newly emotional language that emphasized women's subjective experiences of suffering. Middle-class and elite white women shaped this transition by insisting that their physical and emotional anguish was extreme. Women's attitudes, combined with a growing perception that sensibility to pain was a marker of "civilization," pushed physicians to view suffering as real and problematic. As they began to depict pain relief as an urgent medical concern, physicians envisioned refined white women as the primary beneficiaries of their new technology; this perspective paved the way for the increasingly routine use of anesthesia for middle-class and elite white women.