PREGNANCY--LABOR--PARTURITION.
Perhaps there is no more eventful period in the history of woman than
that in which she first becomes conscious that the existence of
another being is dependent upon her own and that she carries about
with her the first tiny rudiments of an immortal soul.
THE SIGNS OF PREGNANCY
are various. Many females are troubled with colic pains, creeping of
the skin, shuddering, and fainting fits immediately on conception
taking place. Where such symptoms occur immediately after connection,
they are a certain indication of impregnation.
A REMARKABLE CHANGE
takes place in the face in most cases, varying in time from three days
to three months. The eyes are dull and heavy, and present a glassy
appearance; the nose pinched up; the skin becomes pale and livid, and
the whole countenance appears as if five or ten years' advance in life
had been taken at a single step.
Another important and remarkable sign, and one the most to be relied
on, is an increase in the size of the neck. This often occurs at a
very early period, and many females, by keeping a careful daily
measurement of the neck, can always tell when they are pregnant.
A suppression of the menstrual flow is another strong presumptive
sign. It is true a partial flow of the menses often occurs after
pregnancy, from the lower part of the womb, but when the flow is
suddenly stopped without any apparent cause, pregnancy is generally
the predisposing cause.
SOON AFTER CONCEPTION
the stomach often becomes affected with what is called morning
sickness. On first awaking, the female feels as well as usual, but on
rising from her bed qualmishness begins and perhaps while in the act
of dressing retching and vomiting takes place.
This symptom may occur almost immediately after conception, but it
most frequently commences for the first time between two and three
weeks after. Now and then it is experienced only during the last six
weeks or two months of pregnancy, and subsides about the time the
movements of the child begin to be felt.
CHANGES IN THE BREAST
are generally considered as strong signs of pregnancy. When two months
of pregnancy have been completed, an uneasy sensation of throbbing and
stretching fullness is experienced, accompanied by tingling about the
middle of the breasts, centering in the nipples. A sensible alteration
in their appearance soon follows, they grow larger and more firm. The
nipple becomes more prominent, and the circle around its base altered
in color and structure, constituting what is called the areola, and as
pregnancy advances milk is secreted.
THE PERIOD OF GESTATION,
at which these changes may occur, varies much in different females.
Sometimes, with the exception of the secretion of the milk, they are
recognized very soon after conception; in other instances,
particularly in females of a weakly and delicate constitution, they
are hardly perceptible until pregnancy is far advanced or even drawing
toward its termination.
The changes in the form and size of the breasts may be the result of
causes unconnected with pregnancy. They may enlarge in consequence of
marriage, from the individual becoming stout and fat or from
accidental suppression of the monthly flow.
The changes which take place in the nipple, and around its base, are
of the utmost value as an evidence of pregnancy.
ABOUT THE SIXTH OR SEVENTH WEEK
after conception has taken place, if the nipple be examined it will be
found becoming turgid and prominent, and a circle forming around its
base, of a color deeper in its shade than rose or flesh color,
slightly tinged with a yellowish or brownish hue, and here and there
upon its surface will be seen little prominent points from about ten
to twenty in number. In the progress of the next six or seven weeks
these changes are fully developed, the nipple becoming more prominent
and turgid than ever, the circle around it of larger dimensions, the
skin being soft, bedewed with a slight degree of moisture, frequently
staining the linen in contact with it; the little prominences of
larger size, and the color of the whole very much deepened.
Calculations of the
DURATION OF PREGNANCY,
founded upon what has been observed to occur after casual intercourse,
or perhaps a single act, in individuals who can have no motive to tell
us what is false, are likely to be correct. The conclusion drawn from
these is, that labor usually, but not invariably, comes on about 280
days after conception, a mature child being sometimes born before the
expiration of the forty weeks, and at other times not until that time
has been exceeded by several days. A case is on record where the
pregnancy lasted 287 days. In this case the labor did not take place
until that period had elapsed from the departure of the husband for
the East Indies, consequently the period might have been longer than
287 days.
CHILDBIRTH IS A NATURAL PROCESS,
and however complicated and painful habits or disease have made it,
yet the work must be left to nature. Any efforts to assist or hurry
matters will only end in harm. The only cases where interference is
justifiable is where her powers are exhausted or some malformation
exists or malpresentation occurs. When labor is about to commence, the
womb descends into the bottom of the belly and the motions and weight
of the child will be felt much lower down than usual. If in a natural
position the head will fall to the mouth of the womb and press upon
it. This drives forward the membranes which retain the water at the
orifice, and at the proper moment they break and labor then commences.
Labor is caused by involuntary contractions of the uterus and
abdominal muscles. By their force the liquor amnii flows out, the head
of the foetus is engaged in the pelvis, it goes through it, and soon
passes out by the valve, the folds of which disappear. These different
phenomena take place in succession and continue a certain time. They
are accompanied with pains more or less severe, with swelling and
softening of the soft parts of the pelvis and external genital parts,
and with an abundant mucous secretion in the cavity of the vagina. All
these circumstances, each in its own way, favor the passage of the
foetus.
It is proper here to remark that parturition is not necessarily either
painful or dangerous. It is well known that women in an uncivilized
state suffer very little pain or disablement in bringing forth
children. Generally neither pregnancy nor labor interrupt the ordinary
avocation of the mother, except for an hour or two at the birth
itself. The suffering and debilitating influences that often attend
childbirth now are caused by our unnatural modes of living and
nonattention to the laws of health. Numerous well-authenticated
instances are known where women who had previously suffered with
severe labor in childbirth have, by attention to health and diet as
here shown, been delivered of fine healthy children with comparative
ease.
From the
BEGINNING OF PREGNANCY
more than ordinary care should be used in taking regular exercise in
the open air, being careful to avoid fatigue and overexertion. During
the whole period of pregnancy every kind of agitating exercise, such
as running, jumping, jolting in a carriage, and plunging in cold
water, should be carefully avoided, as well as the passions being kept
under perfect control.
THE DIET
must chiefly consist of fruits and farinaceous food, as sago, tapioca,
rice, etc. In proportion as a woman subsists upon aliment which is
free from earthy and bony matter will she avoid pain and danger in
delivery; hence, the more ripe fruit, acid fruit in particular, and
the less of other kinds of food, but particularly of bread or pastry
of any kind, is consumed, the less will be the danger and sufferings
of childbirth. Nearly all kinds of fruit possess two hundred times
less ossifying principle than bread or anything else made of wheaten
flour.
Honey, molasses, sugar, butter, oil, vinegar, etc., when
unadulterated, are entirely free from earthy matter. Common salt,
pepper, coffee, cocoa, spices, and many drugs are much worse than
wheaten flour in their hardening and bone-forming tendency, and should
therefore be avoided. The drink should be tea or lemonade made with
water, soft and clear, and, when practicable, distilled.
No mother who has adopted this mode of living but has blessed the
knowledge of it, and it has saved many a young mother from needless
terror.
In the third month of pregnancy, but not before, the belly begins to
enlarge or swell, and gradually increases in size till the full term
of pregnancy is completed. Between the sixteenth and twentieth week
the womb rises up into the belly, and the motion of the child is felt,
which is called
QUICKENING.
The first time a woman is with child this sensation of quickening is
like that of a bird fluttering within her; at other times she feels a
tickling or pushing sensation, or the child gives a kick or a jump,
and this, too, with so much energy as to move the petticoats, a book,
or any light article she may have in her lap.
It is important to remember these symptoms, and the order in which
they occur: first, cessation of the menses; second, morning sickness;
third, swelling and darting pains in the breast, and dark color around
the nipples; fourth, gradual enlargement of the abdomen or belly;
fifth, the movement of the child.
In ninety-nine cases out of a hundred, if these symptoms are present
the woman is pregnant. Pregnant women are generally affected with
heartburn, sickness of a morning, headache, and that troublesome
disease, toothache, which accompanies pregnancy; all of which may
usually be avoided by keeping the bowels gently open with seidlitz
powders, caster oil, or pills of rhubarb, which should be taken
occasionally, either alone or in combination with colocynth and soap.
A clyster made of warm soapsuds will often be sufficient if repeated
every few days; or senna and manna; and if there is any aversion to
taking medicine, give some simple articles, such as roasted apples,
figs, prunes, or anything that will quiet the stomach and prevent
costiveness of the bowels.
THE TOOTHACHE
often complained of by pregnant women, and which may occur at any
period, is seldom relieved by extraction, having its seat in the
adjacent nerves of the face or jaws, and is neuralgic. The teeth ought
not to be drawn during pregnancy, unless urgently required, but should
be relieved by applying hot fomentations to the face, as a camomile
poultice. Rubbing the jaw externally with spirits of camphor or
laudanum, or applying mustard plasters or blisters behind the ears,
will afford relief.
THE CRAMPS OF THE LEGS. ETC.,
in pregnancy, caused by the pressure of the enlarged womb on the
nerves, are often troublesome, but not attended with any danger, and
may be speedily relieved by a change of posture, and friction, or
rubbing with opodeldoc, spirits of camphor, or hot whisky and salt.
Palpitation of the heart occurs frequently, and usually about the
period of quickening. In general, it is the result of a disordered
stomach and may be relieved by attention to diet and moderate doses of
magnesia and Epsom salts, of equal quantities.
THE PALPITATION OF THE HEART
may be produced by a morbid state of the nerves, and is then termed
hysterical. Attention in all such cases should be paid to the diet,
air, exercise, etc., with the view of improving the strength, the
bowels being kept open by mild means. All exciting or agitating
subjects should be carefully avoided, and the mind of the pregnant
woman kept calm and tranquil; for the mind, in the early stages of
pregnancy, exercises the most powerful influence over the child
through life; and how many peculiar traits of character have been
indelibly fixed upon their offspring from these exciting causes is
evident in many families.
When the palpitation occurs from the state of the nerves, as before
described, producing uncomfortable feelings, a teaspoonful of the
tincture of castor or asafoetida, with an equal quantity of compound
spirits of lavender, mixed in a little water, will seldom fail to
afford relief, which may, if necessary, be repeated on its recurrence.
MORNING SICKNESS
is one of the most painful feelings attendant on the pregnant state,
and it is one of those which medicine commonly fails to relieve. A cup
of camomile or peppermint tea, taken when first awaking, and suffering
the patient to be still for an hour, will frequently alleviate the
distressing sickness; but should it recur during the day, and if these
means fail, two or three teaspoonfuls of the following mixture should
then be taken either occasionally or, when the vomiting and heartburn
are more continual, immediately after each meal:
Take of--
Calcined magnesia, One dram;
Distilled water, Six ounces;
Aromatic tincture of rhatany, Six drams;
Water of pure ammonia, One dram.
Mix. The anxiety and sometimes despondency of mind--in other words,
lowness of spirits--to which pregnant women are more or less liable
greatly depends on the state of their general health and the natural
temper and character of the individual; but it can be greatly
aggravated, and may often be excited by circumstances or officious
persons. Let me, then, urge upon you the _important necessity_ of
keeping the mind as tranquil and cheerful as possible, particularly
during the first four months of pregnancy. A judicious course of this
kind will produce the most beneficial and well-balanced mind in the
child; while, if the contrary, a desponding and nervous temperament,
with many other peculiarities, will be the consequence.
SURE TEST FOR THE DETECTION OF PREGNANCY.
M. Nauche has found that the urine of pregnant women contains a
particular substance, which, when the urine is allowed to stand
separates and forms a pellicle on the surface. M. Enguiser, from an
extensive series of observations, has confirmed the fact, and
ascertained that kisteine, as this particular substance has been
called, is constantly formed on the surface of the urine of women in a
state of pregnancy. The urine must be allowed to stand for from two to
six days, when minute opaque bodies are observed to rise from the
bottom to the surface of the fluid, where they gradually unite and
form a continuous layer over the surface. This layer is so consistent
that it may be almost lifted off by raising it by one of its edges.
This is the kisteine. It is whitish, opalescent, slightly granular,
and can be compared to nothing better than the fatty substance which
floats on the surface of soups after they have been allowed to cool.
When examined by the microscope, it has the aspect of a gelatinous
mass without determinate form; sometimes cubical shaped crystals are
discovered on it, but this appearance is only observed when it has
stood a long time, and is to be regarded as foreign to it. The
kisteine remains on the surface for several days; the urine then
becomes turbid, and small opaque masses become detached from the
kisteine and fall to the bottom of the fluid and the pellicle soon
becomes destroyed.
The essential character of the urine of pregnancy, then, is the
presence of the kisteine; and the characters of the pellicle are so
peculiar that it is impossible to mistake it for anything else. A
pellicle sometimes forms on the surface of the urine of patients
laboring under phthisis, abscess, or disease of the bladder, but may
be easily distinguished by this circumstance, that it does not form in
such a short time as the kisteine, and that in place of disappearing,
as this last, in a few days, it increases in thickness and at last is
converted into a mass of moldiness. There exists, likewise, a very
marked difference between its mucous aspect and that of kisteine; a
difference which is difficult to describe, but which is easily
recognized.
Kisteine appears to exist in the urine from the first month of
pregnancy till delivery. It has even been recognized in the urine of a
few gravid animals.
"PARTURIENT BALM,"
_For Rendering Childbirth Easy and Less Dangerous--A very Important
Medicine._
Take blue cohosh root, four ounces; lady's-slipper root and spikenard
root, of each one ounce; sassafras bark (of root) and clover, of each
half an ounce. Bruise all, and simmer slowly for two hours in two
quarts of boiling water. Strain, and add one pound of white sugar.
Dose: A wineglassful twice a day for two weeks or a month previous to
expected confinement, for the purpose of rendering parturition, or
childbirth, more easy.
Should be taken by every pregnant woman.
ABORTION.
Abortion, or miscarriage, means, in plain language, a woman losing her
child previous to the seventh month of her pregnancy; that is, before
its due time. When this occurs after that period it is called
PREMATURE LABOR.
Miscarriage involves pain and weakness in addition to the loss of
offspring, and is often a severe trial to the maternal constitution.
It may occur at any period of pregnancy, but particular stages are
more liable to the accident than others. These are generally
considered to be about the time of the first menstruation after
conception; again at the twelfth week, and toward the seventh month;
and the liability is increased at those times which correspond to the
menstrual period. When abortion has once taken place it is more likely
to occur again, and some have so strong a tendency to it that they
never go beyond a certain stage, but then invariably miscarry.
THE CAUSE OF ABORTION
may exist in the constitution of the female herself, being the result
of weakness and irritability, or of an overfull habit or a diseased
condition of the womb; or the foetus, or child, may die or be
deficient in development, when it is cast off like a blighted fruit.
Suckling after conception has taken place is not infrequently a cause
of miscarriage. Active diseases occurring during pregnancy, such as
fevers, severe inflammation, eruptive fevers, etc., are almost certain
to occasion the expulsion of the uterine contents. Continued
diarrhoea and the action of strong purgative medicines, particularly
the aloetic, are dangerous. This is a very good reason for those who
are pregnant avoiding all quack aperient medicines; they almost all
contain aloes, and may be very injurious. All undue exertion or
agitation of body or mind, sudden jerks or jumps, riding on horseback
in the early stage, or in a shaking carriage in the latter stages of
pregnancy, may any of them bring on miscarriage. To these may be
added: exertion of the arms in doing anything on a level above the
head; costive bowels and straining consequent therein; sexual
indulgence, or, in plain language, too much connection with your
husband; and luxurious habits. Those who have once suffered from
abortion ought to be extremely careful during succeeding pregnancies,
and all ought to bear in mind the possibility of the occurrence.
THE SYMPTOMS OF THREATENED ABORTION
vary with the constitution. In the strong and plethoric it is often
preceded by shivering and febrile symptoms and by a feeling of weight
in the lower bowels. In the weak there is languor, faintness,
flaccidity of the breasts, general depression, and pains in the back
and loins. Intermittent pains, and discharge of blood from the
passage, tell that the process has begun. If miscarriage occurs within
the first month or two after conception, the process may be
accomplished with so little inconvenience as to escape notice and be
mistaken for a menstrual period. More generally, however, the severity
of the pain and an unusual clotted discharge of blood render the case
evident. The pain, the discharge, and, at the same time, the danger of
an abortion, are in proportion to the advancement of the pregnancy.
When a miscarriage goes on, the pains increase in force and frequency,
and continue, with discharge of blood, fluid or in clots, until the
ovum, or first formation of the child, is expelled; after which both
become moderated till they cease altogether and the red flow gives
place to a colorless one. It is very important that those in
attendance upon the patient should examine every clot that comes away.
If large, tear it in pieces, that they may ascertain whether the
contents of the womb are expelled or not, for there is no safety or
rest, where miscarriage is progressing, till it has taken place and
everything is cast off.
AS SOON AS A FEMALE
experiences threatenings of abortion she ought at once to retire to
bed, upon a mattress, and keep perfectly quiet till every symptom has
disappeared. Sometimes this simple measure, _promptly adopted_, is
sufficient to avert the threatened evil. If there is much feeling of
fullness, and the patient is of full habit generally, eight or a dozen
leeches may be applied to the lower part of the bowels; if there is
fever, saline medicines may be given, such as the common effervescing
draft of carbonate of soda and tartaric acid or lemon juice; or, if
the bowels are much confined, seidlitz powders, assisting the action
by cold clysters, if necessary. When the pains are severe,
particularly in the weak and irritable, twenty or thirty drops of
laudanum should be given, and may be repeated in a few hours if the
symptoms are not improved. In the case of profuse discharge, the
patient should be kept very lightly covered, movement avoided, and
every article of food or drink given cold, or iced if possible,
provided the vital powers are not excessively reduced. Cloths dipped
in cold or iced water should also be applied to the lower part of the
body and frequently changed. Acid drinks, with cream of tartar, may be
freely given. Ten or fifteen drops of elixir vitriol may be given in a
wineglassful of water every two or three hours. Should slight
faintness come on, it is better not to interfere with it, but use
outward remedies--camphor, cold water, vinegar, etc.--as they maybe
salutary. If it reaches to an extent to threaten life, stimulants, as
brandy and water, and others, must be had recourse to. Profuse and
continued discharge, though it may not threaten life, must occasion a
weakness which will take a long time to overcome, and which may
ultimately, if not properly attended to, promote the development of
other diseases of the womb.
IF THE FLOODING IS PROFUSE
and uncontrolled by the means before mentioned, one grain and a half
of sugar of lead may be given every two or three hours, and washed
down with a drink of vinegar and water, to which, if there is much
pain, add from five to ten drops of laudanum.
Pieces of linen or cotton cloth should be soaked in a strong solution
of alum, or a decoction of oak bark; and then well oiled; with this
cloth plug the passage or birthplace; or, some of this astringent wash
may be thrown up with a syringe.
But, during the time and after miscarriage, the general strength must
be supported by a strengthening diet, such as soups, meat, etc.,
avoiding stimulants as much as possible. Nevertheless, in some cases
wine or malt liquors may be necessary in convalescence, or when
recovering, and if so may be assisted by tonic or strengthening
medicines, such as contain mineral acid. Bark or iron are generally
given as the most appropriate remedies. The bowels will, in some
cases, require strict attention, as indeed they do throughout, and for
this purpose castor oil is a good medicine, or clysters of cold or
tepid water are most useful. A teaspoonful of Epsom salts dissolved in
half a pint of water, either cold or slightly warmed, to which add
fifteen drops of elixir vitriol, forms a most excellent and mild
purgative, which should be taken before breakfast. In all cases where
the constitution of the woman has a tendency to miscarriage or
abortion, a quiet state of mind should be observed, avoiding all
violent exertions, particularly lifting heavy weights. These
principles of treatment are to be kept in mind in the management of
miscarriage:
The first, to prevent it, if possible, by rest, opiates, etc.
The second, to allay pain, moderate the discharge of blood, and to
save and support the strength of the patient.
The third, when abortion must take place, to expedite the separation
of the ovum and free the contents of the womb. This is generally done
by simply occasionally drinking cold water, and in difficult cases, if
necessary, by the administration of spurred rye. The dose is a strong
infusion or tea given every twenty or thirty minutes until the desired
effect is produced, as long as the stomach will bear it.
The health of pregnant females should at all times be an object of
great care and interest; and they should be impressed with the
conviction that while
BEARING THE FIRST CHILD
they may, by proper care and attention, lay the foundation for their
future health and that of their offspring; while by neglect and
imprudence in this matter, they may not only enfeeble their
constitution, but entail upon their children an inheritance of
infirmity and disease.
Miscarriage, or abortion, which includes all cases in which delivery
takes place before the sixth month, seldom occurs without being
preceded, or accompanied, or followed, by a morbid discharge of blood
from the womb, which is commonly known by the name of _flooding_.
Abortion, or miscarriage, takes place with the first pregnancy, and
during the first two months; therefore, great care should be observed
during this period, as any cause which either destroys the life of the
child in the womb or brings on morbid or premature contractions in
that organ may induce miscarriage. Coughing severely, or vomiting, a
blow or fall, or a misstep leading to an effort to prevent falling,
may, and does frequently, result in miscarriage; and this having once
occurred, it is, without proper care, exceedingly liable to be the
case again at the same period of a subsequent pregnancy. The same
result may follow any vivid moral impression; for fright, or mental
excitement by passion, or witnessing any accident, will be found often
to end in miscarriage. In some healthy females, however, it occurs
without any other cause than mere fullness of blood. A bleeding from
the womb is often in such cases a first symptom of abortion, and
should be attended to as early as possible before it goes to any
considerable extent. The amount of flooding, in most cases, is in
proportion to the early period of pregnancy at which it takes place,
for in the latter months there is seldom much blood lost. But there
are cases in which pregnant women will lose blood repeatedly from the
womb and yet not miscarry, but these are very rare cases.
In most cases, the occurrence of a woman's flooding between the first
and fourth months, unless very slight, or quickly relieved, is usually
followed by a miscarriage; but as soon as the child and its membranes
are both expelled by the contraction of the womb the flooding soon
ceases. In many such cases it is often very difficult, and sometimes
impossible, to deliver the afterbirth and membranes, which remain and
finally pass off after putrefaction has taken place, resulting in long
and offensive discharges from the womb, and which, unless treated by
the most skillful management, frequently result in many internal
mischiefs of a serious character, such as ulcers, cancers, etc.
In all cases, those who are constitutionally disposed to abortion, or
have a tendency to miscarriage, should take great care to preserve a
quiet state of mind and to avoid all violent exertion; and all active
purgatives should be avoided, and exposure to great heat or cold,
during the time of gestation or pregnancy.
When the miscarriage has really taken place, and the foetus, or
child, is expelled, together with the contents of the womb, the same
precautions should in general be observed as in childbirth.
TO PREVENT MISCARRIAGE,
when it is threatened, or on the appearance of the first symptoms, the
patient should lie down and be as quiet as possible; live on very
light diet; bowels be kept freely open; and an injection of thirty
drops of laudanum should be given in half a pint of slippery elm tea.
Should flooding be present, cold lemonade should be drank freely, and
cloths wet with cold or ice water applied to the thighs and lower part
of the birthplace, which should be repeated until the flooding is
relieved.
MEANS OF PREVENTING ABORTION.
To prevent abortion, women of weak or relaxed habit should use solid
food, avoiding great quantities of tea, coffee, or other weak or
watery liquors. They should go soon to bed and rise early, and take
frequent exercise, but avoid fatigue. They should occasionally take
half a pint of the decoction of lignum-vitae, boiling an ounce of it in
a quart of water for five minutes.
If of a full habit, they ought to use a spare diet and chiefly of the
vegetable kind, avoiding strong liquors and everything that may tend
to heat the body or increase the quantity of blood; and when the
symptoms appear, should take a dram of powdered nitre in a cup of
water gruel every five or six hours.
In both cases the patient should sleep on a hard mattress and be kept
cool and quiet; the bowels should be kept regular by a pill of white
walnut extract or bitterroot.