The Physical Life of Woman: Advice to the Maiden, Wife and Mother Part 16

MORAL ASPECTS OF THIS QUESTION.

Upon proper judgment and discrimination in the application of the facts we have just been dwelling upon, may depend a wife's honor, and the happiness of the dearest social relations. We will suppose an example. A husband, immediately after the impregnation of his wife, is obliged to quit her, and remains absent a year. In the meanwhile she gives birth to two children, at an interval of a number of weeks. The question will then come up, Whether, under such circ.u.mstances, it is possible for her to do so consistently with conjugal purity.

It will be recollected that, in speaking of twins, we remarked that it was not very uncommon for an interval of days or weeks to elapse between the births, and it has just been stated that impregnation during pregnancy is extremely rare. The presumption, therefore, in the case supposed, is as very many to one that the two births were the result of a twin pregnancy. In the absence of any other evidence against the wife's chast.i.ty, it should not even be called in question. This decision receives the support of the maxim in law that a reasonable doubt is the property of the accused, and of the Christian principle that it is better that ninety-nine guilty should escape than that one innocent should be condemned. Hence the teachings of science and of human and divine law all coincide to protect the sacred rights and the precious interests at stake against an unjust suspicion, which even the doctrine of chances would render untenable.

CAN A CHILD CRY IN THE WOMB?

There are some cases, recorded on undoubted authority, in which the child has been heard to cry while in the womb. These are very exceptional. Under ordinary circ.u.mstances, it is impossible for the child either to breathe or cry, because of the absence of air. It is only when the bag of membranes has been torn, and the mouth of the child is applied at or near the neck of the uterus, that this can take place.

The infant is not unfrequently heard to cry just before birth, after labor has commenced, but before the extrusion of the head from the womb, in consequence of the penetration of air into the uterine cavity.

IS IT A SON OR DAUGHTER?

It is a common saying among nurses, that there is a difference in the size and form of the pregnant woman, according to the s.e.x she carries.

This may well be doubted. Neither is it true that one s.e.x is more active in its 'movements' than the other. It is quite possible, however, for a wife to know the s.e.x of the ftus, if she can tell about what time in her month conception took place. If it occurred directly after a monthly sickness, the child is a girl; if directly before, it is a boy.

When a woman is 'out' in her reckoning, and goes beyond the period of her expected confinement, it will ordinarily turn out to be a boy. The skilful doctor can, in the later months of pregnancy, settle the question of s.e.x in some cases. The beats of the ftal heart are more frequent in females than in males. The average frequency of pulsations of twenty-eight female ftuses has been found to be one hundred and forty-four in the minute, the lowest figure being one hundred and thirty-eight; of twenty-two male ftuses, one hundred and twenty, the lowest figure being one hundred and twelve. Therefore, when the pulsations of the heart of the child in the womb are counted,--as can easily be done by a practised medical ear during the last months of pregnancy,--and are found to be over one hundred and thirty in a minute, it is a daughter; if under one hundred and thirty, a son. In this manner, the s.e.x of an unborn child can be predicted with tolerable accuracy, excepting only when illness of the ftus has deranged the action of its heart.

ARE THERE TWINS PRESENT?

Certain signs lead to the suspicion of twins, such as being unusually large, and the fact that the increase in size has been more than ordinarily rapid. Sometimes also the abdomen is divided into two distinct portions by a perpendicular fissure. In other cases the movements of a child can be felt on each side at the same time. And in twin pregnancies the morning sickness is apt to be more distressing, and all the other discomforts incident to this condition increased. But these signs and symptoms, when present in any given case, are not conclusive, for they may be noticed when there is only one child. The doctor has one characteristic and infallible sign by which he can ascertain whether the woman be pregnant with twins. It is furnished to him again by the art of listening,--or auscultation, as it is technically called,--the same that, as we have already seen, may enable him to determine the s.e.x of the child. When the beatings of two ftal hearts are heard on opposite portions of the abdomen, the nature of the pregnancy is apparent.

LENGTH OF PREGNANCY.

What is the ordinary duration of pregnancy? Almost every woman considers herself competent to make the answer--nine months. She may be surprised to learn, however, that such an answer is wanting in scientific precision. It is too indefinite, and is erroneous. There is a great difference between the calendar and the lunar month. Each lunar month having twenty-eight days, the period of nine lunar months is two hundred and fifty-two days. Nine calendar months, including February, represent, on the contrary, two hundred and seventy-three days. Now the average duration of pregnancy is two hundred and eighty days, that is forty weeks, or ten lunar months.

While most extended observations have shown that as a general rule, forty weeks, or two hundred and eighty days, is the true period of pregnancy, are we justified in the conclusion that this is its invariable duration? This important question, upon the answer to which so often depend the honor of families, the rights of individuals, and sometimes the interests of nationalities, has been in all times the subject of careful research by physicians, philosophers, and legislators. On the one side, have been those who contend that the laws of nature are invariable, and that the term of pregnancy is fixed and immutable. On the other side, have been those who a.s.sert that the epoch of accouchement can be greatly advanced or r.e.t.a.r.ded by various causes, some of which are known, and others not yet appreciated. Abundant and satisfactory testimony has proved that the prolongation of pregnancy beyond the ordinary period of two hundred and eighty days, or forty weeks, is possible. Nor is this contrary to what is observed in regard to other functions of the human body. There is no process depending upon the laws of life which is absolutely invariable either as to the period of its appearance or duration. It is known, as we have already pointed out, that p.u.b.erty may be advanced or r.e.t.a.r.ded; the time at which the change of life occurs in women, as we shall have occasion hereafter to show, is also subject to variation; and it is a matter of common observation with mothers, that the period of teething is sometimes strangely hurried or delayed. A certain degree of variability, therefore, being frequently observed, and entirely compatible with health, in the various other natural processes, why should that of pregnancy form an exception, and be invariably fixed in its duration?

And observation upon the lower animals affords most convincing evidence that nature is not controlled by any uniform law in reference to the length of pregnancy. In the cow, the usual period of whose pregnancy is the same as in the human female, instances of calving six weeks beyond the ordinary term are not at all uncommon.

As an ill.u.s.tration of the great interest sometimes attaching to the inquiry under discussion, we may cite the celebrated Gardner Peerage Case, tried by the House of Lords in 1825. Allen Legge Gardner pet.i.tioned to have his name inscribed as a peer on the Parliament Roll.

He was the son of Lord Gardner by his second wife. There was another claimant for the peerage, however,--Henry Fenton Iadis,--on the ground, as alleged, that he was the son of Lord Gardner by his first and subsequently divorced wife. Medical and moral evidence was adduced to establish that the latter was illegitimate. Lady Gardner, the mother of the alleged illegitimate child, parted from her husband on the 30th of January, 1802, he going to the West Indies, and not again seeing his wife until the 11th of July following. The child whose legitimacy was called in question was born on the 8th of December of that year. The plain medical query therefore arose, Whether this child born either three hundred and eleven days after intercourse (from January 30th to December 8th), or one hundred and fifty days (from July 11th to December 8th), could be the son of Lord Gardner. As there was no pretence that there was a premature birth, the child having been well developed when born, the conception must have dated from January 30th. The medical question was therefore narrowed down to this: Was the alleged protracted pregnancy (three hundred and eleven days) consistent with experience?

Sixteen of the princ.i.p.al obstetric pract.i.tioners of Great Britain were examined on this point. Eleven concurred in the opinion that natural pregnancy might be protracted to a period which would cover the birth of the alleged illegitimate child. Because, however, of the moral evidence alone, which proved the adulterous intercourse of Lady Gardner with a Mr. Iadis, the House decided that the t.i.tle should descend to the son of the second Lady Gardner.

There is on record one fact, well observed, which establishes beyond cavil the possibility of the protraction of pregnancy beyond two hundred and eighty days, or forty weeks. The case is reported by the learned Dr.

Desormeaux of Paris, and occurred under his own notice in the Hopital de Maternite of that city. A woman, the mother of three children, became insane. Her physician thought that a new pregnancy might re-establish her intellectual faculties. Her husband consented to enter on the register of the hospital each visit he was allowed to make her, which took place only every three months. So soon as evidence of pregnancy showed itself, the visits were discontinued. The woman was confined two hundred and ninety days after conception.

The late distinguished Professor Charles D. Meigs of Philadelphia published a case, which he deems entirely trustworthy, of the prolongation of pregnancy to four hundred and twenty days, or sixty weeks. Dr. Atlee reports two cases, which nearly equaled three hundred and fifty-six days each. Professor Simpson of Edinburgh records, as having occurred in his own practice, cases in which the period reached three hundred and thirty-six, three hundred and thirty-two, three hundred and twenty-four, and three hundred and nineteen days. In the Dublin _Quarterly Journal of Medical Science_ a case of protracted pregnancy is related by Dr. Joynt. The evidence is positive that the minimum duration must have been three hundred and seventeen days, or about six weeks more than the average. Dr. Elsa.s.ser found, in one hundred and sixty cases of pregnancy, eleven protracted to periods varying from three hundred to three hundred and eighteen days.

In treating of the subject of miscarriage, we mentioned instances, recorded by physicians of skill and probity, proving beyond a shade of doubt that a woman may give birth to a living child long before the expiration of the forty weeks. The Presbytery of Edinburgh, Scotland, some time since decided in favor of the legitimacy of an infant born alive, within twenty-five weeks after marriage, to the Rev. Fergus Jardine.

One of the most enlightened countries in Europe has, in view of the facts in reference to the extreme limits of pregnancy, enacted, in the Code Napoleon, that a child born within three hundred days after the departure or death of the husband, or one hundred and eighty days after marriage, shall be considered legitimate. The law further states that a child born after more than three hundred days shall not be necessarily declared a b.a.s.t.a.r.d, but its legitimacy may be contested. The Scotch legislation on this subject is very similar to the French.

CAUSES OF PROTRACTED PREGNANCY.

It has been a.s.serted by some that an infant is born at ten or eleven months because at nine months it has not acquired the growth which is necessary in order to induce the womb to dislodge it. The popular notion is, that a child carried beyond the usual term must necessarily be a large one. Rabelais has reflected this common opinion in his celebrated romance ent.i.tled 'Gargantua,' in which he represents the royal giant of that name as having been carried by his mother, Gargamelle, eleven months. When born, the child was so vigorous that he sucked the milk from ten nurses. He lived for several centuries, and at last begot a son, Pantagruel, as wonderful as himself. Such reasoning cannot, however, be seriously maintained, as many children carried longer than nine months have not been more fully developed than some born a few weeks prematurely; and the size of the child has nothing to do with the bringing on of labor, as we shall show hereafter. Protracted pregnancies are caused by a defect in the energy of the womb, induced by moral as well as physical influences. As a rule, a woman who leads a regular life, and observes the physiological laws of her being, which laws it has been our aim to point out, will be confined at the term that nature usually marks out, that is, at the expiration of two hundred and eighty days, or forty weeks, from conception.

This brings us to the consideration of the question,

HOW TO CALCULATE THE TIME OF EXPECTED LABOR.

Many rules for this purpose have been laid down. We shall merely give one, the most satisfactory and the most easily applied. It was suggested by the celebrated Professor Naegele of Heidelberg, and is now generally recommended and employed by physicians. The point of departure in making the calculation is _the day of the disappearance of the last monthly sickness_; three months are subtracted, and seven days added. The result corresponds to the day on which labor will commence, and will be found to be two hundred and eighty days from the time of conception, if that event has occurred, as ordinarily, immediately after the last menstrual period. Suppose, for instance, the cessation of the last monthly sickness happened on the 14th day of January; subtract three months, and we have October 14; then add seven days, and we obtain the 21st day of the ensuing October (two hundred and eighty days from January 14) as the time of the expected confinement. This method of making the 'count' may be relied upon with confidence, and only fails, by a few days, in those exceptional cases in which conception takes place just before the monthly period, or during the menstrual flow.

CARE OF HEALTH DURING PREGNANCY.

This subject, the proper management of the health from conception to childbirth, is worthy of careful consideration. The condition of pregnancy, though not one of disease, calls for peculiar solicitude, lest it should lead to some affection in the mother or in the child. For it ought to be remembered that the welfare of a new being is now in the balance. The woman has no longer an independent existence. She has entered upon the circle of her maternal duties. She became a mother when she conceived. The child, though unborn, lives within her; its life is a part of her own, and so frail, that any indiscretion on her part may destroy it. The danger to the child is not imaginary, as the large number of miscarriages and still-births proves.

All mothers desire to have healthy, well-formed, intelligent children.

How few conduct themselves in such a manner as to secure a happy development of their offspring! Puny, deformed, and feeble-minded infants are daily ushered into the world because of a want of knowledge, or a sinful neglect of those special measures imperatively demanded in the ordering of the daily life, by the changed state of the system consequent upon pregnancy. We shall therefore point out those laws which cannot be infringed with impunity, and indicate the diet, exercise, dress, and, in general, the conduct most favorable to the mother and child during this critical period, in which the wife occupies, as it were, an intermediate state between health and sickness.

FOOD.

The nourishment taken during pregnancy should be abundant, but not, in the early months, larger in quant.i.ty than usual. Excess in eating or drinking ought to be most carefully avoided. The food is to be taken at shorter intervals than is common, and it should be plain, simple, and nutritious. Fatty articles, the coa.r.s.er vegetables, highly salted and sweet food, if found to disagree, as is often the case, should be abstained from. The flesh of young animals--as lamb, veal, chicken, and fresh fish--is wholesome, and generally agrees with the stomach. Ripe fruits are beneficial. The diet should be varied as much as possible from day to day. The craving which some women have in the night or early morning may be relieved by a biscuit, a little milk, or a cup of coffee.

When taken a few hours before rising, this will generally be retained, and prove very grateful, even though the morning sickness be troublesome. Any food or medicine that will confine or derange the bowels is to be forbidden. The taste is, as a rule, a safe guide, and it may be reasonably indulged. But inordinate, capricious desires for improper, noxious articles, should of course, be opposed. Such longings, however, are not often experienced by those properly brought up. It is a curious fact, that the modification in the digestive system during pregnancy is sometimes so great that substances ordinarily the most indigestible are eaten, without any inconvenience, and even with benefit, while the most healthful articles become hurtful, and act like poison.

As pregnancy advances, particularly after the sixth month, a larger amount of food, and that of a more substantial character, will be required. The number of meals in the day should then be increased, rather than the quant.i.ty taken at each meal.

CLOTHING.

The dress during pregnancy should be loose and comfortable, nowhere pressing tightly or unequally. The word _enceinte_, by which a pregnant woman is designated, meant, originally, without a cincture,--that is, unbound. The Roman matrons, so soon as they conceived, were obliged to remove their girdles. Lycurgus caused the enactment of the Spartan law, that pregnant women should wear large dresses, so as not to prejudice the free development of the precious charges of which nature had rendered them the momentary depositaries. Stays or corsets may be used, in a proper manner, during the first five or six months of pregnancy, but after that they should either be laid aside, or worn very loosely.

Any attempt at concealing pregnancy, by tight lacing and the application of a stronger busk, cannot be too severely condemned. By this false delicacy the mother is subjected to great suffering, and the child placed in jeopardy. The shape of the stays should be moulded to that of the changing figure, and great care should be taken that they do not depress the nipple or irritate the enlarging b.r.e.a.s.t.s.

The amount of clothing should be suited to the season, but rather increased than diminished, owing to the great susceptibility of the system to the vicissitudes of the weather. It is especially important that flannel drawers should be worn during advanced pregnancy, as the loose dress favors the admission of cold air to the unprotected parts of the body. A neglect of this precaution sometimes leads to the establishment of the painful disease known as rheumatism of the womb.

Pressure upon the lower limbs, in the neighborhood of the knee or the ankle joint, should be avoided, more particularly towards the last months. It is apt to produce enlargement and knotting of the vein, swelling and ulcers of the legs, by which many women are crippled during their pregnancies, and sometimes through life. Therefore the garters should not be tightly drawn, and gaiters should not be too closely fitted, while yet they should firmly support the ankle.

EXERCISE.

Moderate exercise in the open air is proper and conducive to health during the whole period of pregnancy. It should never be so active nor so prolonged as to induce fatigue. Walking is the best form of exercise.

Riding in a badly-constructed carriage, or over a rough road, or upon horseback, as well as running, dancing, and the lifting or carrying of heavy weights, should be scrupulously avoided, as liable to cause rupture, severe flooding, and miscarriage. During the early months, in particular, extraordinarily long walks and dancing ought not to be indulged in. Journeys are not to be taken while in the pregnant state.

Railway travelling is decidedly objectionable. The vibratory motion of the cars is apt to produce headache, sickness at the stomach, faintness, and premature labor. All these precautions are especially to be observed in the first pregnancy.

We must not be understood as condemning exercise and fresh air. They are of the greatest importance to mother and child. But the amount of exercise should be regulated by the dictates of common sense and the woman's own sensations. If she can only walk a short distance each day with comfort, let that suffice. She should not force herself to go to a certain place nor to promenade during a certain time in the twenty-four hours. So soon as fatigue is felt, the walk should cease. Let the walks be frequent and short, rather than few and long. They should also be made as pleasant as possible, by companionship and surroundings that will occupy the feelings and imagination in an agreeable manner with new and cheerful impressions. A tendency to indolence is to be combated. A gently active life is best calculated to preserve the health of the mother and her unborn child. But with even the most robust a moderation of the ordinary pursuits and avocations is called for. The nervous and delicate cannot make with safety their customary daily exertions in the performance of their household or social duties and pleasures.

Towards the end of pregnancy the wife should economize her forces. She should not remain long standing or kneeling, nor sing in either of these postures.

BATHING.

Those who have not been accustomed to bathing should not begin the practice during pregnancy, and in any case great care should be exercised during the latter months. It is better to preserve cleanliness by sponging with tepid water than by entire baths. Foot-baths are always dangerous. Sea-bathing sometimes causes miscarriage, but sea air and the sponging of the body with salt water are beneficial. The shower-bath is of course too great a shock to the system, and a very warm bath is too relaxing. In some women of a nervous temperament, a lukewarm bath taken occasionally at night during pregnancy has a calming influence. This is especially the case in the first and last month. But women of a lymphatic temperament and of a relaxed habit of body are always injured by the bath.