The Physical Life of Woman: Advice to the Maiden, Wife and Mother Part 17

VENTILATION.

We have spoken of the benefits of outdoor air during pregnancy.

Attention should also be directed to keeping the atmosphere in the sitting and sleeping rooms of the house fresh. This can only be accomplished by constantly changing it. The doors and windows of every room, while unoccupied, should be kept thrown open in the summer-time, and opened sufficiently often in the winter to wash out the apartments several times a day with fresh air. The extremes of heat and cold are to be, with equal care, avoided. The house should be kept light. Young plants will not grow well in the dark. Neither will the young child nor its mother flourish without sunlight. The ancients were so well aware of this, that they constructed on the top of each house a solarium, or solar air-bath, where they basked daily, in thin attire, in the direct rays of the sun.

SLEEP.

During pregnancy a large amount of sleep is required. It has a sedative influence upon the disturbed nervous system of the mother. It favors, by the calmness of all the functions which attends it, the growth of the ftus. Neither the pursuit of pleasure in the evening, nor the observance of any trite maxims in regard to early rising in the morning, should be allowed to curtail the hours devoted to slumber. Pregnant women have an instinctive desire to lie abed late, which, like the other promptings of nature during this period, should not be disregarded. At least eight hours out of the twenty-four can be profitably spent in bed.

No night-watching ought ever to be undertaken during pregnancy.

Feather beds should be avoided. The heat which they maintain about the body is inconvenient and dangerous, predisposing to flooding and exhausting perspirations. The hair or sponge mattress is to be preferred. The bed-clothing should not be too heavy. Blankets are to be employed rather than coverlids, as they are lighter and more permeable to perspiration. The mattress and cover should be well aired during the day. The sleeping-room should be capacious and well ventilated, and no curtains permitted about the bed.

Occasional rest is also necessary in the daytime. A nap of an hour or two upon a sofa or lounge will then prove very refreshing. In the earlier months of pregnancy it will tend to prevent miscarriage, and in the latter months to relieve the distress consequent upon the increased size of the womb. It is not unusual, as the close of pregnancy approaches, for a feeling of suffocation to ensue when the woman attempts to lie down. This may be overcome by supporting the back and shoulders with cushions and pillows. Or a bed-chair may be employed.

This, if well constructed and covered, will often be found very grateful at night, in the last few weeks of pregnancy.

THE MIND.

A tranquil mind is of the first importance to the pregnant woman. Gloomy forebodings should not be encouraged. Pregnancy and labor are not, we repeat, diseased conditions. They are healthful processes, and should be looked upon as such by every woman. Bad labors are very infrequent. It is as foolish to dread them, as it is for the railway traveller to give way to misgivings in regard to his safety. Instead of desponding, science bids the woman to look forward with cheerfulness and hope to the joys of maternity.

The bad effects of fear upon the mother's mind are ill.u.s.trated by Plutarch, who, in his Life of Publicola, mentions that, 'at a time when a superst.i.tious fear overran the city of Rome, all the women then pregnant brought forth imperfect children, and were prematurely delivered.' But we have already spoken, in treating of mothers' marks, of the influence of mental emotions over the unborn child, and the necessity of avoiding their exciting causes.

Because of their deleterious tendency, severe study as well as arduous and protracted manual labor ought to be avoided. The nervous systems of many women are also injuriously affected during pregnancy by perfumes, which at other times are agreeable and innocuous. It is therefore prudent not only to exclude all offensive scents, but also to abstain from the strong odors of various strong perfumes, eau-de-cologne, and of flowers. Large bouquets often cause feelings of faintness, and sometimes temporary loss of consciousness. The extreme liability of the nervous system of the pregnant woman to be affected injuriously to herself and child by scenes of suffering or distress, and by disgusting or frightful objects, cannot be too strongly impressed upon every one. She should be protected from all that will disturb her, and should be constantly treated with soothing and encouraging kindness. Her manifestations of irritability, her caprices, her melancholy antic.i.p.ations, are not to be scoffed at, but combated with a mixture of reasoning and patient forbearance. On her part, she should endeavour to co-operate with those around her, in sedulously shunning all injurious influences, and in banishing as quickly as possible all improper longings. She should remember that, although she herself may escape mischief from them, her child may suffer. She is the custodian of interests dearer to her than her own.

RELATION OF HUSBAND AND WIFE DURING PREGNANCY.

During those days when the wife, if she were not pregnant, would have been 'unwell,' marital intercourse should be abstained from. It is then injurious to the mother, and dangerous to the life of the child, as it is liable to excite miscarriage. But if this habitual epoch of the monthly sickness be avoided, there is no reason why pa.s.sion should not be gratified in moderation and with caution during the whole period of pregnancy. There is one exception to be made to this general course of conduct. In those cases in which a miscarriage has occurred in the first pregnancy, every precaution should be employed--for reasons which have been dwelt upon in a previous article--to prevent its happening again after the second conception. Under such exceptional circ.u.mstances, therefore, the husband and wife should sleep apart during the first five months of pregnancy. After that period their ordinary relations may be resumed. When a miscarriage has taken place, intercourse should not be permitted within a month of the accident. The observance of this direction is of the utmost importance. Its neglect is the frequent cause of severe and intractable diseases of the womb.

EFFECT OF PREGNANCY ON HEALTH.

We have had occasion to remark that pregnancy is not a condition of disease. It is not only an evidence of health, but during its continuance it confers increased physical vigor. As a rule, a woman enjoys _better health_ during her pregnancy than at any other time; she is less liable to contagious and other maladies; she is less apt to die than at any other period of her life; and her general const.i.tution seems also then to receive a favorable impress, for wives and mothers live longer than celibates. It is wisely decreed that when woman is engaged in this, to her, anxious stage of reproduction, she shall not be exposed to the pains and dangers of disease, and that those great covenants of nature--marriage and child-bearing--shall be rewarded by added strength and length of days.

There are certain disorders incident, in exceptional cases, to pregnancy, of which we shall shortly speak. In general, however, we repeat that this condition is one of extraordinary health. More than this, in numerous instances it exerts an ameliorating influence upon pre-existing diseases, suspending their march, or bringing about a decidedly curative effect. Thus, various obstinate chronic affections of the skin, of the womb and ovaries, and of the brain and nervous system, frequently get well during pregnancy; and it is well known to every physician, that by the judicious management of this state, and of the lying-in period, troublesome displacements of the womb may be arrested.

It should nevertheless ever be recollected that the condition of pregnancy is one of excitement and enhanced susceptibility to impressions of all kinds. For this reason a change in the habits of life is necessary; and the importance of the directions laid down for the care of the health during this period, cannot be too strongly insisted upon.

The diseases to which the wife is exposed during pregnancy will be treated of in the chapter on 'Health in Marriage.'

CONFINEMENT.

_PREPARATIONS FOR CHILDBIRTH._

Certain foolish preparations are sometimes made by wives, with the best intentions. Perhaps one of the most common and absurd of these is the local use of sweet oil, in order to facilitate the dilatation of the parts, for which purpose it is perfectly inert. There are, however, some wise and even necessary precautions which every wife should know and employ, to guard against unpleasant and dangerous complications in childbirth.

In particular, _the condition of the b.r.e.a.s.t.s_ towards the close of pregnancy demands attention. Scarcely any pain in the lying-in chamber is greater or more difficult to bear than that which the young mother suffers from excoriated nipples. This troublesome and often very intractable affection is nearly always the consequence of the want of care previous to confinement. During the latter part of pregnancy the nipples sometimes become sunken or flat, being retracted as the b.r.e.a.s.t.s increase in size, because of the want of elasticity on the part of the milk tubes. In order to remedy this fault, we have known a breast-pump or puppy to be applied. Such treatment is dangerous, as it may excite premature contraction of the womb, and miscarriage. Nipple-shields, with broad bases and openings, should always be obtained. They are safe, and effectually secure the prominence of the nipples, when worn constantly, day and night, during the last month or so of pregnancy.

Wives who have never had children ought to take special care to ascertain before labor whether this depressed condition of the nipples exists, and to correct it in the manner indicated.

In the first pregnancy it is also important to _harden the nipples_.

This may be done by occasionally gently rubbing them between the thumb and finger, and by bathing them twice a day during the last six weeks with tincture of myrrh, or with a mixture of equal parts of brandy and water, to which a little alum has been added. This procedure will render the surfaces less sensitive to the friction of the child's mouth, and thus avert the distress so often occasioned in the first confinement by tenderness of the nipples.

If the nipples be rough or nodulated in appearance, like a strawberry or a raspberry, they are more apt to become excoriated or fissured than if they present a smooth surface. Under such circ.u.mstances, make a solution of the sulphate of zinc, of the strength of one grain to the ounce of rose water, in a wide-mouthed bottle, then tilt the bottle upon the nipple, and allow it to remain there for a few minutes several times a day. Simple tenderness of the nipples and slight fissures may be averted by the application either of a lotion of borax (two scruples of borax in three ounces of water, and an ounce of glycerine), of the honey of borax, or of the tincture of catechu, and by protecting the parts from the pressure of the stays and the friction of the flannel vest.

It is of the greatest moment to the comfort of the mother, that all affections of the nipples should be prevented or remedied before labor; for the treatment of sore nipples when the child is at the breast is often unsatisfactory, while the suffering they occasion is very great, even sometimes giving rise to mammary abscess.

There are certain _articles of clothing_ and _dressings for the bed_ which should be cared for in advance, in order that they may be ready when required.

The mother should be provided with short-gowns, to be worn over the chemise instead of the ordinary night-gowns. It is of consequence to procure a proper _bandage_. It should be made of heavy muslin, neither too coa.r.s.e nor too fine; an ordinarily good quality of unbleached muslin is the best. The material is to be cut bias, about one and a quarter yard in length, and from twelve to eighteen inches in breadth, varying, of course, with the size of the person. It should be just large enough to encircle the body after confinement, with a margin of a couple of inches, and to extend down below the fulness of the hips. The measurement should be taken, and the bandage made to fit, when four and a half months advanced. It should be narrow above, wider below, and gored in such a manner that it will be a little narrower at the lower extremity than a few inches above, so as to prevent it, when adjusted, from sliding upwards. A bandage constructed in this manner will be very comfortable; and is not apt to become displaced, after application, as is invariably the case when a towel or a straight piece of muslin is used. The way in which it is to be applied will be detailed hereafter.

The _child's clothing_ should consist first of a piece of flannel or some woollen material for a binder. This should be from four to six inches in width, and from twelve to sixteen inches in length; that is to say, wide enough to extend from the armpits to the lower part of the abdomen, and long enough to go once and a half times around the child, having the double fold to come over the abdomen. There should be no embroidery about this. A shirt, which it is desirable should be woollen, is to be provided to place over the binder. It should be made to come up tolerably high in the neck, and to extend down the arm. Neither it nor any other portion of the child's clothing should be starched. The petticoat, which may be open its whole length behind, is to be put over the shirt; two may be used--a short and a long one. Next comes the child's ordinary frock or slip, and above this an ap.r.o.n to protect the dress from the frequent discharges from the stomach. Then a shawl, of flannel or any other warm material, is to be provided, to throw over the shoulders if the weather be cold. Socks, and pieces of old soft linen, free from stiffening, for napkins or diapers, complete the child's outfit.

For the _permanent and temporary dressing of the bed_ there should be provided a piece of impervious cloth (oiled silk is the neatest) about a yard square; a piece of ordinary table oil-cloth or rubber-cloth; a number of old sheets and comfortables, and a piece of thick carpet. The manner in which these are to be used will be explained shortly.

A pair of small rounded scissors; a package of large pins, one and a half inches in length, for the bandage of the mother, and smaller ones for that of the child; some good linen bobbin for the doctor to tie the navel-string; good toilet soap and fine surgical sponge for washing the child; a piece of soft linen or muslin for dressing the navel; a box of unirritating powder; and a pile of towels,--should all be had and laid aside many weeks before they are wanted. These, together with the material for dressing the bed, the child's clothing, and the mother's bandage, ought to be placed together in a basket got for the purpose, in order that they may all be easily and certainly found at a time when perhaps the hurry and excitement of the moment would render it difficult otherwise to collect them all immediately.

SIGNS OF APPROACHING LABOR.

One of the earliest of the preliminary signs of the coming on of confinement occurs about two weeks before that event. It is a dropping or subsidence of the womb. The summit of that organ then descends, in most cases, from above to below the umbilicus, and the abdomen becomes smaller. The stomach and lungs are relieved from pressure, the woman breathes more freely, the sense of oppression which troubled her previously is lost, and she says she feels 'very comfortable.' This sensation of lightness and buoyancy increases, and a few days before the setting in of labor she feels so much better that she thinks she will take an extra amount of exercise. The mother of a number of children is acquainted with this sign, but the wife with her first child may exert herself unduly in the house or outdoors, and induce labor when in the street or away from home. Hence the importance of a knowledge of this premonitory symptom.

A second precursory sign of labor is found in the increased fulness of the external parts, and an augmented mucous secretion, which may amount even to a discharge resembling whites, and requiring the wearing of a napkin. This symptom is a good one, indicating a disposition to relaxation, and promising an easy time.

The third preliminary sign which we shall mention, is the change in the mental state of the pregnant woman. She has a feeling of anxiety and of fidgetiness, sometimes accompanied with depression of spirits. This condition of emotional distress, modified in particular cases by reason, self-control, and religion, may continue for several days, perhaps, when

THE SYMPTOMS OF ACTUAL LABOR

make their appearance. The first of these is generally the 'show.' It is the discharge of the plug of mucus which has occupied the neck of the womb up to this time, and is ordinarily accompanied by a little blood.

Perhaps before this, or perhaps not for some hours after, the 'pains'

will develope themselves. These recur periodically, at intervals of an hour or half an hour at the outset, and are 'grinding' in character.

_True_ labor pains are distinguished from _false_ by the fact that they are felt in the back, pa.s.sing on to the thighs, while false pains are referred to the abdomen; by their intermittent character, the spurious pains being more or less continuous; and by the steady increase in their frequency and severity. In case of doubt as to their exact nature, the doctor should be summoned, who will be able to determine positively whether labor has begun.

The other symptoms which point to the actual commencement of labor are a frequent desire to empty the bowels and bladder, nausea and vomiting, which, in the early part of confinement, is a good sign; shiverings, unattended with any sensation of cold; and, finally, the rupture and discharge of the contents of the 'bag of waters.'

Before pa.s.sing on to the consideration of the management of the confinement into which the wife has now entered, a few words may be appropriately said upon the

CAUSE OF LABOR.

Neither the size nor the vigor of the child has any influence in bringing about delivery at full term. The ancient theory--which received the support of the distinguished naturalist Buffon--that the infant was the active agent in causing its own expulsion, is an exploded one. It was a.s.serted by some that hunger excited the ftus to struggle to free itself from the womb; others were disposed to attribute its efforts to accomplish its entrance into the world, to the need of respiration which it experienced. But all these ingenious theories, which presupposed the embryo to be actuated by the same feelings which would influence a grown person if shut up in such a confined abode, are unsatisfactory, and not tenable. It is well known that the child may die in the womb, without r.e.t.a.r.ding or interfering in any way with the coming on of the process of labor. This fact alone shows that the ftus is, or at any rate may be, absolutely pa.s.sive either in regard to the induction or advancement of delivery. The determining cause of labor is seated in the womb itself.

The contractions of this organ occasion the 'pains' and expel the child, a.s.sisted by the muscles of the abdomen and the diaphragm. That the a.s.sistance of the latter forces is not necessary, is conclusively proved by the occurrence of childbirth after the decease of the mother. For instance, a case is on record in which labor commenced and twins were born after the mother had been dead for three days.