Mother's Remedies, Thomas Jefferson Ritter [reading well .TXT] 📗

signs of pregnancy. It must not be forgotten, however, that sure signs of pregnancy, such as cannot be induced by other causes, are very limited, especially in the early months. [OBSTETRICS OR MIDWIFERY 517]

Changes occur in the genital organs that may lead a physician to suspect that pregnancy may exist; but the first symptom that attracts the attention of the woman, is the passing of the monthly period. This is not an absolute sign of pregnancy, since other things or conditions may cause it. The effect of the mind upon the body may cause it, and it also occurs sometimes in early married life without any appreciable cause, unless it may be then due to the effect upon the nervous system of the marital relation. Again, the monthly sickness sometimes continues in a greater or less degree, during a part or even the whole of pregnancy. Usually this discharge is due to some diseased condition of the cervix. The fear of impregnation in unmarried women after illicit intercourse will occasionally suspend menstruation for one or two months.

Nausea and Vomiting.—Another symptom upon which considerable dependence is placed is the morning sickness (nausea and vomiting). While this symptom is common, yet its absence does not prove that the woman is not pregnant. Some women go through the whole pregnancy without any sign of this symptom.

Nausea accompanied or not by vomiting may appear at the very time of conception, but it usually appears about the fourth or fifth week of pregnancy and continues until the sixteenth week or longer. In some cases it may last but a short time, in others it may continue until confinement. It may be light or severe; It generally manifests itself upon arising in the morning and subsides in a short time, but it may occur at any time of the day and continue during the entire waking hours. It may be absent entirely and, in rare instances, manifest itself in the husband alone. I have known of one such case. This nausea may be excited only by various odors or sights or may be caused by constipation. An increased secretion from the salivary glands usually accompanies the stomach disturbances and in some cases it may amount to salivation. An irresistible desire for certain articles of food or drink, generally of a sour or acid nature, is often developed. Indigestion, gas in the bowels and belching of gas are frequently present. The appetite is often capricious or it may be entirely lost (anorexia).

Breasts.—Changes in the breasts also constitute a sign of pregnancy. As an early symptom, there may be a feeling of fullness, sometimes pain. They become larger and firmer from the development of the individual lobules, which have an irregular knotty feel. A fat deposit takes place between the lobules and in the other parts of the breast. The nipples increase in size, are harder to the touch, become more prominent. A few drops of a turbid fluid, colostrum, may be pressed from the nipple as early as the third month. The veins under the skin become larger and more conspicuous. The rose-colored circles (rings) around the nipples are broadened and are slightly elevated above the surrounding skin and there is a marked increase in their pigmentation, the color varying with the complexion of the individual from reddish pink to brown and black. These changes usually occur at the beginning of the third month, and if the woman has already had a child the question of pregnancy has been decided by inspection of these breast changes.

Bladder.—This is sometimes irritable in the later months, causing a frequent desire to pass urine. It sometimes occurs in the second or third week and is sometimes followed, later, by an inability to retain the urine which escapes at any time. This, however, is not frequent.

[518 MOTHERS' REMEDIES]

Abdominal changes.—There is a slight flattening of the lower abdomen at the second month, due to the sinking of the womb. There is also a slight retraction (drawing back) of the navel. After the third month, when the womb begins to ascend out of the pelvis, a progressive enlargement of the abdomen begins and continues until near the end of pregnancy, when the womb again sinks and the so-called lightening occurs. The protrusion of the abdomen is more marked usually on the right side. There is often an increased deposit of fat in the lower portion of the abdomen, as well as on the hips and thighs. The navel may protrude after the sixth month,

Pigmentation.—Pigmentation or darkening of the middle line of the abdomen begins by the eighth or twelfth week, and a dark band about 1/8 of an inch wide extends from the pubis (bone) to and around the navel or even higher. This shows plainer in brunettes, where it is quite conspicuous. Discolorations also appear on other parts of the body, especially on the face, "moth patches."

Quickening.—This is caused by the movement of the child (foetus) in the womb. The impact of the enlarging womb, through the child (foetal) movements, against the abdominal wall about the sixteenth week of pregnancy gives rise to this sensation called quickening. Some women claim to have experienced this sensation at a much earlier date, and by some it is not felt at all. Gas in the bowels and contraction of the muscles of the abdomen may give a chance for mistakes. In the later months of pregnancy, the movements sometimes become so violent as to produce perceptible movements of the womb and the abdominal muscles, and sometimes they are the cause of the pain.

The Blood.—The blood is increased in quantity and slightly altered in its composition. The water, fibrin and white corpuscles are increased; the red cells are at first relatively diminished, but later return to normal.

Nervous System.—The nervous system is over sensitive and the disposition of the woman may undergo a radical change, mental exaltation and depression are often exhibited.

Constipation is the Rule.—Neuralgias in different parts of the body, especially in the face and teeth, are common. Palpitation of the heart and difficulty in breathing may be experienced. A discharge from the vagina is almost always present, due to the increased circulation in the cervix and vagina.

The Foetal Heart-beat.—This is the one positive sign of pregnancy and it may be heard as early as the sixteenth to the twentieth week. It has been compared to the ticking of a watch under a pillow. It ranges in frequency from one hundred and ten to one hundred and fifty to a minute.

[OBSTETRICS OR MIDWIFERY 519]

Pelvic Signs.—As early as the first month of pregnancy a faint violet color of the anterior wall of the vagina just below the opening of the urethra may be distinguished. In the third month this color has become purplish and pronounced. This sign is present in eighty per cent of cases. There is also a more or less marked lividity of the vaginal portion of the cervix from the first month of pregnancy. Also there is softening of the cervix as early as the sixth week, and as pregnancy advances the whole of the cervix is softened.

Duration of Pregnancy.—This is for all practical purposes two hundred and eighty days.

How to Determine Date of Confinement.—The best rule is to count backward three months from the first day of the last menstrual period and add seven days to it. To be more accurate, in April and September only six days should be added; in December and January, five days; and in February, four days.

Position of the Womb.—At four months the top of the womb has risen above the pelvic brim bone in front; at five months, it is midway between the bone (pubic) and the navel; at six months, it is at the navel; at seven months, it is four fingers breadths above the navel; at eight months, it is midway between the navel and the bottom of the breast bone; at nine months, it is to the breast bone; from the middle to the end of the ninth month, the top of the womb sinks to about the position occupied at the eighth month.

Twins occur about once in ninety to one hundred and twenty, triplets once in one thousand eight hundred and seventy-five, and quadruplets once in three hundred and seventy-one thousand one hundred and twenty-six pregnancies. The causes are unknown. Twin conception is more common in women who have borne children, and more so in the elderly than in the young, first bearing women (primiparae).

Sex.—Children from the same ovum (egg) are always of the same sex. Of twins in general, more than one-third are males, less than one-third are females, and in the remaining one-third both sexes occur. The after-birth is always, at least at first, double.

Diagnosis.—In twin pregnancy the symptoms and disorders of pregnancy are apt to be exaggerated, and watery swelling above the pubic bone is almost always present in the latter months. The abdomen is larger and broader and there may be a depression dividing the abdominal wall in two spaces. The womb is much distended and the walls are thin.

Hygiene of pregnancy.—In pregnancy the dividing line between health and disease is often so shadowy that every care should be given the pregnant woman, not only that she shall escape dangers that may come, but that the future health of the coming baby may be safeguarded.

The care taken in pregnancy therefore should include attention to clothing, food, exercise, rest, sleep, functions of all excreting organs, the breasts, nervous system and the mind.

[520 MOTHERS' REMEDIES]

Clothing.—This should be worn loose. The heavier garments should not be held by the waist but suspended from the shoulders. Flannels, if possible, should be worn next the skin excepting, possibly, during the warmest weather. Every precaution should be taken not to take cold or to chill the surface of the body, as this might bring on an acute trouble of the kidneys. As soon as the womb has risen out of the pelvis during the fourth month, the corset should be absolutely abandoned, since pressure upon the enlarging womb tends to cause acute Bright's disease and uraemia, and these troubles are always to be guarded against. During the later months of pregnancy, when the abdominal enlargement is great, a linen or elastic bandage may be worn with great comfort, but it must be so put on as to support and not press upon the womb.

Food.—The food of the pregnant woman should be simple, wholesome, nutritious, of the kind that is easily digested and enough to satisfy the demands of her system; excessive eating should be avoided. A mixed diet is to be preferred, but the diet should be of such kind as to help to overcome the constipation, usual in pregnancy. Meat should not be eaten in as great quantities. It not only tends to produce more constipation but also has injurious effect upon the kidneys, and anything that in any way puts a greater burden upon the kidneys in pregnancy should be avoided. All foods that are likely to produce indigestion, heart burn, or irritation of the stomach and liver, such as sweets, fried, greasy, highly spiced foods; greasy rich gravies, or pastry should not be eaten.

The heartiest meal should be taken near midday and the stomach, especially at night, should never be overloaded. Water should, be drank freely, as it tends to overcome the constipation and wash out the kidneys. Some women do better with lighter meals and taken more frequently. Some do better by taking their breakfast before rising.

Bathing.—Extremes in hot and cold bathing should be avoided. The skin should be kept active by daily comfortable baths, followed by a brisk rubbing with a rough towel. The Bowels and Bladder.—The bowels, as before stated, are usually constipated and should be kept open by coarse foods, fruit and, when necessary, mild laxatives; mineral waters and enemas especially should not be given. It should not be forgotten that in some women injections into the bowel are liable to bring on contractions of the womb.

No woman, and especially no pregnant woman, should ever neglect the bowels, as much discomfort and ill health are caused by improper eliminations of the bowel contents. The bladder should also have proper care. This is apt to be irritable during the early and later months of pregnancy, owing to being pressed upon by the womb. A mild inflammation arises in some cases. The woman should take plenty of water, either pure or effervescing, to induce sufficient secretion in the kidneys, and also to flush them. This is also very good for an irritable bladder. In order that the physician may keep himself informed regarding the condition of the kidneys, the urine of every pregnant woman should be examined, both chemically and microscopically, every two weeks from the beginning of pregnancy; during the late