-This is the state of a women from the time of conception to the time of delivery. The duration of the period is 280 days. If it terminates before this period, and yet late enough for a living child to be born, the birth is spoken of as premature. If the birth occurs earlier than this it is called a miscarriage, and if within the first three months it is generally spoken of as an abortion. Before birth the child is called the embryo, or foetus.
Calculation of the Date of Delivery.- The duration of pregnancy is, as has just been stated,280 days, or forty weeks. The best way of calculating is to take the last day of the last menstrual period, and calculate from that nine calendar months. To this add one week. On the previous page will be found the full obstetric table.
Quickening is the name given to the first occasion on which the mother becomes conscious of the independent movements of the child. This is felt about the fifteenth week after conception. It is often accompanied by fainting on the part of the mother, especially if it is the first pregnancy.
The Signs of pregnancy are chiefly these:-Stopping of the periods, increase in the size of the body, morning nausea, vomiting, increase in size of breasts, and darker appearance of the areolae round the nipples. But it should be borne in mind that all these symptoms may occur in connection with diseases of the womb, without there being any child. The only absolute sign is the child’s heart-beat, which a practised ear can hear on listening over the woman’s abdomen in the later months of pregnancy.
General Management of pregnancy.-Some women experience better health during the period of pregnancy than at any other time, but it is more general for women to suffer various inconveniences, if not actual disease, during some part or other of the term. Every woman should regard the care of her health as of the utmost importance, as any indiscretion will be visited not on herself alone, but on her child. There is no need for her to be idle and consider herself an invalid, but excesses of all kinds she must avoid-fatiguing and violent exercise, heavy lifting, indulgence in the pleasures of the table.
Diet.-This should be of a plain, wholesome, and nourishing kind, all alcoholic stimulants being avoided; also strong tea, coffee, spices, high seasoning, rich food, sweets, and pastry. It should be taken at regular times. Oatmeal porridge, whole-meal bred, and other bone producing foods should be taken with milk.
Sleep.-It is highly important that the woman should have plenty of sleep. She requires more than when in an ordinary state. She should retire early;the bedroom should be well-ventilated, should not have very much furniture, and the bed should have no hanging. Then the woman must be allowed to sleep as long as she feels the necessity, and rise when she wakes naturally.
Bath.-She may do as she usually does about bathing; the morning cold bath or sponge down, if she is hardly and used to it, will do good, but she must beware of straining herself on getting into or out of the bath
Dress.-This is a matter of the greatest importance. Stays must be either of a special kind, which give free play to the movements of the ribs, or must be discarded altogether. This is necessary for many reasons. The mother has to do a double amount of breathing- for herself and her child-and it is therefore important that there must be nothing to hamper the movements of the chest-wall and the diaphragm to diminish the breathing space. Nature made the ribs movable, from the first to the last, and also the abdominal walls movable and muscular. Stays have the effect of fixing the lower ribs, limiting the breathing space, and crowding the abdominal organs into half their natural space. Stays are accountable for weak backs (Which ought to be strong enough to hold themselves up)and a multitude of other ailments, among them all kinds of displacements, constipation, and piles.
I am aware the great difficulty is how to fit on the clothes is stays are discarded. They must be hung from the shoulders and from the hips. The shoulders may bear the upper half of the garment, and the hips-not the soft part above the hip-bones, but the hip-bones themselves-by a broad belt made to fit to the bones, or the skirts themselves may be made to fit them. From the hip-bones down to the hip-joints the bones spread outwards, so as to bear any amount of weight. On no part of the body should the clothes press tightly. Garters must give place to suspenders. The clothes must be suited to the season, and warm enough to guard against chills. A great weight of clothes is objectionable.
Disorders of.-It is not often that a woman passes all through the period of pregnancy without some of the ailments incident to the state. Morning sickness is the best known. Vertigo, headache, fainting, toothache, and a number of others may become serious enough to require special treatment. They are discussed under this heading, but reference may also be made to the several diseases under their own special headings.
Bladder Irritation.-This is a frequent accompaniment of pregnancy. The patient experiences a constant desire to pass water, more troublesome during the day than at night. It is due to pressure of the uterus on the neck of the bladder. As soon as the womb gets to a certain size it rises out of the pelvis(the lowest part of the abdominal cavity, closed in by walls of bone, which make a kind of basin), and then the irritation passes away of itself if it come on in the earlier months. When it comes on during the later months it is due to pressure on the bladder itself.
General Treatment.-The patient must lie down as much as possible on her back.
Medicines.-(Every two hours.)
Belladonna3.
-This will usually allay the irritability.
Pulsatilla3.
-After Belladonna
Breasts Painful.-Pain in the breasts is very common during pregnancy. If it becomes severe give Bryonia 3 every few hours.
Cramps.-The pressure of the uterus on the great nerves of the lower limbs often gives rise to cramps.
General Treatment.-Keep the lower limbs warm, and let the patient lie on the back a great part of the day when not exercising.
Medicines.-
Veratruma.3.
-If the limbs are very cold.
Nux v.3.
-In general; When there is constipation.
Digestive Disorders. – Toothache.- Some women “lose a tooth” with each pregnancy. In general, the cause of this is improper dieting. The child must have bone salts for its teeth, and if the mother does not supply it out of the food she takes, her own bones and teeth must go short of their proper amount. Whole wheat-meal and bread made of it, groats and coarse oatmeal, are excellent foods, and will save many a tooth if women will only persuade themselves to eat them in preference to white bread, sweets, and pastry.
Medicines.-(Every hour while it lasts)
Kreosotum3 -If the tooth is decayed.
cham.6.
-When the pain is unendurable, worse at night and from warmth.
Magnesia carb.6.
-Great nervous excitability.
Sepia6.
-If there is no decay.
Salivation.-Incessant flow of saliva is a very common accompaniment of pregnancy, and a very annoying one.
Medicines.-(Every four hours)
Mercurius sol.6.
-This will suffice in most cases.
Sul.6.
-After Mercurius, if insufficient.
Heartburn.-Many women have heartburn during the whole time they are pregnant.
General Treatment.-They must avoid all sweet food and drinks, and anything likely to create acid.
Medicines.-(Every four hours)
Calcareac.6.
-When there is much acidity.
Pulsatilla3 -In fair, quick-tempered women.
Capsic.3.
-When there is not much acidity.
Morning Sickness.-This is the most characteristic and most troublesome of all the disorders incident to pregnancy. It generally occurs in the morning, but by no means always. There may be all degrees of it, from simple nausea, which never goes on to vomiting, to vomiting after every morsel of food taken. Sickness lasts, as a rule, ten weeks-from the fifth or sixth week to the sixteenth. The sickness usually comes on immediately on rising from bed, and continues for an hour or two. It may recur less severely in the evening or it may last all day.
General Treatment.-Food must be taken frequently in small quantities medicines must be given a quarter of an hour before food. The Patient should endeavour to take some nourishment- milk, beef-tea, chicken tea, or solid food if she prefers it- immediately after vomiting. Koumiss(or fermented milk) will sometimes be retained when nothing else will.
Medicines.-(A quarter of an hour before each meal, until amelioration has taken place: then two or three times a day)
Ipecac.3.
-Nausea and vomiting, with great uneasiness in the stomach;vomiting of drink and undigested food; bilious vomiting and tendency to ulceration off the bowels.
Nux v.3.
-Nausea and vomiting, chiefly in the morning while eating, or immediately after eating, or immediately after eating or drinking; acid and bitter eructations and regurgitations; violent hiccough, waterbrash, pain and sensation of weight in the pit of the stomach; constipation and irritable temper.
