Part 59

Dec. 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Sep. 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 Oct.

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THE SIGNS AND SYMPTOMS OF LABOR.

1. Although the majority of patients, a day or two before the labor comes on, are more bright and cheerful, some few are more anxious, fanciful, fidgety and reckless.

2. A few days, sometimes a few hours, before labor commences, the child "falls" as it is called; that is to say, there is a subsidence--a dropping--of the womb lower down the abdomen. This is the reason why she feels lighter and more comfortable, and more inclined to take exercise, and why she can breathe more freely.

3. The only inconvenience of the dropping of the womb is, that the womb presses more on the bladder, and sometimes causes an irritability of that organ, inducing a frequent desire to make water. The wearing the obstetric belt, as so particularly enjoined in previous pages, will greatly mitigate this inconvenience.

4. The subsidence--the dropping--of the womb may then be considered one of the earliest of the precursory symptoms of child-birth, and as the herald of the coming event.

5. She has, at this time, an increased moisture of the vagina--the passage leading to the womb--and of the external parts. She has, at length, slight pains, and then she has a "show," as it is called; which is the coming away of a mucous plug which, during pregnancy, had hermetically sealed up the mouth of the womb. The "show" is generally tinged with a little blood. When a "show" takes place, she may rest assured that labor has actually commenced. One of the early symptoms of labor is a frequent desire to relieve the bladder.

6. She ought not, on any account, unless it be ordered by the medical man, to take any stimulant as a remedy for the shivering. In case of shivering or chills, a cup either of hot lea or of hot gruel will be the best remedy for the shivering; and an extra blanket or two should be thrown over her, and be well tucked around her, in order to thoroughly exclude the air from the body. The extra clothing, as soon as she is warm and perspiring, should be gradually removed, as she ought not to be kept very hot, or it will weaken her, and will thus retard her labor.

7. She must not, on any account, force down--as her female friends or as a "pottering" old nurse may advise--to "grinding pains"; if sue does, it will rather retard than forward her labor. 8. During this stage, she had better walk about or sit down, and not confine herself to bed; indeed, there is no necessity for her, unless she particularly desire it, to remain in her chamber.

9. After an uncertain length of time, the pains alter in character. From being "grinding" they become "bearing down," and more regular and frequent, and the skin becomes both hot and perspiring. These may be considered the true labor-pains. The patient ought to bear in mind then that "true labor-pains" are situated in the back, and loins; they come on at regular intervals, rise gradually up to a certain pitch of intensity, and abate as gradually; it is a dull, heavy, deep sort of pain, producing occasionally a low moan from the patient; not sharp or twinging, which would elicit a very different expression of suffering from her.

10. Labor--and truly it maybe called, "labor." The fiat has gone forth that in "sorrow thou shalt bring forth children." Young, in his "Night Thoughts," beautifully expresses the common lot of women to suffer:

"'Tis the common lot; in this shape, or in that, has fate entailed The mother's throes on all of women born, Not more the children than sure heirs of pain."

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SPECIAL SAFEGUARDS IN CONFINEMENT.

1. Before the confinement takes place everything should be carefully arranged and prepared. The physician should be spoken to and be given the time as near as can be calculated. The arrangement of the bed, bed clothing, the dress for the mother and the expected babe should be arranged for convenient and immediate use.

2. A bottle of sweet oil, or vaseline, or some pure lard should be in readiness. Arrangements should be made for washing all soiled garments, and nothing by way of soiled rags or clothing should be allowed to accumulate.

3. A rubber blanket, or oil or waterproof cloth should be in readiness to place underneath the bottom sheet to be used during labor.

4. As soon as labor pains have begun a fire should be built and hot water kept ready for immediate use. The room should be kept well ventilated and comfortably warm.

5. No people should be allowed in or about the room except the nurse, the physician, and probably members of the family when called upon to perform some duty.

6. During labor no solid food should be taken; a little milk, broth or soup may be given, provided there is an appetite. Malt or spirituous liquors should be carefully avoided. A little wine, however, may be taken in case of great exhaustion. Lemonade, toast, rice water, and tea may be given when desired. Warm tea is considered an excellent drink for the patient at this time.

7. When the pains become regular and intermit, it is time that the physician is sent for. On the physician's arrival he will always take charge of the case and give necessary instructions.

8. In nearly all cases the head of the child is presented first. The first pains are generally grinding and irregular, and felt mostly in the groins and within, but as labor progresses the pains are felt in the abdomen, and as the head advances there is severe pain in the back and hips and a disposition to bear down, but no pressure should be placed upon the abdomen of the patient; it is often the cause of serious accidents. Nature will take care of itself.

9. Conversation should be of a cheerful character, and all allusions to accidents of other child births should be carefully avoided.

10. ABSENCE OF PHYSICIAN.--In case the child should be born in the absence of the physician, when the head is born receive it in the hand and support it until the shoulders have been expelled, and steady the whole body until the child is born. Support the child with both hands and lay it as far from the mother as possible without stretching the cord. Remove the mucus from the nostrils and mouth, wrap the babe in warm flannel, make the mother comfortable, give her a drink, and allow the child to remain until the pulsations in the cord have entirely ceased. After the pulsations have entirely ceased then sever the cord. Use a dull pair of scissors, cutting it about two inches from the child's navel, and generally no time is necessary, and when the physician comes he will give it prompt attention.

11. If the child does not breathe at its arrival, says Dr. Stockham in her celebrated Tokology, a little slapping on the breast and body will often produce respiration, and if this is not efficient, dash cold water on the face and chest; if this fails then close the nostrils with two fingers, breathe into the mouth and then expel the air from the lungs by gentle pressure upon the chest. Continue this as long as any hope of life remains.

12. AFTER-BIRTH.--Usually contractions occur and the after-birth is readily expelled; if not, clothes wrung out in hot water laid upon the bowels will often cause the contraction of the uterus, and the expulsion of the after-birth.

13. If the cord bleeds severely inject cold water into it. This in many cases removes the after-birth.