Carolyn Conant Van Blarcom

“ This aspect of maternity nursing—what it means to the nurse herself—should be given full recognition, for although the demands which are made upon her are exacting, she will find more than compensating interest and gratification in her work.
It provides a channel of expression for some of her most elemental and deeply rooted impulses. The desire to create exists within most of us, and surely the nurse tastes of the joys of creation when she watches the beautiful baby body grow and develop under her care. ”

“ And as recovery progresses the patient becomes aware, perhaps only vaguely, of another change which is not always a welcome one. For nine months she has been the centre of interest in her immediate circle; she has been the object of unremitting concern and solicitude, and much as she and her family may have tried to keep her life normal, she and her needs have constantly been given the first consideration. The very mystery of the child developing within her has created an attitude of respect, almost of reverence, which was never her portion before. ”

“ And so you look into the eyes of this baby of yours and pledge yourself to stand by and do for him all that lies in your power, realizing already that the keeping of that pledge is going to bring you, along with its demands, an endless and satisfying happiness; a consciousness that you are doing something indispensable to your baby’s welfare that no one else in the world can do. ”

“ But with the gradual growth of the race, with the beginning of the struggle for existence and the appearance and spreading of disease, all interfering with the natural growth and development of the body, the function of child bearing ceased to be a normal function, as designed by its Maker, and became one fraught with dangers to both mother and child. Nevertheless, through ignorance of these changes brought on by civilization, the idea that the function is a normal process, the risk slight and fatalities infrequent and when occurring, inevitable, is the almost universal belief to-day. ”

“ But to the woman herself, who must resume the functions of mother, homemaker, wife and general utility person, the disability may be enough to make life endlessly dreary and discouraging. And yet, she is perhaps only just below the physical level upon which she could live her life with joy and eagerness; and proper care when the baby came would have left her upon that level.
The effect of the mother’s impairment reaches far beyond her own invalidism, for such women are not as well able to rear and care for their children satisfactorily as are fresh, buoyant mothers. ”

“ But probably of graver importance to the public welfare than the well defined nutritional disturbances, themselves, is the fact that between a state of good health and the level upon which a disease is recognizable is a long scale, along which is ranged an uncounted army of under-par, half-sick people. These are the ones who are tired, nervous, susceptible to infections, with feeble recuperative powers, and in general are more or less ineffective in the business of life. ”

“ Perhaps it will be well for the nurse to pause just here for a fresh reminder that the end really to be desired through prenatal care is not so much the mere prevention of death among mothers and infants, as the promotion of health, as well; our charges must be not only saved but saved to mental and physical health, vigor and well-being, capable of being useful, productive citizens. Happily, both life and health are conserved by the same measures, and effort toward either end helps to accomplish both. ”

“ The nurse who is able to go into a home quietly and unobtrusively and accept what she finds, even carpets and draperies, and still do clean work, is doing better nursing than the one who arranges a faultless room but upsets her patient and disrupts the household in the process. ”

“ If your diet is faulty, your milk will be faulty in the same respect and your baby, being incompletely nourished, will start life with tissues that are lacking in those substances that are needed to make them sound and to promote health. That is what we have in mind when we say that the mother’s milk must be satisfactory not alone in quantity but in quality as well, if the baby is to be well nourished. ”

“ This makes us hope that before long good care during pregnancy, childbirth and young motherhood will be available to every woman in the land. But quite as earnestly do we also hope that every woman in the land who is looking forward to motherhood will seek this care. Certain it is that the expectant mother who does seek care, whether from a doctor in his office or through a prenatal clinic, is approaching her motherhood in the only way that is safe for herself and her baby. ”

“ She has spent nine months looking forward to an event that has been consummated; she has spent nine months in a state of more or less apprehension and suspense that have been abruptly ended, and we know that it is quite natural for any one to experience a letting down, or something akin to collapse, when long-continued uncertainty is ended, even though it ends happily. ”

“ It is hoped that the nurse may understand from this discussion that the conflicting thoughts which her patient does not discuss, but buries and keeps below the surface of her mind, are the factor that works harm in her mental life. If the nurse can get her patient to ventilate these thoughts, they will be robbed of much of their power to injure. But this patient, like any one else, will talk freely only when she talks spontaneously and she will do this only when she senses in her nurse a sympathy and a sincere concern over her troubles. ”

“ The average nurse has a deep maternal instinct. She may not be conscious of it as such, but it is this instinct which prompts her to select nursing from the wide range of occupations and professions which are open to her. And it is entirely natural that she should derive great satisfaction from this vicarious motherhood—this giving of her knowledge and skill in service to the woman with a baby in her arms. ”

“ She should never lose sight of the fact that she is not being trained solely to conform to any one hospital routine or to become expert in only one method of nursing care. She is being prepared to go out and give nursing care to any young woman and her baby who need it, no matter where or how they are situated or by what methods they are treated.
If conditions are such that the doctor’s orders and the patient’s requirements seem impossible of fulfillment, then the nurse must attempt the impossible and attempt it with confidence of success. ”

“ And so, the young woman, to whom we refer so impersonally as “the patient,” is an intensely personal being at this time, experiencing a number of the most poignant of the human emotions: awe, expectancy, doubt, uncertainty, dread and in some cases fear amounting almost to terror. And through it all her body is being racked and exhausted with pain that grows harder and harder to bear. ”

“ There can be no doubt that nervous and emotional disturbances are detrimental to the physical well-being of the patient in labor, also, and this fact alone is enough to warrant an effort to avert them. If the nurse appreciates the significance of the emotional influence and shapes her attitude and conduct accordingly, she will thereby help to increase the ease and safety of the actual delivery. Just what that attitude shall be, no one can say, for it must be developed, in each case, in such a way as to win the confidence and meet the needs of that particular patient. ”

“ When the time comes, and it seems to be approaching, that pregnancy, labor, the puerperium and infancy are regarded as crucial periods in the life history, demanding all the preventives and safeguards that all branches of medicine and nursing can offer, these periods will cease to be so enormously destructive of life and health.
We cannot build a strong race with sickly and maimed mothers and babies, and we can scarcely have other than sickly and maimed mothers and babies without care. ”

“ England and New Zealand, as countries, have pointed the way toward accomplishing a nation-wide reduction of maternal and infant mortality and morbidity by making provision for widely organized prenatal care. They recognize the problem as one of public concern. They get at the heart of it: ignorance on one hand and poor or inadequate care on the other. They apply a practical solution, comprising a system of preventive, instructive prenatal care, together with improved and increased facilities for medical and nursing care at the time of delivery and afterward. ”

“ As long as the nurse remains with her patient, therefore, she must try to impress upon both the patient and the members of her household that the most important single factor in the care of the new baby is the sustained and regular care which the nursing mother should take of herself. For it must be remembered constantly that it is not alone breast feeding, but satisfactory breast feeding that nourishes and builds and protects the baby. ”

“ That fact must not be overlooked for each patient is an entirely new and different problem and not like any other that the nurse has had before. But the nurse who is sincere and sympathetic and who earnestly tries to put herself in her patient’s place and see things from her standpoint, will, by virtue of that very attitude, accomplish much toward sensing the patient’s temperament and establishing harmonious relations. Moreover, the patient, herself, will all unconsciously make something of an adjustment to the nurse when she feels the nurse’s sincerity and her eagerness to be of service. ”