Childbirth

“ Bear witness, then, I respectfully ask of all of you, that I, for one, have no sympathy with that nonsensical foolishness which would lead some people to tell you that pregnancy and childbirth are matters which need cause you no trouble, no agony, and no pain. ”

“ The superstitions surrounding childbirth are peculiar and cruel. Those who practice obstetrics are generally old women, a doctor is seldom called in except on rare occasions, and the midwives endeavor to aid natural labor by means of domestic medicines, shampooning, etc, at times doing much serious mischief. The cruelest part of their procedure is immediately after childbirth, causing the mother to lie by a hot fire for a period of from five to thirty days. ”

“ You have probably learned, in one way or another, that the complications associated with childbirth that are most serious are infections (childbed fever) , convulsions, abortions or miscarriages and severe bleeding, but perhaps you have not heard that you, yourself, can help greatly in the prevention of all of these conditions, in your own case, and chiefly by little more than exercising good common sense. ”

“ Respecting our third question—Shall we employ a physician on occasions of childbirth? I remark that people should, themselves, be the judges. If you possess the courage that I have seen exhibited among the peasantry of the Silesian mountains of Germany, you may get along almost without an assistant of any kind. There childbirth is looked upon in a light very different from what we see in our own country. ”

“ The fact that there is pain in childbirth, or, if through modern medical science, the pain is eliminated, is beside the point. Childbirth consists of a new baby coming into the world. The mother might even die, but childbirth has taken place. ”

“ Furthermore, if there is to be notable improvement in the management of cases of childbirth, the appearance of untoward symptoms should not be awaited before consulting a physician; on the contrary, prospective mothers must be taught that they should be under competent medical supervision throughout pregnancy.
At present intelligent women demand some knowledge of the anatomical and physiological changes incident to the development of the embryo and the birth of the child. ”

“ These few examples give some idea of the benefits of prophylaxis in the practice of obstetrics. Prospective mothers should understand not only that there is an advantage in taking such precautions, but that they may be risking their lives, or at least their future well-being, unless they insist upon competent medical attention. It is true, of course, that pregnancy and childbirth are generally normal processes, but they are not always so. ”

“ The apprehensions of dangers which associate themselves in the minds of many with childbirth are not often realized. If the parts are not diseased, and the mother is in good health, and the laws of the unfolding life have been carefully observed, there is little peril, although, generally, considerable pain. ”

“ Statistics are available to show that less than half of all pregnancies are normal and that the illness and loss of human life, from causes associated with childbirth, are distressingly and needlessly high. ”

“ It is therefore highly important that all persons who may happen to be with a female so affected should not attend another case of childbirth for some time, and particularly that they should not wear any portion of the same clothing they had then on, and that they [421] should bathe the whole body several times. ”

“ Desirous of remaining young and fresh as long as possible, fearing the dangers and troubles of childbirth and the bringing-up of children, the American woman has an increasing aversion to pregnancy, childbirth, suckling and the rearing of large families. ”

“ They found that about half of the mothers in those communities had no medical attention whatever in childbirth. Untrained women, friends or neighbors, frequently someone’s grandmother, were in attendance. ”

“ PAINLESS CHILDBIRTH.
WHY SHOULD A WOMAN SUFFER?—Childbirth is a natural function, as natural as eating, sleeping or walking. If the laws of nature are complied with it loses most, if not all, of its terrors. The facts show that Indian women, and those of other uncivilized races have children without experiencing pain, and with none of the so common modern complications. ”

“ Although the childbearing function is the origin and source of the human race, existing throughout the ages, the processes connected with it have only in recent years been clearly understood.
Our present-day knowledge of the processes connected with childbirth makes it easy to understand how, in the early ages of the human race, the function was a normal function, with little or no danger to mother or child. ”

“ It may be at the end of two weeks, or it may not be until the close of four or five weeks, in the case of the mother who cannot nurse her child; for the nursing of the breast greatly facilitates the shrinking of the uterus. Extensive lacerations may hinder the involution as well as other accidents of childbirth, so it must be left with the physician to decide in each individual case when the mother may enter into the activities of life and assume the responsibilities of the care of the baby and the management of her home. ”

“ Hegar considers that there is hygienic justification for the limitation of the number of children to which a woman gives birth. The most suitable age for motherhood lies in his opinion between the ages of twenty and forty years. Childbirth in women younger or older than this entails too much danger both to mother and child. ”

“ Among the peasant women of the mountains in Austrian Silesia, childbirth is regarded in a very different light from that among the women of our own country. They are exceedingly hardy and robust, and seem to care as little about giving birth to a child as if it were an everyday occurrence. ”

“ During the months of gestation, while the uterus has been enlarging to accommodate its daily increasing contents, the generative passages have also been increasing in size and becoming soft and distensible, so that a seeming impossibility is in due time accomplished without physical damage, though possibly not without intense suffering. However, it is a most gratifying fact that modern medical science may do much to mitigate the pains of childbirth. It is possible, by a proper course of preparation for the expected event, to greatly lessen the suffering usually undergone ”

“ Males or females that are unclean through running issue, and a woman after childbirth, must in addition bring a sacrifice, because their uncleanness occurs less frequently than that of women in their separation. All these cases of uncleanliness, viz., running issue of males or females, menstruations, leprosy, dead bodies of human beings, carcases of beasts and creeping things, and issue of semen, are sources of dirt and filth. ”

“ I’m a physician, practicing obstetrician and gynecologist, and I think I’ve had a passing experience in matters of abortion. Now, when I was a medical student, in 1949, we had no such science as fetology. We were taught that the unborn child—the fetus—was something in the uterus, but it was really an article of faith as to whether or not it was a human being, and whether or not that human being had any unique, personal qualities. ”

“ Conception Soon After a Preceding Pregnancy.—Conception sometimes follows birth (or abortion) with astonishing rapidity, and some women seem for a period of their lives either always pregnant or with infants at their breasts. This prolificity is often alluded to, and is not confined to the lower classes, as often stated, but is common even among the nobility. Illustrative of this, we have examples in some of the reigning families in Europe to-day. A peculiar instance is given by Sparkman in which a woman conceived just forty hours after abortion. ”

“ On the other hand, the careless washing of the feet in cold water, a single effort at the wash-tub, a rapid drive, fright, a piece of bad news, coitus, the slightest nervous or physical disturbance, may produce abortion where predisposing cause sufficient does exist. We will here classify the exciting causes of abortion, in reference to the consequent treatment and the possibility of prevention, as maternal and foetal, dependent upon, acting by means of, the maternal system and organs or those of the ovum. Those dependent upon the mother are amenable to preventive treatment ”

“ The Vagaries of Pregnancy.—Certain foolish, old-fashioned ideas, have crept into the minds of impressionable people regarding pregnancy, which are aptly termed vagaries. It is believed by some that if the pregnant woman is the victim of fright, or is badly scared, or witnesses a terrifying or tragic sight, her child will be, in some way, affected by it. If the incident is not of sufficient gravity to cause an abortion or a miscarriage it will not, in any way mark, or affect the shape of the child in the womb. ”

“ It is because so many women fail to appreciate this that abortions and premature births are often followed by ill health and invalidism. Under proper care, an abortion 80or premature labor is not, of itself, any more serious for a woman than a normal delivery.
Bleeding from the vagina, or a sudden increase in the size of the abdomen with perspiration and a sudden feeling of faintness, may be the beginning of severe bleeding, or hemorrhage, from any one of a number of causes, and in such a case the expectant mother should notify her doctor, go to bed at once and keep quiet until he arrives. ”

“ But as the object of the present work is to illustrate abortion, and not the complete life-circle of the fœtus, I shall stop the number of my propositions at the fifth iiimonth of its intro-uterine existence. After that period, the various phenomena of fœtal gestation are so uniform, that they afford less matter of interest to the philosopher.
13. Conception, or that result which follows sexual congress, in virtue of which one, or more individuals, of the same species is called into being, takes place in the ovarium of women. ”

“ A WRONG TO THE MOTHER AND CHILD.—Sometimes the mother is diseased; the outlet from the womb, as a result of laceration by a previous child-birth, is frequently enlarged, thus allowing conception to take place very readily, and hence she has children in rapid succession. Besides the wrong to the mother in having children in such rapid succession, it is a great injustice to the babe in the womb and the one at the breast that they should follow each other so quickly that one is conceived while the other is nursing. ”

“ Normal Course.—We have already delineated the normal course of abortion at this period. The death of the embryo has usually preceded, often for weeks, and is characterized by the feeling of pelvic congestion, gastric and vesical irritation, weariness, weakness, and increase of uterine and vaginal secretion; the membranes have developed more or less; expulsion is inaugurated by hemorrhage. If the cause be more violent, the flow of blood is free. Usually there is but a slight oozing, which ceases at times, but gradually increases; the suffering which accompanies uterine contraction is present. ”

“ A miscarriage or abortion is said to be "complete" when the fetus with its membranes and after-birth is expelled clean and whole, or in other words when the womb empties itself completely. A miscarriage or abortion is said to be "incomplete" when some part of the embryo is left in the womb.
What to Do When a Miscarriage is Threatened.—When a woman, who is pregnant, begins to flow she should at once go to bed and keep perfectly quiet and send for a physician. A miscarriage is a treacherous condition and is so regarded by all medical men. ”

“ There is some uncertainty respecting the exact length of the period of gestation, which grows out of the difficulty of determining, in many cases, the exact time when conception takes place.
Uterine Life.—The uterine life of the new individual begins with the impregnation of the ovum, which occurs the instant it is brought in contact with the zoösperms of the male. While in the uterus, the young life is supported wholly by the mother. She is obliged to provide not only for her own sustenance, but for the maintenance of her child. ”

“ THE CAUSE OF ABORTION [129] may exist in the constitution of the female herself, being the result of weakness and irritability, or of an overfull habit or a diseased condition of the womb; or the fœtus, or child, may die or be deficient in development, when it is cast off like a blighted fruit. Suckling after conception has taken place is not infrequently a cause of miscarriage. Active diseases occurring during pregnancy, such as fevers, severe inflammation, eruptive fevers, etc., are almost certain to occasion the expulsion of the uterine contents. ”

“ The pain, the discharge, and, at the same time, the danger of an abortion, are in proportion to the advancement of the pregnancy. When a miscarriage goes on, the pains increase in force and frequency, and continue, with discharge of blood, fluid or in clots, until the ovum, or first formation of the child, is expelled; after which both become moderated till they cease altogether and the [130] red flow gives place to a colorless one. It is very important that those in attendance upon the patient should examine every clot that comes away. ”

“ The fact, therefore, is now scientifically established that the embryo from the first moment of conception or fecundation is a human being, having a human immortal soul.
II. Now we come to the direct study of abortion. Abortion, or miscarriage, strictly means the expulsion of the fœtus before it is viable, i.e., before it is sufficiently developed to continue its life outside of the maternal womb. The period of arrival at viability is usually after the twenty-eighth week of gestation. ”