Gestation

“ From the moment of conception, during the months of gestation, at the time of childbirth and after, changes of great interest take place in the germ of human life and in the body of the mother. Her body is marvelously fitted for the reception and development of the ovum, the embryo and the fetus through the various stages of fertilization, germination, development, maturity, to the time of the eventual exit of the child into the outer world to begin its own independent life. ”

“ In general it may be said that if the rudimentary or imperfectly developed uterus is at all competent to carry out the function of gestation, the necessary changes sometimes occur in the organ with remarkable rapidity, and result in normal pregnancy and parturition. ”

“ Malformations of the pelvis, accidental injuries and the diseases and displacements to which the uterus is liable, on the one hand; and, on the other, various morbid conditions of the ovum or placenta leading to the death of the foetus, are among the direct local causes. The general causes embrace certain states of the system which are apt to exercise a more or less direct influence upon the progress of utero-gestation. ”

“ This matter of conception and gestation, after a miscarriage, has of late been made the subject of special study, and there is little doubt that from this, as the primal origin, arises much of the nervous, mental, and organic derangement and deficiency that, occurring in children, cuts short or embitters their lives. ”

“ 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. ”

“ They are two in number, and externally to them may be seen the loosely weaved caducous membrane. During three months of utero-gestation, from the moment of conception, has this mass lived—but the embryo has not advanced from what it was at four or five weeks, nor could it. The time was spent by Nature in playfully modelling, forming, and cutting out what would almost appear an artificial plaything ”

“ Examples are related of children being born after ten full months of gestation; but these cases are very doubtful, for it is extremely difficult to know the exact period of conception. The legislation in France, however, has fixed the principle, that child-birth may take place up to the two hundred and ninety-ninth day of pregnancy.
Nothing is more curious than the mechanism by which the fœtus is expelled; everything happens with wonderful precision; all seems to have been foreseen, and calculated to favor its passage through the pelvis and the genital parts. ”

“ This life-form, thus started, grows according to the laws of its becoming more and more, until, at the expiration of a fixed period, which varies greatly in different animals, it becomes a complete young individual, of the nature and kind of its parents. The fertilization of the ovum in the female is called conception; its growing state is called gestation, and its birth, on becoming a separate being, is called parturition. In its growing condition, and before its birth, the new young life form is known as the foetus. ”

“ The latter succeeds immediately to the former; beginning at the moment when the new being is grafted on the maternal womb, and continuing until its expulsion from thence at the full period of gestation. It follows, therefore, that the Embryonic or former state is that in which the new being is as yet, without any direct or indirect communication with the mother, and still less so with external objects. This state persists for about two weeks after fecundation, during which the Embryo continues to derive its nourishment from the cortical membrane of the Ovum. (Boer, Soemmering, Plagge, myself.) ”

“ But the aggravated horrors of childbirth, and the alarming increase in the performance of the Cæsarian section, together with the general surfeit of the body and the intensified loathing of men, will cause these retrograde movements to diminish, and very soon such a clamour will arise for extra-corporeal gestation that science will be allowed no rest until a technique is discovered that will meet the public demand. ”

“ 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. ”

“ The next step is to exhibit its various stages of development, and to show how it is nourished and maintained in its proper position. This is requisite in order to understand the origin of many diseases and accidents which occur during gestation, and also to explain the various signs by which it is determined whether a female is pregnant or not.
FŒTAL DEVELOPMENT.
The development of a perfectly formed human being from the egg in which it originates, is one of the most astonishing phenomena that can come under our observation, and is eminently deserving the study of every rational being. ”

“ It is likewise difficult to determine the shortest period at which gestation may terminate, and the child be able to survive. A child may be born and continue to live for some months, after twenty-four or twenty-five weeks of gestation ”

“ The child made an early recovery. Rogers mentions a fetus that was found in a man's bladder. Bouchacourt reports the successful extirpation of the remains of a fetus from the rectum of a child of six. Miner describes a successful excision of a congenital gestation.
Modern literature is full of examples, and nearly every one of the foregoing instances could be paralleled from other sources. ”

“ It would appear, then, from these observations, that the period of gestation in the domestic sow varies according to age, constitution, food, and the peculiarities or idiosyncrasies of the peculiar breed. Young and weakly sows not only produce fewer pigs, but farrow earlier than those of more mature age and sounder constitution; and moreover, as might be expected, their offspring are deficient in vigor, often indeed puny and feeble. Here, having trenched upon the subject, we may advert to the principles upon which the breeding of swine should be conducted. ”

“ PREGNANCY. CONCEPTION. In order to procreate the human species, there is a periodical discharge of blood from the vagina of every female, termed the catamenia, or menses. The secretion of this fluid commences at that period of life termed puberty, which occurs at different ages, according to the climate. In some latitudes it commences as early as eight or ten, and in others not until fifteen. As soon as conception or pregnancy commences, this discharge ceases, and goes to support the fœtus, or the child. ”

“ THE PLACENTAL STAGE.—Although the third stage is chiefly concerned with the separation and the delivery of the after-birth, on which account it is known as the placental period, the description of other no less remarkable events belongs here. Even after the infant is born the umbilical cord extends from its navel to the placenta, just as it has done throughout pregnancy. Among larger mammals separation of the new-born from the mother is brought about in one of two ways; sometimes the activity of the young breaks the navel-string, though more frequently the mother bites it in two. ”

“ The comparative growth of the fœtus infinitely surpasses that of its whole future existence. But the exact age of uterine embryos, and of abortives, is, in some degree, conjectural. Before the seventeenth day after conception, its rudiments are not even visible to the naked eye: the glary ovum has then slidden down from the ovarium, through one of the lateral tubes into the womb. The size of an abortion, comprehending the fœtus, its membranes, waters, and placenta, at the end of six weeks, does not exceed in size that of a pigeon’s or hen’s, and in three months, a goose’s egg. ”

“ Look at the figure of the fœtus in this Ovum, see how its growth has been checked!—In size it represents an embryo scarcely five weeks old—yet 20the Ovum came away at four months and a half from a patient whom I was engaged to attend in her confinement. Examine the cord; it is like the amnionic vessels, distended with florid blood.
REMARKS. In the knowledge of the doctrine of abortion and the treatment of it, a preparation like the present is of infinite value. ”

“ 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. ”

“ 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. ”

“ 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. ”

“ Young women of mature years should be made familiar with the physiological conditions which attend conception and maternity, and they need to know that from the [Pg 172] moment of conception life exists in the embryo, and that from the moment the spermatozoön enters and assimilates with the ovum a separate individual life is really begun, and that she is, at that very moment, the mother of this life within her as truly as when, in the later months, she feels the quickening within her, or after its birth experiences the joy of a mother who clasps her newborn infant in her arms. ”

“ At a later period, indeed, when the embryo is larger, when the ovum or conception has contracted adhesions with the uterus, and the umbilical vessels have penetrated the caruncles, the chorion extends further, and at its extremities on either side, and as it were in a couple of appendices, there is a certain fluid of a yellow colour, which you might call excrementitious, kept separate and distinct.
The human conception scarcely differs in any respect from an egg during the first months of pregnancy. ”

“ In the normal course of nature the living embryo carries on its work of self-evolution within the maternal womb, deriving its nourishment from the placenta through the vital cord, till, on reaching maturity, it is by the contraction of the uterus issued to lead its separate life. Abortion is a fatal termination of this process. ”

“ A new human being is the ultimate result of conception, but the chorion, amnion, placenta and umbilical cord must also be created to serve as aids in building and protecting the developing child during its uterine life. The part played by these accessory structures is so vital, in spite of being temporary, that it will be well for us to look into their origin and functions before considering the fetus itself which they serve. ”

“ The experience of ages has firmly established the fact that the fetus is expelled when ready to enter the world, or as we say, when it has become mature. But how does the fetus assert its maturity? There is the kernel of the matter; that is the real problem, a problem for the solution of which, happily, we possess better facilities than have heretofore existed. One solution that has been suggested assumes that the fetus loses ultimately its power to assimilate the nourishment provided through the mother's blood. ”

“ After one has traced the development of the human body in the uterus, and even faintly understood its growth and method of nourishment, it is impossible to believe that the mother’s thoughts or experiences could in any way deform or mark her child, or alter its sex. That the mother’s “reaching up,” for example, could slip the cord around the unborn baby’s neck is manifestly absurd, as well as the previously mentioned superstitions about the eight-month baby’s slender chances for survival. ”

“ But quickening,—a period usually occurring from the one hundred and fifteenth to the one hundred and thirtieth day after conception, but varying within still more appreciable limits in different women, and in the same women in different pregnancies, from variations in the amount of liquor amnii, the early strength of the fœtus, and other causes, and also, if at all, owing in its first sensation to rising of the womb from the pelvis, probably occurring a little earlier with boys than with girls, from their relative difference in size, [3] —is often absent, even throughout pregnancy ”