Pregnancy

“ An especially important chapter in the history of woman at this period of life relates to the dietetics of pregnancy and parturition, and to the regulations to be observed for the maintenance of health at this time and in connection with the processes of pregnancy, parturition, puerperal involution of the uterus, and lactation. ”

“ We saw that in some women menstruation runs a perfectly smooth course, free from any disagreeable symptoms. The same is true of pregnancy. It is remarkable how smooth and easy the entire course is with some women. Many women know that they are pregnant only because of the non-appearance of the monthly periods; and even in the later months they feel no discomfort, attending to all their work and pleasures as usual; and even childbirth is a trifling matter with them. ”

“ 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. ”

“ Put yourself at once under the care of a physician.
Insistence on the importance of medical advice should not be taken to imply that pregnancy is to be regarded as other than a normal process. Its dangers are comparatively slight, as we should expect, since the property of all living matter to reproduce its kind is both fundamental and essential; the continuance of living creatures in this world, plants as well as animals, depends upon the Reproductive Process. ”

“ Menstruation, which is the evidence of sexual maturity, is a monthly hemorrhage from the uterus which escapes through the vagina, normally recurring throughout the entire child-bearing period, except during pregnancy and lactation. The duration of this child-bearing period, or sexual activity, is about thirty years and continues from puberty to the menopause. ”

“ The Cessation of Menstruation.—The failure of menstruation to appear when it is expected is nearly always the first symptom of pregnancy to attract attention, and, as a rule, when this happens to healthy women during the child-bearing period—which usually extends from the fifteenth to the forty-fifth year—it may be taken to indicate that conception has occurred. ”

“ 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. ”

“ Although pregnancy may become established at any time during the interval between the periods of bleeding, it is more likely to be established just before a period is expected or shortly after it has ceased. Furthermore, whenever conception does take place, the preliminary preparations for the reception of the embryo are followed by much more elaborate arrangements for its protection and nutrition. ”

“ The physiology of pregnancy really represents an adjustment of the various functions of the maternal organism, which are altered to meet the demands made upon the mother’s organs by the body which is developing, growing and functioning within hers. ”

“ Thus, various obstinate chronic affections of the skin, of the womb and ovaries, and of the brain and nervous system, frequently get well during pregnancy; and it is well known to every physician, that by the judicious management of this state, and of the lying-in period, troublesome displacements of the womb may be arrested.
It should nevertheless ever be recollected that the condition of pregnancy is one of excitement and enhanced susceptibility to impressions of all kinds. For this reason a change in the habits of [Pg 218] life is necessary ”

“ The initial symptoms of pregnancy are so widely known that in most instances the prospective mother herself makes the diagnosis shortly after conception has taken place; but now and then pregnancy advances for several months unrecognized and is then detected by a physician who has been consulted on account of symptoms which the patient has incorrectly attributed to some other condition. On the other hand, women sometimes suspect that they are pregnant when they are not ”

“ If any ailment arises during pregnancy it is a consequence of neglect, or injury, for which the woman herself is responsible,—it is not a natural accompaniment of, or a physiological sequence to pregnancy. ”

“ We can scarcely wonder however that even intelligent and educated people hold utterly improbable beliefs about pregnancy, for the most fanciful of them are quite as easy to believe as the thing that we know actually occurs—the development of a human body from a single cell. ”

“ The doubt of pregnancy will be much less frequent than that of menstruation, for the powerful influence of pregnancy on the psychic life of woman is well-known, and it is hence the more important to call in the physician in cases of crimes committed by pregnant women, or in cases of important testimony to be given by such women. ”

“ May Proceed from Other Causes.—But a ceasing-to-be-unwell may proceed from other causes than that of pregnancy, such as disease or disorder of the womb or of other [271] organs of the body—especially of the lungs—it is not by itself alone entirely to be depended upon; although, as a single sign, it is, especially if the patient be healthy, one of the most reliable of all the other signs of pregnancy. ”

“ 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. ”

“ The symptoms which indicate pregnancy are cessation of the menses, enlargement of the mammæ, nausea, especially in the morning, distention of the abdomen, and movement of the foetus. A married woman has reason to suspect that she may have conceived, when, at the proper time, she fails to menstruate, especially when she knows that she is liable to become pregnant. ”

“ I am not, nor have ever been, a very robust woman, so naturally felt the strain of pregnancy perhaps more than some women feel it, but coming away from home as I did, over two hundred miles, when I was married, when I found out my condition, I put myself in the hands of a good doctor, and that helped me a good deal. ”

“ First, a woman who has been infected and never properly treated, becomes pregnant, and though, perhaps, showing signs of good health in every other respect, has a miscarriage; pregnancy and miscarriage follow each other at short intervals, four, six or eight times. ”

“ 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. ”

“ Granted that it remains fixed, woe to the woman if she becomes pregnant. The womb cannot assume the constantly changing positions of pregnancy, and the result is either abortion or malformation of the fetus, together with great and constant suffering to the woman. ”

“ Bastardy, however, seems to be, as yet, beyond the control of this agent, as I have reason to believe that, in many country parishes, the majority of women are in an advanced state of pregnancy when married. ”

“ In some you see all distempers of women collateral to their pregnancy, which is certainly a very necessary and an infinitely extensive subject, while on the practical article of the deliverance they give you nothing but what is barren, jejune, or even false. ”

“ There are many other possible symptoms of pregnancy, but their value is very uncertain and as we have seen, even the ones described above are not entirely dependable. But if you have missed two periods; if your breasts have grown larger and firmer; if your nipples are stiffer and more prominent and you can squeeze colostrum from them, you may be reasonably certain that a baby is coming. ”

“ Except in rare cases the observance of this precaution is less urgent after the fourth month, when the ovum has become more securely attached to the womb. But again, toward the end of pregnancy the development of the mother's body necessitates a comparatively large amount of rest; patients who continue to exert themselves may expect to suffer from shortness of breath and a number of other annoyances. ”

“ Although the symptoms of pregnancy have been observed throughout the ages by women who have borne children, and accoucheurs of one sort and another who have attended them, a positive diagnosis at an early stage of this condition is sometimes still baffling to the most experienced obstetricians. ”

“ That children should derive, under his providence, their being, all their solids and all their fluids, in a word, the whole mass of their bodies, from the substance of the mother.
3. For this purpose he has given to the body of the female an extra quantity of blood and nutritious juices.
4. Before pregnancy this superabundance is evacuated at periodical times.
5. In pregnancy, that which was formerly evacuated is retained for the formation and growth of the fetus, or the general strengthening of the system during the time of pregnancy. ”

“ The separation and extrusion of the placenta, on the contrary, are apt to be imperfect when pregnancy ends in the early months, and medical attention is necessary to determine whether the uterus has been emptied completely. ”

“ For its physiological action, both in menstruation and in pregnancy, is the direct consequence of ovarian functions, and closely dependent upon them; and the period of its prominent activity does not come until after the action of the ovaries has been completely established; that is, the period of maternity is, or should be, consecutive to the period of adolescence, and the work of gestation only entered upon when the work of ovulation has long been thoroughly accomplished. ”

“ Often a drug is given credit for efficiency where conception has been erroneously suspected. Shortly after the menstrual date passes, some medicine is resorted to, and the subsequent phenomenon, regarded as the interruption of pregnancy, is really no more than normal menstruation. In another group of cases miscarriage does actually occur, although the medicine employed plays only a minor role in its production. ”

“ The degree to which lactation hinders conception is so widely known, that women often suckle their infant for a very long period, with the definite aim of preventing the speedy recurrence of pregnancy. ”

“ We have only to consider, whether there does not frequently, during pregnancy, take place a discharge, so closely resembling menstruation in its periods, quantity, duration, and appearance, that neither the female herself nor her medical adviser shall be able to detect any difference between them ”

“ The various and profound modifications of the system which attend the periods of utero-gestation, pregnancy and child-bearing do not leave the nervous centres unaffected. Most women are liable to slight changes of disposition and temper, morbid longings, strange likes and dislikes during pregnancy, more especially during the earlier months ”

“ There is no organ in the body, with the exception of the stomach, that exercises a more extensive control over the female system 62than the womb. Hence, when in the condition of pregnancy, it affects, directly or indirectly, various parts of that system. The effects of pregnancy, however, vary much according to the constitution of the female. ”

“ EVIDENCE OF CONCEPTION.—Very many medical authorities, distinguished in this line, have stated their belief that women never pass more than two or three days at the most beyond the forty weeks conceded to pregnancy—that is two hundred and eighty days or ten lunar months, or nine calendar months and a week. ”

“ Slemons makes the interesting observation, that women who are unaware of their pregnancy for several months are seldom troubled with nausea, while those who erroneously believe themselves to be pregnant will suffer from this well-known symptom of pregnancy, until convinced of their mistake. ”

“ The condition of the germ-plasms, i.e., the condition of the ovum and the spermatozoa at the time of conception is more important than all subsequent care during gestation.
As there are foolish people who possess a peculiar knack of misinterpreting and misunderstanding everything, I wish to emphasize that hygiene during pregnancy should not be neglected. Everything possible should be done to put the mother in the best possible physical and mental condition. ”

“ Hence all the means that restore the system to health, medicinal and hygienic, may be recommended as tending to cure the complaint, and hence we have to inquire whether there is serious disease in any of the organs when the question of pregnancy arises, on account of the disappearance of the menses. ”

“ Conception with Deficient Organs.—Having spoken of conception with some obstructive interference, conception with some natural or acquired deficiency of the functional, organic, or genital apparatus must be considered. It is a well-known fact that women exhibiting rudimentary development of the uterus or vagina are still liable to become pregnant, and many such cases have been recorded; but the most peculiar cases are those in which pregnancy has appeared after removal of some of the sexual apparatus. ”