Obstetrics Or Midwifery
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Abdominal changes
There is a slight flattening of the lower abdomen at the second month, due to the sinking of the womb. There is also a slight retraction (drawing back) of the navel. After the third month, when the womb begins to ascend out of the pelvis, a progressive ... Abortion, Miscarriage, Premature Labor. (Accidents of pregnancy)
These three terms indicate a premature expulsion of the products of conception. Let us medically define these terms as follows; Abortion implies expulsion of the foetus before the sixteenth week. Miscarriage, the expulsion between the sixteenth and twe... AFTER-PAINS
Women who have borne children frequently suffer from the after-pains, occurring at irregular intervals, for two or three days and they may give rise to much distress. A few drops of spirits of camphor on a lump of sugar will often give relief when they ... Albumin in the urine. (Albuminuria)
While the urine of about six to ten per cent of all pregnant women contains albumin, the appearance of this symptom should always be regarded with apprehension. Women who are in their first pregnancy are most frequently affected. If the woman has had d... Bathing
Extremes in hot and cold bathing should be avoided. The skin should be kept active by daily comfortable baths, followed by a brisk rubbing with a rough towel. The Bowels and Bladder. The bowels, as before stated, are usually constipated and should be ke... Bladder
This is sometimes irritable in the later months, causing a frequent desire to pass urine. It sometimes occurs in the second or third week and is sometimes followed, later, by an inability to retain the urine which escapes at any time. This, however, is ... Bleeding After Delivery, Post-Partum Hemorrhage
Bleeding from the womb occurring six hours after delivery is called post partum and after that time, is known as puerperal child-birth bleeding or hemorrhage. Causes. A relaxed condition of the womb, the retention of clots or parts of the membranes, ... Breasts
Changes in the breasts also constitute a sign of pregnancy. As an early symptom, there may be a feeling of fullness, sometimes pain. They become larger and firmer from the development of the individual lobules, which have an irregular knotty feel. A fat... Care of the Breasts
Careful attention should be given them from the first. The nipples should be bathed after labor, with an antiseptic lotion (bichloride, 1-2000), dried and then covered with castor oil, a small square of clean sterile gauze being laid over each to prot... Clothing
This should be worn loose. The heavier garments should not be held by the waist but suspended from the shoulders. Flannels, if possible, should be worn next the skin excepting, possibly, during the warmest weather. Every precaution should be taken not t... Constipation
The enlarging womb pressing upon the rectum and also irregularity in diet causes constipation at this time. Daily free bowel movements are necessary to prevent the kidneys from overworking. As stated before, the diet should be strictly regulated. Cascar... Constipation is the Rule
Neuralgias in different parts of the body, especially in the face and teeth, are common. Palpitation of the heart and difficulty in breathing may be experienced. A discharge from the vagina is almost always present, due to the increased circulation in t... CONVULSIONS. (Eclampsia)
All forms of convulsions may occur during pregnancy. They may occur during pregnancy and during labor. These are usually the result of kidney trouble. The attacks occur most often during the last three months of pregnancy. Their frequency is one to thre... DEVELOPMENT AT DIFFERENT MONTHS
First month. There are indications of the eyes, mouth and anus. The extremities are rudimentary. The heart is 4/10 of an inch long. Second month. It is now about one inch long. The eyes, nose and ears can be distinguished. External genitals. There... Diagnosis
In twin pregnancy the symptoms and disorders of pregnancy are apt to be exaggerated, and watery swelling above the pubic bone is almost always present in the latter months. The abdomen is larger and broader and there may be a depression dividing the abd... Diet
This should consist at first of liquid, unstimulating food, given in small quantities and frequently. If the baby does not nurse, the liquids should be restricted. Some women on the first day can take milk, milk toast, or if desired, dry or buttered toa... Difficult Breathing
This usually comes late in pregnancy and is due to the pressure of the womb upon the diaphragm; the patient should avoid excitement and sleep with the shoulders well elevated. In the ninth month the womb drops lower and the breathing is better. ... Disorders of Pregnancy
Nausea and vomiting. The simple nausea and vomiting of pregnancy needs no treatment. This kind generally disappears by the third or fourth month, but it may persist in a mild form during the greater part of pregnancy. Generally the regulation of the die... Duration of Pregnancy
This is for all practical purposes two hundred and eighty days. ... Examination of the Patient
The physician needs to satisfy himself as to the position of the child, etc. This can be done by an examination of the abdomen and also of the vagina. He must determine whether the child is alive, its position, the condition of the cervix and mouth of t... Exercise, Rest and Sleep
Plenty of exercise in the open air should be taken daily, without this health cannot be maintained. It should not be violent or so great as to fatigue and overtire. Slow riding in a carriage and walking will give the best results. Horseback riding and r... Food
The food of the pregnant woman should be simple, wholesome, nutritious, of the kind that is easily digested and enough to satisfy the demands of her system; excessive eating should be avoided. A mixed diet is to be preferred, but the diet should be of s... How to Determine Date of Confinement
The best rule is to count backward three months from the first day of the last menstrual period and add seven days to it. To be more accurate, in April and September only six days should be added; in December and January, five days; and in February, fou... Hygiene of pregnancy
In pregnancy the dividing line between health and disease is often so shadowy that every care should be given the pregnant woman, not only that she shall escape dangers that may come, but that the future health of the coming baby may be safeguarded. ... Indigestion and Heart-burn
This should be treated the same as under other conditions. Diet, habits, should be regulated. The bowels and kidneys should be regulated and do their eliminating work. For heart-burn the popular remedy, magnesia may be taken or dilute hydrochloric acid ... Inevitable Abortion
The abortion is probably inevitable if the bleeding becomes persistent and free, the cervix softens, the womb dilates and the labor pains set in. Still in spite of all these conditions, the bleeding and pain may cease, and the pregnancy go on to full te... INFLAMMATION OF THE BREAST, Abscess; Broken Breast
This usually results from germs. The breast inflames, the milk tubes are choked and distended, there may be fever. There is sometimes severe local pain, hard swelling and an abscess forms and if this breaks it is called broken breast. Treatment, P... Labor
Labor may be defined as the physiological termination of pregnancy whereby the mature foetus (child) and its appendages (after-birth, etc.), are separated from the maternal organism. ... MANAGEMENT OF LABOR
Preparation of the Bed. The bed should be high, springs not soft, with a firm and smooth mattress. It should be placed so that both sides are accessible. The bed should be made up on the right side as a rule, as the woman usually lies on her left side w... Management of the Second Stage
After the rupture of the membranes the labor proceeds faster and a termination may be expected within a reasonable time. There is a short lull in the pains, usually, after the waters have escaped and during this time the patient should remove her cloth... MILK LEG
This is due to infection. It usually arises from an extension of a blood clot (thrombosis) of the womb or pelvic veins, to the thigh (femoral) vein, resulting in a partial or complete obstruction of the vein. It may come in less frequent cases, from a l... MOTHERS' REMEDIES
1. Pregnancy, A Great Aid for. "Soothing syrup or Mother's friend, while pregnant. Two ounces each of cramp bark, blue cohosh, slippery elm, raspberry leaves, squaw vine, orange peel and bitter root. Simmer gently in sufficient water to keep herbs cover... Nausea and Vomiting
Another symptom upon which considerable dependence is placed is the morning sickness (nausea and vomiting). While this symptom is common, yet its absence does not prove that the woman is not pregnant. Some women go through the whole pregnancy without an... Nervous System
The nervous system is over sensitive and the disposition of the woman may undergo a radical change, mental exaltation and depression are often exhibited. ... Nervous System and the Mind
The pregnant woman is very susceptible to annoying conditions of the social and domestic surroundings; such should be removed, if possible, and excitement of every kind should be avoided. Everything should be made bright and comfortable around her, chee... OBSTETRICS OR MIDWIFERY
Small bodies are contained in the ovaries. These are called eggs or ova. The human egg is about 1/125 of an inch in diameter. This egg enlarges and one or more escape from the ovaries, usually about the time of the monthly sickness, and are caught b... Pelvic Signs
As early as the first month of pregnancy a faint violet color of the anterior wall of the vagina just below the opening of the urethra may be distinguished. In the third month this color has become purplish and pronounced. This sign is present in eighty... Pigmentation
Pigmentation or darkening of the middle line of the abdomen begins by the eighth or twelfth week, and a dark band about 1/8 of an inch wide extends from the pubis (bone) to and around the navel or even higher. This shows plainer in brunettes, where it i... Piles
When these are troublesome the rectum should be emptied by a small dose of salts, and the parts thoroughly washed with warm water, the piles pushed back and local lotions applied (see treatment of piles). Hot fomentations of witch-hazel frequently give ... Placenta Praevia
The after-birth is placed in the lower part of the womb; (after-birth before the child). This is a dangerous condition and terrible bleeding may occur. It occurs about one time out of every one thousand. The main symptom is bleeding and this may occur a... Position of the Womb
At four months the top of the womb has risen above the pelvic brim bone in front; at five months, it is midway between the bone (pubic) and the navel; at six months, it is at the navel; at seven months, it is four fingers breadths above the navel; at ei... Premonitory Signs of Labor
Premonitory signs of labor, usually observed from one to two weeks before the onset of the labor pains, is a sinking down of the womb in the abdomen, whereby some of the unpleasant features of pregnancy are relieved, and the so-called "lightening" takes... Pulse and Temperature
The temperature may rise one to one and one-half degrees without the case being abnormal. The pulse falls after labor, ranging between sixty and seventy. A rise of temperature, a rapid pulse, a flushed face, a chill, pain or tenderness of the abdomen, a... Quickening
This is caused by the movement of the child (foetus) in the womb. The impact of the enlarging womb, through the child (foetal) movements, against the abdominal wall about the sixteenth week of pregnancy gives rise to this sensation called quickening. So... Rest
Complete rest of the body and mind is essential to the well being of the lying-in woman. She is better off without any company, and should see no one except her family for the first week or two. Outside visitors should be prohibited. The lying-in room s... Second Stage
The pains now become more frequent and severe and last longer, and the patient now manifests a strong desire to expel the contents of the womb. The woman now feels better in bed and when the pains come she involuntarily bears down, with each contraction... Sex
Children from the same ovum (egg) are always of the same sex. Of twins in general, more than one-third are males, less than one-third are females, and in the remaining one-third both sexes occur. The after-birth is always, at least at first, double. ... STAGES OF LABOR
First stage extends from the beginning of labor until the mouth of the womb is dilated. Second stage, from the complete dilation until the complete birth of the child. Third stage, from the birth of the child until the expulsions of the after-birth--Pla... Teeth
The teeth are often affected during pregnancy, softening and decaying rapidly, causing severe neuralgia. The teeth should be cleaned frequently during the day to get rid of the secretions of the mouth, and at night before retiring. Milk of magnesia shou... THE BLADDER
If the patient is not able to pass urine it should be drawn once in eight or twelve hours or oftener if required. A No.7 rubber catheter is best. After it has been used, it should be sterilized by boiling and then kept in a bichloride solution (1-2000).... The Blood
The blood is increased in quantity and slightly altered in its composition. The water, fibrin and white corpuscles are increased; the red cells are at first relatively diminished, but later return to normal. ... THE BOWELS
There should be a movement of the bowels the second or third day, and a soap and water enema containing a small teaspoonful of spirits of turpentine and one-half ounce of glycerin, will usually be sufficient. Later cascara cordial, castor oil, etc., may... The Breast and Nipples
These should be bathed once or twice daily in cool or tepid water until the last month or two of pregnancy. Astringent application should not be applied to the nipples to harden them. If the nipples are small, undeveloped or retracted they should be pul... THE CHILD
The eyes should be washed soon and normal respiration established. If the child does not breathe well, cold water may be sprinkled in the face and chest and if this fails, immersions in hot water at 106 degrees F., and sprinkling with cold water mus... The First Stage
The first stage varies greatly in different women. The average duration of this stage is from ten to fourteen hours in the woman with the first child, and six to eight hours in the woman who has borne children. During this stage the woman prefers to rem... The Foetal Heart-beat
This is the one positive sign of pregnancy and it may be heard as early as the sixteenth to the twentieth week. It has been compared to the ticking of a watch under a pillow. It ranges in frequency from one hundred and ten to one hundred and fifty to a ... The Lochia
By this term is meant the discharges from the womb and soft parts after labor. They are mixed with blood at first and contain dark clots, mucus, shreds of the after-birth and pieces of the membrane. They become paler in color from the end of the third t... The Vagina
When there is a profuse discharge of leucorrhea, a daily vaginal douche is necessary. This should consist of a quart of warm solution (as much as the water will dissolve) of boric acid, or an equal amount of mild carbolic acid (one to eighty). The tempe... Third Stage
The birth of the head is very soon followed by the shoulders and the rest of the body, and the woman is now at comparative rest. The cord is now tied and cut and the child laid away, if all right, in a warm place until it can be washed and dressed. Foll... Threatened Abortion
If a bleeding takes place in the woman who is pregnant, abortion may be assumed to threaten; a careful examination will usually settle this matter. ... Treatment
Regulation of the diet; in pronounced cases the diet should consist entirely of milk and the patient should take three or four quarts in twenty-four hours. Meats, pastry and sweets must be prohibited, but vegetables such as squash, spinach, salads may b... Treatment of the Inevitable Abortion
If the cervix is hard and the canal is not dilated, especially if the bleeding is free, the vagina should be packed full at once, if possible, with iodoform gauze. Rolls five yards long and two inches wide can be bought perfectly adapted to this purpose... Treatment of Threatened Abortion
The patient should go to bed, lie down and remain there, and if possible be not only quiet physically, but also quiet mentally. The main remedy is opium, and if necessary to obtain a quick action it can be given hypodermically in the form of morphine. ... Varicose Veins and Piles
Varicose veins: These are due to the pressure on the veins so that the return flow of blood is impeded and occur as a rule late in pregnancy. They are seen oftenest on the inner side of the thighs, the lower extremities, the vulva, and in the region of ...