The Eugenic Marriage, Volume I. (of IV.)
W >> W. Grant Hague, M.D. >> The Eugenic Marriage, Volume I. (of IV.)[75]
CHAPTER VII
THE HYGIENE OF PREGNANCY.
DAILY CONDUCT OF THE PREGNANT WOMAN--INSTRUCTIONS REGARDING HOUSEHOLD
WORK--INSTRUCTIONS REGARDING WASHING AND SWEEPING--INSTRUCTIONS
REGARDING EXERCISE--INSTRUCTIONS REGARDING PASSIVE
EXERCISE--INSTRUCTIONS REGARDING TOILET PRIVILEGES---INSTRUCTIONS
REGARDING BATHING--INSTRUCTIONS REGARDING SEXUAL INTERCOURSE--CLOTHING
DURING PREGNANCY--DIET OF PREGNANT WOMEN--ALCOHOLIC DRINKS DURING
PREGNANCY--THE MENTAL STATE OF THE PREGNANT WOMAN--THE SOCIAL SIDE OF
PREGNANCY--MINOR AILMENTS OF PREGNANCY--MORNING NAUSEA, OR
SICKNESS--TREATMENT OF MORNING NAUSEA, OR SICKNESS--NAUSEA OCCURRING AT
THE END OF PREGNANCY--UNDUE NERVOUSNESS DURING PREGNANCY--THE 100 PER
CENT. BABY--HEADACHE--ACIDITY OF THE STOMACH, OR
HEARTBURN--CONSTIPATION--VARICOSE VEINS, CRAMPS,
NEURALGIAS--INSOMNIA--TREATMENT OF INSOMNIA--PTYALISM, OR EXCESSIVE
FLOW OF SALIVA--VAGINAL DISCHARGE, OR LEUCORRHEA--IMPORTANCE OF TESTING
URINE DURING PREGNANCY--ATTENTION TO NIPPLES AND BREASTS--THE VAGARIES
OF PREGNANCY--CONTACT WITH INFECTIOUS DISEASES--AVOIDANCE OF DRUGS--THE
DANGER SIGNALS OF PREGNANCY.
CONDUCT OF THE PREGNANT WOMAN
The young wife will arrange her daily routine according to the physician's
instructions, which, by the way, she should faithfully carry out. If you
are one of the fortunate many who enjoy reasonably good health, you have
doubtless been told to follow a plan very similar to the one we shall now
briefly outline.
For the first six months she can safely continue to do her household work.
It is to her advantage to do so for many reasons, but especially because it
helps to keep her physically in good condition, and because it keeps her
mind engaged, thus avoiding a tendency to nervous worry. After the sixth
month it is desirable to give up the heavier part of the work. Washing and
sweeping should be absolutely prohibited. Moving furniture or heavy trunks
must not be done by the prospective mother, but all light work can and [76]
should be indulged in to the very end. Find time to spend at least one hour
and a half in the open air every day. Unless there is a medical reason
against active exercise there is nothing so beneficial to the pregnant
woman as walking, nor is there any substitute for it. A drive or motor ride
into the country, or a car ride around town, is an excellent device against
ennui and is highly desirable during this time, but not as a substitute for
the daily long walk. A pregnant woman must keep her muscles strong and in
good tone if she hopes to do her share toward having a short and easy
confinement. She must keep active to ensure perfect action of all her
organs--the stomach must digest; the bowels and kidneys must act perfectly;
the heart, and lungs, and nerves must be supplied with good blood and fresh
air; the appetite must be keen, and the sleep sound. Walking in the open
air will do all this and nothing else can, to the same satisfactory degree.
Light passive exercise at home is desirable to those very few who cannot
walk in the open air, but at best it is a poor substitute. It is necessary
to avoid any exercise or any labor of the following character from the very
beginning of pregnancy: stretching, lifting, jarring, jumping, the use of
the sewing machine, bicycling, riding, and dancing.
She should continue to employ the same toilet privileges she has been
accustomed to except the use of the vaginal douche, which must be stopped
from the date of the first missed menstrual period. This is the only safe
rule to follow and no exception should be made to it except upon the advice
of a physician.
Bathing during the entire course of pregnancy is a highly necessary duty.
It is particularly advantageous during the later months because it relieves
the kidneys at a time when they are called upon to perform an excess of
work. The temperature of the bath should be warm and rapidly cooled at the
finish. Brisk rubbing with a course towel will ensure the proper reaction.
Sexual intercourse must be restricted during pregnancy; and it should be
wholly abstained from during what would have been the regular menstrual
periods, if pregnancy had not occurred, for the reason that abortion is[77]
apt to take place. It is most harmful during the early and late months of
pregnancy. Sexual intercourse is distasteful to most and harmful to every
pregnant woman.
CLOTHING DURING PREGNANCY.--The clothing should be so constructed as to
relieve any undue pressure on the breasts or abdomen. For this reason it
should be suspended from the shoulder. When it is appreciated that clothing
supported by the waist crowds the growing womb, and exerts pressure upon
the kidneys, and is responsible for many of the kidney complications that
occur during pregnancy, no further reason need be given for discarding all
clothing, except very light garments, that are not held by some device
whose support is from the shoulders. A specially constructed linen waist is
made and sold for this purpose. It is fashioned so that all the lower
garments and the garters can be fastened to, and supported by it. Corsets
should be absolutely discarded from the very first day of pregnancy.
In a large woman with a lax abdomen, a properly made abdominal support will
not only be a great comfort but of real advantage. It should exert a
support upward by lifting the abdomen, not by constricting it. It should
therefore be obtained from a reliable dealer and be made and applied to
effect the above object,--otherwise it may do more harm than good.
DIET OF PREGNANT WOMEN.--Some degree of digestive disturbance and loss of
appetite is the rule early in pregnancy. By the fourth month these
conditions invariably cease, and the appetite and the ability to digest
will greatly improve. The diet from the very beginning of pregnancy should
be plain and easily digested. It is not possible to formulate an absolute
table of what or what not to eat, as the same foods do not agree equally
well with all patients. The individual taste should be catered to within,
reason, and the meals should be taken at regular intervals. Articles of
diet that experience shows do not agree with the patient should be rigidly
excluded from the menu. A varied diet of nutritious character is essential
during pregnancy in order to ensure good blood, health, and strength. A
monotonous diet, or a diet composed largely of stale tea, coffee, and [78]
cake, is not permissible, and may do untold harm. Pastries and desserts of
all kinds should be excluded. In the later weeks of pregnancy, because of
the large size of the womb, the diet should be cut down as the stomach is
interfered with in the process of digestion. Should the patient at any time
during pregnancy experience a loss of appetite, or an actual disgust for
food as sometimes occurs, it is preferable to suggest a change of scene and
surroundings rather than the use of medicine. A short vacation, a change of
table, new scenery, will promptly effect a cure. This condition is mental
rather than physical; the patient allows herself to become introspective;
the daily routine becomes monotonous and stale; hence a change of a few
days will be all that is necessary. If it is not possible for the patient
to obtain a change of scene, a complete change of diet for a few days will
often tide over the difficulty. We have known patients to take kindly to an
exclusive diet of kumyss, or matzoon, or predigested foods, with stale
toast or zwieback, to which can be added stewed fruits. Alcoholic drinks
should be left out entirely.
THE MENTAL STATE OF THE PREGNANT WOMAN.--The coming baby should be the text
of many interesting, spontaneous talks between the young couple from the
time when it is first known that a new member of the family is on its way.
The husband should feel that he is a party to the successful consummation
of the little one's journey. He can contribute enormously to this end. It
should be his duty, born of a sincere affection and love, to formulate the
programme of events which has for its main object the wife's entire mental
environment. He should encourage her to live up to the physician's
instructions, and arrange details so that she will obtain the proper
exercise daily. He should read to her in the evening, and arrange his own
business affairs so that he will be with her as much as is possible. In
many little ways he can impress upon her the fact that they both owe
something to the unborn babe and that each must sacrifice self in its
behalf. His principal aim, of course, will be that she will not worry or
have cause to worry. He will so direct her mental attitude that she will
dwell only upon the bright side of the picture; she will thus strive to[79]
realize the hope that the baby will be strong and healthy, and she will,
prompted by his encouragement and devotion, try to do her duty faithfully.
Working together in this way, much can be done that means far more than we
know of, and in the end the little one comes into the world a welcome baby,
created in love and born into the joy of a happy, harmonious, contented
home.
THE SOCIAL SIDE OF PREGNANCY.--The social side of the question should not
be overlooked or neglected at this time. Here again the imperative
necessity arises to warn the young wife against certain individuals who
seem to have a predilection toward recounting all the terrible experiences
they have heard regarding confinements. It is astonishing to learn how
diversified a knowledge some women burden themselves with in this
connection. They can recount case after case, with the harrowing details of
a well-told tale, and seem to delight in so doing. Every physician has met
these women. The young wife must not permit or encourage any reference to
her condition. Simply refusing to discuss the question is the only sure
method of preventing its discussion. She will find among her friends a few
who have her best interests at heart, and these few will strive sincerely
to be of real usefulness to her. If she will keep in mind that the most
important element in the success of the whole period, and consequently the
degree of her own health, happiness, and comfort, as well as that of her
unborn baby, is the character of her own thoughts from day to day, and
month to month, she will be complete master of the situation. By constantly
dwelling on happy thoughts, reading encouraging and inspiring books,
admiring and studying good pictures, working with cheerful colors in sunny
rooms, exercising, dieting, and sleeping in a well-aired room, she will
have no cause to regret her share in the task before her, or the kind of
baby she will bring into the world.
MINOR AILMENTS OF PREGNANCY.--There are certain minor ailments which it
would be well to be familiar with lest a little worry should creep into the
picture.
Maternity is not only a natural physiological function, but it is a [80]
desirable experience for every woman to go through. The parts which
participate in this duty have been for years preparing themselves for it.
Each month a train of congestive symptoms have taxed their working
strength; pregnancy is therefore a period of rest and recuperation,--a
physiological episode in the life history of these parts. 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. Find out, therefore, wherein
you are at fault, rectify it, and it will promptly disappear.
MORNING NAUSEA OR SICKNESS.--So-called morning nausea or sickness is very
frequently an annoying symptom. It is present as a rule during the first
two or three months of pregnancy. How is it produced and how can it be
remedied?
It is produced most frequently by errors in diet. It may be caused by an
unnatural position of the womb or uterus, by nervousness, constipation, or
by too much exercise or too little exercise. The physician should be
consulted as soon as it is observed to be a regular occurrence. He will
eliminate by examination any anatomical condition which might cause it; or
will successfully correct any defect found. When the cause is defined his
instructions will help you to avoid any error of diet, constipation, or
exercise. Many cases will respond to a simple remedy,--a cup of coffee,
without milk, taken in bed as soon as awake will often cure the nausea. The
coffee must be taken while still lying down,--before you sit up in bed. If
coffee is not agreeable any hot liquid, tea, beef tea, clam bouillon, or
chicken broth, or hot water may answer the purpose, though black coffee,
made fresh, seems to be the most successful. Ten drops of adrenalin three
times daily is a very certain remedy in some cases, though this should be
taken with your physician's permission only. If the nausea occurs during
the day and is accompanied with a feeling of faintness, take twenty drops
of aromatic spirits of ammonia in a half glass of plain water or Vichy
water. Sometimes the nausea is caused by the gradual increase of the [81]
womb itself. This is not usually of a persistent character and disappears
as soon as the womb rises in the abdominal cavity at the end of the second
month.
Nausea frequently does not occur until toward the end of pregnancy. In
these cases the cause is quite different. Because of the size of the womb
at this time the element of compression becomes an important consideration.
The function of the kidneys, bowels, bladder, and respiration may be more
or less interfered with, and it may be desirable to use a properly
constructed abdominal support, or maternity corset. These devices support
and distribute the weight, and prevent the womb from resting on or
compressing, and hence interfering with, the function of any one organ. If
the womb sags to one side, thereby retarding the return circulation of the
blood in the veins from the leg, it may cause cramps in the leg, especially
at night, or it may cause varicose veins, or a temporary dropsy. The
correct support will prevent these troublesome annoyances; a properly
constructed maternity corset is often quite effective. The diet should
receive some special attention when these conditions exist. Any article of
diet which favors fermentation (collection of gas) in the stomach or bowel
should be excluded. These articles are the sugars, starches, and fats. It
can readily be understood that if the bowels should be more or less filled
with gas, or if they should be constipated, it will cause, not only great
distress, but actual pain. Regulation of the diet, therefore, and exercise
(walking best of all) will contribute greatly to the avoidance of these
unnecessary sequelae.
It must be kept in mind that the entire apparatus of the body is
accommodating a changed condition, and though that condition is a natural
one, it requires perfect health for its successful accomplishment. This
means a perfect physical and mental condition,--a condition that is
dependent upon good digestion, good muscles, healthy nerves, clean bowels,
and so on. The slightest deviation from absolute health tends to change the
character of the body excretions, the quality of the blood, etc. If the
excretions are not properly eliminated, the blood becomes impure, and so we
sometimes get itching of the body surfaces, especially of the abdomen [82]
and genitals; neuralgias, especially of the exposed nerves of the face and
head; insomnia and nervousness. These are all amenable to cure, which again
means, as a rule, correct diet and proper exercise as the principal
remedial agencies.
UNDUE NERVOUSNESS DURING PREGNANCY.--This is very largely a matter of will
power. Some women simply will not exert any effort in their own behalf.
They are perverse, obstinate, and unreasonable. The measures which
ordinarily effect a cure, they refuse to employ. It is useless to argue
with them; drugs should never be employed; censure and affection are
apparently wasted on them; they cannot even be shamed into obedience. The
maternal duty they owe to the unborn child does not seem to appeal to them.
We do not know of any way to handle these women and to our mind they are
wholly unfit to bring children into the world. Fortunately these women are
few in number. The maternal instinct will, and does, guide most women into
making sincere efforts to restrain any undue nervous tendency, and to be
obedient and willing to follow instructions. There is nothing so beneficial
in these cases as an absolutely regulated, congenial, daily routine, so
diversified as to occupy their whole time and thought to the exclusion of
any introspective possibility. Frequent short changes to the country or
seashore to break the monotony, give good results in most of these cases.
The domestic atmosphere must also be congenial and the husband should
appreciate his responsibility in this respect.
Women of this type should have their attention drawn to the following facts
in this connection: While the most recent investigations of heredity prove
that a woman cannot affect the potential possibilities of her child, she
can seriously affect its physical vitality. The following illustration may
render our meaning clear: suppose your child had the inborn qualities
necessary to attain a 100 per cent. record of achievement in the struggle
of life; anything you may or may not do cannot affect these qualities--the
child will still have the ability to achieve 100 per cent. Inasmuch,
however, as a mother can affect the health or physical qualities of her[83]
child she is directly responsible, through her conduct, as to whether her
child will ever attain the 100 per cent. record, or if it does, she is
responsible for the character of its comfort, its health, its enjoyment,
all through its life's struggle toward the 100 per cent. achievement
record. She may so compromise its physical efficiency that it will succumb
to disease as a consequence of the ill health with which its mother
unjustly endowed it, even though it possess the ability to attain the 100
per cent. if it lived.
We often see brilliant children who are nervous and physically unfit, and
we see others of more ordinary mental achievement who are healthy and
robust animals. The one is the offspring of parents possessing unusual
mental qualities but who are physically unable or unwilling to render
justice to their progeny; the other parents may be less gifted mentally,
but they are healthy and they are willing to give their best in conduct and
in blood to their babies. Many of these brilliant children never achieve
their potential greatness because they fall by the wayside owing to
physical inability, while the healthy little animals achieve a greater
degree of success because of the physical vitality which carries them
through. To achieve a moderate success and enjoy good health is a better
eugenic ideal than the promise of a possible genius never attained because
of continuous physical inefficiency.
The nervous and willful mother should therefore consider how much depends
upon her conduct. It cannot be too frequently reiterated and emphasized
that every mother should do her utmost to guard and retain her good health.
Good health means blood of the best quality and this is essential to the
nourishment of the child. To keep in good health does not mean to obey in
one respect and fail in other essentials. It means that you must obey every
rule laid down by your physician, willingly and freely in your own interest
and in the interest of your unborn babe. In no other way may you hope to
creditably carry out the eugenic ideal that "the fit only shall be born."
HEADACHE.--This is a symptom of great importance. If it occurs [84]
frequently, without apparent cause, the physician should be consulted at
once, as it may indicate a diseased condition of the kidneys, and
necessitate immediate treatment. Headaches may, of course, be caused in
many ways and most frequently they do not have any serious significance,
but they must always be brought to the attention of the physician. As a
rule they are caused by errors of diet,--too much sugar, candy, for
instance, late and indigestible suppers, indiscriminate eating of rich
edibles, etc.,--or they may be products of nervous excitement (too little
rest), as shopping expeditions, strenuous social engagements, late hours,
etc.
ACIDITY OF THE STOMACH, AND SO-CALLED HEARTBURN.--These are sometimes in
the early months of pregnancy annoying troubles. The following simple means
will relieve temporarily: A half-teaspoonful of bicarbonate of soda or
baking soda in a glass of water or Vichy water; or a half teaspoonful of
aromatic spirits of ammonia in Vichy, or plain water; or a tablespoonful of
pure glycerine. The best remedy is one tablespoonful of Philip's Milk of
Magnesia taken every night for some time just before retiring.
Heartburn is the result of eating improper food, or a failure to digest the
food taken. Starchy foods should be avoided. Meats and fats should be taken
sparingly. Avoid also the et ceteras of the table, as pickles, sauces,
relishes, gravies, mustard, vinegar, etc. Good results follow dry
meals,--meals taken without liquids of any kind. Live on a simple, easily
digested, properly cooked diet. Chew the food thoroughly, take plenty of
time and be cheerful.
CONSTIPATION DURING PREGNANCY.--Most women are as a rule more or less
constipated during pregnancy. It is caused by failure to take the proper
amount of outdoor exercise, to take enough water daily, to live on the
proper diet, to live hygienically, or because of wrong methods of dress. It
is most important that the bowels should move thoroughly every day.
Pregnancy no doubt aggravates constipation by diminishing intestinal
activity. Consequently there is a greater need for activity on the part of
the woman, and open air exercise is the best way to accomplish this. [85]
She should eat fruits, fresh vegetables, brown or Graham bread, or bran
muffins, figs, stewed prunes, and any article of diet which she knows from
experience works upon her bowel. She should drink water freely; a glass of
hot water sipped slowly on arising every morning or one-half hour before
meals, is good. Mineral waters, Pluto, Apenta, Hunyadi, or one teaspoonful
of sodium phosphate, or the same quantity of imported Carlsbad salts in a
glass of hot water one-half hour before breakfast, answers admirably. If
the salts cannot be taken a three- or five-grain, chocolate-coated, cascara
sagrada tablet, may be taken before retiring, but other cathartics should
not be taken unless the physician prescribes them. Rectal injections should
be avoided as a cure of constipation during pregnancy. They are very apt to
irritate the womb and if taken at a time when the child is active, they may
annoy it enough to cause violent movement on its part, and these movements
may cause a miscarriage. See article on "Constipation in Women."
VARICOSE VEINS, CRAMPS, AND NEURALGIA OF THE LIMBS.--When cramps or painful
neuralgia occur repeatedly in one or both legs, some remedial measures
should be tried. Inasmuch as the cause of this condition is a mechanical
one, it would suggest a mechanical remedy. The baby habitually seeks for
the most comfortable position, and having found it stays there until
conditions render it uncomfortable. He does not consult you in the matter,
but he may be subjecting you to untold misery and pain. The child may rest
on the mother's nerves or blood-vessels as they enter her body from her
lower limbs. If the pressure is sufficient, it can interfere quite
seriously with the return blood supply, because veins which carry back to
the heart the venous or used blood, are vessels with thin, soft,
compressible walls, while arteries which carry blood away from the heart
cannot be compressed easily, because their walls are hard and tense. The
condition therefore is that more blood is being sent into the limb than is
being allowed to return; in this way are produced varicose veins. If these
varicose veins burst or rupture we have ulcers, which may quickly heal,[86]
or they may refuse to heal, and become chronic. A dropsical condition of
the leg may follow, and because of interference with the circulation of the
blood we get cramps and neuralgias. How can we remedy this painful
condition?
Sometimes we don't succeed, but at least we can try. So long as the cause
exists, it is self-evident that rubbing the limb with any external
application, will not give any permanent relief, though it is well to try.
When rubbing, to relieve cramps at night, always rub upward. It is not a
condition that calls for medicine of any kind, while hot baths and hot
applications will only make the trouble worse. The remedy that promises the
quickest and longest relief is for the patient to assume the knee-chest
position for fifteen minutes, three times a day, till relief is permanently
established. The patient rests on her knees in bed, and bends forward until
her chest rests on the bed also. The incline of the body in this position
is reversed; hips are highest, the head lowest. The baby will seek a more
comfortable position and this new position may relieve the pressure and
cure the condition. Doing this three times daily for fifteen minutes gives
relief to the leg by reestablishing a normal blood circulation, and very
soon the baby finds a new position that does not interfere with its
mother's blood supply, and the cramps, and neuralgia and dropsy, and maybe
the varicose veins will soon show improvement. Wearing the proper kind of
abdominal support may help, as explained on page 77. If the varicose veins
are bad, it is desirable to wear silk rubber stockings or to bandage the
limbs.