<h2><SPAN name="LESSON_IV" id="LESSON_IV"></SPAN><span class="lght">LESSON IV</span><br/> GESTATION OR PREGNANCY</h2>
<p>Gestation is "the act of carrying young in the Uterus,
from the time of conception to that of parturition." Conception
occurs at the moment of the impregnation of the
ovum; parturition is the act of delivery, or childbirth.
Pregnancy is "the state of being with child." The terms
"period of gestation," and "period of pregnancy,"
respectively, are employed by medical authorities to
designate the time during which the mother carries the
young within her own body—from the moment of the
impregnation of the ovum until the moment of the final
delivery of the child into the outer world.</p>
<p>The term of pregnancy in woman continues for over
nine calendar months (or ten lunar months)—from about
275 to 280 days, though in exceptional cases it may be
terminated in seven calendar months, or on the other hand
may continue for ten calendar months. The usual method
is to figure 280 days from the <b>first day</b> of the <b>last menstruation</b>.
A simple method of calculating the probable
date of delivery is as follows: <b>Count back three months,
and then add seven days, and you will have the date of
probable delivery.</b> Example: A woman's <b>first day of last
menstruation</b> is March 28. Counting back three months
gives us December 28; and adding seven days to this
gives us January 4, as the date of probable delivery. There
will always be a possible margin of a few days before or
after the ascertained probable date—but the delivery will
very closely approximate said date. Ignore the shortage
of days of February in this calculation, the same being
covered by the general margin allowed.</p>
<p><b>Development of the Impregnated Ovum.</b> In the preceding
<span class="pagenum"><SPAN name="Page_34" id="Page_34">{34}</SPAN></span>lesson we terminated our consideration of the impregnated
ovum at the point at which, after the process of
segmentation, the "primitive trace" had appeared. This
primitive trace appears as an opaque streak, or straight
line, formed of an aggregation of cells of a distinctive
quality. This delicate "trace" or "streak" is the first
indication of the form of the coming child. It is the basis,
pattern, or mould, in or around which the spinal column
is to be formed, and around which the entire young body
is to be developed by the wonderful and intricate processes
of dividing and reduplication, and the folding and
combination of cells. From one end of this "trace"
develops the head; from the other end develops the lower
end of the spine. At a later stage there appear tiny
"buds" in the positions at which the arms and legs should
be; these gradually develop, and their ends split into
tiny fingers and toes, and finally are transformed into
perfect little arms and legs, miniatures of those of the
adult human being.</p>
<p>The term "the embryo" is employed to designate the
developing young creature in the earlier stages of its
development, particularly before the end of the third
month of its existence. After the end of the third month
the embryo is called "the fetus." In the short space of
280 days the young creature evolves and develops from a
single simple cell into a complex organism—a perfect
miniature human being. Nature works a wonderful
miracle here, and yet so common is it that we take it all as
a matter of course, and lose sight of the miracle. From
the most simple forms are formed in the developing
creature the most complex organs and parts. The heart
is formed from a tiny straight line of cells, by enlargement
and partition. The stomach and intestines, likewise,
develop from a tiny straight line of cells arranged as a
tiny tube—the stomach is formed by dilation of one part<span class="pagenum"><SPAN name="Page_35" id="Page_35">{35}</SPAN></span>
of the tube, while the large intestine experiences a similar
though lesser distention and a greater growth in length;
the smaller intestines being formed by growth in length
and circumference. The other organs evolve from similar
simple beginnings.</p>
<p>The embryo is nourished during its earlier stages by
means of the "yolk sack," or "umbilical vesicle," which
is outside the body of the embryo, being joined to it by
means of the umbilical duct. This yolk sack (originally
formed by a "drawing together" in the ovum, which thus
separates itself into two portions or areas) is an important
feature of the life of the embryo, as it nourishes and
sustains it in its earlier stages. Blood vessels form in this
yolk sack, and after a time its fluid is absorbed, and after
the third month the sack gradually disappears.</p>
<p>After the passing away of the yolk sack, the embryo
is nourished and sustained by the "allantois," another
peculiar sack which is formed. This sack readily becomes
filled with blood-vessels, and serves to nourish the embryo
by sustenance obtained from the body of the mother
through the walls of the Uterus, a direct communication
with the blood-vessels of the mother thus being secured.
The blood in the embryo, and that in the mother, come
into close contact, thus allowing the embryo to be nourished
by the blood of the mother. After a time, in turn,
the allantois diminishes and dwindles away, its offices
being taken up and performed by the "placenta" or
"afterbirth."</p>
<p><b>The Placenta or Afterbirth.</b> The Placenta, or afterbirth,
is a round, flat substance or organ, contained within
the Uterus, by which communication and connection is
established and maintained between the fetus and the
mother, by means of the umbillical cord. It is a flat, circular
mass, about seven inches in diameter, and weighing
about sixteen ounces. It is attached to the sides of the<span class="pagenum"><SPAN name="Page_36" id="Page_36">{36}</SPAN></span>
Uterus of the mother during the period of gestation, and is
expelled from the body of the mother, as "the afterbirth,"
after the birth of the child.</p>
<p>Let us pause a moment, and reconsider the several
steps in Nature's plan for nourishing the embryo and
fetus. In the first place, as we have seen, there is the yolk
sack or umbillical vesicle, filled with a fluid which nourishes
the embryo. This gradually disappears in time, and
is replaced by the "allantois" which by connection with
the walls of the Uterus is enabled to nourish the fetus
from and by the blood of the mother. For a short time,
however, the embryo is nourished by both the yolk sack
and the allantois. Then the allantois assumes the entire
task, and the yolk sack passes away. Then, later, the
placenta replaces the allantois, and the latter passes away
as did its predecessor. The placenta works along the same
general lines as the allantois, but is a far more complex
way and with a much higher degree of efficiency, as we
shall see presently.</p>
<p>The placenta is connected with the body of the fetus
by what is known as "the umbillical cord." The
"umbillicus" or "navel" in the human being marks the
place at which the umbillical cord entered the body of
the fetus, from which it was severed after the birth of
the child. The purpose of the umbillical cord is to contain
and support the umbillical arteries and veins through
which the fetus obtains nourishment from the placental
substance, and through which the return blood flows. The
rich red arterial blood is carried from the placenta to the
fetus, and is then distributed over the body of the fetus,
nourishing and building it up; the dark venous blood,
laden with the waste products of the body of the fetus, is
carried back to the placenta, there to be repurified and
rendered again rich and nourishing.</p>
<p>The story of the circulation of the blood of the fetus<span class="pagenum"><SPAN name="Page_37" id="Page_37">{37}</SPAN></span>
is most interesting. Although the fetal blood is derived
from that of the mother, as we have said, yet the maternal
blood does not pass directly from the circulatory system
of the mother into that of the fetus; nor does the blood
of the fetus return directly into the circulatory system of
the mother. In fact, the fetal blood never comes in direct
contact with that of the mother, or vice versa. The fetus
has an independent circulatory system of its own, and
yet, at the same time, from the moment of the placental
connection until the moment of childbirth, all its nourishment
is derived from its mother.</p>
<p>The secret of the above paradoxical statement is made
apparent when we understand the meaning of the scientific
term "osmosis." Osmosis is "the passage of a fluid
through a membrane"; it is a chemical process, caused by
the chemical affinity between two liquids or gases
separated one from the other by a porous diaphragm or
substance. In the process of osmosis in the case before
us, the fetal blood takes up nourishing substances and
oxygen from the blood of the mother, and passes on to
the latter the waste products of the fetal system, by
means of passing these substances through the thin porous
membranes which separate the two independent systems
of blood vessels, i. e., the system of the fetus, and that of
the mother. Before birth, in fact, the fetus has its blood
nourished and oxygenated by means of the food partaken
of by its mother, and the oxygen taken in by the mother
in her breathing. After its birth, the infant eats and
breathes for itself, and thus nourishes its blood supply
directly, instead of receiving it indirectly from the
mother.</p>
<p>The Placenta begins to be formed about the third
month of gestation, and continues to develop steadily
from that time. At the time of the delivery of the child
the Placenta covers nearly or quite one-third of the inner<span class="pagenum"><SPAN name="Page_38" id="Page_38">{38}</SPAN></span>
space of the distended Uterus of the mother. The total
"afterbirth" consists of the Placenta, the umbillical cord,
and the remaining membranes of the ovum, all of which
are expelled after the birth of the child.</p>
<p><b>The Amnion.</b> An important appendage contained in
the Uterus in connection with the developing fetus is that
known as "The Amnion." This is an inner sack which
forms within the womb, and which serves to enclose the
fetus, and also to sheath the umbillical cord. The Amnion
encloses the embryo very snugly during the early stages
of its development, but it gradually becomes distended
with a pale watery fluid, known as "the amniotic fluid,"
the purpose of which is to "float" the fetus and to give
it mechanical support on all sides. This fluid is composed
of water carrying in solution small quantities of albumin,
urea, and salt.</p>
<p><b>Sex in the Embryo and Fetus.</b> It is impossible to determine
the sex of the embryo during its early stages. During
the fourth week the first traces of the sexual glands
appear, but not until the fifth week can the sex be determined
even by the microscope. If the embryo is to become
a male, certain ducts are transformed into convoluted
tubules, and each is attached to the testes which have
been formed from the genital nucleus. If the embryo is
to become a female, the ducts join to form the uterus and
vagina, other portions being transformed into the
fallopian tubes and connecting with the ovaries which
have been formed otherwise. The outer genitals appear in
the early stages of the embryo, but there is no apparent
distinction between the sexes, the external organs being
the same in all cases, and consisting of a small tubular
organ with a small lateral fold of skin on either side.
Later, in the male, a groove appears on the under side of
this primitive organ, thus forming the urethra, the
scrotum being formed from the folded skin at the side. In<span class="pagenum"><SPAN name="Page_39" id="Page_39">{39}</SPAN></span>
the female, the primitive organ ceases to develop as in
the male, and thus becomes proportionately smaller, and
evolves into the clitoris of the female; the two lateral
folds, on each side, being transformed into the labia
majora, or "outer lips" of the female external genitals.</p>
<p><b>Position of the Fetus.</b> During the period of gestation
the fetus lies "curled up" in the bag of the amnion. The
head is usually relaxed and inclined forward, the chin
resting on the breast; the feet are bent up in front of the
legs, the legs bent up on the thighs, the knees separated
from each other, but the heels almost touching on the
back of the thighs; the arms bent forward and the hands
placed between them as though to receive the chin between
them. The folded-up fetus forms an oval, the longest
diameter of which is about eleven inches at its greatest
stage of growth. Nature here shows a wonderful ability
to pack the fetus into as little space as possible, and in
such a position as to protect it from injury, and to discommode
the mother as little as possible.</p>
<p>The following interesting statement made by Helen
Idleson, M. D., in a European medical journal several
years ago, gives a very clear idea, expressed in popular
terms, of the appearance and characteristics of the
embryo or fetus in the various stages of its development:</p>
<p>"The growth of the embryo after fecundation is very
rapid. On the <b>tenth day</b> it has the appearance of a semi-transparent
grayish flake. On the <b>twelfth day</b> it is nearly
the size of a pea, filled with fluid, in the middle of which
is an opaque spot, presenting the first appearance of an
embryo, which may be clearly seen as an oblong or curved
body, and is plainly visible to the naked eye on the fourteenth
day. The <b>twenty-first day</b> the embryo resembles
an ant or a lettuce seed. Many of its parts now begin to
show themselves, especially the cartilaginous beginnings
of the spinal column, the heart, etc. The <b>thirtieth day</b> the<span class="pagenum"><SPAN name="Page_40" id="Page_40">{40}</SPAN></span>
embryo is as large as a horse-fly, and resembles a worm,
bent together. There are as yet no limbs, and the head is
larger than the rest of the body. When stretched out it is
nearly half an inch long. Toward the fifth week the heart
increases greatly in proportion to the remainder of the
body, and the rudimentary eyes are indicated by two
black spots toward the sides, and the heart exhibits its
external form, bearing a close resemblance to that in an
adult. In the <b>seventh week</b>, bone begins to form in the
lower jaw and clavicle. Narrow streaks on each side of
the vertebral column show the beginning of the ribs. The
heart is perfecting its form, the brain enlarging, and the
eyes and ears growing more perfect, and the limbs sprouting
from the body. The lungs are mere sacks, and the
trachea is a delicate thread, but the liver is very large.
In the seventh week are formed the renal capsules and
kidneys.</p>
<p>"At <b>two months</b>, the forearm and hand can be distinguished,
but not the arm; the hand is larger than the
forearm, but it is not supplied with fingers. The distinction
of sex is yet difficult. The eyes are prominent. The
nose forms an obtuse eminence. The nostrils are rounded
and separated. The mouth is gaping, and the epidermis
can be distinguished from the true skin. The embryo is
from one-half to two inches long, the head forming more
than one-third of the whole. At the end of <b>three months</b>,
the eyelids are distinct but shut; the lips are drawn together;
the forehead and nose are clearly traceable, and
the organs of generation prominent. The heart beats
with force; the larger vessels carry red blood; the fingers
and toes are well defined, and the muscles begin to be
developed.</p>
<p>"At the <b>fourth month</b>, the embryo takes the
name of 'fetus.' The body is six to eight inches in
length. The skin has a rosy color, and the muscles produce
<span class="pagenum"><SPAN name="Page_41" id="Page_41">{41}</SPAN></span>a sensible motion. A fetus born at this time might
live several hours. At <b>five months</b> the length of the body
is from eight to ten inches. At <b>six months</b>, the length is
twelve and one-half inches. The hair appears on the head,
the eyes closed, the eyelids somewhat thicker, and their
margins, as well as their eyebrows, are studded with very
delicate hairs. At <b>seven months</b>, every part has been increased
in volume and perfection; the bony system is
nearly complete; length, twelve to fourteen inches. If
born at this period, the fetus is able to breathe, cry and
nurse, and may live if properly cared for.</p>
<p>"At <b>eight months</b>, the fetus seems to grow rather in
length than in thickness; it is only sixteen to eighteen
inches long, and yet weighs from four to five pounds.
The skin is very red, and covered with down and a considerable
quantity of sebaceous matter. The lower jaw,
which at first was very short, is now as long as the upper
one. Finally, at term, <b>nine months</b>, the fetus is about
nineteen to twenty-three inches long, and weighs from
six to eight pounds. The red blood circulates in the
capillaries, and the skin performs the functions of perspiration;
the nails are fully developed."</p>
<p>Another writer says: "There is a superstition that a
child born at eight months is not as liable to live as if
born at seven months; indeed, many suppose that an
eight months' child never survives. Facts do not prove
this idea to be correct. Personally, I have known several
eight months' babies to live and do well, and I believe
that their chance of life is much greater than if born at
seven months."</p>
<p>Children born in the seventh month of gestation are
capable of living, though great care is required to rear
them for the first few months after birth. The "incubators"
now so common in large cities have greatly increased
the chances of the "seven months' child," and,<span class="pagenum"><SPAN name="Page_42" id="Page_42">{42}</SPAN></span>
for that matter, of those born even earlier. There are a
number of cases of record where children have been born
after six months of gestation, and a few even before the
six months, but these cases are rare and unusual, and
such children usually die soon after birth.</p>
<p>The following table, given by a good authority, shows
the average length and weight of the human embryo and
fetus:</p>
<table border="0" cellpadding="1" cellspacing="0" summary="Average length and weight of the embryo or fetus at different gestational ages">
<tr><th>Age.</th><th>Length in inches.</th><th>Weight.</th></tr>
<tr><td align="left">2 weeks</td><td class="pad-r" align="right">0.1</td><td align="left">Not given</td></tr>
<tr><td align="left">3 weeks</td><td class="pad-r" align="right">0.2</td><td align="left">3 grains</td></tr>
<tr><td align="left">4 weeks</td><td class="pad-r" align="right">0.3</td><td align="left">Not given</td></tr>
<tr><td align="left">5 weeks</td><td class="pad-r" align="right">0.5</td><td align="left">Not given</td></tr>
<tr><td align="left">6 weeks</td><td class="pad-r" align="right">0.7</td><td align="left">Not given</td></tr>
<tr><td align="left">7 weeks</td><td class="pad-r" align="right">0.9</td><td align="left">Not given</td></tr>
<tr><td align="left">8 weeks</td><td class="pad-r" align="right">1.5</td><td align="left">4 drachms</td></tr>
<tr><td align="left">3 months</td><td class="pad-r" align="right">3.0</td><td align="left">2 ounces</td></tr>
<tr><td align="left">4 months</td><td class="pad-r" align="right">6.0</td><td align="left">5 ounces</td></tr>
<tr><td align="left">5 months</td><td class="pad-r" align="right">9.0</td><td align="left">10 ounces</td></tr>
<tr><td align="left">6 months</td><td class="pad-r" align="right">12.0</td><td align="left">1 pound</td></tr>
<tr><td align="left">7 months</td><td class="pad-r" align="right">15.0</td><td align="left">3 pounds</td></tr>
<tr><td align="left">8 months</td><td class="pad-r" align="right">17.0</td><td align="left">5 pounds</td></tr>
<tr><td align="left">9 months</td><td class="pad-r" align="right">20.0</td><td align="left">6 to 9 pounds</td></tr>
</table>
<p>Professor Clark holds that if at birth the infant weighs
less than 5 pounds, it rarely thrives, though the records
show that many infants weighing much less than this
have lived and thrived. In very rare cases, infants have
been known to weigh no more than one pound at birth,
and to have still survived and thrived. And, on the
other hand, many cases are known where infants were
born, and thrived, who weighed more than twice the
average weight. So, at the last, it is difficult to lay down
hard and fast rules in the case.</p>
<p><b>Delivery.</b> At the termination of the period of gestation,
the child is born into the world, and, instead of depending
upon the blood of the mother for nourishment
and oxygen, it begins to ingest its own food, to eliminate
its own waste matter through the regular channels of
the body, and to use its own lungs for the purpose of
obtaining oxygen for its blood and to burn up the waste
products in the lungs.</p>
<p><span class="pagenum"><SPAN name="Page_43" id="Page_43">{43}</SPAN></span></p>
<p>The process of bringing a child into the world is called
"parturition." The fetus is expelled from the body of
the mother by the contraction of the muscles of and
around the Uterus, and also by the contraction of the
abdominal walls. In the early stages of labor, the uterine
muscles are brought into play; but when the fetus enters
into the vaginal passage the abdominal muscles manifest
their energy. The uterine and abdominal muscular movements
are purely involuntary, although the mother may
aid in the delivery by voluntary muscular movements.
The involuntary muscular movements are due to the reflex
action originating, probably, in a part of the spinal
cord.</p>
<p>The uterine contractions are rhythmical, and have
been compared to the contraction of the muscles of the
heart. Each "labor pain" begins with a minimum of
contraction, the activity increasing until a maximum is
reached, when it gradually decreases, only to be followed
a little later by a new contraction. When the fetus is
finally expelled from the Uterus (followed later by the
placenta or "afterbirth") that organ begins a gradual
contraction to its normal size, shape, and condition, the
restorative process usually lasting over several weeks.</p>
<p><b>The Physical Signs of Pregnancy.</b> The physical signs
of pregnancy in the case of women of normal health are
as follows:</p>
<p><b>(1) Cessation of the menses, or menstruation.</b> While
it is true that a non-pregnant woman may occasionally
pass over a menstrual period, yet as a general rule the
complete cessation of a period by a married woman, particularly
when the woman has previously been regular in
this respect, may be considered a probable indication of
pregnancy; and when the second period has been passed
the probability merges almost into a certainty. An examination
by a competent physician will set all doubts
at rest.</p>
<p><span class="pagenum"><SPAN name="Page_44" id="Page_44">{44}</SPAN></span></p>
<p><b>(2) Enlargement of the breasts.</b> This indication
usually manifests itself in about six or eight weeks after
conception. This enlargement is usually preceded by a
sensation of tingling and throbbing. The enlargement is
manifested in the form of a rather hard and knotty increase,
differing from the ordinary fatty increase; the
lobules, arranged regularly around the nipple, are plainly
distinguishable beneath the skin by means of the touch
of the fingers.</p>
<p><b>(3) Darkening of the areolar tissue surrounding the
nipple.</b> In the unimpregnated condition this tissue is of a
pinkish shade; but after impregnation the shade grows
darker and the circle increases in size. However, when
the woman bears several children in somewhat rapid succession,
this dark color may become permanent and accordingly
ceases to be an indication.</p>
<p><b>(4) Enlargement of the abdomen.</b> This indication
manifests itself about the second month, at which time
the Uterus begins to elevate the intestines by rising up
from the pelvis. In the fourth month the Uterus has
risen so far out of the pelvis that it assumes the form and
appearance of a hard round tumor. The entire abdomen
then begins to enlarge. The Uterus causes an enlargement
in the region of the navel at the sixth month, and
the region of the diaphragm at the ninth month.</p>
<p><b>(5) Quickening, or "signs of life."</b> This indication
manifests first from the fourth month to the fifth—at
about the exact half of the entire period of gestation. At
this time, and afterward, the movements of the embryo
are plainly discernable to the mother.</p>
<p><b>The Disorders of Pregnancy.</b> There are a number of
physical disorders usually accompanying pregnancy, some
of which are trifling, but some of which require the advice
of a competent physician. The best plan is for the woman
to consult a physician shortly after she discovers herself<span class="pagenum"><SPAN name="Page_45" id="Page_45">{45}</SPAN></span>
to be pregnant, and thereafter to visit him occasionally
for advice during the period of gestation. The too common
plan of postponing the call upon the physician until
the eighth or ninth month is not a wise one, for in many
cases the advice of a competent physician at an earlier
stage of the pregnancy will obviate serious complications.
The call upon the physician should usually be made not
later than the third or fourth month, and positively not
delayed longer than the fifth month. The physician should
make an examination to ascertain whether the child is in
the normal position in the Uterus, and should also examine
the urine each month to ascertain whether the kidneys
are functioning normally.</p>
<p>What is called "morning sickness" is one of the most
common of the disorders of pregnancy. It is marked by
nausea or vomiting, or both, early in the morning, usually
shortly after arising. Some women have at least faint
symptoms of this disorder from the very beginning of
conception, but usually it does not manifest until the
third, fourth, or fifth week of pregnancy. It usually
ceases at the end of the third or fourth month. Except
in very severe cases, in which the physician should be
consulted, the disorder is not serious, and requires but a
little common-sense treatment, and rational habits of living.
An authority says: "Eat of some fruit that best
agrees with palate or stomach; drink hot water; eat nothing
until a real hunger demands food. Where nausea
occurs after eating, a tart apple or orange is good."
Another authority says: "Let women suffering from
morning sickness try acid fruit—apples, oranges, or even
lemons, if their sourness is not unpleasant. If a single
orange or apple after each meal does not suffice, let them
try two; let them eat ten if that number is necessary to
conquer the distress. The principle is a correct one, and
the relief certain. Let fruit be eaten at all hours of the<span class="pagenum"><SPAN name="Page_46" id="Page_46">{46}</SPAN></span>
day—before meals and after, on going to bed at night
and at getting up in the morning. If berries are in season,
let them be eaten in the natural state—that is, without
sugar. If the sickness still continues, omit a meal now
and then, and substitute fruit in its stead. By persistence
in this course, not only will nausea be conquered, but an
easy confinement guaranteed."</p>
<p>The pregnant woman often develops a capricious appetite.
This disorder may manifest in one or more of
several forms, as for instance: the woman may lose her
appetite, and take but little food; or she may develop an
abnormally large appetite, and eat much more than is
necessary; or she may take a dislike to certain kinds of
food—many women have an aversion toward meat during
pregnancy; or she may have a "craving" for certain articles
of food, sometimes for kinds of food not liked at
other times, such as sour pickles, sour cabbage, etc. A
little common sense, and the presence of attractive articles
of fruits, etc., will do much to relieve these troubles;
in extreme cases the physician's advice will help.</p>
<p>The pregnant woman should have her teeth put in
good order as soon as possible, as troubles with teeth
sometimes manifest themselves during pregnancy, and
give much trouble and annoyance. Difficulty in urination,
constipation, piles, irritation or itching of the genital
organs, varicose veins, liver spots, and similar disorders,
which are sometimes manifest during pregnancy, in some
form or degree, should receive the attention and care of
a competent physician.</p>
<p>The following general advice from a competent authority
is worthy of being followed: "If everything is
satisfactory, if there is no severe vomiting, kidney trouble,
etc., the usual mixed diet may continue. The only
changes I would make are the following: Drink plenty
of hot water during the entire time of pregnancy: a glass<span class="pagenum"><SPAN name="Page_47" id="Page_47">{47}</SPAN></span>
or two in the morning, two or three glasses in the afternoon,
the same at night. From six to twelve glasses may
be consumed. Also plenty of milk, buttermilk and fermented
milk. Plenty of fruit and vegetables. Meat only
once a day. For the tendency to constipation, whole
wheat bread, rye bread, bread baked of bran, or bran
with cream. As to exercise, either extreme must be
avoided. Some women think that as soon as they become
pregnant, they must not move a muscle; they are to be
put in a glass case, and kept there until the date of
delivery. Other women, on the other hand, of the ultra-modern
type, indulge in strenuous exercise, and go out
on long fatiguing walks up to the last day. Either extreme
is injurious. The right way is moderate exercise,
and short, non-fatiguing walks. Bathing may be kept up
to the day of the delivery. But warm baths, particularly
during the last two or three months, are preferable to
cold baths."</p>
<p><b>Childbirth.</b> The first indication of approaching delivery
of the child is that of the descent of the child into
the pelvis of the mother, from its former position up near
the diaphragm. When this occurs, the mother usually
experiences a feeling of relief, and a greater ease in
breathing because of the relaxation of the former pressure
on the diaphragm. Sometimes this occurs several days
preceding delivery, while in other cases it occurs only a
few hours before delivery. There usually occurs about
the same time a slight discharge of mucus tinged with
blood. The latter is called "the show," and is caused by
the unsealing of the mouth of the womb, and indicates
that the Uterus is preparing to discharge its contents.</p>
<p>Labor, in childbirth, consists of three stages. In the
first stage, the Uterus alone contracts, and the mouth of
the womb dilates; in the second stage, the abdominal
muscles assist the Uterus in expelling the child; in the<span class="pagenum"><SPAN name="Page_48" id="Page_48">{48}</SPAN></span>
third stage, the Placenta (afterbirth) and membranes are
expelled.</p>
<p>After the delivery of the child, and after the pulsation
in the umbillical cord has ceased (usually from ten to
thirty minutes after delivery), the umbillical cord is
severed and tied by the physician. In natural labor, the
expulsion of the afterbirth occurs from within a few minutes
to an hour after the delivery of the child. Nature is
sometimes slow in expelling the afterbirth, but caution
should be exercised in the matter of using force to assist
Nature in this matter, for injury to the Uterus has often
resulted from malpractice in such a case. The afterbirth
is not firmly attached to the womb, but is like the peel of
an orange which Nature sloughs off in due time.</p>
<p><span class="pagenum"><SPAN name="Page_49" id="Page_49">{49}</SPAN></span></p>
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