What Women Should Know/Chapter 11

Among the disagreeable accompaniments of pregnancy are cramps, swelled feet, varicose veins, fainting, hysteria and toothache.

Cramps.—The best remedy I have found for cramps in the legs is to spring at once to the feet and bear the weight of the body upon them. Brisk rubbing is recommended, and will probably, in some cases, prove useful.

Swelled Feet and Varicose Veins.—If the feet swell and the veins burst, the woman must stand or walk as little as possible. The swollen veins come from the pressure of the womb upon the blood-vessels beneath it, and in a recumbent position this pressure is removed. However, cramps, swelled feet and varicose or bursting veins may all be avoided by a light and appropriate diet and abundance of exercise, which will tend to keep down the weight of the fetus, so that it shall not become burdensome.

No meed of greatly Enlarged Size in a Pregnant Woman.—There is indeed no necessity for the woman to become so bulky and unwieldy in form. There is no good in it, but rather positive ​evil, as it is such a tax upon her strength to carry about her increased weight. With the proper regimen her appearance need not be greatly altered. And though she must, of course, wear her clothing light and loose about her waist, if she would not interfere seriously with her own comfort and the health of her future child, she may find herself able to wear her ordinary clothing to the last with little or no alteration.

I knew a woman who during several pregnancies had been obliged to make radical changes in her wardrobe, but who at last was induced by me to make a partial trial of the fruit diet recommended by Dr. Holbrook during the three months previous to her confinement. The change it made was at once marked. She walked, she rode, she ran, with nearly as much ease as in ordinary health. I saw her helping her husband build a fence but two weeks before her confinement, and she wore her dresses unaltered to the last. One day, but a few weeks before her sickness, having visited the city and being about to return home, she found on reaching the wharf that the boat had already begun to push out from the landing. She stood a moment in hesitation, and was about to go back, but two of the hands in the stern of the boat, seeing her trouble, called to her to come on. The boat was swinging round out into the open river, and the stern still rested against the wharf. Without stopping a moment to consider, she ran at the top of her speed, weighed down with a heavy basket and ​bundle, reached these over the railing of the boat to the two men who were waiting for her, and while they were setting them down made a spring herself to the top of the railing, and with the assistance of the men jumped safely down. This she assured me she accomplished with as much ease as she could have done it at any time in her life, and it was not until the whole affair was over that she thought of any reason why she should not have undertaken such a thing. At any former time such an act would have been an impossibility.

Fainting.—Fainting fits are not uncommon during pregnancy. They usually occur about the period of quickening, but may come on at any time. They are the result of a delicate constitution, combined perhaps with too artificial a mode of life, excitements, late hours, and stimulating but not sufficiently nutritive diet. There is no especial danger in these attacks of fainting, except where there is reason to believe the heart is diseased. In the latter case a physician ought at once to be consulted. In ordinary cases the patient, upon the first feeling of faintness, ought to be laid down without a pillow, and her dress thoroughly loosened. The windows should be opened, water sprinkled in her face, and the usual means for restoring animation resorted to. It is scarcely necessary to say that there should be as few attendants as possible, and all spectators should be banished from the room. This symptom indicates a change required in the habits of life to simpler, plainer, more natural ​ones: in brief, proper exercise and proper diet are required here as well as in nearly all other cases. A change of air may prove beneficial when the patient is subject to attacks of fainting.

Palpitation of the Heart.—Pregnant women frequently experience palpitation of the heart. This need cause no special uneasiness. It results from the pressure of the womb upon the large blood-vessels. Although it may give temporary discomfort, it will pass away upon confinement. A few drops of camphor taken internally will probably afford relief.

Hysteria during Pregnancy.—Hysteria is one of the most disagreeable accompaniments of pregnancy, and in suffering from it women usually receive far less sympathy than they deserve. Its symptoms are a choking sensation like a ball rising in the throat; paroxysms of laughing and crying; a feeling of unrest, causing the patient to constantly change her position, sometimes even with violence; and an inability to occupy the mind without great nervous prostration.

In severe cases the feeling of unrest develops into actual paroxysms, during which the patient flings herself violently from side to side, frequently doing herself physical injury.

Hysteria results from too close confinement and from improper occupation, either physical or mental, or from want of occupation.

Remedy for Hysteria in a Pregnant Woman.—The attacks of hysteria can be temporarily cured in a pregnant woman, the same as in a young girl, ​by the use of small doses of assafœtida taken as often as required. Tincture of valeria is also an excellent anti-nervous medicine. A dose of the latter is from forty to eighty drops.

How to avoid Hysteria.—It is commonly supposed that a woman during pregnancy must not be subjected to long or severe mental effort. This is all a mistake. Let her work with her brain as steadily and as long as she chooses, so that she balances this labor by ample rest, recreation and exercise in the open air. If a woman begins to feel her mind overtaxed and her nerves overstrained, she should not lay the facts to too much mental study and work, but to too little counter-balancing physical exercise and rest. There is most danger from hysteria to those who have not sufficient employment for the mind—whose hands and brains are alike idle. It is a well-known though not sufficiently considered fact that hysterical symptoms are to be more frequently met with among women of leisure than among those who perform either hard physical or mental labor.

The close confinement which propriety (!) seems to dictate to women in this condition is a great promoter of hysterical symptoms. During several periods of enforced seclusion, I was a great sufferer from certain forms of hysteria. The form the most dreadful to me (who never could, with any degree of satisfaction, remain unoccupied a moment) was that which compelled me to sit for days and weeks together with hands folded, unable to pick up a book or a newspaper, or ​even to use my needle for more than a few moments at a time, while pen and pencil had to be alike laid aside. If I read, the words would reproduce themselves, and repeat themselves over and over again until they completely wearied me. On the slightest provocation I would fall into paroxysms of laughter, which would change to crying and then to laughing again, until I reached a state of extreme nervous prostration. If I played chess or dominoes of an evening, I would lie awake far into the night, wearily going over the game and all its possible complications; and after I fell asleep the ghosts of kings and queens, knights and pawns—of aces and double sixes—would haunt me till morning, making my sleeping-hours more tedious than my wakeful ones.

Oh the dreadful weariness of those days! I hope I may never have to pass through them again. And I would, if I could, save every other woman from a like dreadful experience. I shall have something more to say in another chapter regarding the avoidance of these nervous symptoms.

Toothache.—The best remedy for toothache is a piece of cotton saturated with oil of cloves and placed in the cavity of the tooth. This will generally give immediate relief. Creosote is frequently used instead of oil of cloves, but it is not so good, as it causes the tooth to decay. Let me warn the sufferer from toothache not to have 'the tooth extracted during her pregnancy, unless she is prepared to run the risk of worse suffering than even the tooth occasions her. ​A tooth extracted during this period has even been known to produce abortion. The toothache is most probably sympathetic, and will pass away altogether when the real cause of it no longer remains.

Pruritus.—One of the most disagreeable accompaniments of pregnancy is pruritus, or itching of the private parts. It is, however, fortunately, a symptom seldom experienced. To cure this, stimulants of all kinds must be avoided. A tepid sitz-bath of salt and water will probably afford relief. The woman should remain in the bath but a short time, repeating it daily if necessary. This bath will be beneficial in other respects. The parts may be also bathed two or three times a day with vinegar and water. If there are pimples in addition to the itching, glycerine may be used with advantage. This trouble is caused by the pressure brought upon these parts.

Constipation.—If a woman follows the suggestions I have already given in regard to diet and exercise, there is little danger of her being troubled with constipation of the bowels. If, however, she suffers with it from any cause, and a course of careful dieting will not remove it, the simplest and safest remedies had best be employed first. A suppository made of a small piece of soap, of molasses candy or of tallow, pushed a little way up the anus into the rectum, will probably give immediate relief. The next simplest remedy is the use of a clyster or injection of tepid water, or molasses and water applied with an ordinary syringe or a patent rubber syringe. ​This is exceedingly beneficial, and productive of ⟨no⟩ evil results. If the patient wishes to take purgative medicines, she must go to her physician for a prescription, for I positively will give her none, so thoroughly convinced am I that they are not only unnecessary, but absolutely injurious, during this period of a woman's life. I was asked by a young wife and expectant mother not long since if it were necessary to take a dose of castor oil every two weeks during her pregnancy, she saying she had been advised to do so. I told her most emphatically, no. Neither is it necessary or desirable to take castor oil shortly before confinement. If the bowels have been kept in proper order, they require no physic whatever; and if they have been allowed to get into an improper condition, castor oil is not going to help them except for the time being.

Piles during Pregnancy.—A pregnant woman frequently suffers from piles. They are almost invariably the result of an improper or neglected condition of the bowels or of the use of purgative medicines. They are external or internal according as they are around or within the fundament. They present the appearance of soft dark-red tumors, varying in size from a pea to a walnut. When they burst and discharge blood during stool, they are called bleeding piles. After this discharge of blood there is generally a sense of relief. The blind piles are the most painful, inasmuch as there is no relief by bleeding.

​Treatment of Piles.—First, reduce the bowels to their proper state. When any portion of the rectum or lower bowel protrudes after a stool, it must be pushed carefully into place by the finger, the nail having been previously pared. Sponging with hot chamomile and poppy-head tea several times each day will give relief in extreme cases. When stool is attended with much pain, the parts should be well anointed with lard and camphor, or a suppository of tallow may be used with advantage.

How Piles may be Avoided.—Piles are greatly to be dreaded; for if once established, they frequently cling to the sufferer through life. It is easier to prevent than to cure them. This can be done by keeping the bowels properly open by diet and exercise, not by drugs. The improper use of the latter frequently causes piles.

Incontinence of Urine.—The pregnant woman, during the latter months of pregnancy, is frequently troubled with an inability to retain her water. There is nothing alarming in this, though it is somewhat inconvenient. It is caused by the pressure of the womb upon the bladder. The bladder must be emptied very frequently, as the retention of urine for a lengthened period, even if it be possible, is not only very painful, but positively injurious.

Heartburn.—Heartburn is a frequent and distressing accompaniment of pregnancy. It is caused by improper food, taken probably in too great quantity. A change in the diet is required, avoiding all ​food that is rich or stimulating in character. A less quantity must also be eaten. If the trouble still continue, let it be borne in mind that it is not an alkali—the usual remedy in cases of heartburn—that is required, but an acid, to correct this acidity of the stomach. An orange, a tart apple, or a tumbler of not too sweet lemonade, will probably bring immediate relief. Vitriolic or citric acid may be also used with benefit. Lime-water and milk will bring relief when the heartburn is moderate. A few blanched almonds or roasted groundnuts have been found in mild cases to bring relief.

Salivation during Pregnancy.—Women are occasionally troubled with an excessive flow of saliva during the early months of gestation. This salivation is almost invariably accompanied by, and is the result of, constipation and heartburn; therefore whatever removes these latter will in all likelihood cure the salivation. If it is severe, a physician had better be consulted, who may possibly suggest some means of relief. The same course of treatment pursued in heartburn, frequent rinsing of the mouth with limewater, and the use of solid food alone, will bring relief in ordinary cases. This symptom usually passes away about the fifth or sixth month.

Various Pains Accompanying Pregnancy.—The enlarged womb pressing against the liver and ribs frequently causes severe pain in the side, or, pressing against the sternum or breast-bone, causes a sensation like the pricking of a needle at the ​lower extremity of that bone. Again, the motion of the child is sometimes so strong as to be exceedingly painful. These various pains are troublesome only during the last months of pregnancy. Some of them result from the woman's enlarged size, and whatever reduces that size will of course materially mitigate her sufferings. Patience is the only thing to be recommended.

False Labor Pains.—False labor pains are exceedingly troublesome and hard to be borne. Every woman does not suffer from these, but they are liable to come on at any time within six weeks previous to confinement. They are often intermittent in character—that is, coming at a regular hour in the day, and disappearing with a like regularity; exceedingly severe, similar to true labor pains and almost as hard to endure. A woman who has ever felt them recognizes them at once, and never mistakes them for real pains. There is no certain remedy for them, so far as I know, though camphorated oil or laudanum applied to the lower portion of the abdomen will sometimes afford relief. When they are intermittent in character—that is, coming and going at regular periods—they may be successfully treated with quinine; but I think I should prefer to suffer the pains than take the medicine—though that may be prejudice. While suffering these pains the patient must keep off her feet as much as possible, and seek such a position as will give her most ease. It will be found well, if practicable, for her to occupy both hands and mind, in ​order that her thoughts may not dwell too constantly on her sufferings.

Marks.—It is currently believed among the majority of women that any sudden or strong impression of the mother, such as fright, or the sight of any disagreeable object, or failing to obtain the object of a "longing," may be communicated to the child, leaving a "mark" upon his personal appearance bearing a strong resemblance to the object which has caused this impression. My own observation has not, of course, been very extended, but so far as it goes, it is mainly against the truth of the marking theory. Physicians are divided in their opinions on the subject. Some deny the possibility of such a thing, basing their denial on the tolerably well-established fact that there is no direct communication between the nervous systems of the mother and child. One physician states that, in many thousand cases of hospital and private practice, he had never discovered a single example of so-called marks following or corresponding to any fright or strong impression of the mother. Others admit the possibility of the transmission of these impressions, being reluctantly forced to this admission by occasional apparently well-authenticated evidence.

That children are frequently marked in various ways is well known, but probably in a large majority of cases, if not in all, these marks may be regarded as mere freaks of Nature. The spots—brown, yellow, red, blue or black in color—which are frequently observed on the skin of new-born infants, and which ​are supposed to represent certain objects or fruits craved by the mother during pregnancy, are the result of an alteration of a portion of the skin, which, though a species of disease, is not in the slightest degree dangerous in its character. They remain stationary after birth, and require no treatment whatever.

Deformities or peculiarities may be inherited, or they may be the results of accidents to the mother—such as falls or blows—during the period of gestation. I have often wondered, if it were possible to obtain the record, how many of these deformities would be found the result of attempted but unsuccessful abortion.

There is no doubt that long-continued mental impressions leave their mark upon the child, but there is less ground for belief that sudden nervous ones do. It is well for the pregnant woman to keep her mind quiet and calm and free from all disturbing influences, to surround herself with pleasant objects and subject herself to agreeable associations. By all means let her not become the victim of foolish fears in regard to mother's marks. If there is any truth in the matter, there is more danger of bad results from the mind dwelling morbidly on possible consequences from an untoward event or a frightful object, than there is from the first impression which that event or object creates. Let a woman consider herself when pregnant just the same in all respects as when in ordinary health, exercising her will that she shall be so. She may then meet whatever comes to her fearlessly and ​unshrinkingly, and laugh in the face of her advisers who would seek to imbue her with their own superstitions. I may be wrong; nevertheless, I am tolerably confident of the position I take.

The balance of this chapter has no special reference to the disorders of pregnancy. It consists of advice, hygienic and otherwise, concerning that state—advice which it would not do to omit, and which occupies too brief a space to be entitled to a separate chapter-head.

Bathing During Pregnancy.—Cleanliness is a duty to every one, and quite as much a duty during pregnancy as at any other time. Those who have faith in the efficacy of water in counteracting all the ills to which human flesh is heir, lay great stress upon the desirability of making use of various kinds of baths—particularly lukewarm sitz-baths—during the period of pregnancy. The use of baths is undoubtedly a preservative of health, and should be resorted to more frequently and with more scrupulous regularity than is common. But care should be taken that in the use of the bath there are no sudden shocks to the physical or nervous system. For this reason it is better to use a hand-bath. If cold water chills the system in its peculiarly sensitive state, let the water be slightly tepid. Warm sitz-baths will be found highly beneficial, as the period of confinement approaches, in relaxing the system. A small tub or a large hand-basin may be used for this purpose, being partially filled with tepid water, and the patient sitting ​down in it, with the upper part of her body carefully covered.

To Prevent Sore Nipples.—Sometimes the nipples are so tender that the woman suffers exceedingly when she comes to nurse her babe. To avoid this, the nipples should be bathed daily for some time before confinement in a wash of alum-water or with cologne-water, for the purpose of hardening them.

To Prevent Cracking of the Skin of the Abdomen.—The violent stretching to which the skin of the abdomen is subjected by the constantly enlarging womb sometimes causes its under tissues to crack. These cracks are permanent, leaving the woman scarred and disfigured for life. It is well to guard against them by frequent rubbing of the bowels with lard or sweet oil. If the skin feels sore from stretching, the bowels should be rubbed every night and morning with warm camphorated oil. A broad flannel belt be also worn, made comfortably tight and fastened may by strings. This, if put on properly, will afford support to the abdomen.

Descent of the Womb before Delivery.—A short period before confinement the womb sinks down into the pelvis, and the pressure and pain which have been felt in the region of the heart, liver, ribs and sternum disappear. This descent may take place only a few hours before delivery, or it may occur several days, or even weeks, previously. There is now a pressure felt in the hips and groin and against the lower part of the back. Sometimes the pressure upon ​the rectum is so great that symptoms are felt similar to those of tenesmus—that is, a desire to void the bowels without the ability to do so. The greatest relief is experienced from lying down. A woman, if she suffers much, should not be too often upon her feet at this period. If, however, she has lived properly and rationally, she will find her sufferings greatly diminished.

Possibility of determining Presentation of Child without Examination.—When the womb has thus descended into the cavity of the uterus, it is not impossible for the woman to feel a hard, solid substance resting on the lower bones of the pelvis, and causing her some difficulty in walking. This solid substance is the head of the child pressing against the mouth of the womb, and this feeling ensures a right presentation. The feet are small and yielding, and could not be felt except as they moved, while the breech is too large and presents too extended an are to sink so low down. Besides, even if it were possible for it to descend the same as the head, there is not the solidity about it that would make its presence plainly felt.