Getting ready to be a mother

by Carolyn Conant Van Blarcom

To begin with, there is the pelvis. This is a very irregular, bottomless, bony basin, or curved canal, within which lie the reproductive or generative organs to be described presently. The pelvis is really composed of four bones which are entirely separate in early life but firmly welded into one rigid structure in adults. I mention this because many women believe that labor pains are caused by a spreading or opening of these bones, whereas, as we shall see presently, the pains are really due to the strong contractions of the muscles of the uterus (or womb) in which the baby lies, which force the baby down through this inflexible ring. You may see in Fig. [1] how the pelvis is placed in the body, being interposed between the spinal column, which it supports, and the thighs upon which it rests. We can feel two of its prominent points on either side below the waist, as our hips, and we rest upon two other projections while in the sitting position.

Fig. 1.—Diagram showing the structure of the pelvis and its position in the body, the inlet being heavily outlined.

This bony canal is drawn in, or narrowed about midway in its length so that it is broader above and below than it is in the middle. You are likely to bear the doctors speak of this narrow part as the inlet. I thought you would be interested to know about this for it is largely in order to discover the size and shape of the inlet that the doctor is so anxious to make certain examinations and measurements.

The wide part of the pelvis above the inlet is called the upper, or false pelvis, while the smaller cavity below is known as the true pelvis. During the early part of pregnancy the baby lies in the true pelvis, but as pregnancy advances and he grows larger, he pushes up through the inlet into the larger pelvis where he remains until he is born. When that time comes he must pass down through the inlet again on his way into the world. If this opening is about the usual size and shape and the baby is of an average size, he will usually pass through with comparatively little trouble. But if the inlet is smaller than normal or of an unusual shape, it may be difficult, or even impossible, for the head of a normal-sized baby to pass through without the doctor’s assistance. You can see how important it is, therefore, for the doctor to know beforehand about the size and shape of the pelvic inlet, since it enables him to plan to help with the birth, if necessary, thus saving mother and baby from exhausting themselves in trying to do the impossible. In the old days many mothers and babies were injured, and sometimes even lost their lives, because doctors did not know about measuring the pelvis and planning ahead of time for a difficult labor. But now they know how to make things easier and safer.

It is worth mentioning here that proper care during infancy and childhood, with proper food, fresh air and exercise, helps to promote normal development of the pelves of little girls, and this in turn tends to make childbirth normal for these children when they grow up and are ready to have babies of their own.

The Generative or Reproductive Organs. The pelvis is an interesting structure but not nearly so interesting as the generative organs which lie within it: the uterus (or womb), tubes and ovaries. These, with the vagina, are often called the internal genitalia because they are inside the body. The pelvis practically remains rigid and inactive throughout pregnancy and labor, but the ovaries and the uterus are constantly active and are concerned with an undertaking which is so utterly amazing that it is far beyond our powers of understanding. We can only look on and wonder.

Fig. 2.—Drawing showing the structure and relation of the female generative organs, as viewed from the side. (Drawn by Max Brödel. Used by permission of A. J. Nystrom and Co., Chicago.)

The uterus, or womb, in which the baby develops, is a firm little mass of muscle, which, in its non-pregnant state, is much the shape of a slightly flattened pear, about three inches high, an inch and a quarter wide at its broadest point, three quarters of an inch thick, and weighs about two ounces. We usually speak of the main part of the uterus as the body: the round top as the fundus and the smaller part of the organ, below, as the neck or cervix. This important little organ is placed about the middle of the true pelvis, with the upper end pointing slightly forward. (See Fig. [2].) It is more or less swung in this position by being attached to ligaments instead of to any fixed part, the ligaments, in turn being attached to the sides of the pelvis. This explains why the uterus may move about, tip forward or backward, and how, by a stretching of the ligaments that hold it, it is able to grow and push upwards as pregnancy advances.