Getting ready to be a mother

by Carolyn Conant Van Blarcom

Since the ovum is insecurely attached to the uterine lining until the sixteenth or eighteenth week, an abortion is more likely to occur during this time than later, while of this period, the second and third months seem to be the most perilous. Abortions are less likely to happen during first pregnancies than succeeding ones and their frequency seems to increase with the number of pregnancies. They occur more often among women over thirty-five years than in younger ones, and in all cases are most likely to take place at the time when menstruation would fall due were the woman not pregnant.

The prevention of abortions is of such obvious importance and there is so much that you can do to this end, that we shall take up the question somewhat at length. Preventive treatment really begins very early. In the discussion about menstruation we referred to the importance of finding out the cause of painful periods, in the interest of good obstetrics, since inflammation of the uterine lining or a misplaced uterus might be responsible for the pain and if neglected might cause an abortion later on. The correction of such troubles, no matter when they are discovered, is an early step toward preventing abortions.

But after pregnancy has actually begun, there are certain preventive measures which have proved to be very effective. A woman who is pregnant for the first time, and who, therefore, does not know whether she is likely to have an abortion or not, should avoid such risks as fatigue, sweeping, lifting or moving heavy objects, running a sewing machine by foot, running, jumping, dancing, traveling or any action which might jar or jolt her during the first sixteen or eighteen weeks.

An expectant mother who has had an abortion will have to take even greater precautions, as she is in more danger than is a woman who has not had this experience. It is of prime importance, to begin with, that she have the cause of her previous abortion discovered, and if possible corrected. And since the accident is most likely to be repeated at about the same time, or a little earlier, in each succeeding pregnancy it is a wise precaution for the expectant mother to remain quietly in bed for at least a week before and after the time when an abortion may be feared.

Complete rest and relaxation are such effective preventive measures that patients with a tendency to have abortions who have been willing to stay in bed during most of their pregnancy have sometimes been rewarded by going through the entire period and in the end giving birth to a normal, fully developed baby. As out-of-door exercise is clearly impossible in such cases, it is important that the patient keep her room very well ventilated all of the time, and possibly, under the doctor’s direction, have massage or bed exercises.

The marital relation is usually considered inadvisable in all cases after the eighth month of pregnancy, and among women who have had abortions or miscarriages it is best omitted throughout the entire period. This is particularly true of women over thirty-five who are pregnant for the first time.

To sum it up in a word, your part in preventing an abortion or miscarriage after pregnancy has begun, consists largely of avoiding fatigue; resting when tired; avoiding physical shocks such as blows upon the abdomen, jolts or falls particularly during the first sixteen or eighteen weeks and at the time when menstruation would ordinarily occur if you were not pregnant, and avoiding overwork during the later weeks of pregnancy.

The common symptoms of abortions or miscarriages are bleeding, often accompanied by recurring pain, beginning in the small of the back and finally felt as cramps in the lower part of the abdomen. Since menstruation is suspended during pregnancy you should always regard bleeding or a bloody discharge as a symptom of a possible miscarriage, whether you have pain or not. Upon its appearance you should send for the doctor, go to bed at once and keep absolutely quiet.

Should you be so unfortunate as to have a miscarriage, in spite of all your precautions, bear in mind that you will need to stay in bed quite as long afterwards and have the same care as though you had given birth to a fully developed baby. It is because so many women fail to appreciate this that abortions and premature births are often followed by ill health and invalidism. Under proper care, an abortion or premature labor is not, of itself, any more serious for a woman than a normal delivery.

Bleeding from the vagina, or a sudden increase in the size of the abdomen with perspiration and a sudden feeling of faintness, may be the beginning of severe bleeding, or hemorrhage, from any one of a number of causes, and in such a case the expectant mother should notify her doctor, go to bed at once and keep quiet until he arrives.