Getting ready to be a mother

by Carolyn Conant Van Blarcom

Second Stage. The first stage is ended, and the second stage begins, when the cervix is wide enough for the baby to pass through. From this time on you should stay in bed and if neither the doctor nor the nurse has arrived, your cool-headed friend must stand by and not leave you alone. The bag of waters usually, though not always, breaks at this time, and there is a rush of fluid. But the character of the pains changes even though the membranes do not rupture. They come about every two minutes, now, from the beginning of one pain to the one following, each pain lasting about a minute. They are stronger and more forcible and you begin to have an uncontrollable desire to strain or bear down.

If the doctor or nurse is with you, they will tell you how to use your pains to advantage, but if they are not there you would better avoid bearing down since you want to retard the baby’s birth, if possible, until one or the other arrives. In such a case, you may delay matters by opening your mouth and breathing deeply during pains and by lying on your side.

We all know that in spite of the most careful planning, babies are sometimes born before the arrival of doctor or nurse and that the mother and her cool-headed friend, who is standing by, meet the emergency together. Fortunately, births occurring under such circumstances are not the ones that are likely to be associated with trouble for either mother or baby, so there is little or no cause for concern. Most doctors feel that the wisest course for the cool-headed friend to follow at such a time is to do nothing at all. So if the baby arrives in advance of the doctor, why, he is here, and that is about all there is to it! The moment you have been longing for, for nine long months, has come; your anxiety and waiting are all over, and with much less trouble than you expected.

Third Stage. After the baby is born, your pains will subside for a few moments and then the uterus will begin again to contract and gradually detach the placenta from its inner surface, forcing it out just as the baby was expelled.

In the meantime the baby is lying on the foot of the bed with the cord connecting him with the placenta which is still within your uterus. Under no circumstances should anyone pull on the cord to aid in the expulsion of the placenta. It will come away, naturally, in due time. When the placenta is finally expelled, the third and last stage of labor is over.

In case you and your cool-headed friend feel that something should be done, perhaps I would better assure you once more that when a baby is born so quickly and easily that he arrives before the doctor, you have cause for relief only—not anxiety. Practically the only unfavorable conditions which may arise are hemorrhage in your case and failure to breathe satisfactorily, on the part of the baby, and you and your cool-headed friend may as well understand how simply these possibilities may be met.

Although, as everyone knows, there is normally a certain amount of blood lost at the time of confinement, varying from one half to one pint, this is accepted as a matter of course. A serious hemorrhage very rarely occurs because of one of Nature’s ingenious provisions. The tiny muscle fibers that make up the uterine wall run in every direction, criss-cross, up and down and around, forming a veritable tangle. After the placenta comes away, all of these little fibers contract, or grow shorter, and the result is that the muscles squeeze down upon the blood-vessels so tightly that they are closed and blood cannot escape.

Accordingly, as long as the uterine muscles are contracted there can be no hemorrhage. The fortunate thing about this is that you can find out if they are contracted, and if they are not, you, yourself can stimulate them to do so. If you will press your fingers down deep into your abdomen, near the navel, you will feel the uterus as a hard round mass, which is often likened to a baseball. If it continues to feel hard and round there cannot be any serious amount of bleeding, but if it becomes soft, the tiny muscle fibers are relaxing their grip on the vessels and bleeding may possibly occur. Quite naturally the thing to do, then, is to stimulate the muscles to contract and this is done by kneading the uterus through the abdominal wall. You will feel it grow hard under your hand and then you will know that everything is all right.

Your friend may want to bathe you and put on a pad but it would be better to leave this for the doctor or nurse for this reason: Childbed fever is the result of introducing infective material into the vagina. Remember that. If no germs gain entrance, there will be no childbed fever. When your baby came quickly and there was a rush of water, your vagina was well washed out. If you and your friend keep fingers and everything else away from the vaginal outlet and the area immediately surrounding it, it will remain clean and you need not worry about the possibility of infection.

Perhaps I have given more space to all of this than seems warrantable, but I want you to know just what is going on so that you will not be worried. And also, in order that you will not make trouble for yourself by trying to do something when all that you really need do is to lie still, as comfortably as possible, keep your hand on the uterus and knead it enough to keep it hard.