Obstetrical Nursing / A Text-Book on the Nursing Care of the Expectant Mother, the Woman in Labor, the Young Mother and Her Baby

by Carolyn Conant Van Blarcom

Apparently, then, our national health is in a large measure dependent upon good obstetrics and good obstetrics includes good nursing.

Good nursing implies more than the giving of bed baths and medicines, boiling instruments and serving meals. It is more than going on duty at a certain time, carrying out orders for a certain number of hours and going off duty again. It implies care and consideration of the patient as a human being and a determination to nurse her well and happily, no matter what this demands.

In carrying on her work, the maternity nurse may be called upon to aid in prenatal supervision and instruction; to prepare for and assist with a delivery, or to give either exclusive or visiting nursing care to a young mother and her baby. These patients may be in a hospital or at home and the home may be of any kind from a palace to a hut or a tenement. The patients may be in a city, a small town, or a rural community, and in the care of doctors whose methods vary widely.

But in spite of the diversity of conditions and the fact that no two will be quite alike, the general need of all of these patients will be the same.

Their need is care, which includes cleanliness in order to prevent infection; suitable food; fresh air and exercise; regular and sufficient rest and sleep; an equable body temperature; early treatment of complications and correction of physical defects. In short, each patient needs to be watched; needs clean care and to practice the approved principles of personal hygiene from the beginning of pregnancy. This without regard to race, color, creed, occupation, status, or location. It means all maternity patients and their babies the country over.

There was a time when the obstetrician first saw his patient in labor or shortly beforehand, and when the care of the baby began at birth or soon afterward.

We know what this tardy attention has cost in human lives and suffering.

We know, too, that among the mothers, abortion, miscarriages, toxæmias, difficult or impossible labors may be largely prevented through prenatal care; while among babies, the enormously high death rate, during the first month of life from causes which begin to operate before birth, convinces us that we must begin to take care of the baby nine months before he is born, if he is to have the greatest benefits of present available knowledge. Such early care reduces still births and injury during labor; it reduces premature births, which is important, because the nearer the baby goes to term the better his chance of survival and of good health, and prenatal care also increases the prospects of satisfactory breast feeding.

Although we know that the ideal is to have all maternity patients supervised and instructed entirely by a physician from the beginning of pregnancy and then delivered in a well conducted hospital, it is scarcely probable that this ideal will ever be realized. There will always be patients who cannot afford to employ a doctor for so long a period; there will always be communities in which hospital provisions do not exist or are inadequate. There will always be expectant mothers whom it would be unwise to remove from home, excepting under pressing conditions, because of the influence exerted by their mere presence in keeping the family group intact. And so on, through a number of deterring conditions which will probably never cease to exist, and which will keep the patient at home.

Since patients who are supervised during pregnancy and delivered in hospitals usually recover, the high rate of death and injury, in this country, is to be found among women who are unsupervised before labor and subsequently delivered at home. Accordingly, if this widespread injury is to be reduced, the essentials of the care which is found to be efficacious must be made available for all patients throughout the length and breadth of the land.