These fanciful beliefs, however, are sometimes serious matters to the young woman who is traveling, day by day, toward a great and mysterious event, and they should not be laughed to scorn, but explained away seriously and with sympathy. She may be told quite simply, that after conception she gives her baby only nourishment; that the baby’s connection with her body is through the cord and placenta, in neither of which are there nerves; and that even if the blood could carry mental and nervous impulses, which it cannot, the maternal and fetal blood never come in actual contact with each other. A tale which she has heard about a woman who saw something distressing and later gave birth to a marked child may cease to worry her if she is reminded of the innumerable babies, beautiful and unmarked, which are born to women who have had equally shocking experiences. It is scarcely probable that any woman lives through the ten months of pregnancy without seeing, hearing or thinking things that would disfigure a baby if maternal impressions could produce such results, and yet newborn babies are very rarely blemished. Although the ultimate causes of marks and deformities of the fetus are not definitely known, they are probably to be found in faulty development very early in the embryonic life, and, therefore, are not preventable.
HYGIENE OF PREGNANCY
In coming to the expectant mother’s personal hygiene, we find that an understanding of the physiology of pregnancy almost of itself indicates what this hygiene should include. We shall take it up in detail, however, and describe what is at present considered a reasonable outline of the routine desired for the average pregnant woman, who is found by careful examination to be normal and free from complications, and needing only to keep well. But, as has been said, and must be oft repeated, the ideal routine cannot be deposited en bloc upon all expectant mothers. It must be adjusted to the individual and to her circumstances.
Excretions. Although, as has been explained previously, the pregnant woman does not have to eat for two, she does have to eliminate the waste and broken-down products from two bodies, through her own excretory organs: the kidneys, skin, lungs and bowels. True, the amount of the baby’s ash is not great, but is of such a character that its elimination is important and increases the strain upon the maternal excretory apparatus.
Kidneys. One of the most important factors in prenatal care is promoting the function of the kidneys and watching their output. It is probably more true of the kidneys than of any other organs that a slight abnormality which would not give trouble at other times may, if neglected during pregnancy, produce very grave results. The amount of urine passed in twenty-four hours should be measured, and a specimen prepared, once a month during the first half of pregnancy and every two weeks afterward. If less than three pints are passed the patient should know, without further instruction, that she is not taking enough water and must take more. And so it is the nurse’s duty, in this connection, to convince her patient of the importance of drinking an abundance of water, and periodically measuring her urine and sending specimens to the doctor for examination.
She is very likely to follow such advice if she is told that by so doing she will help to prevent convulsions, for most women know of this complication and dread it.
In preparing a specimen, a covered or corked receptacle which is large enough to hold the voidings for twenty-four hours, must be thoroughly washed and scalded; in it should be collected the total amount of urine voided during twenty-four hours and kept in a place that is cool enough to prevent putrefactive changes. The additional precaution of putting a teaspoonful of chloroform into the receptacle is wise and does not injure the specimen. The patient should be instructed to empty her bladder at any designated hour, and then keep all urine voided from that time until the corresponding hour on the following day. The urine should be shaken so as to mix thoroughly the different voidings, and six or eight ounces poured into a bottle which has been washed and scalded, carefully corked and labelled with the date, patient’s name, address and the total amount for twenty-four hours.
If the nurse is called upon to test for albumen, either of the following will serve, unless the doctor specifies a test which he prefers:
Heat and acetic acid test: Fill a test tube about half full of urine and gently boil the upper part in a flame; add five drops of 2% to 5% acetic acid and again boil gently. The presence of albumen is shown by a white cloud in the upper part of the urine.
Esbach’s test: Fill a test tube half full of urine; add eight or ten drops of Esbach’s Solution. The presence of albumen is shown by a white flocculent precipitate in the upper part of the urine.