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

Fig. 37.—Abdominal binder used in Figs. [34], [35] and [36], showing darts at top of front to fit it over the abdomen.

Figs. 38 and 39.—Front and back view of home-made stocking supporters made of webbing or 1–inch strips of muslin and a pair of child’s side garters. The straps are sewed together in the back, but pinned in front to permit adjustment as the abdomen enlarges. (By courtesy of the Maternity Centre Association, New York.)

The expectant mother’s shoes also merit considerable attention and thought. Her feet are larger than usual because they are likely to be somewhat swollen during the latter part of pregnancy, and the increased weight of her body tends to spread them. This added weight also increases the strain put upon the arch and flat foot is a not infrequent result, unless the arch is well supported. Another reason for the need of proper shoes is that, as pregnancy advances, the body’s centre of gravity changes. The pregnant woman becomes unstable on her feet and needs low, broad, firm heels. They need not necessarily be flat at first, if the patient has been accustomed to wearing moderately high ones, for the sudden lowering of the heels may injure her arches. High French heels, of course, should be avoided because they not only increase the difficulty and discomfort of walking but cause backache, as well, by forcing a posture that adds to the pressure on the lower part of the abdomen. They also increase the risk of turning the ankles, tripping and falling.

The patient’s shoes should be an inch longer than those she ordinarily wears; they should have broad toes and fit snugly over the instep, in spite of being large. If her shoes are not comfortable the expectant mother will tire easily and tend to take less exercise than she should.

Diet.—It is advisable for both nurse and patient to understand, and keep clearly in mind, the purposes which are served by the food intake of the expectant mother, and what foods and practices will defeat, and what will accomplish these purposes. Her food should provide nourishment, as under ordinary conditions; it should promote the functions of her skin, kidneys and bowels, because of the waste from her own and her baby’s body which she must excrete; it should be adequate to build and nourish the baby’s body without drawing materials from the mother’s own tissues. Moreover, proper food during pregnancy is an essential factor in preparing the mother to nurse her baby, which is as important as nourishing the fetus in utero.

In order to accomplish these various ends the patient must not only eat suitable food, but she must digest and assimilate it. This requires that she sedulously guard against overeating, constipation and indigestion of any kind. Indigestion may be avoided during pregnancy exactly as it is at other times, by eating proper food; by cultivating a happy frame of mind; by exercise, fresh air, adequate rest and sleep.

If accustomed to a fairly simple, well-balanced, mixed diet, the average expectant mother will need to make little or no change, excepting to make her evening meal light if it has been a hearty one; for she uses her nutritive material with surprising economy and does not have to “eat for two,” as is so commonly believed. It is a safe general principle that an amount and kind of food that keeps the expectant mother, herself, in a state of health and good nutrition, is favorable to satisfactory development of the fetus until the latter part of pregnancy.

She will probably be able to understand why this is true if it is explained that her baby gains nine-tenths of his weight after the fifth month, and one-half of his weight during the last eight weeks of pregnancy; also that if she takes too much food, the excess is stored up in both her own and the baby’s tissues; if too little, the fetus is nourished and her body deprived.

It is very unwise for the mother to diet with the idea of keeping the child small, and thus make labor easy, unless she is so ordered by her physician. In general, it is the size of the fetal skull that makes labor easy or difficult, and not the amount of fat distributed over the child’s body. And if the patient cuts down the minerals in her diet to make the fetal bones soft, and thus increase the compressibility of the skull, the fetus will extract lime from her bones and teeth, so that the only effect is upon herself.