Cereals.—For their nourishing and laxative qualities, cereals are important, and their food value is increased by the milk and cream which are usually taken with them. Cooked cereals should invariably be cooked longer than the usual directions suggest. Bran, eaten alone, as a cereal or in combination with other grains, is an excellent laxative.
Breads.—Graham, cornmeal, whole wheat and bran bread are all good. In general the expectant mother will be on the safe side if she eats sparingly, if at all, of very fresh or hot breads and hot cakes.
Desserts.—Desserts are very important for they add to the attractiveness of most people’s meals, and if wisely chosen and properly made, may supply a good deal of easily digested nourishment. They may include, in addition to fresh and cooked fruits and preserves, ice-cream, a wide variety of custards, creams and puddings made largely of milk, eggs, and some ingredient to give substance and firmness, such as gelatine, cornstarch, rice, tapioca, farina, arrow-root and similar materials.
Fresh Air and Exercise. If the nurse has become aware of the value of promoting all of the normal physiological processes of the pregnant woman, she already realizes how important are fresh air and exercise to the patient and her expected baby.
The average individual uses every minute the oxygen contained in four bushels of air, and since the pregnant woman takes in through her lungs the oxygen for both herself and the baby, she must have an adequate quantity of constantly changing air to supply at least this amount. She should spend at least two hours of each day in the open air. If the weather is so stormy or severe as to make it undesirable for her to go out from under cover, because of the danger of getting wet or chilled, she may wrap up well and take her airing on a protected porch or in a room with all of the windows wide open. But this is only a part of it, for the air in her house, or rooms, must be kept fresh all day by being constantly changed; this requires a steady inpouring of fresh air and outpouring of stale, vitiated air.
A very good way to accomplish this is to have one or more windows open slightly, top and bottom, all the time. But there must be no sudden changes of temperature, nor drafts, for fear of chilling the patient’s skin. At night she should sleep in a room with the windows open, taking care to be well protected by light, warm coverings.
Each detail of the expectant mother’s daily routine seems to be more important than the last. And so when we come to the question of regular outdoor exercise we almost think that whatever else may be neglected, this is indispensable, since it promotes digestion, stimulates the functions of the skin and lungs; steadies the nerves, quiets the mind and promotes sleep. And more than that, walking, which is probably the most satisfactory form of exercise, also strengthens some of the muscles that are used during labor. But exercise is downright injurious if continued to the point of fatigue, no matter how little has been taken. Each woman must be a law unto herself in this matter, therefore, and must be impressed with the importance of stopping before she is tired. She should start by walking only a short distance, increasing gradually until she is able to walk possibly as much as an hour in the morning and an hour in the afternoon, if she can do so without fatigue.
All violent exercises and sports are of course to be avoided, particularly swimming, horseback riding, and tennis. While motoring and carriage riding are pleasant diversions, they cannot be classed as exercise. They should be taken only in comfortable vehicles and over smooth roads, so that there will be no jarring nor jolting, and the patient should not do the driving herself.
A certain amount of exercise, in the shape of light housework, may be taken indoors. It is distinctly beneficial, if not continued to the point of fatigue, both because of the exercise which it provides, and also the diversion and interest, for these promote mental and physical health. But this indoor exercise must not interfere with, nor to any degree replace, the daily exercise out of doors; nor must it include heavy work, such as washing, sweeping, heavy lifting, running a sewing machine by foot nor much running up and down stairs. However, the amount and kind of work which a woman may comfortably and safely do are so related to what she has been accustomed to, that it is not possible to offer more than general suggestions, which will help in the planning for each individual. All patients will do well to moderate their activities at the time when they would ordinarily menstruate.
There are patients to whom massage and gymnastics are beneficial during pregnancy, when for some reason the out-of-door activities are contra-indicated. This might be true of a patient with heart trouble, for example, or one who is being kept in bed to avert an abortion, and accordingly is a matter which must be entirely in the doctor’s hands.