Primipara, or the first Pregnancy.
Woman who has borne children before.
a. a. The neck of the Womb.—b. b. b. The body of the Womb.—c. The Os Tincæ, or mouth of the Womb.—d. d. The cut edges of the Vagina.—e. The Fœtus.—f. f. The Fallopian Tubes, Ovaries, and Round Ligaments.—g. The Placenta.
Most of the changes produced can be readily distinguished by the finger, after seeing this representation, and making a proper comparison between it and the natural state in Plate IV.
The Neck is not much enlarged at this period, but its lower part is somewhat soft to the feeling. The Os Tincæ is more rounded than in the unimpregnated state, particularly in the Primipara, in whom in fact it is nearly circular, the lips being quite smooth and closed. In the female who has already borne children it is somewhat open, so that the finger may often be introduced; and the lips feel rough, owing to scars and laceration in previous deliveries. It is also larger altogether, and softer, than in the primipara. The whole length of the neck at this stage is about two inches.
The body of the uterus, when pressed between the two hands, will be found much larger than ordinary, and more round, and it will feel heavy when pushed up by the finger.
In regard to the precise value of these probable signs, it can only be said, when they are observed, that it is certain that the womb is enlarged, and most probably from pregnancy. But at the same time it must be remembered that several diseases, and particularly suppressed and irregular menstruation, or the development of tumors and polypi, will effect very similar changes, and that it is not always possible to say whether they arise from these abnormal growths or from pregnancy, though it can generally be done. But though we cannot, in every case, say when these signs exist, that the female must be pregnant, we can nearly always say, when they do not exist, that she cannot be so, particularly if the other usual signs are absent.
End of the fourth month.—By this time the neck has become a little shorter still, and the mouth more open, but on the whole there is not much change to be felt internally. The body of the womb however, has now ascended above the superior strait of the Pelvis, and begins permanently to enlarge the Abdomen. It may be distinctly felt between the two hands, like a firm round ball, somewhat elastic, and resisting when pressed. This is the period when the motions of the fœtus are usually felt first, and these motions, with the ascension of the womb, are sometimes experienced very suddenly, so as to alarm the female, and produce certain curious sensations, with much nervous derangement. This is called quickening, and, with some persons, is always so well marked as to indicate not only their condition, but the very period, with great precision. Many however, never experience anything at all peculiar at this time.