It not unfrequently happens that menstruation continues with regularity during the whole period of pregnancy. Exceptional cases are given by distinguished writers on midwifery, of women menstruating during their pregnancy, and at no other time.
As a general rule, when a healthy wife misses her monthly sickness, she is pregnant. But this symptom, though a strong one, must be supported by others before it can be regarded as establishing anything.
2. Morning sickness is a very common, a very early, and, in the opinion of most mothers, a very conclusive symptom of pregnancy. We have already had occasion to remark that it sometimes makes its appearance almost simultaneously with conception. It usually comes on in the first few weeks, and continues until the third or fourth month or until quickening. This symptom is apt to be a troublesome one. Often the vomiting is slight, and immediately followed by relief. But it may produce violent and ineffectual straining for some time. It is, however, not to be called a disease: unless it proceeds to an exhausting degree, it must be looked upon as favorable and salutary. There is an old and true proverb, that 'a sick pregnancy is a safe one.' The absence of nausea and vomiting is a source of danger to the mother and child. Women who habitually fail to experience them, are exceedingly apt to miscarry. In such cases medical skill should be invoked to bring about the return of these symptoms, of such importance to healthful pregnancy.
Morning sickness is therefore a very general, almost constant, accompaniment of the pregnant condition; and great dependence may be placed upon it as a sign.
3. Changes in the breasts are valuable as symptoms. They become larger and firmer, and the seat of a pricking or stinging sensation. The nipples are swollen, prominent, and sometimes sore or painful. The veins beneath the skin appear more conspicuous, and of a deeper blue than ordinary. The peculiar circles of rose-coloured skin which surround the nipples increase in extent, change to a darker color, and become covered with a number of little elevations. Subsequently, numerous mottled patches, or round spots of a whitish hue, scatter themselves over the outer part of this circle.
The time at which these changes make their appearance is variable. They may begin to develope themselves in two or three weeks, oftener not until the second or third month, and in women of a delicate build, sometimes not until the latter end of pregnancy. Occasionally no alteration whatever occurs in the breasts until after confinement, in which cases the secretion of milk is delayed for several days after the birth of the child. In some rare instances the breasts never assume maternal proportions, and the mother is debarred from the pleasure and duty of nursing her own child.
4. Quickening is the next symptom we will consider. By this term is meant the arrival of that time when the mother first becomes conscious by the movements of the child of its presence. The ancients thought that then life was imparted to the new being. Modern physiology emphatically condemns this absurdity. The embryo is as much alive in the very earliest moments of pregnancy as at any future stage of its existence. Let every woman therefore remember that she who produces abortion is equally guilty in the eyes of science and of Heaven, whether the act be committed before or after the period of quickening.
How is quickening produced? Undoubtedly by the movements of the child. So soon as its nervous and muscular systems become sufficiently developed to enable it to move its limbs, the mother, if the movements be sufficiently active, is rendered sensible of her situation. But the muscular contractions may not be strong enough to impart any sensation to the mother. In many cases in which they are too feeble to be noticed by herself, the skilled accoucheur is capable of recognizing them. And the movements of the fœtus may be excited in various ways known to physicians.
Time of quickening.—This symptom usually occurs about the middle of pregnancy, near the eighteenth week. Some women feel the movements of the fœtus as early as the third month of pregnancy, others not till the sixth month. Cases occur in which no movement whatever is felt until the eighth or ninth month, or even not at all. It has been suggested that a fœtus which does not indicate its presence in this way is a kind of 'Lazy Lawrence,' too indolent to move. Certainly, many of both sexes exhibit after birth such indomitable love of repose, that it can readily be supposed they were equally passive in fœtal life.
The non-occurrence of this sign may, however, be due to the debility of the young child, or to a want of sensibility in the walls of the womb itself.