CONFINEMENT.
PREPARATIONS FOR CHILDBIRTH.
Certain foolish preparations are sometimes made by wives, with the best intentions. Perhaps one of the most common and absurd of these is the local use of sweet oil, in order to facilitate the dilatation of the parts, for which purpose it is perfectly inert. There are, however, some wise and even necessary precautions which every wife should know and employ, to guard against unpleasant and dangerous complications in childbirth.
In particular, the condition of the breasts towards the close of pregnancy demands attention. Scarcely any pain in the lying-in chamber is greater or more difficult to bear than that which the young mother suffers from excoriated nipples. This troublesome and often very intractable affection is nearly always the consequence of the want of care previous to confinement. During the latter part of pregnancy the nipples sometimes become sunken or flat, being retracted as the breasts increase in size, because of the want of elasticity on the part of the milk tubes. In order to remedy this fault, we have known a breast-pump or puppy to be applied. Such treatment is dangerous, as it may excite premature contraction of the womb, and miscarriage. Nipple-shields, with broad bases and openings, should always be obtained. They are safe, and effectually secure the prominence of the nipples, when worn constantly, day and night, during the last month or so of pregnancy. Wives who have never had children ought to take special care to ascertain before labor whether this depressed condition of the nipples exists, and to correct it in the manner indicated.
In the first pregnancy it is also important to harden the nipples. This may be done by occasionally gently rubbing them between the thumb and finger, and by bathing them twice a day during the last six weeks with tincture of myrrh, or with a mixture of equal parts of brandy and water, to which a little alum has been added. This procedure will render the surfaces less sensitive to the friction of the child's mouth, and thus avert the distress so often occasioned in the first confinement by tenderness of the nipples.
If the nipples be rough or nodulated in appearance, like a strawberry or a raspberry, they are more apt to become excoriated or fissured than if they present a smooth surface. Under such circumstances, make a solution of the sulphate of zinc, of the strength of one grain to the ounce of rose water, in a wide-mouthed bottle, then tilt the bottle upon the nipple, and allow it to remain there for a few minutes several times a day. Simple tenderness of the nipples and slight fissures may be averted by the application either of a lotion of borax (two scruples of borax in three ounces of water, and an ounce of glycerine), of the honey of borax, or of the tincture of catechu, and by protecting the parts from the pressure of the stays and the friction of the flannel vest.
It is of the greatest moment to the comfort of the mother, that all affections of the nipples should be prevented or remedied before labor; for the treatment of sore nipples when the child is at the breast is often unsatisfactory, while the suffering they occasion is very great, even sometimes giving rise to mammary abscess.
There are certain articles of clothing and dressings for the bed which should be cared for in advance, in order that they may be ready when required.
The mother should be provided with short-gowns, to be worn over the chemise instead of the ordinary night-gowns. It is of consequence to procure a proper bandage. It should be made of heavy muslin, neither too coarse nor too fine; an ordinarily good quality of unbleached muslin is the best. The material is to be cut bias, about one and a quarter yard in length, and from twelve to eighteen inches in breadth, varying, of course, with the size of the person. It should be just large enough to encircle the body after confinement, with a margin of a couple of inches, and to extend down below the fulness of the hips. The measurement should be taken, and the bandage made to fit, when four and a half months advanced. It should be narrow above, wider below, and gored in such a manner that it will be a little narrower at the lower extremity than a few inches above, so as to prevent it, when adjusted, from sliding upwards. A bandage constructed in this manner will be very comfortable; and is not apt to become displaced, after application, as is invariably the case when a towel or a straight piece of muslin is used. The way in which it is to be applied will be detailed hereafter.