The Prospective Mother, a Handbook for Women During Pregnancy

by J. Morris Slemons

During pregnancy the mother must get rid not only of her own waste products, but also of those of the child. The waste products of the child, if weighed, would not amount to a great deal; but they are by no means negligible. So far as we can tell, it is chiefly on account of their peculiar character that they increase the work of the mother's excretory organs. Whatever the cause, they do increase it, and experience has taught us that these organs must always be kept in a healthful condition to protect both the mother and the child from harm. Consequently a prospective mother who wishes to take proper care of her body must, in the first place, direct her attention toward keeping up the normal activity of all the excretory functions.

THE BOWELS.—While pregnant, nine out of ten women suffer from mild constipation. Those who have been previously troubled with this complaint may find it aggravated from the outset, but in most instances it does not appear until after several months have passed. Constipation is explained by the fact that the enlarged womb presses against the intestines; and, as the enlargement increases, constipation generally becomes more pronounced. No doubt there was a time when women, perhaps unconsciously, counteracted this natural result of pregnancy by the use of a diet consisting largely of fruit and vegetables and also by outdoor exercise. Such measures, indeed, still afford the simplest means of overcoming constipation.

Throughout pregnancy the bowels should move at least once every day. When they do not, some of the waste material that should be removed is absorbed by the body and seeks to leave it through the organs that are already doing their full share of work. For example, under such conditions, the kidneys, instead of exerting themselves more vigorously, may become less active than they were.

It is everyone's duty to form the habit of having the bowels move regularly. Now the most favorable opportunity for assisting the intestines to empty themselves occurs shortly after meal-time, since the involuntary movements of the intestines are most active while digestion is in progress. It should be regarded as an imperative duty, therefore, to grant Nature such an opportunity every morning just after breakfast. This should be done at a definite hour, day after day, even though the inclination is absent; and in many instances the desired habit will be formed.

A glass of water on going to bed or on getting up has a laxative effect; and there are other dietary measures which may be employed with advantage. Thus, coarseness of the food, as we know, stimulates intestinal activity, and this fact explains the peculiar value of Graham bread, bran bread, and corn bread. Fresh fruit and vegetables counteract constipation for two reasons, namely, because they leave in the bowels a relatively large amount of undigested substance, and because they contain ingredients that have a specific purgative action. Such ingredients are especially noteworthy in rhubarb, tomatoes, apples, peaches, pears, figs, prunes, and berries.

Enemas used as a routine measure are mischievous. They interfere with the "tone" of the bowel-muscle so that it acts sluggishly and bring about a condition in which the bowels will not move without artificial stimulation. At best these irrigations remove no more than the contents of the lower bowel, and should be employed only when there is acute and urgent need of clearing out the rectum.

Obstinate constipation is uncommon, and strong purgatives are seldom needed. If they become necessary, a physician should be consulted as to what to take. Whenever dietary measures and exercise, which is discussed in the next chapter, fail to counteract the natural tendency toward constipation, the prospective mother may generally resort to "senna prunes" or some equally simple and harmless household remedy. Senna prunes are prepared as follows: Place an ounce of dried senna leaves in a jar and pour a quart of boiling water on them. Allow to stand two or three hours; strain off the leaves and throw them away. To the liquor add a pound of prunes. Cover and place on the back of the stove, allowing to simmer until half the liquor has boiled away. Add a pint of water and sweeten to taste, preferably with brown sugar. The prunes should be eaten with the evening meal. The number required must be learned from experience. Begin with half a dozen, and increase or decrease the number, as required. The syrup is an even stronger laxative than the prunes.

THE KIDNEYS.—Any one may judge for herself whether or not the bowels are doing their work satisfactorily, but not so with the kidneys. For this purpose the urine must be examined by a physician. In spite of this fact, considerable responsibility rests upon the prospective mother, whose duty it is to collect the specimens properly—a detail that is apt to be neglected. It is impossible to urge too strongly the importance of saving, at regular intervals, all the urine passed in twenty-four hours, of protecting it from decomposition, and of sending a sample to the physician. The intervals may be longer at first, for the kidneys have very little extra work to do until the sixth month. Usually, therefore, it is a satisfactory plan to send a sample for analysis the first of each month during the early half of pregnancy; but during the latter half one should be sent the first and the fifteenth of each month.

To estimate the exact amount of urine passed in twenty-four hours and to protect it properly, in the first place, the vessel in which it will be collected should be carefully scalded out. As a further precaution against decomposition, add a teaspoonful of chloroform to the vessel, which should be kept covered, and not allowed to stand in a warm room. Unless these details are conscientiously observed, putrefaction may take place and vitiate the analysis the physician wishes to make. The precise amount of urine which the kidneys excrete in twenty-four hours will be determined as follows: At a convenient time, for example at 8 A.M., empty the bladder and throw the urine away; this marks the beginning of the observation. Subsequently, save all the urine passed during the day and night, and finally at 8 o'clock the next morning empty the bladder and add this urine to that previously collected. The total amount, thus collected, should be measured.

It is unnecessary to send all the urine to the physician; six ounces, somewhat less than half a pint, will be enough. But the physician should know what the total amount was found to be; therefore, a record of the measurement, the date, and the patient's name should accompany the sample. If limited to a single fact about the urine, it would be most helpful to know the amount passed during the twenty- four hours. In this way, as I have already pointed out, the patient herself may derive valuable information, for if the urine is scanty in amount—that is, less than a quart—she should drink more water.