There are various mechanical inconveniences connected with this state. In the earlier months more particularly, there is pressure upon the rectum, causing a tendency to constipation. This should be guarded against, not by “the due administration of mild laxative medicines,” for that only tends to make matters worse in the end, but by the use of proper food, such as cracked wheat or rye, brown or unbolted bread, Indian mush, well boiled, and good fruits and vegetables, in their season. Exercise, employment, daily bathing, and clysters, tepid or cold, according to the season, and the patient’s strength, should all be brought to bear in the case.
Pressure upon the urethra, or neck of the bladder, is also one of the mechanical evils of pregnancy, rendering the evacuation of urine difficult, and sometimes painful. To prevent this, the patient should be exceedingly careful to evacuate the bladder frequently, and never to allow the calls of nature to go unanswered; nor should she stand or walk too much at a time, as this is calculated, in a powerful manner, to increase the difficulty. The same may be said in regard to the feeling of weight which is experienced in the loins during the early part of the period; and in reference to all these mechanical evils of pregnancy, I remark that it is of great service for the patient to recline, for a short period, a number of times a day. If she is of active disposition and habits she may not feel inclined to do so; yet she will find the practice a good one, and productive of much comparative comfort.
If the abdomen becomes too pendulous, as it sometimes does, owing to the flaccidity of the abdominal parietes, a considerable degree of relief may be obtained from stays of a proper construction. These, however, should be so fashioned and arranged as not to overheat the parts, otherwise they will be made weaker, and thus more harm than good will be the result. The wet girdle, suitably applied, is an excellent appliance. Nor should any of these helps be used too much of the time.
EXPOSURE TO DISEASE.
Pregnant females should not expose themselves to infectious diseases; although it appears to be established that they are not, under such circumstances, as liable to contract such disease as at other times. Still, if they do contract them, the result is likely to be a more serious one; and in case the mother escapes, the child may suffer, and abortion, even, may be the result.
VACCINATION.
I am opposed to vaccination at all times. It is better, I believe, to live carefully and consistently in all respects, and trust nature for the result. There are many objections to vaccination, which I need not here mention. Pregnant women especially, who are necessarily, in the present state of things, more than others, subject to inflammatory diseases, and less liable, when attacked by acute disease, to recover therefrom, should not be vaccinated. Here are Professor Meigs’s earnest injunctions on the subject. Writing to his class, he observes:
“Pregnant women ought not to be vaccinated. This is a rule which I would advise you to depart from only on the most urgent occasions. If a woman have been ever vaccinated, and appeal to you to re-vaccinate her, because there is a prevalent variolous epidemic, I hope you will refuse to accede to her request. Small-pox is exceedingly and peculiarly pernicious to pregnant women. She who has it, and miscarries, or who is brought to bed at term, generally dies. It is, in my opinion, inexcusable to expose her to so great a risk—a risk far greater than that from accidental contagion, or that of the epidemy. But the vaccine is identical with the variolous animal poison, saving some lessened intensity of its malignant form, derived from its having been modified by the nature of another mammal. To inoculate a cow with small-pox virus, is to give her the vaccine disease, with the lymph of which you can vaccinate, but not reproduce unmodified small-pox. Keep your pregnant patients clear of small-pox, in all its forms, whether modified or unmodified. Do not vaccinate them. I have been the witness of dreadful distress from the operation. Eschew it, I entreat you.”
By way of digression, we may inquire, if pregnancy is an objection to vaccination, why should any person be vaccinated? If those who are in a condition which renders them most susceptible of disease should not be exposed to the variolous poison, why should others who are less susceptible? If any are to take the risk of small-pox without vaccination, I think the strong can afford to do it, rather than the weak. If vaccination is good for any thing, it should be, I think, the most worth for those who are the most liable to harm from the variolous disease.