Advice to a wife and mother in two parts

by Pye Henry Chavasse

398. A medical man ought in such a case always to be sent for. There is as much care required in a miscarriage as, or more than, in a labor.

399. If bearing down, expulsive pains—similar to labor pains—should accompany the flooding; if the flooding increase, and if large clots come away; if the breasts become smaller and softer; if there be coldness, and heaviness, and diminution in the size of the belly; if the motion of the child (the patient having quickened) cannot be felt; if there be “the impression of a heavy mass rolling about the uterus [womb], or the falling of the uterine tumor from side to side in the abdomen [belly] as the patient changes her position;”[^[75]] and if there be an unpleasant discharge, she may rest assured that the child is dead, and that it is separated from all connection with her, and that the miscarriage must proceed, it being only a question of time. Of course, in such a case—if she has not already done so—she ought immediately to send for a medical man. A miscarriage sometimes begins and ends in a few days—five or six; it at other times continues a fortnight, and even in some cases three weeks.

400. Treatment.—If a patient has the slightest “show,” she ought immediately to confine herself either to a sofa or she should keep in bed. A soft feather bed must be avoided; it both enervates the body and predisposes to a miscarriage. There is nothing better for her to sleep on than a horse-hair mattress. She either ought to lie flat upon her back or should lie upon her side, as it is quite absurd for her merely to rest her legs and feet, as it is the back and the belly, not the feet and the legs, that require rest.

401. Let her put herself on a low diet, such as on arrow-root, tapioca, sago, gruel, chicken-broth, tea, toast and water, and lemonade; and whatever she does drink ought, during the time of the miscarriage, to be cold. Grapes, at these times, are cooling and refreshing.

402. The temperature of the bedroom should be kept cool; and, if it be summer, the window ought to be thrown open; aperient medicines must be avoided; and if the flooding be violent, cold water should be applied externally to the parts.

403. Let me strongly urge upon the patient the vast importance of preserving any and every substance that might come away, in order that it may be carefully examined by the medical man.

404. It is utterly impossible for a doctor to declare positively that a lady has miscarried, and that all has properly come away, if he have not had an opportunity of examining the substances for himself. How often has a lady declared to her medical man that she has miscarried, when she has only parted with clots of blood! Clots sometimes put on strange appearances, and require a practiced and professional eye to decide at all times upon what they really are.

405. The same care is required after a miscarriage as after a labor; indeed, a patient requires to be treated much in the same manner—that is to say, she ought for a few days to keep her bed, and should live upon the diet I have recommended after a confinement, avoiding for the first few days stimulants of all kinds. Many women date their ill state of health to a neglected miscarriage; it therefore behooves a lady to guard against such a catastrophe.

406. A patient prone to miscarry, ought, before she become pregnant again, to use every means to brace and strengthen her system. The best plan that she can adopt will be TO LEAVE HER HUSBAND FOR SEVERAL MONTHS, and go to some healthy spot; neither to a fashionable watering-place nor to a friend’s house, where much company is kept, but to some quiet country place; if to a healthy farm-house so much the better.

407. Early hours are quite indispensable. She ought to lie on a horse-hair mattress, and should have but scant clothing on the bed. She must sleep in a well-ventilated apartment. Her diet should be light and nourishing. Gentle exercise ought to be taken, which should alternate with frequent rest.