Advice to a wife and mother in two parts

by Pye Henry Chavasse

408. Cold ablutions ought every morning to be used, and the body should be afterward dried with a coarse cloth. If it be winter, let the water be made tepid and let its temperature be gradually lowered until it be used quite cold. A shower-bath is, in these cases, serviceable; it braces and invigorates the system, and is one of the best tonics that she can use.

409. If she be already pregnant it would not be admissible, as the shock of the shower-bath would be too great, and may bring on a miscarriage; but still she ought to continue the cold ablutions.

410. A lady who is prone to miscarry, ought, as soon as she is pregnant, to lie down a great part of every day; she must keep her mind calm and unruffled; she should live on a plain diet; she ought to avoid wine and spirits and beer; she should retire early to rest, and she must have a separate sleeping apartment. She ought as much as possible to abstain from taking opening medicine; and if she be actually obliged to take an aperient—for the bowels must not be allowed to be constipated—she should select the mildest (such as either castor oil or lenitive electuary or syrup of senna), and even of these she ought not to take a larger dose than is absolutely necessary, as a free action of the bowels is a frequent cause of a miscarriage.

411. The external application of castor oil as a liniment, and as recommended at page [144], is a good and safe remedy for a patient prone to miscarry; and if sufficiently active, is far preferable to the mildest aperient. Another great advantage of the external application of castor oil is, it does not afterward produce constipation as the internal administration of castor oil is apt to do. If the external application of castor oil in the manner advised at page [144] should not have the desired effect, then an enema—a clyster of warm water, a pint—ought, in the morning, two or three times a week to be administered.

412. Gentle walking exercise daily is desirable: long walks and horseback exercise ought to be sedulously avoided. A trip to the coast, provided the railway journey be not very long, would be likely to prevent a miscarriage; although I would not, on any account, recommend such a patient either to bathe or to sail on the water, as the shock of the former would be too great, and the motion of the vessel and the sea-sickness would be likely to bring on what we are anxious to avoid.

413. As the usual period for miscarrying approaches (for it frequently comes on at one particular time), let the patient be more than usually careful; let her lie down the greatest part of the day; let her mind be kept calm and unruffled; let all fashionable society and every exciting amusement be eschewed; let both the sitting and the sleeping apartments be kept cool and well ventilated; let the bowels (if they be costive) be opened by an enema (if the external application of castor oil, as before recommended, be not sufficient); let the diet be simple and yet be nourishing; let all stimulants, such as beer, wine, and spirits, be at this time avoided; and if there be the slightest symptoms of an approaching miscarriage, such as pains in the loins, in the hips, or in the lower belly, or if there be the slightest show of blood, let a medical man be instantly sent for, as he may, at an early period, be able to ward off the threatened mishap.

FALSE LABOR PAINS.

414. A lady, especially in her first pregnancy, is sometimes troubled with spurious labor pains; these pains usually come on at night, and are frequently owing to a disordered stomach. They affect the belly, the back, and the loins; and occasionally they extend down the hips and the thighs. They attack first one place and then another; they come on at irregular intervals; at one time they are violent, at another they are feeble. The pains, instead of being grinding or bearing down, are more of a colicky nature.

415. Now, as these false pains more frequently occur in a first pregnancy, and as they are often more violent two or three weeks toward the completion of the full time, and as they usually come on either at night or in the night, it behooves both the patient and the monthly nurse to be cognizant of the fact, in order that they may not make a false alarm and summon the doctor before he is wanted, and when he cannot be of the slightest benefit to the patient.

416. It is sometimes stated that a woman has been in labor two or three weeks before the child was born! Such is not the fact. The case in question is one probably of false pains ending in true pains.