Advice to a wife and mother in two parts

by Pye Henry Chavasse

443. If nurses better understood the proper method of bandaging patients after their labors, there would not be so many ladies with pendulous bellies and with ungainly figures. It is a common remark that a lady’s figure is spoiled in consequence of her having had so many children. This, provided efficient bandaging after every confinement had been properly resorted to, ought not to be. But then, if a monthly nurse is to do those things properly, she ought to be properly trained, and many of them have little or no training; hence the importance of choosing one who thoroughly knows and will conscientiously do her duty.

444. A monthly nurse who thoroughly understands her business will always have the lying-in room tidy, cheerful, and well ventilated. She will not allow dirty linen to accumulate in the drawers, in corners, and under the bed; nor will she allow any chamber utensil to remain for one moment in the room after it has been used. If it be winter, she will take care that the fire in the grate never goes out, and that it is never very large, and that the room is kept as nearly as possible at one temperature—namely, at 60° Fahrenheit. She will use her authority as a nurse, and keep the other children from frequently running into the room, and from exciting and disturbing her mistress; and she will make a point of taking charge of the baby, and of keeping him quiet while the mother, during the day, is having her necessary sleep.

445. A good monthly nurse fully comprehends and thoroughly appreciates the importance of bathing the external parts concerned in parturition every night and morning, and sometimes even oftener, for at least two or three weeks after a confinement. And if the medical man deem it necessary, she ought to understand the proper manner of using a vaginal syringe. If the nurse be self-opinionated, and tries to persuade her mistress not to have proper ablution—that such ablution will give cold—she is both ignorant and prejudiced, and quite unfit for a monthly nurse; and my advice is, that a lady ought on no account to engage such a person a second time.

446. In another part of this work I have entered fully on the vital importance of ablution after a confinement, and I need not say more than again to urge my fair reader to see that the monthly nurse properly carries it out, and that, if there be any objections made to it by the nurse, the medical man be appealed to in the matter, and that his judgment be final. Assured I am that every doctor who understands his profession will agree with me, that the regular ablution of the parts after a labor is absolutely indispensable. The nurse, of course, will take care to guard the bed from being wet, and will not expose the patient unnecessarily during the process; she will be quick over it, and she will have in readiness soft, warm, dry towels to speedily dry the parts that have been bathed. The above is most important advice, and I hope that my fair inquirer will engage a monthly nurse that will do her duty in the matter.

447. Before concluding a list of some of the duties of a monthly nurse, there are four more pieces of advice I wish to give both to a wife and to a monthly nurse herself, which are these: (1) Never to allow a nurse, until she be ordered by the doctor, to give either brandy, or wine, or porter, or ale to the patient. (2) I should recommend every respectable monthly nurse to carry about with her an india-rubber vaginal syringe. One of the best for the purpose is Higginson’s syringe,[^[84]] which is one constructed to act either as an enema apparatus, or, by placing the vaginal pipe over the enema pipe, as a vaginal syringe. She will thus be armed at all points, and will be ready for any emergency. It is an admirable invention, and cannot be too well known. (3) I should advise a monthly nurse while on duty, whatever she may do at other times, to doff her crinoline. A woman nursing a baby with a stuck-out crinoline is an absurdity, and if it were not injurious both to the mother and to the infant (as the nurse in crinoline cannot do her duty either to the one or to the other) she would be a laughable object. A new-born baby pillowed in steel! (4) I should recommend every monthly nurse, while in the lying-in room, to wear either list slippers or the rubber slippers, as creaking shoes are very irritating to a patient. “Nurses at these times should wear slippers and not shoes. The best slippers in sick-rooms are those manufactured by the North British Rubber Company, Edinburgh: they enable nurses to walk in them about the room without causing the slightest noise; indeed, they may be called ‘the noiseless slipper’—a great desideratum in such cases, more especially in all head affections of children. If the above slippers cannot readily be obtained, then list slippers—soles and all being made of list—will answer the purpose equally as well.”[^[85]]

PART III.
LABOR.

THE PRECURSORY SYMPTOMS OF LABOR.

448. A day or two before the labor commences, the patient usually feels better than she has done for a long time; she is light and comfortable; she is smaller, and the child is lower down; she is more cheerful, breathes more freely, and is more inclined to take exercise, and to attend to her household duties.

449. A few days, sometimes a few hours, before labor commences, the child “falls,” as it is called, that is to say, there is a subsidence—a dropping—of the womb lower down the belly. This is the reason why she feels lighter and more comfortable, and more inclined to take exercise, and why she can breathe more freely.

450. The only inconvenience of the subsidence of the womb is that the womb presses on the bladder, and sometimes causes an irritability of that organ, inducing a frequent desire to make water.