471. Meddlesome midwifery cannot be too strongly reprobated. The duty of a doctor is to watch the progress of a labor, in order that, if there be anything wrong, he may rectify it; but if the labor be going on well, he has no business to interfere, and he need not be much in the lying-in room, although he should be in an adjoining apartment.
472. These remarks are made to set a lady right with regard to the proper offices of an obstetrician; as sometimes she has an idea that a medical man is able, by constantly “taking a pain,” to greatly expedite a natural labor. Now, this is a mistaken and mischievous, although a popular notion.
473. The frequent “taking of a pain” is very injurious and most unnatural. It irritates and inflames the passages, and frequently retards the labor.
474. The occasional, but only the occasional, “taking of a pain” is absolutely necessary to enable the medical man to note the state of the parts, and the progress of the labor; but the frequent “taking of a pain” is very objectionable and most reprehensible.
475. As a rule, then, it is neither necessary nor desirable for a medical man to be much in a lying-in room. Really, in a natural labor, it is surprising how very little his presence is required. After he has once ascertained the nature of the case, which it is absolutely necessary that he should do, and has found all going on “right and straight,” it is better, much better, that he retire in the daytime to the drawing-room, in the night season to a bedroom, and thus to allow nature time and full scope to take her own course without hurry and without interference, without let and without hindrance. Nature hates hurry and resents interference.
476. The above advice, for many reasons, is particularly useful. In the first place, nature is not unnecessarily interfered with. Secondly, it allows a patient, from time to time, to empty her bladder and bowels,—which, by giving more room to the adjacent parts, greatly assists and expedites the progress of the labor. Thirdly, if the doctor is not present he is not called upon to be frequently “taking a pain,” which she may request him to do, as she fancies it does her good and relieves her sufferings; but which frequent taking of a pain in reality does her harm, and retards the progress of the labor. No; a doctor ought not to be much in a lying-in room. Although it may be necessary that he be near at hand, within call, to render assistance toward the last, I emphatically declare that in an ordinary confinement—that is to say, in what is called a natural labor—the only time, as a rule, that the presence of the doctor can be useful, is just before the child is born; although he ought to be in readiness, and should therefore be in the house some little time before the event takes place. Let the above most important advice be strongly impressed upon your memory. Oh! if a patient did but know what a blessed thing is patience, and, in an ordinary labor, the importance of non-interference!
477. Bear in mind, then, that in every well-formed woman, and in every ordinary confinement, nature is perfectly competent to bring, without the assistance of man, a child into the world, and that it is only an ignorant person who would, in a natural case of labor, interfere to assist nature.[[88]] Assist nature! Can any thing be more absurd? As though God in his wisdom, in performing one of his greatest wonders and processes, required the assistance of man! It might with as much truth be said that in every case of the process of healthy digestion it is necessary for a doctor to assist the stomach in the process of digesting the food! No; it is high time that such fallacies were exploded, and that common sense should take the place of such folly. A natural labor, then, ought never to be either hurried or interfered with, or frightful consequences might, and in all probability will, ensue. Let every lying-in woman bear in mind that the more patient she is, the more kind and the more speedy will be her labor and her “getting about.” Let her, moreover, remember, then, that labor is a natural process—that all the “grinding” pains she has are doing her good service, are dilating, softening, and relaxing the parts, and preparing for the final or “bearing down” pains; let her further bear in mind that these pains must not, on any account whatever, be interfered with either by the doctor, by the nurse, or by herself. These pains are sent for a wise purpose, and they ought to be borne with patience and resignation, and she will in due time be rewarded for all her sufferings and anxieties by having a living child. Oh, how often have I heard an ignorant nurse desire her mistress to bear down to a “grinding” pain, as though it could do the slightest good! No, it only robs her of her strength and interferes with the process and progress of the labor. Away with such folly, and let nature assert her rights and her glorious prerogative! It might be thought that I am tedious and prolix in insisting on non-interference in a natural labor, but the subject is of paramount importance, and cannot be too strongly dwelt upon, and cannot be too often brought, and that energetically, before the notice of a lying-in woman.
478. Fortunately for ladies, there is great talent in the midwifery department, which would prevent—however anxious a patient may be to get out of her trouble—any improper interference.[[89]]
479. I say improper interference. A case sometimes, although rarely, occurs, in which it might be necessary for the medical man to properly interfere and to help the labor; then the patient must leave herself entirely in the hands of her doctor—to act as he thinks best, and who may find it necessary to use promptness and decision, and thus to save her an amount of unnecessary lingering pain, risk, and anxiety. But these cases, fortunately, are exceptions—rare exceptions—and not the rule.
480. It is, then, absolutely necessary, in some few cases, that a medical man should act promptly and decisively; delay in such emergencies would be dangerous: