Advice to a wife and mother in two parts

by Pye Henry Chavasse

489. The after pains generally increase in intensity with every additional child. This only bears out, in some measure, what I before advanced, namely, that the pain is less severe and of shorter duration before each succeeding labor, and that the pain is greater and of longer duration after each succeeding one.

490. The after pains are intended by nature to contract—to reduce—the womb somewhat to its non-pregnant size, and to assist clots in coming away, and therefore ought not to be needlessly interfered with. A judicious medical man will, however, if the pains be very severe, prescribe medicine to moderate—not to stop—them. A doctor fortunately possesses valuable remedies to alleviate the after pains.

491. Nature—beneficent nature—ofttimes works in secret, and is doing good service by preparing for the coming event, unknown to all around. In the very earliest stages of labor pain is not a necessary attendant.

492. Although pain and suffering are the usual concomitants of childbirth, there are, nevertheless, well-authenticated cases on record of painless parturition.[^[90]]

493. A natural labor may be divided into three stages. The first, the premonitory stage, comprising the “falling” or subsidence of the womb, and the “show.” The second, the dilating stage, which is known by the pains being of a “grinding” nature, and in which the mouth of the womb gradually opens or dilates until it is sufficiently large to admit the exit of the head of the child, when it becomes the third, the completing stage, which is now indicated by the pains being of a “bearing down” expulsive character.

494. Now, in the first or premonitory stage, which is much the longest of the three stages, it is neither necessary nor desirable that the patient should be confined to her room; on the contrary, it is better for her to be moving about the house, and to be attending to her household duties.

495. In the second or dilating stage, it will be necessary that she should be confined to her room, but not to her bed. If the drawing-room be near at hand, she ought occasionally to walk to it, and if a pain should come on the while, lie on the sofa. In this stage it is not at all desirable that she should keep her bed, or even lie much on it. She is better up and about, and walking about the room.

496. In the first and the second stages she must not, on any account, strain or bear down to the pains, as many ignorant nurses advise, as, by robbing her of her strength, it would only retard the labor. Besides, while the mouth of the womb is dilating, bearing down cannot be of the slightest earthly use—the womb is not in a fit state to expel its contents. If by bearing down she could (but which fortunately she cannot) cause the expulsion of the child, it would, at this stage, be attended with frightful consequences—no less than the rupture of the womb! Therefore, for the future, let not a lady be persuaded, either by any ignorant nurse or by any officious friend, to bear down until the last or the complete stage, when a gentle bearing down will assist the pains to expel the child.

491. In the third or completing stage, of course it is necessary that she should lie on a bed, and that she should, as above advised, bear gently down to the pains. The bearing down pains will indicate to her when to bear down.

498. If, toward the last, she be in great pain, and if she feel inclined to do so, let her cry out,[^[91]] and it will relieve her. A foolish nurse will tell her that if she make a noise, it will do her harm. Away with such folly, and have nothing to do with such simpletons!