Advice to a wife and mother in two parts

by Pye Henry Chavasse

575. Let me urge the importance of the patient, immediately after childbirth, making water while she is in a lying position. I have known violent flooding to arise from a lying-in woman being allowed, soon after delivery, to sit up while passing her water.

576. The “female slipper”[^[103]] (previously warmed by dipping it in very hot water and then quickly drying it) ought, at these times, and for some days after a confinement, to be used. It is admirably adapted for the purpose, as it takes up but little room and is conveniently shaped, and readily slips under the patient, and enables her to make water comfortably, she being perfectly passive the while. It should be passed under her in front, and not at the side of the body.

577. If there be any difficulty in her making water, the medical man must, through the nurse, be immediately informed of it. False delicacy ought never to stand in the way of this advice. It should be borne in mind that, after either a very lingering or a severe labor, there is frequently retention of urine,—that is to say, that although the bladder may be full of water, the patient is, without assistance, unable to make it.

578. After the patient, while lying down, trying several times to pass her water, and after, allowing twelve or fifteen hours to elapse, and not being able to do so, it will be well for her to try the following method: Let the pot de chambre be well warmed, let the rim be covered with flannel, let her, supported the while by the nurse, kneel on the bed, her shoulders being covered with a warm shawl; then let her, with the pot de chambre properly placed between her knees on the bed, try to make water, and the chances are that she will now succeed.

579. If she does not, twenty-four hours having elapsed, the doctor must be informed of the fact; and it will then be necessary, absolutely necessary, for him, by means of a catheter, to draw off the water. It might be well to state that the passing of a catheter is unattended with either the slightest danger or pain; and that it is done without exposing her, and thus without shocking her modesty.

THE BOWELS.

580. The bowels are usually costive after a confinement. This confined state of the bowels after labor is doubtless a wise provision of nature, in order to give repose to the surrounding parts—especially to the womb; it is well, therefore, not to interfere with them, but to let them have perfect rest for three days. Sometimes before the expiration of the third day the bowels are relieved, either without medicine or merely by the taking of a cupful of warm coffee. If such be the case, all well and good; as it is much better that the bowels should be relieved without medicine than by medicine; but if, having taken the coffee, at the end of the third day they are not opened, then early on the following—the fourth—morning, a dose of castor oil should be given in the manner recommended at paragraph 281. Either a teaspoonful or a dessertspoonful, according to the constitution of the patient, will be a proper dose. If, in the course of twelve hours, it should not have the desired effect, it must be repeated. The old-fashioned custom was to give castor oil on the morning after the confinement; this, as I have before proved, was a mistaken plan.

581. After a lying-in, and when the bowels are not opened either naturally or by the taking of a cupful of warm coffee, if medicine be given by the mouth, castor oil is the best medicine, as it does not irritate either the patient’s bowels, or, through the mother’s milk, gripe the infant. Aperient pills, as they most of them contain either colocynth or aloes, or both, frequently give great pain to the babe, and purge him much more than they do the mother herself; aperient pills, therefore, after a confinement ought never to be taken.

582. If the patient object to the taking of castor oil, let the nurse, by means of an enema apparatus, administer an enema. This is an excellent, indeed the best, method of opening the bowels, as it neither interferes with the appetite nor with the digestion; it does away with the nauseousness of castor oil, and does not, in the administration, give the slightest pain. If the first enema should not have the desired effect, let one be given every quarter of an hour until relief be obtained. One of the best for the purpose is the following:

Take of—Olive oil, two tablespoonfuls;