Advice to a wife and mother in two parts

by Pye Henry Chavasse

REST AND QUIETUDE.

593. A horizontal—a level—position for either ten days or a fortnight after a labor is important. A lady frequently fancies that if she supports her legs, it is all that is necessary. Now, this is absurd; it is the womb and not the legs that requires rest; and the only way to obtain it is by lying flat either on a bed or on a sofa: for the first five or six days, day and night, on a bed, and then for the next five or six days she ought to be removed for a short period of the day either to another bed or to a sofa; which other bed or sofa should be wheeled to the side of the bed, and she must be placed on it by two assistants, one taking hold of her shoulders and the other of her hips, and thus lifting her on the bed or sofa, she herself being perfectly passive, and not being allowed to sit erect the while. She ought, during the time she is on the sofa, to maintain the level position.

594. She ought, after the first nine days, to sit up for an hour; she should gradually prolong the time of the sitting; but still she must, for the first fortnight, lie down a great part of every day. She should, after the first week, lie either on a sofa or on a horse-hair mattress.

595. The above plan may appear irksome, but my experience tells me that it is necessary, absolutely necessary. The benefit the patient will ultimately reap from it will amply repay the temporary annoyance of so much rest. Where the above rules have not been adopted, I have known flooding, bearing down of the womb, and even “falling” of the womb, frequent miscarriages, and ultimately ruin of the constitution, to ensue.

596. “Falling of the womb” is a disagreeable complaint, and the misfortune of it is, that every additional child increases the infirmity. Now, all this might, in the majority of cases, have been prevented, if the recumbent posture for ten days or a fortnight after delivery had been strictly adopted.

597. If a patient labor under a “falling of the womb,” she ought to apply to a medical man, who will provide her with a proper support, called a pessary, which will prevent the womb from “falling down,” and will effectually keep it in its proper place.

598. It is only a medical man, accustomed to these matters, who can select a pessary suitable for each individual case. A proper kind of, and duly-adjusted, pessary is a great comfort to a patient, and will enable her both to take her proper exercise and to follow her ordinary employments; indeed, if a suitable pessary be used, it is so comfortable that the patient often forgets that she is wearing one at all. Those pessaries ought only to be employed that can be removed every night, as there is not the least necessity for a patient to sleep in one, as the womb does not usually come down when the patient is lying down. Moreover, a pessary ought to be kept perfectly clean, and unless it be daily removed it is utterly impossible to keep it so. It is a great comfort and advantage to a patient to be able both to introduce and to remove the pessary herself, which, if a proper kind be employed, she can, when once taught, readily do.

599. If “falling of the womb” be early and properly treated, there is a good chance of a patient being perfectly cured, and thus of being able to dispense with a pessary altogether.

DIETARY.

600. For the first day the diet should consist of nicely made and well-boiled gruel, arrow-root and milk, bread and milk, tea, dry toast and butter, or bread and butter; taking care not to overload the stomach with too much fluid. Therefore, either a cupful of gruel, or of arrow-root, or of tea, at a time, should not be exceeded, otherwise the patient will feel oppressed; she will be liable to violent perspiration, and there will be a too abundant secretion of milk.