True labor pains are distinguished from the false by the fact that they are felt considerably in the back, passing down to the thighs, and by their coming on at regular intervals. At first they recur nearly every two hours, and they steadily increase in number and frequency, and are grinding in their character. There are other signs which denote the actual commencement of labor; there is usually a frequent desire to empty the bowels and bladder, perhaps shiverings or rigors unattended with a sensation of cold, sometimes a severe rigor, and these signs are preceded or accompanied or followed by a discharge of mucus and blood, called the show.
It is well now to send for the medical man, though if he lives near by it is only necessary to let him know that his services may shortly be required. If the patient suffers from nausea, vomiting, or chills and shiverings, let her know that they are only incidents of her labor and not unfavorable. Do not let her increase the pains or attempt to increase them in any way; it is much better that the labor should progress in a natural manner, even if it is very slow.
The preparation of the bed for the occupancy of the mother is now to be attended to. Cover the right side of the bed (as the patient will probably lie on her left side) with a piece of water-proof cloth or oil cloth; upon the top of this a sheet is to be placed and fastened with safety pins. Over this permanent dressing (on the top of the bed sheet) a neatly folded draw sheet is adjusted (and a second rubber and draw sheet is desirable), which, after the labor, can be removed, leaving the first clean and dry. This second draw sheet and rubber, and also a folded comfortable can be placed a little nearer the foot of the bed than the other, and after the lady’s confinement she can be drawn up on the permanent dressing, and the temporary dressing can be easily removed. The other bedclothes may be adjusted in the usual manner.
A piece of carpet can be thrown on the floor by the side of the bed, and it is well to have a hassock to put between the patient’s feet and the foot-board or bed-post.
To dress for the occasion, a folded sheet should be adjusted around the waist (or, instead of this, or above this, a petticoat), to extend from the waist to the feet. (These will be removed after the delivery.) Then a chemise should be put on in the usual manner, and drawn up and folded high under the arms. She should then have on a clean nightgown, and over it a warm wrapper; this can easily be slipped off when she is about to go to bed, and the night-dress, if it is a long one, can be folded up under her arms, so that it will not be soiled.
The STAYS must not be worn, as that prevents the free action of the muscles of the chest and abdomen. The patient, during the first stage of labor, may walk about or sit down, and need not confine herself to the bed. She may be allowed such food as she can eat, but should not be urged to take food.
The best beverage for her is either a cup of warm tea, or of gruel or arrowroot. Cold water will not hurt her if she desires it. A patient ought, during labor, frequently to pass water. Some women, from false delicacy, do not attend to it, and suffer severely for it.
The doctor ought to have some room to retire to that the patient may be left very much to herself, and that she may have opportunity whenever she desires to of thoroughly emptying either the bladder or bowels. It is better that not more than two women be present with her, and even one of these can be dispensed with if necessary.
The room should be kept quiet.—Let the attendants be quiet and self-possessed, and let there be no noise, or excitement, or whispering. There may be ordinary cheerful conversation, but when the pains become very frequent and severe, it is best that this should be hushed enough to have the patient feel that the attendants are not neglectful of her, or careless about her. Cheerful words spoken to the patient of the blessed relief that will come after enduring so much pain will do good.
When the membranes are ruptured and the waters discharged, the doctor should be called in immediately. When he is present you will be subject entirely to his direction.