Soon after the termination of the labor the woman may partake of some light food—tea and toast, panada, or anything of a light, unirritating character. From the very first, under ordinary circumstances, the woman may be permitted to change her position as she may desire, from side to side, or to be propped up in bed. Before going to sleep she ought to urinate—in a lying position, if so inclined, or she can be raised up and supported in a sitting position for a few minutes, if she desires to be. The patient must not be allowed to exert herself, or remain too long in a sitting posture. But I have never known a woman to be harmed by being raised up and sitting for a minute at this particular time.
Unless there is unusual suffering from afterpains or hemorrhage, or something that requires the attention of the physician, the patient will now be desiring and seeking sleep, and everything should be arranged for this object.
CHAPTER VII.
DIRECTIONS TO THE NURSE DURING THE MONTH.
The nurse will receive from the medical man such directions as the peculiarities of the case seem to demand, but I deem it proper here to give some general instructions. First, in regard to
CARE OF THE MOTHER.
Rest is essential to the mother during the month. She should remain in bed nearly all the time for at least two weeks, and should not return to her household duties under a month. Perfect tranquility is essential, that the womb may resume its former size and situation, and that inflammation, ulceration, prolonged debility, pain and excessive discharges be avoided, and that a good form be preserved. As a means of preventing a flabby, pendulous belly, she may also, when she does walk around, wear a utero-abdominal supporter or a well-fitting bandage. If a bandage is worn it should be made of strong linen, cut bias, setting snugly to the form, but not exerting unpleasant pressure. Its breadth should be from twelve to eighteen inches.
The diet of a nursing woman should be both light and nourishing. I would suggest for the first day well-boiled gruel, bread and milk, panada, tea, dry toast and butter, or bread and butter. For the second day, beef tea may be added (F. 58), and she should be served with food four times; the third day she may eat a little chicken or game, and mashed potatoes or rice pudding, and on the fourth day she can partake once of mutton or beef. Arrow root (F. 44), with these articles mentioned, may form part of her diet thereafter, but she may partake of such articles of her former diet as are wholesome and nourishing. The woman must not be starved; she demands food that will allow her to recuperate her strength. Give her as nutritious food as she has appetite for, and can easily digest and assimilate. (F. 58.)
For a BEVERAGE give toast water, barley water, and milk with the chill taken off and a little salt added, tea, cocoa, or chocolate made with one-half milk, new milk and water, cacao and broma, made with a large proportion of milk. Either of these may be freely used as a drink. I have always allowed my patients to drink freely of water from the first, and an occasional cup of coffee is not harmful. When the mother experiences any inconvenience from any articles of diet or drink, she should not hesitate to abandon them, for if they disagree with her they will also disagree with the child. (F. 10, 16, 18, 19, 20, 23, 25, 28.)
The LOCHIAL DISCHARGE, which occurs directly after a lying-in, is at first of a reddish color, and gradually changes to a brownish hue, and afterwards to a greenish shade. It is necessary that there should be some discharge to continue for a week, and it often continues for three weeks more. In some cases it has a disagreeable odor.
Ablutions and cleansings are very necessary at this time. The parts should be carefully cleansed every day, and it is never amiss to use for this purpose a weak solution of chlorinated soda, or carbolic acid, or permangenate of potassa, etc., (F. 153.) They may be used quite weak at first, and afterwards of greater strength, if they do not cause smarting. Tar water is excellent for an injection. The woman should daily assume a position that will facilitate the discharge of the lochia; sometimes get on her knees, or she may occasionally lie on her face and stomach. There should be no bandages applied so as to confine the secretions. A soft sponge and warm water may be used for ablutions at first, or the parts may be bathed with warm water and oat meal gruel; after bathing they should be dried with warm, dry towels; they may then, by means of a piece of linen rag, be anointed with salad oil or vaseline, or other bland oil. Once or twice a day the vagina should be syringed out with some injection. (F. 153, 155.)