To wash or cleanse the patient so that the pores of the skin in every part are free and unobstructed, a soft napkin wet with warm soap and water, should be passed underneath the bedclothing, and she should be rubbed all over without any exposure to a draught of air. In some way she should take a sponge bath every day.
The CLOTHING which a patient will wear immediately after a labor has been already, indicated. As some garments worn during labor are not necessarily soiled, they may be worn until the third or fourth day, when the dress should be changed. This may be done without tiring or exposing the patient. Without raising her up you can pull the bedgown down from over each arm, and after removing it from under the body, you can draw down the chemise and remove it from below. You can place her arms in the sleeves of the clean chemise, throw it over her head and pull it down; and put on a clean bedgown in a similar manner, or both may be put on at once.
The BED CLOTHING as well as the body linen should be changed frequently. In changing the upper sheet it should be pulled off from below, and the clean one can be carried down in its place without removing the other bedclothes, by plaiting the lower half of it. To put on a clean under-sheet, plait one side of it, and place that under the patient while she lies on her side, then let her turn on her back or other side onto it, and draw out the plaited part. Care of this kind is necessary until she is able to sit. Have the sheets well aired, and have a proper temperature in the room.
The lying-in room should always be kept well ventilated and rather cool; it is injurious to the patient to have the room kept at a high temperature. Perhaps the ventilation can be secured by having a little fire in the room, and by occasionally leaving the door of the apartment ajar, at the same time being careful to guard against draughts. But visitors remaining in the room, or any additional number of persons, serve to vitiate the air, as well as to prevent the necessary repose of the patient. A sensation of chilliness may be felt by the woman after delivery, and her feet may be cold; if they are, something warm should be applied to them, and sufficient clothing should be on the bed; but afterwards be careful not to overload her with clothes, as well as to avoid having the room overheated.
Too much light in the room may be injurious to the eyes of the mother or child, and it is often necessary to darken the room somewhat for a few days.
The lying-in woman will usually be confined to her room for two weeks. After the first fifteen days she may very properly remove to another room adjoining, or near at hand, and during her absence her room and bed may be ventilated by throwing the windows wide open and throwing the bedclothes back. Ordinarily she may, at the end of three weeks, take her meals with the family, but she ought still to lie down occasionally to rest her back. At about this time she may take an airing in a carriage, if the weather be fine.
All lying-in women ought not to be treated alike in regard to DIET, etc. While a light, unstimulating diet is best at first in ordinary cases, the weak and delicate require good, nourishing food from the commencement, such as beef tea, chicken broth, mutton chops, eggs, etc., (F. 57, 58, 59.) Oatmeal gruel increases the secretion of milk, is nourishing and easily digested, at the same time it is simple and bland, and proper for those that are corpulent, or strong and robust, and the same may be said of good cow’s milk. But, as the healthy mother furnishes daily from a quart to a quart and a half, she needs some meat to keep up her strength. Never give stimulants to increase the woman’s strength, or to increase the quantity of milk.
In some cases, after a severe and lingering labor, there is RETENTION OF URINE. If the bladder cannot otherwise be emptied, the catheter must be used every six or eight hours.
The bowels are usually costive after a confinement, and I prefer to give a dose of castor oil the third day. If this or some other aperient is not given, enemas should be administered sufficient to cause evacuations.
The care of the MOTHER’S BREASTS is important. Before the milk is abundantly secreted, she should not be fretted by very frequent ineffectual attempts at nursing, though it may be necessary to draw out the nipple by means of a breast pump. The milk should be drawn out when the breasts become full and distended, and they should not be allowed to remain hard and sore. Apply fomentations; cabbage leaves, wilted in hot vinegar and water, or warm solution of carbolic acid, one part to eighty. If they continue to be swelled and painful use F. 221, 223. It may be necessary to make gentle pressure upon them by means of strips of adhesive plaster, or by a sort of jacket or bandage, that should be prepared especially for the purpose. When the breasts are closely bandaged they should be supported on each side by pads of cotton, so that the pressure will be made equally upon them.