work can and should be indulged in to the very end. Find time to spend at least one hour and a half in the open air every day. Unless there is a medical reason against active exercise there is nothing so beneficial to the pregnant woman as walking, nor is there any substitute for it. A drive or motor ride into the country, or a car ride around town, is an excellent device against ennui and is highly desirable during this time, but not as a substitute for the daily long walk. A pregnant woman must keep her muscles strong and in good tone if she hopes to do her share toward having a short and easy confinement. She must keep active to ensure perfect action of all her organs—the stomach must digest; the bowels and kidneys must act perfectly; the heart, and lungs, and nerves must be supplied with good blood and fresh air; the appetite must be keen, and the sleep sound. Walking in the open air will do all this and nothing else can, to the same satisfactory degree.
Light passive exercise at home is desirable to those very few who cannot walk in the open air, but at best it is a poor substitute. It is necessary to avoid any exercise or any labor of the following character from the very beginning of pregnancy: stretching, lifting, jarring, jumping, the use of the sewing machine, bicycling, riding, and dancing.
She should continue to employ the same toilet privileges she has been accustomed to except the use of the vaginal douche, which must be stopped from the date of the first missed menstrual period. This is the only safe rule to follow and no exception should be made to it except upon the advice of a physician.
Bathing during the entire course of pregnancy is a highly necessary duty. It is particularly advantageous during the later months because it relieves the kidneys at a time when they are called upon to perform an excess of work. The temperature of the bath should be warm and rapidly cooled at the finish. Brisk rubbing with a course towel will ensure the proper reaction.
Sexual intercourse must be restricted during pregnancy; and it should be wholly abstained from during what would have been the regular menstrual periods, if
pregnancy had not occurred, for the reason that abortion is apt to take place. It is most harmful during the early and late months of pregnancy. Sexual intercourse is distasteful to most and harmful to every pregnant woman.
Clothing During Pregnancy.—The clothing should be so constructed as to relieve any undue pressure on the breasts or abdomen. For this reason it should be suspended from the shoulder. When it is appreciated that clothing supported by the waist crowds the growing womb, and exerts pressure upon the kidneys, and is responsible for many of the kidney complications that occur during pregnancy, no further reason need be given for discarding all clothing, except very light garments, that are not held by some device whose support is from the shoulders. A specially constructed linen waist is made and sold for this purpose. It is fashioned so that all the lower garments and the garters can be fastened to, and supported by it. Corsets should be absolutely discarded from the very first day of pregnancy.
In a large woman with a lax abdomen, a properly made abdominal support will not only be a great comfort but of real advantage. It should exert a support upward by lifting the abdomen, not by constricting it. It should therefore be obtained from a reliable dealer and be made and applied to effect the above object,—otherwise it may do more harm than good.
Diet of Pregnant Women.—Some degree of digestive disturbance and loss of appetite is the rule early in pregnancy. By the fourth month these conditions invariably cease, and the appetite and the ability to digest will greatly improve. The diet from the very beginning of pregnancy should be plain and easily digested. It is not possible to formulate an absolute table of what or what not to eat, as the same foods do not agree equally well with all patients. The individual taste should be catered to within, reason, and the meals should be taken at regular intervals. Articles of diet that experience shows do not agree with the patient should be rigidly excluded from the menu. A varied diet of nutritious character is essential during pregnancy in order to ensure good blood, health, and strength. A monotonous diet, or a diet composed largely
of stale tea, coffee, and cake, is not permissible, and may do untold harm. Pastries and desserts of all kinds should be excluded. In the later weeks of pregnancy, because of the large size of the womb, the diet should be cut down as the stomach is interfered with in the process of digestion. Should the patient at any time during pregnancy experience a loss of appetite, or an actual disgust for food as sometimes occurs, it is preferable to suggest a change of scene and surroundings rather than the use of medicine. A short vacation, a change of table, new scenery, will promptly effect a cure. This condition is mental rather than physical; the patient allows herself to become introspective; the daily routine becomes monotonous and stale; hence a change of a few days will be all that is necessary. If it is not possible for the patient to obtain a change of scene, a complete change of diet for a few days will often tide over the difficulty. We have known patients to take kindly to an exclusive diet of kumyss, or matzoon, or predigested foods, with stale toast or zwieback, to which can be added stewed fruits. Alcoholic drinks should be left out entirely.