CHAPTER VIII
THE MANAGEMENT OF LABOR
When to Send for the Physician in Confinement Cases—The Preparation of the Patient—The Beginning of Labor—The First Pains—The Meaning of the Term "Labor"—Length of the First Stage of Labor—What the First Stage of Labor Means—What the Second Stage of Labor Means—Length of the Second Stage—Duration of the First Confinement—Duration of Subsequent Confinements—Conduct of Patient During Second Stage of Labor—What a Labor Pain Means—How a Willful Woman Can Prolong Labor—Management of Actual Birth of Child—Position of Woman During Birth of Child—Duty of Nurse Immediately Following Birth of Child—Expulsion of After-birth—How to Expel After-birth—Cutting the Cord—Washing the Baby's Eyes Immediately After Birth—What to Do with Baby Immediately After Birth—Conduct Immediately After Labor—After Pains—Rest and Quiet After Labor—Position of Patient After Labor—The Lochia—The Events of the Following Day—The First Breakfast After Confinement—The Importance of Emptying the Bladder After Labor—How to Effect a Movement of the Bowels After Labor—Instructing the Nurse in Details—Douching After Labor—How to Give a Douche—"Colostrum," Its Uses—Advantages of Putting Baby to Breast Early After Labor—The First Lunch—The First Dinner—Diet After Third Day.
When to Send for the Physician in Confinement Cases.—The physician should be notified just as soon as it is known that labor has begun. The adoption of this course is necessary for a number of reasons. It is only just that he should have an opportunity to arrange his work so that he may be at liberty to give his whole time to your case when he is wanted. He may not be at home at the moment, but can be notified, and can arrange to be on hand when your case progresses far enough to need his personal attention. It will relieve your mind to be assured that he will be with you in plenty of time.
Don't worry unnecessarily if he does not come immediately when you notify him, provided you notify him at the beginning of labor. There is plenty of time. You have a lot of work to do before he can be of any help. Many women entertain the idea that a physician can immediately perform some kind of miracle to relieve them of all pains at any stage in labor. This is a mistaken idea. No physician can hasten, or would if he could, a natural confinement. He waits until nature accomplishes her work, and he simply watches to see that nature is not being interfered with. If something goes wrong, as it does now and again; or if the pains become too weak, or if the proper progress is not being made, he may help nature or take the case out of her hands and complete the confinement. If it is thought best to do this, there will be plenty of time.
The Preparation of the Patient and the Conduct of Actual Labor.—It is assumed that the patient has adhered to the instructions of the physician given during the early days of her pregnancy. These instructions included directions as to exercise, diet, bathing, etc.
Having calculated the probable date of the confinement, it is the better wisdom to curtail all out-of-door visiting, shopping, social engagements, etc.,—everything in fact out-of-doors except actual exercise, for two weeks previous to the confinement date. The usual walk in the open air should be continued up to the actual confinement day. The daily bath may be taken, and it is desirable that it should be taken, up to and on the confinement day.
The Meaning of the Term "Labor."—By labor is meant, the task or work involved in the progress by means of which a woman expels from her womb the matured ovum or child. After the child has been carried in the womb for a certain time (estimated to be 280 days) it is ripe, or fully matured, and is ready to be born. The womb itself becomes irritable because it has reached the limit of its growth and is becoming overstretched. Any slight jar, or physical effort on the part of the patient, or the taking of a cathartic, is apt to set up, or begin the contractions which nature has devised as the process of "labor" by which the womb empties itself.