We return from this digression to the condition of our interesting countrywomen; and, as a tribute of respect to the memory of her Royal Highness, would endeavour to direct to their advantage the preceding observations.
It is almost peculiar to the females of this happy land, that they occupy that station in society for which they were designed. Regard is paid to their education—their intellects are cultivated—whilst they retain that modesty and refinement which should ever designate them.
How much of our personal happiness do we owe to them!—are we not indebted to them for the sweetness and chastity of social intercourse—for the cheerfulness of domestic life—for the solace of times of sickness and sorrow—for the building up of our families, and the perpetuation of our names in human existence? Their claims are innumerable, and as cogent as the happiness and welfare of men can suggest.
Every expression of regard to their comfort and happiness is demanded; and when they are subjected to inordinate care, the token should be peculiar and spontaneous. It is unpardonable, that in the treatment of female diseases there should be either rudeness or indecency.
The express object of this paper is to check a disposition to draw illegitimate and unfavourable conclusions from recent circumstances—to divert their thoughts from fear. Yet, as they are capable of reasoning, and, indeed, will not be satisfied, without a rational demonstration, that there is no ground for evil forebodings; we shall endeavour to meet them on this fundamental principle. And, first, we shall attempt to evince that the death of the Princess Charlotte, neither indicates a condition more precarious than heretofore, nor does it detract from the efficient aid which art is adequate to afford at this interesting moment. In the second place we shall point out some circumstances in natural and premature labour, on which recovery greatly depends.
In the case before us there is nothing peculiar. Royalty has no exemptions from disease; nor is there any royal exoneration from the contingencies of human life. If a female, in ordinary rank, die of fever, it is not brooded over to excess; and if one in these subordinate walks fall in the hour of child-birth, soon its influence subsides. But illustrious station gives unparalleled horror to death; not because it differs abstractedly from the death of others, but, because in the fall of persons eminent in rank or office, the relationships of life are more deranged, and even the interests of a country may be affected. Yet is the article death the same. Truly a life so valuable to the country, as that of her Royal Highness, did not exist in Britain. Yet this does not modify the event itself, for death recognizes no distinctions; and so rarely does it happen in these circumstances, that there are persons who have practised midwifery for a series of years without meeting with such an occurrence. The very circumstance that encircles that event with peculiar mystery and solemnity, is calculated to impart to those we are now addressing, the greatest encouragement—it was unexpected. Were it not uncommon, it would not have been unlooked for; and the public are incompetent judges of the unfrequency: for the unfavourable instances, which are rare, are, on this account, topics of popularity; whilst the thousands of happy results, which happen every week, pass unobserved.[3]
In the management of pregnancy, the treatment should commence with the earliest period. To regulate the condition of mind is important; to avoid the sight of disgusting objects,[4] and other circumstances likely to evolve any strong emotion. To live temperately; to avoid stimulating diet; to regulate the bowels by some unirritating aperient, and to use but moderate exercise.
In the arrangements preparatory to parturition, the objects which present themselves are two-fold. First, to secure efficient aid; and, secondly, such attendance as may be most likely to keep the mind comfortable, and which shall carry into full effect every means devised at the time of child-birth as well as subsequently. On the former topic it is neither proper nor necessary to speak. The selection of persons to attend, in parturition, is unquestionably momentous. The nearest relatives are often the most unsuitable. Kindness and sympathy exhibited with confidence inspire courage and patience; but if they are associated with anxiety and impatience, their usefulness is completely frustrated. If relatives are chosen, they should be such as know how to regulate their feelings—when to withhold, as well as when to impart. On the other hand, those who have no feeling, no commiseration, (and there are such among women), should be fully excluded from such an occasion, and there should not be one person present as a mere spectator. But of ordinary attendants, the selection of a good nurse is of chief importance. It should be essential that she have discharged maternal duties; that she be experienced—good tempered—moderately active—of good understanding—modest, not forward; and not loquacious. She should know how to discharge the duties of her office without stepping beyond it. She should have judgment enough to buoy up the spirits when they needlessly flag, and caution enough not to permit unusual symptoms to arise without the cognizance of those on whom that responsibility more particularly rests.
Persons whose minds have been little cultivated, are apt to seek undue commendation, and to gain by improper means the confidence of their employer. However well disposed and well informed the lady, perhaps her knowledge of parturition may be circumscribed by her personal experience. But the nurse is supposed to have gained much knowledge, beyond the immediate obligations of her own station, by her intercourse with medical practitioners. She thinks herself competent to the comparison of the different methods of management which may consist in mere circumstantial differences, but which by her are made important. She thinks herself competent to change diet, to administer medicine, to regulate the time of rising and sitting up, in the absence of the practitioner, and often even contrary to his orders. Because they have seen spirituous liquor given in some cases without actual injury, they think it may be given in all; and it is often only by a positive injunction this can be counteracted. They propagate unnecessary follies respecting the peculiar dangers of certain days. And if the patient be dejected, they rally them, and often urge the necessity of premature rising to dinner or tea, to promote cheerfulness. Within the last few weeks, though spirits had been decidedly prohibited in a case of first parturition, as soon as the practitioner had left, the nurse so boldly urged some brandy, that the lady could not refuse compliance. The obtrusiveness and loquacity of this person very materially affected the recovery of an interesting woman. We express ourselves strongly and decidedly on this point, because we pity a delicate inexperienced female, who happens at so critical a moment to be managed by an ignorant or obtrusive nurse; and because we have no question that most of the evils which spring up subsequently to parturition, arise from the contravention of proper orders, either respecting quietude or diet. During the first few days or week in all cases the entire regulation of even minute particulars should be under the direction of the medical attendant; and in some cases this attention must be carried farther. It must not be tolerated that a woman who shall have had the longest experience, and who may even be able to detect striking differences, should prescribe either counter to established regulations, or when medical advice is accessible. There certainly are instances of sudden transition, in which the nurse must act according to her best judgment, and in which, if wrong, she is not blame-worthy. When on this topic, I cannot totally exonerate the accoucheur from some connivance in the assumed importance of the nurse; and through a want of explicitness and decision, she has often been left either to the selection of her own plans, or plans have been so carelessly or loosely suggested, that it may justly be questioned whether it was intended they should be enforced.
It would indeed be a great advantage to society, if persons of this description were not permitted to assume the office of nurse without testimonials: but as the field is now open, not only should ladies be circumspect in the selection, but it behoves the guardians of the public health, even if it be unsolicited, to counsel their friends in the choice. In their intercourse with nurses, they are best qualified to assert their respective merits, and they ought to distinguish between the meritorious and the ignorant or froward.