- Heavy menstrual pains.
- Backache.
- Hemorrhage.
The approach of the calendar date of the third month of pregnancy should be watched for, and all work of a strenuous nature studiously avoided; while at the first signs of the backache or any unusual symptom, the expectant mother should immediately go to bed and send for the physician. One patient who had aborted on four different occasions was able to pass this danger period by adhering to a rigid program of prevention during her fifth pregnancy. Two weeks before the third month arrived she discontinued her teaching and went to bed. She remained there four weeks, thus running over into the middle of the following month. Gradually, she resumed her duties of teaching, carried her precious bundle of life to full term, and is now the proud and happy mother of a splendid baby girl.
Should abortion seem imminent, from one-eighth to one-fourth of a grain of morphine sulphate will greatly reduce all uterine contractions, and this, with the general quieting effect on the whole system, will usually suffice to prevent an abortion. The patient should quietly remain in bed from three days to one week.
If the abortion takes place—if a clot accompanied by hemorrhage is passed—save everything, lie in bed very quietly and send for your physician at once; and when he does arrive, be content if he does not make an internal examination at once, for if he should there is more or less danger of infection. And I repeat—throw nothing away—burn nothing up, save everything that passes until your physician has carefully examined it.
SUDDEN ABDOMINAL PAIN
Sudden or severe pains in the abdomen should be reported at once to your physician, while you should immediately go to bed and quietly remain there until you receive further instruction from your doctor when he calls.
In the later stages of pregnancy any appearance of blood should likewise be noted and reported without delay. These symptoms may not always be serious, but they are also associated with grave complications, and should, therefore, be given prompt attention.
MISCARRIAGE
Abortion is a term used to designate the loss of the embryo prior to or at the third month. Miscarriage applies to the expulsion of the fetus or emptying of the uterus after the third month. It is possible for a miscarriage to occur anytime during the interim between the fourth and ninth months. After the uneventful passing of the third month, if an accident threatens, we instruct the mother to remain quietly in bed three to five days at the calendar date comparable with each menstrual period; and as she approaches the seventh month, we adjure her to be unusually careful and prudent.
The causes of miscarriages are many: Disease of the embryo, imperfect fetal development, some constitutional disease of the mother, a faulty position of the uterus, or it may result from something unusual about the lining of the uterus such as an endometritis—an inflammation of the mucus membrane.