Preparations for Confinement

sheet, bed, patient, waterproof, folded, labour, mattress and blanket

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The Bed should be a single one if at all possible. It should stand out from the wall so that both sides can easily be got at, and in such a position that the window does not face the patient, who should be able to lie on one side with her back to the light.

The position of the bed should also be such that, the patient lying on her left side, the medical attendant can be seated at the bed-side in front, and will have the patient's back to wards him and the patient's head on his left hand, while the light from the window is full on the front of the bed, or sideways on the front and foot. The more plain the bed the better—of enamelled iron or wood, or of brass, —the workmanship as simple as possible.

It should be without hangings or valance. Nothing should be permitted under the bed at any time, for however brief a period.

If the bed is new, a wire mattress is probably supplied with it, and a hair mattress on this is sufficient. If the bed is old and tends to sag in the middle, this may be corrected by a straw mattress, on the top of which the hair mattress rests.

But the history of these straw and hair mat tresses should be known. If they.are not quite new, the patient should make sure they have not been used in any case of illness of doubtful character.

To prevent sagging, in an old bed, wooden laths across the bed under the mattress may be used.

Bolster and pillows should be free of sus picion, like the mattress. Blankets and sheets should have been washed, in anticipation of their use, and should have been kept aside till needed, so that everything is perfectly fresh and clean.

The patient, aided by the nurse, should take pains, on the eve of the confinement, to go over everything needed and make sure that every thing is ready and clean.

Once the labour has begun it is extremely undesirable that anything in the shape of extra pillows, sheets, cushions, &c., should be brought in, and more particularly that any thing should be borrowed and brought in from a neighbour in a hurry. Infection may thus be carried.

A foreseeing nurse will anticipate all possible requirements and provide for them. She will even make sure that the extra pillow to put between the patient's knees as the labour pro gresses, and the stool against which she may press with her feet, are at hand and in a con dition fit for the purpose.

Special Bed Requirements.--The bed is made in the ordinary way, with certain additions. These special requirements are: A rubber or mackintosh or waterproof under the under sheet.

A rubber or macintosh or waterproof on the top of the under sheet.

A folded sheet or blanket on the upper waterproof.

The folded sheet or blanket is so placed that the patient lies on it, and it receives all dis charges from the womb during labour. It must, therefore, be large enough to prevent anything escaping on to the under sheet. The top water proof is immediately under this folded sheet or blanket, and should project with a considerable margin beyond the sheet on every side. After the labour is over, the folded sheet and its water proof are rolled up and withdrawn from under the mother and enclose within them all dis charge, so that there should be no soiling of the under sheet. The waterproof that then remains under the under sheet is only a further protection to the bed, lest anything should have escaped on to the under sheet. But where expense is a serious consideration, this under waterproof can be done without.

"Accouchement Sets" are now obtainable at all druggists'. They consist of two thick squares of wood-wool, with a dozen or so of wool diapers or sanitary towels. One of these wood-wool sheets—the longer of the two---is used during labour, instead of the folded sheet or blanket, is removed and burnt after labour, and is replaced by the smaller one.

As much care must be taken that the folded sheet or blanket is perfectly fresh and clean as with the more permanent bed-clothing. Soiled garments must never be used for this purpose.

If the cost of the articles does not need to be taken into account, the under waterproof ought to be a large square of thin rubber; the upper waterproof should be broad enough to extend in the bed from the waist to the knees of the patient, and should reach from one side of the bed to the other, overlapping both edges. On the top of this should be a large-sized wood wool accouchement sheet, or an ordinary sheet or half-blanket may be used, folded lengthways and laid across the bed, just overlapping the front, and the excess rolled up on the other side. As the labour progresses, and this sheet becomes soiled, it is drawn through under the patient, the soiled part being rolled up on itself, and thus a fresh portion is always under the patient. But the accouchement sheet is to be preferred, because it sucks up or absorbs the discharge and does not permit it to flow away over the bed.

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