Changes in the Breasts begin in the early weeks, and are at first feelings of fulness and tenderness, and sometimes even of sharp pain. The breasts feel firmer to the touch also, and the veins of the skin over them are more marked. About the ninth week the nipple is more erect and prominent, from the greater supply of blood. Around the nipple is a dark circle, called the areola. After the ninth week the colour of this areola deepens, and the areola itself be comes larger; the little elevated points present in the ordinary condition of the breast become more prominent and marked. These appear ances are always much more pronounced in dark than in fair women. In dark women, also, about the fifth month, an outer circle of faint colour ' may be perceived, called the secondary areola, which has been described as presenting the appearance produced on a dingy white, or tinted surface, by drops of water falling on it and taking out the colour. The deepening of colour is due to the deposit of an additional quan tity of pigment in the deep layer of the skin, and, since the deposit is more or less permanent, the change is most marked in first pregnancies.
Increased darkness of colour also occurs in a line about a quarter of an inch broad along the middle line of the belly from the navel down wards.
In some women also patches of a yellowish brown colour appear on the forehead, cheeks, 'breast, and neck, which, however, disappear .shortly after the birth of the child.
These signs, then, of suppression of the nioll tidy discharge, morning sickness, and simi lar digestive disturbances, and changes occur ring in the breasts, are the earliest indications of the pregnant state. Not one of them, how ever, taken alone, is to be regarded as offering satisfactory proof of that condition, but all taken together, while not affording conclusive proof, are to be regarded as very strong pre sumption of such an occurrence.
Among the later signs of pregnancy are— enlargement of the abdomen, movements of the child—quickening, and detection of the sounds of the child's heart.
Enlargment of the Abdomen does not occur till towards the fourth month, when the womb begins to rise upwards from the cavity of the pelvis (p. 63) into the abdomen. In the earlier weeks the increased weight of the womb, due to its added contents, causes it to sink more deeply in the pelvis, and this pro duces in the second month rather a flattening of the surface of the belly.
By the fourth month the womb, requiring increased room, has risen upwards, and may be detected above the edge of the bony ridge in front. By that time the person will be con scious of an increasing tightness of the dress, and by the end of that month the hollow round the navel is less marked than usual.
A progressive increase in size occurs till, at the seventh month, the hollow has disap peared, and the navel is on a level with the rest of the skin, after which time it begins to extend beyond the general surface. But, as with the other signs, this one must not be con sidered alone, for a tumour in the belly, dropsy connected with the ovaries, discharges pent up within the womb, as already noted (p. 627), and other causes will produce enlargement, which only skilled persons can distinguish from one another. Nor yet can this sign be taken along with that of suppression of the monthly illness as conclusive evidence of preg nancy, because monthly discharges prevented from escaping will occasion both conditions.
Movements of the A mother first becomes conscious of the move ments of the child in the womb at a period, roughly stated, about the middle of pregnancy. More accurately it is from the sixteenth or seventeenth week of pregnancy onwards that the movements may be detected, and if the date be noted, it affords valuable aid in deter mining the probable time of delivery. The period at which these movements are felt is called the period of quickening, because it was thought that then for the first time the child became active. In reality it is active before this, but about this time the enlarging womb comes into contact with the belly walls, and so the movement becomes sensible to the mother. The sensations are actually due to movements of the child—kicks, movements of the knees, &c.,—and are at first felt as feeble flutteriugs, which, as pregnancy advances, be come more and more pronounced, till they may even occasion pain and cause the mother to cry out.
By the fifth month they may be excited by pressing with the hands from the outside on the belly walls. In later stages the movement is easily visible, and one may be able to feel with the hand the outline of a knee, &c., as it passes along the wall of the womb. Now this is one of the most convincing signs of preg nancy, but it is yet possible to be in error regarding it. Rapid movements of gas in the intestine, irregular contractions of the muscles of the belly wall, heaving movements due to a bulging of the wall of a large artery (aneurism), &c., may be mistaken for movements of a child, and have been so mistaken by women who had previously borne children. Moreover, cases of what have been called "phantom tumour" have occurred, in which enlargement of the belly and the sensation of jerking movements were due to spasmodic contractions of the muscles of the walls of the belly.