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The Management of Pregnancy

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The mouths of pregnancy are periods of con siderable anxiety and trouble to most women, and are especially so to those who pass through theui for the first time. It is natural that women pregnant for the first time should seek advice and counsel from more-experienced female friends, who are, as a rule, too willing to offer the results of their experience, and to impress their lessons on the mind of their less experienced friend. As a rule, however, the advice is as various as it is plentiful, and often very conflicting. It is, moreover, so often accompanied and enforced by narrations of misfortune and trouble that the mind of the receiver is often perplexed and confused, and also filled with grave fears, which she can hardly utter. Now it must not be forgotten that pregnancy is a natural process, that nature is usually sufficiently able to accomplish well her purposes, and that the vast majority of pregnancies, if allowed to pursue, without meddlesome interference, their natural course, end naturally, easily, and successfully.

The woman, who is looking forward with some quite natural anxiety to the birth of her child, should turn a deaf ear to the tales of woe, which friends too often delight to com municate, and should endeavour to preserve a cheerful and equable frame of mind, which is the only condition justified by the facts. She ought early in the months of her pregnancy to determine who shall be her medical attendant, and if she has any doubts or misgivings, or really wishes advice on any particular point, she ought without hesitation to go to him for it. If she has made even an ordinarily good choice, she will find her doubts removed, and her mind quieted, and will have an authority, to whom the advice of her friends can be sub mitted, and by whom it can be, without offence to them, satisfactorily disposed of.

Much may be done, by pursuing a regular method of living, to make the months pass in comparative ease and comfort. To aid in ac complishing this, some general directions will be given.

is no special diet suited more than another to the pregnant state. The rule is plain nourishing food at appropriate and re gular intervals. Very rich and highly-seasoned dishes are undesirable. In some cases there is a craving for certain articles, and provided they belong to the nourishing class of foods, the yielding to the craving in moderation is not to be denied; but in a few cases the crav ing is for unwholesome and nauseous sub stances. This is to be considered as morbid, and ought to be held in restraint not only by the person herself, but also by all who sur round her.

Stimulants are neither necessary nor desir able in ordinary circumstances. It is not

denied that they are often useful and perhaps also necessary, but the tibiefulness and necessity ought to be judged of by the medical attendant and not by the patient herself or her friends.

Clothing should be carefully adapted to the varying condition of the person, and should never be at any part tight fitting. Enough has already been said on the subject of corsets (p. 611), but in the pregnant condition their evils are much increased. "The Romans were so well aware of the mischief caused by com pression of the waist during gestation, that they enacted a positive law against it; and Lycurgus, with the same view, is said to have ordained a law compelling pregnant women to wear very wide and loose clothing." In the later months a bandage, broad in front and narrow behind, if properly fitted so as to support the womb without compressing it, will give much comfort. It should be put on while the person lies in bed on her back, and should be removed at night.

Exercise. — During the early months of pregnancy there is difficulty in taking walking exercise, because the womb sinks down lower than usual on account of its increased weight, and makes walking attended with discomfort if not actual pain. When the womb has risen upwards, owing to its requiring more space, this difficulty becomes less, and thus during the middle months of the nine, exercise is more pleasant and less fatiguing. Towards the end of pregnancy it becomes increasingly difficult because of the size and weight, and also because the joints become lax, in prepara tion for the period of delivery. Gentle, regular, and moderate exercise, obtained by walking, should, however, be persisted in throughout the whole period, never, however, so as to cause pain. The patient must not allow her inclination to be completely at rest so to over come her as to prevent her obtaining the slight change and beneficial stimulus which a short period in the open air will secure to her. In particular the desire to avoid the public gaze ought not to keep the person completely in doors for the last month or two of pregnancy, as it too often practically does. Gentle car riage exercise need not be forbidden, but jolt ing over rough roads is plainly likely to be injurious. Lengthened shopping expeditions and such like are too frequently the cause of miscarriage during the early months as well as during the later mouths. While more rest is needed than in the non-pregnant state, an in creased amount of rest ought not to be per mitted to lead on to idle, lazy, and indolent habits.

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