About the fourth month the uterus rises above the pelvis into the abdominal cavity, and can then he felt through the abdominal wall. Soon after the mother commences to " feel life," owing to the jerking movements of the fcetus. At about this time, or a little later, an experienced physician is able to distinguish the heart-beats of the fcetus. " Feeling life " and the fetal heart-sounds are positive signs of pregnancy. In the sixth month of preg nancy the upper border of the uterus is at the height of the navel ; in the ninth month it extends to the pit of the stomach. If the baby be large, or if an excessive amount of " waters " he present, or if there be twins, respiration may be interfered with. Sleep is usually disturbed by the inconvenience of lying on the back.
Relaxation of the abdominal wall gives rise to so-called " pendulous " abdomen. This may cause a faulty position of the fcetus ; and, in order to prevent this as well as to limit permanent distention of the abdominal muscles, it may be advisable to wear an abdominal bandage. Whenever pregnancy has begun, or if the patient has skipped a menstrual period and it seems probable that she is pregnant, great care must be taken to preserve her own health as well as that of her child. Miscarriage, with its disastrous consequences, is only of too frequent occurrence ; and the mother should take special precautions to avoid it. See ABORTION. It is not necessary to omit the daily routine work of the house unless it be excessive. Light household work is, in fact, advisable ; but a pregnant woman should avoid all heavy work, as well as excessive attention to social duties, amusements, travelling, etc.
The conditions for normal pregnancy are mental calm and cheerful ness, the proper amount of work and rest, moderation in everything, and avoidance of all nervous excitement. A carefully regulated mode of living will prove the best means of overcoming the disorders which occur at the beginning as well as at the end of pregnancy. Since these disorders are mostly of a nervous nature, it is absolutely wrong for a mother to treat her self with excessive tenderness, and to regard herself as in invalid. The diet should be restricted, especially during the latter half of pregnancy, and should consist of non-irritating, readily digestible foods, which do not tend to cause flatulence. Over-indulgence in fatty, sweet, and farinaceous foods, as well as in liquids, is known to produce heavy infants, profuse waters, and difficult and delayed labour.
The frequent disorders of the stomach are partly due to indiscretion in diet, or are aggravated thereby. The bowels should be evacuated every day at a certain hour, and, if necessary, this should be brought about by the aid of enemas or mild purges (rhubarb, cascara, Carlsbad salt, etc.). Before resorting to these remedies, an attempt should be made to regulate the stools by letting the first meal in the morning consist of a glass of Nva t some honey, prunes, plenty of butter, and brown bread. If the vomiting becomes very severe, the family physician should be consulted. It is not wise for patients to take such a disturbance stoically, believing it to be unavoidable. Much may be done for this condition. Diarrhea may usually be effectively treated by dietetic measures, including the use of oatmeal gruel, arrowroot, etc.
Slight disturbances of circulation may occur during pregnancy, and are characterised by palpitation, dizziness, fainting spells, etc. These may be combated by lying down, and by taking a small dose of Hoffmann's anodyne. Dilatation of the veins of the leg may be treated by wrapping the limbs in elastic bandages. Constricting garments, corsets, and tight waist bands must he avoided. Toward the end of pregnancy the feet may become swollen, especially in the evening. This is a sign of congestion, because the head of the foetus partly obstructs the blood-vessels by pressure on the pelvis. If the swelling be permanent, and if the hands and eyelids are also involved, a more serious affection of heart or kidneys may be the cause of the symptom. In this case immediate treatment by the family physician is necessary ; otherwise the heart is apt to fail during birth, or poisoning may cause eclamptic convulsions. Both these conditions may lead to abor tion or to the death of the child. It is very important to have the physician examine the urine from time to time, with regard to its colour, quantity, and sediments, as this may indicate the possible occurrence of eclampsia, and make it practicable to avoid it. The urine must be voided every few hours, as an over-filled bladder is very liable to lead to retroversion of the uterus and to other disturbances, either during delivery or later.