CHAPTER XVII.

SURROUNDINGS AND AFTER-CARE OF THE MOTHER.

Maternity Should Have the Largest and Brightest Room in the House.—It is Her Coronation Room.—Simplicity of Labor with Healthy Women.—Science Has Reduced Risk to the Minimum.—The Exaltation of Motherhood.—The Rest after Labor.—How to Prepare a Bed for the Parturient.—Deliverance of Mother from Friends and Visitors.—Sanitary Pads.—Regular Nursing.—Undisturbed Sleep.—No Binder Necessary for Mother.—The Care of the Breasts.—Diet.—Sitting Up.—Six or Eight Weeks Needed to Regain Normal Condition.—The Use of the Douche.—Sore Nipples.—The Bearing of Children not to be Dreaded.—The Joy of Motherhood.

The room chosen for the lying-in should be as large and warm and sunshiny as any room in the house. It should be far enough from the living rooms to be quiet the greater part of the day, and yet not so far as to feel isolated. The centre of the home at this time is the little mother, and the room in which she rests after her perilsome journey is the throne room, where love and homage crown her queen, and welcome right royally the little prince or princess, who has come to share her reign. Nothing unpleasant should be allowed to enter this room, for the happy and quick getting up of the patient depends much upon the smooth running of the home machinery. One hour of mental disturbance, may add days to the lying-in, and one discordant person can make more unrest and trouble than all the others combined can overcome. Therefore look well to the helpers in the home, that they be in harmony with the home-keeper.

Had we to deal with labor in its simplicity, as a physiological act, natural and uncomplicated with faulty living and semi-invalidism, the physician’s and attendant’s duties in the days following delivery, could be expressed in few words; but owing to the results of our boasted civilization and high pressure living, which too often in its mad rush has robbed womankind of the sturdy physique, and sound brawn and endurance so much needed in the everyday emergencies of life, she comes to the ordeal of maternity badly fitted for its strain, and with little or no reserve power, either to carry her through the hours of incomparable pain, or to aid in her restoration in the days following. In other words, labor has come to be pathological or abnormal, instead of physiological or normal, in the majority of cases, and as such, the attendant cares have come to be correspondingly onerous.

That great changes have been made in the past thirty years since the promulgation of the germ theory of disease, in the management of the lying-in room is unquestioned. The patient is no longer left to the recuperative forces of nature alone, but is aided as well by every wise provision of art and science, and as a consequence the mortality rate of parturients has been reduced to a minimum.

But something more than getting the mother up is desired, namely, getting her up as well and strong as ever. Child-bearing should not deplete a woman’s strength, neither should it detract from her beauty and freshness, but should add charms, even as it adds to her mental and spiritual attractiveness by the sweet consciousness and dignity that she is a mother, and that henceforth a little soul looks to her for the interpretation of life’s meaning, and for the guiding of little feet along its devious paths. Oh mother, what a privilege; that you may shape this fair thing into a soul to your thought and God’s liking, for His promises are sure along these lines. Listen! “Instead of thy fathers shall be thy children, whom thou mayest make princes in all the earth.” As if the dear Lord were comforting His daughters in going out from the home nest, and the peculiar protecting care of the father, by reminding them that henceforth a sublimer thing awaited them than the protection of a father’s love; namely, themselves assuming the part of parent, enfolding and shaping in their love, the little lives, according to His will, into fair and noble souls that shall bless the world and make it richer for their living.

Immediately following delivery, the physician in charge should see that his patient is made comfortable. A rest of half an hour at least should be allowed her, while physician and nurse look after the little one. Then lacerations if any must be seen to—for they will occur occasionally even in the most skillfully conducted labors.

If the gown is turned up under the shoulders during delivery, and held securely in place with a safety pin, there will be no necessity for changing this, and a toilet of the bruised and sore parts will take but a few moments, and the mother will be ready for her long delightful rest.

It may not be out of place to give directions for making the bed preparatory to the confinement. There is a right way and a wrong way for doing even this. The bed should be made double. First over the mattress should be placed a square of rubber sheeting—or oilcloth if the rubber is not easily obtainable—large enough to cover the entire middle of the bed, and within eighteen inches of the head and foot. This should be securely fastened at the four corners with safety pins, and at the middle on each edge, to prevent wrinkling. Over this is placed a sheet covering the entire bed; over this a sheet folded lengthwise, then crosswise, to make a square; this is called the draw sheet, and must be fastened at the corners with safety pins. This is the first bed and that which is to remain after the toilet is made following delivery. Over this a third sheet is placed covering the entire bed, then another draw sheet fastened as the other. These last two are removed with small discomfort to the patient, after delivery, and a clean fresh bed remains.

An excellent thing to insure greater cleanliness, is to prepare a bag about two feet square, made of old cotton cloth, and filled to a thickness of three or four inches, with wheat bran. This, if placed directly under the body will absorb all the discharges, and can be burned when removed, and thus much washing be saved.

Now the mother should be left several hours undisturbed; for she needs rest, and must have it. One rule should be made inviolable for every lying-in room; namely, no company should be allowed, other than the immediate family, until the patient is sitting up; then she will be strong enough to bear the “ohs” and “ahs” of admiration, and the wise and otherwise volumes of advice, upon the care and training of the little one, which will be gratuitously bestowed. The nurse will have no difficulty in carrying this out if she have the physician’s authority to support her. Many little mothers have been hindered in their recovery, and have finally gotten up weak and nervous, through the indiscretions of their thoughtless, if well-meaning friends. The heartfelt prayer of every parturient should be, “Lord, I am delivered of my child safely, now deliver me from my friends.”

Before confinement two dozen of napkins or pads should be prepared for the mother in the following manner. Get an ordinary grade of cheese cloth, and enclose in a square of it folded corner-wise, a strip of medicated cotton six inches long. These can be used as napkins for the mother safely, as they are aseptic, and after they are soiled can be burned. These are comparatively inexpensive, as a pound of cotton will make the entire number.

If the confinement has been in every way a normal one, the care necessary will be easily given. To keep the baby quiet and contented, and from the beginning free from night nursing, that the mother may be insured a good period of rest, is one of the strongest aids to her speedy recovery. What I mean by freedom from night feeding is this. At ten o’clock the baby may be put to the breast, and then not again until four or five in the morning. That they can be thus taught, and that they will thrive under it, I have many times demonstrated; and that the mother will thrive is a foregone conclusion. This will be further discussed in the chapter on the care of the baby.

No binder for the mother is necessary, as I have in my own practice many times demonstrated. It seems to me a reflection on the creative work of the Maker. They are used and recommended ostensibly as a support, and to insure a good form after getting up; while in reality they defeat the first purpose by crowding down the uterus instead of holding it in place; while the muscles of the abdomen are quite capable of contracting and insuring the former figure, without the use of a binder.

On the day following delivery the physician will see that the patient urinates freely, and the bowels, if they have been kept open before delivery, will need no attention until nature calls for an evacuation. A simple enema of warm water will be all that is needed to aid in this. Immediately after delivery, and after the toilet, to patients who can take it, I recommend a cup of hot milk, to others a cup of beef tea made from beef extract, if more acceptable than the milk.

Until the mother’s milk is established, the food should be light and simple, with not too much of liquid to stimulate too great a flow of milk. If the milk comes with a rush the breasts may be painfully distended, and more may be secreted than the baby will take. If so, all that will be needed is a gentle rubbing of the breasts from the circumference toward the nipple, with the fingers dipped in hot lard. The nurse if well chosen will be schooled in this, and only enough milk should be rubbed out to relieve the breasts, as very soon the little one will need all that is secreted.

After the milk is established the diet can be more generous, and on the eighth day if all goes well, the little mother can sit up in bed to eat her meals; and after the tenth day she may have her wrapper on and slip out into a rocker for a few hours, but she should avoid walking about for some days yet. The reason for this carefulness? The uterus which has enlarged from a tiny organ, weighing a few ounces, to many times its original size and weight, cannot regain its original condition in a day. To quote from Leavitt again. “In normal cases complete involution, (_i. e._, reduction to normal size), is effected in _six or eight weeks_. The progress of uterine diminution is graphically shown by Heschl, from the weight of the organ at different periods. Immediately after delivery he found that it weighed twenty-two to twenty-four ounces; in one week it was reduced to nineteen to twenty-one ounces; at the end of the second week it weighed ten to eleven ounces; at the close of the third week it weighed five to seven ounces; and at eight weeks its weight was but a little in excess of that which preceded the first pregnancy.” All this methodical work of nature may be greatly hindered by carelessness and by getting up too early, hence, “make haste slowly.”

The douche in the after care of the parturient has been variously discussed. A hot douche immediately following delivery, to cleanse thoroughly the uterus of any clots or bits of membrane that may be hiding there, is, we believe, productive of no harm, and may obviate much trouble thereafter. A daily douche of hot water containing a little calendula or listerine, is cleansing and is often very grateful to the patient, but is not, in the absence of unnatural conditions, a necessity. Nature undisturbed knows how to take care of the outlets, in cleansing and recuperation, if all has gone well. In many cases the douching is overdone, and is productive of weakness rather than strength.

Should the nipples give trouble, from sensitiveness or fissures, washing them off and dusting them with calendulated boracic acid, or simply bathing with calendula, may heal them very quickly. If this alone fails, before each nursing apply over the nipple a piece of gold-beater’s skin—which may be obtained of any reliable druggist—puncturing with several openings to allow the milk to pass through. Make a fresh application each time, and by thus persistently keeping the lips of the child from the sensitive surfaces they are enabled to heal.

With all these careful directions, dear young mothers, do not be frightened into thinking that the bearing of children is something to be dreaded, and something which involves great danger. It is neither. The bearing of children was intended in our creation and is a natural, physiological process, and the All-wise Creator has amply fitted us for it. If we come to maternity unprepared, it must be because of ignorance on our part how to fit ourselves properly, or from unhygienic and harmful ways of living. Heed the laws of health, keep a sweet, trustful spirit, avoid excitement, consider yourself strong enough for the great office for which nature designed you, and you will be the “joyful mother of children.” Otherwise your joy will be mixed with fear and a thousand foolish worries, that totally unfit you for your high office.

Be happy that you are capable of becoming a mother, be happy when you have the promise, and be happiest of all when you hold your little one in your arms. Train them, all that are given you, to the fear of God, and for the good of mankind, and you will be a great woman, whether your name ever reaches beyond your immediate neighborhood or not. It is a great thing to become a mother of children. To become God’s vicegerent in creating and training souls that may bring gladness and regeneration to the dark places of the earth. Mothers, mothers! rate your privileges high, and live and train to a glorious fulfillment of noble purposes these gifts from God.