Obstetrics for NursesReed, Charles B. (Charles Bert)
Science
Obstetrics for Nurses
Reed, Charles B. (Charles Bert)
Maternity nursing
=The subject of maternal impressions= is the cause of much anxiety
during pregnancy. It is safe to assure the mother that it is nearly
impossible to mark her child by emotional stress. There is no
demonstrable nervous communication between mother and child, and most of
the deformities that occur and are attributable to shock, etc., can be
explained by our knowledge of intrauterine changes. Furthermore, the
same deformities occur in lower animals, to which it is difficult to
ascribe such high nervous organization.
Many of the birthmarks, supposedly due to shock, occur too late in the
pregnancy to affect the child, even if it were possible, for the child
is completely formed before the fourteenth week.
=The Determination of Sex.=—It is not possible to know in advance of
delivery whether the child will be a male or a female. It is equally
impossible to determine or even to influence the sex of the coming
child. Many theories have been advanced, and much talent has been wasted
in trying to solve this problem.
Reasoning by analogy from the facts obtained from lower animals, the sex
of the child is unalterably decided the moment conception occurs. The
responsibility for the decisions seems to lie with the male cell. All we
really know is that the sexes appear in the ratio of 100 girls to 106
boys.
CHAPTER V
ABNORMAL PREGNANCY
After the diagnosis of pregnancy has been satisfactorily established, no
further internal examinations are necessary in the absence of special
indications, until about the thirtieth week.
At this time a series of complete physical examinations may be required
to determine the presentation and position of the child, the presence
and rate of fœtal heart tones, the diameters of the head, the length and
approximate maturity of the child, as well as the condition of the bony
and soft passages of the mother.
It is thus that an appreciation of the obstetrical problem is secured
and a course laid out for its successful solution.
Pregnancy is not a disease, but a normal function; but the woman is
exposed, nevertheless, to many grave risks that are peculiar to her
condition and to many complications accidental or otherwise which are
more serious on account of her pregnancy.
=The Toxæmias.=—The growing ovum brings about changes in the maternal
metabolism that are manifested by characteristic symptoms which in other
better known conditions are recognized as due to toxæmia. Therefore,
while there is no positive proof as yet that these symptoms, arising
during pregnancy, are toxæmic in origin, the evidence goes to show that
they are; and, therefore, should be classified as toxic.
Postmortem findings in eclampsia and pernicious vomiting such as
extensive thromboses, cell necrosis, and interstitial hæmorrhages are
very suggestive.
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