The Prospective Mother, a Handbook for Women During PregnancySlemons, J. Morris (Josiah Morris)
Science
The Prospective Mother, a Handbook for Women During Pregnancy
Slemons, J. Morris (Josiah Morris)
Obstetrics; Pregnancy
The vulva and neighboring parts are bathed with a 1-1000 bichlorid
solution. Soiled dressings are removed, the gown changed, and, if
necessary, clean sheets put on the bed. A sterile sanitary pad is
placed over the vulva and a fresh one substituted as often as
necessary, but none of the pads should be destroyed. All the
dressings must be saved so that the doctor may see how much blood has
been lost. As we have learned, bleeding regularly occurs while the
placenta is separating and thereafter; excessive bleeding will rarely
follow a normal delivery if the attendant has heeded the precaution
to leave everything to nature. If ever the loss of blood should
become alarming before the doctor arrives, it is advisable to raise
the foot of the bed, to keep the patient quietly on her back, to
grasp the womb through the abdominal wall, and to massage it
constantly until the nearest physician can be gotten.
Of these directions the most important is that which relates to the
management of the womb, for in cases in which labor has been normal
in other respects the relaxation of its muscle is most often
responsible for flooding. What to do in this event must therefore be
made plain. First the patient should try to empty her bladder, and,
if she cannot, pressure made above the organ will usually expel the
urine. The attendant will then take her seat on the edge of the bed,
facing the patient's feet, and will locate the womb. When there is
flooding one may expect to recognize the womb as a large, rather soft
mass lying in the mid-line of the abdomen with its upper margin
somewhat above the navel. With one hand, or with both if necessary,
the mass is grasped in such a way that the fingers cover the top of
it and pass backward toward the spinal column; the thumb remains in
contact with the front of the organ. The womb is stroked and squeezed
much as one kneads dough, and for this reason the procedure is
technically called kneading. Such manipulations cause the muscle
fibers to contract firmly, and in consequence the blood vessels are
tightly closed and bleeding ceases. Similarly, cold applications to
the abdominal wall tend to provoke uterine contractions; placing over
the womb an ice-cap or towels wrung out of cold water and doubled
several times often have a beneficial influence when there is a
tendency toward relaxation. Some physicians also recommend that the
child be placed at the breast, since suckling is known to cause
uterine contractions. There are other measures which are occasionally
employed, but they should be used only by physicians, for in the
hands of an inexperienced person they may do more harm than good.
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