In those women who have borne children, and those who have gone through
a miscarriage, retroflexion is frequently met. A little reflection
will make this clear, for when we remember how the pregnant uterus at
any time from conception to final delivery becomes congested and the
seat of a corresponding growth of its own tissue to accommodate the
growing fetus, we at once perceive that either after an abortion or on
delivery at full term, the enlarged and congested uterus is in the best
possible condition, to lose its normal place and sink backwards. The
pernicious custom in vogue in most countries, of keeping a woman on the
flat of her back after delivery, has never been as vehemently opposed
by the intelligent members of the profession, as the gravity of the
subject demands. Some women have an idea that the longer and quieter
they remain on their backs, the surer they are to make an excellent
recovery from the lying-in chamber. American and English practitioners
are inclined to recommend this as the most proper way to lie, but there
is no doubt that this not only favors the occurrence of retroflexion,
but that it actually causes it.
The woman who rests on her back gives to the heavy body of the womb an
opportunity to sink backwards, after the distended bladder has pushed
the organ high enough up so that its own weight may throw it over,
until it finds resistance on the posterior wall of the pelvic cavity.
Many nurses insist on the dorsal position for days, and never permit
the patient the privilege of lying upon one or the other side. Aside
from the injurious effect that this has on the position of the uterus,
it is exceedingly tiresome to be compelled to remain for several days
in one position. Women should be allowed to lie on all sides, after
delivery, and no longer on one side than on another. And to insure
against a retroversion or flexion, she must also lie on the abdomen a
certain length of time during each twenty-four hours.
Tight bandaging after delivery, for “preserving the figure,” greatly
aggravates the displacement; the binder should be so applied that it
feels comfortable but not too tight, its purpose being to offer a
gentle support to the suddenly relaxed abdominal muscles, and thus
stimulate them to contract to their normal form.
The symptoms of retroflexion are greatly varied by the pathological
conditions that affect the uterus, or by the complications that may
have caused the flexion.
It is indisputable that the uterus may be retroflected for an
indefinite length of time without causing any inconvenience. From this
it may be inferred that the retroflection itself does not constitute
the disease, but the inflammatory processes, in which the organ is
involved, or the relaxation of the adjacent structures, as we find
them immediately after confinement, constitute the actual diseased
conditions.