SPECIAL SAFEGUARDS IN CONFINEMENT.
1. Before the confinement takes place everything should be carefully arranged and prepared. The physician should be spoken to and be given the time as near as can be calculated. The arrangement of the bed, bed clothing, the dress for the mother and the expected babe should be arranged for convenient and immediate use.
2. A bottle of sweet oil, or vaseline, or some pure lard should be in readiness. Arrangements should be made for washing all soiled garments, and nothing by way of soiled rags or clothing should be allowed to accumulate.
3. A rubber blanket, or oil or waterproof cloth should be in readiness to place underneath the bottom sheet to be used during labor.
4. As soon as labor pains have begun a fire should be built and hot water kept ready for immediate use. The room should be kept well ventilated and comfortably warm.
5. No people should be allowed in or about the room except the nurse, the physician, and probably members of the family when called upon to perform some duty.
6. During labor no solid food should be taken; a little milk, broth or soup may be given, provided there is an appetite. Malt or spirituous liquors should be carefully avoided. A little wine, however, may be taken in case of great exhaustion. Lemonade, toast, rice water, and tea may be given when desired. Warm tea is considered an excellent drink for the patient at this time.
7. When the pains become regular and intermit, it is time that the physician is sent for. On the physician's arrival he will always take charge of the case and give necessary instructions.
8. In nearly all cases the head of the child is presented first. The first pains are generally grinding and irregular, and felt mostly in the groins and within, but as labor progresses the pains are felt in the abdomen, and as the head advances there is severe pain in the back and hips and a disposition to bear down, but no pressure should be placed upon the abdomen of the patient; it is often the cause of serious accidents. Nature will take care of itself.
9. Conversation should be of a cheerful character, and all allusions to accidents of other child births should be carefully avoided.
10. ABSENCE OF PHYSICIAN.—In case the child should be born in the absence of the physician, when the head is born receive it in the hand and support it until the shoulders have been expelled, and steady the whole body until the child is born. Support the child with both hands and lay it as far from the mother as possible without stretching the cord. Remove the mucus from the nostrils and mouth, wrap the babe in warm flannel, make the mother comfortable, give her a drink, and allow the child to remain until the pulsations in the cord have entirely ceased. After the pulsations have entirely ceased then sever the cord. Use a dull pair of scissors, cutting it about two inches from the child's navel, and generally no time is necessary, and when the physician comes he will give it prompt attention.
11. If the child does not breathe at its arrival, says Dr. Stockham in her celebrated Tokology, a little slapping on the breast and body will often produce respiration, and if this is not efficient, dash cold water on the face and chest; if this fails then close the nostrils with two fingers, breathe into the mouth and then expel the air from the lungs by gentle pressure upon the chest. Continue this as long as any hope of life remains.
12. AFTER-BIRTH.—Usually contractions occur and the after-birth is readily expelled; if not, clothes wrung out in hot water laid upon the bowels will often cause the contraction of the uterus, and the expulsion of the after-birth.
13. If the cord bleeds severely inject cold water into it. This in many cases removes the after-birth.
14. After the birth of the child give the patient a bath, if the patient is not too exhausted, change the soiled quilts and clothing, fix up everything neat and clean and let the patient rest.
15 Let the patient drink weak tea, gruel, cold or hot water, whichever she chooses.
16. After the birth of the baby, the mother should be kept perfectly quiet for the first 24 hours and not allowed to talk or see anyone except her nearest relations, however well she may seem. She should not get out of bed for ten days or two weeks, nor sit up in bed for nine days. The more care taken of her at this time, the more rapid will be her recovery when she does get about. She should go up and down stairs slowly, carefully, and as seldom as possible for six weeks. She should not stand more than is unavoidable during that time, but sit with her feet up and lie down when she has time to rest. She should not work a sewing machine with a treadle for at least six weeks, and avoid any unusual strain or over-exertion. "An ounce of prevention IS worth a pound of cure," and carefulness will be well repaid by a perfect restoration to health.