The Project Gutenberg EBook of The Mother and Her Child, by William S. Sadler and Lena K. Sadler This eBook is for the use of anyone anywhere at no cost and with almost no restrictions whatsoever. You may copy it, give it away or re-use it under the terms of the Project Gutenberg License included with this eBook or online at www.gutenberg.org Title: The Mother and Her Child Author: William S. Sadler Lena K. Sadler Release Date: March 14, 2007 [EBook #20817] Language: English Character set encoding: ISO-8859-1 *** START OF THIS PROJECT GUTENBERG EBOOK THE MOTHER AND HER CHILD *** Produced by Audrey Longhurst, Hillie Plantinga and the Online Distributed Proofreading Team at http://www.pgdp.net Transcriber's Notes 1. Punctuation has been added where it was missing in the text (mostly missing periods). 2. Seven typographical errors have been corrected, this is indicated in the html like this, hover with the mouse over the word for an explanation. Cover Frontispiece T H E M O T H E R A N D H E R C H I L D BY WILLIAM S. SADLER, M. D. PROFESSOR OF THERAPEUTICS, THE POST-GRADUATE MEDICAL SCHOOL OF CHICAGO; DIRECTOR OF THE CHICAGO INSTITUTE OF PHYSIOLOGIC THERAPEUTICS; FELLOW OF THE AMERICAN MEDICAL ASSOCIATION; MEMBER OF THE CHICAGO MEDICAL SOCIETY; THE ILLINOIS STATE MEDICAL SOCIETY; THE AMERICAN ASSOCIATION FOR THE ADVANCEMENT OF SCIENCE, ETC. AND LENA K. SADLER, M. D. ASSOCIATE DIRECTOR OF THE CHICAGO INSTITUTE OF PHYSIOLOGIC THERAPEUTICS; FELLOW OF THE AMERICAN MEDICAL ASSOCIATION; MEMBER OF THE CHICAGO MEDICAL SOCIETY; THE MEDICAL WOMEN'S CLUB OF CHICAGO; NATIONAL CONGRESS OF MOTHERS AND PARENT-TEACHER ASSOCIATION; THE CHICAGO WOMAN'S CLUB, ETC. ILLUSTRATED publisher (8K) TORONTO McCLELLAND, GOODCHILD & STEWART CHICAGO: A. C. McCLURG & CO. 1916 Copyright A. C. McClurg & Co. 1916 Published August, 1916 Copyrighted in Great Britain W. F. HALL PRINTING COMPANY, CHICAGO TO "BILLY" WHO, BECAUSE OF HIS UNCONSCIOUS CONTRIBUTIONS TO ITS PRACTICAL FEATURES, SHOULD BE REGARDED AS A CO-AUTHOR, THIS VOLUME IS AFFECTIONATELY DEDICATED BY HIS PARENTS THE AUTHORS PREFACE For many years the call for a book on the mother and her child has come to us from patients, from the public, and now from our publishers—and this volume represents our efforts to supply this demand. The larger part of the work was originally written by Dr. Lena K. Sadler, with certain chapters by Dr. William S. Sadler, but in the revision and re-arrangement of the manuscript so much work was done by each on the contributions of the other, that it was deemed best to bring the book out under joint authorship. The book is divided into three principal parts: Part I, dealing with the experience of pregnancy from the beginning of expectancy to the convalescence of labor: Part II, dealing with the infant from its first day of life up to the weaning time; Part III, taking up the problems of the nursery from the weaning to the important period of adolescence. The advice given in this work is that which we have tried out by experience—both as parents and physicians—and we pass it on to mothers, fathers, and nurses with the belief that it will be of help in their efforts at practical and scientific "child culture." We believe, also, that the expectant mother will be aided and encouraged in bearing the burdens which are common to motherhood by the advice and instruction offered. While we have drawn from our own professional and personal experience in the preparation of this book, we have also drawn freely from the present-day literature dealing with the subjects treated, and desire to acknowledge our indebtedness to the various writers and authorities. We now jointly send forth the volume on its mission, as a contribution toward lightening the task and inspiring the efforts of those mothers, nurses, and others who honor us by a perusal of its pages. [Pg vii] [Pg viii] William S. Sadler. Lena K. Sadler. Chicago, 1916. CONTENTS PART I THE MOTHER CHAPTER PAGE I The Expectant Mother 1 II Story of the Unborn Child 7 III Birthmarks and Prenatal Influence 14 IV The Hygiene of Pregnancy 21 V Complications of Pregnancy 35 VI Toxemia and Its Symptoms 47 VII Preparations for the Natal Day 53 VIII The Day of Labor 63 index Twilight Sleep and Painless Labor 71 X Sunrise Slumber and Nitrous Oxid 84 XI The Convalescing Mother 93 PART II THE BABY XII Baby's Early Days 103 XIII The Nursery 114 XIV Why Babies Cry 123 XV The Nursing Mother and Her Babe 133 XVI The Bottle-Fed Baby 147 XVII Milk Sanitation 156 XVIII Home Modification of Milk 165 XIX The Feeding Problem 177 XX Baby's Bath and Toilet 190 XXI Baby's Clothing 202 XXII Fresh Air, Outings, and Sleep 213 XXIII Baby Hygiene 222 XXIV Growth and Development 232 PART III THE CHILD XXV The Sick Child 251 XXVI Baby's Sick Room 266 XXVII Digestive Disorders 274 [Pg ix] [Pg x] XXVIII Contagious Diseases 285 XXIX Respiratory Diseases 300 XXX The Nervous Child 308 XXXI Nervous Diseases 323 XXXII Skin Troubles 333 XXXIII Deformities and Chronic Disorders 341 XXXIV Accidents and Emergencies 348 XXXV Diet and Nutrition 360 XXXVI Caretakers and Governesses 370 XXXVII The Power of Positive Suggestions 380 XXXVIII Play and Recreation 390 XXXIX The Puny Child 400 XL Teaching Truth 405 Appendix 427 Index 449 ILLUSTRATIONS The mother and her child Frontispiece FIGURE PAGE 1 Steps in early development 10 2 The "expectant" costume 23 3 The photophore 43 4 Taking the blood pressure 48 5 Breast binder 59 6 How to hold the baby 110 7 Making the sleeping blanket 117 8 In the sleeping blanket 118 9 Homemade ice box 149 10 Heating the bottle 151 11 A sanitary dairy 158 12 Articles needed for baby's feeding 167 13 Supporting the baby for the bath 194 14 Developmental changes 240 15 The cooling enema 290 16 X ray showing tuberculosis of the lung 346 17 Father and Mother Corn and Morning Glory 406 PART I THE MOTHER [Pg xi] THE MOTHER AND HER CHILD PART I THE MOTHER CHAPTER I THE EXPECTANT MOTHER There can be no grander, more noble, or higher calling for a healthy, sound-minded woman than to become the mother of children. She may be the colaborer of the business man, the overworked housewife of the tiller of the soil, the colleague of the professional man, or the wife of the leisure man of wealth; nevertheless, in every normal woman in every station of life there lurks the conscious or sub-conscious maternal instinct. Sooner or later the mother-soul yearns and cries out for the touch of baby fingers, and for that maternal joy that comes to a woman when she clasps to her breast the precious form of her own babe. MOTHERHOOD THE HIGHEST CALLING Motherhood is by far woman's highest and noblest profession. Science, art, and careers dwindle into insignificance when we attempt to compare them with motherhood. And to attain this high profession, to reach this manifest "goal of destiny," women are seeking everywhere to obtain the best information, and the highest instruction regarding "mothercraft," "babyhood," and "child culture." In an Indiana town not long ago, at the close of a lecture, a small, intellectual-appearing mother came forward, and, tenderly placing her tiny and emaciated infant in my arms, said: "O Doctor! can you help me feed my helpless babe? I'm sure it is going to die. Nothing seems to help it. My father is the banker in this town. I graduated from high school and he sent me to Ann Arbor, and there I toiled untiringly for four years and obtained my degree of B. A. I have gone as far as I could—spent thousands of dollars of my unselfish father's money—but I find myself totally ignorant of my own child's necessities. I cannot even provide her food. O Doctor! can't something be done for young women to preparé them for motherhood?" MOTHERCRAFT PREPARATION The time will come when our high and normal schools will provide adequate courses for the preparation of the young woman for her highest profession, motherhood. This young mother, who had reached the goal of Bachelor of Arts, found to her sorrow that she was entirely deficient in her education and training regarding the duties and responsibilities of a mother. In every school of the higher branches of education that train young women in their late teens there should be a chair of mothercraft, providing practical lectures on baby hygiene, dress, bathing, and the general care of infants, and giving instruction in the rudiments of simple bottle-feeding, together with the caloric values of milk, gruels, and other ingredients which enter into the preparation of a baby's food. Young women would most enthusiastically enroll for such classes, and as years passed and marriage came and children to the home, imagine the gratitude that would flood the souls of the young mothers who were fortunate enough to have attended schools where the chairs of motherhood prepared them for these new duties and responsibilities. EARLY MEDICAL SUPERVISION Just as soon as it is known that a baby is coming into the home, the expectant mother should engage the best doctor she can afford. She should make frequent calls at his office and intelligently carry out the instruction concerning water drinking, exercise, diet, etc. Twenty-four hour specimens of urine should be frequently saved and taken to the physician for examination. In these days the blood-pressure is closely observed, together with approaching headaches and other evidences of possible kidney complications. The early recognition of these dangers is accompanied by the immediate employment of appropriate sweating procedures and other measures designed to promote the elimination of body poisons. Thus science is able effectively to stay the progress of the high blood-pressure of former days, and which was so often followed by eclampsia—uremic poisoning. In these days of careful urine analysis, expertly administered anaesthetics, and up-to-date hospital confinements, the average intelligent woman may enter into pregnancy quite free from the oldtime fears, whose only rewards were grief and cankering care. All fear of childbirth and all dread of maternal duties and sacrifices do not in the least lessen the necessary unpleasantness 1 2 3 associated with normal labor. It lies in the choice of every expectant mother to journey through the months of pregnancy with dissatisfaction and resentment or with joy and serenity. "The child will be born and laid in your arms to be fed, cared for, and reared, whether you weep or smile through the months of waiting." THE RESENTFUL MOTHER A little woman came into our office the day of this writing, saying: "Doctor, I'm just as mad as I can be; I don't want to be pregnant, I just hate the idea." As I smiled upon this girl-wife of nineteen, I drew from my desk a sheet of paper and slowly wrote down these words for the head of a column: "Got a mad on," and for the head of another, "Got a glad on;" and then we quickly set to work carefully to tabulate all the results that having a "mad on" would bring. We found to her dismay that its harvest would be sadness of the heart, husband unhappy, work unbearable, while all church duties as well as social functions would be sadly marred. Then, just as carefully, we tabulated the benefits that would follow having a "glad on." Her face broke into a smile; she laughed, and as she left the office she assured me that she would accept Nature's decree, make the best of her lot, and thus wisely align herself with the normal life demands of old Mother Nature. This view of her experience, she came to see, would bring the greatest amount of happiness to both herself and husband. She left me, declaring that she was just "wild for a baby;" and there is still echoing in my ears her parting words: "I'm leaving you, Oh, such a happy girl! and I'm going home to Harold a happy and contented expectant mother." There often enters on the exit of a discontented and resentful expectant mother, a woman, very much alone in the world— perhaps a bachelor maid or a barren wife, who, as she sits in the office, bitterly weeps and wails over her state of loneliness or sterility; and so we are led to realize that discontentment is the lot of many women; and we are sometimes led to regret that ours is not the power to take from her that hath and give to her that hath not. EARLY SIGNS OF PREGNANCY Among the first questions an expectant mother asks is: "What are early signs of pregnancy?" The answer briefly is: 1. Cessation of menstruation. 2. Changes in the breast. 3. Morning sickness. 4. Disturbances in urination. Menstruation may be interrupted by other causes than pregnancy, but the missing of the second or third periods usually indicates pregnancy. Accompanying the cessation of menstruation, changes in the breast occur. Sensation in the breasts akin to those which usually accompany menstruation are manifested at this time in connection with the unusual sensations of stinging, prickling, etc. Fully one-half of our patients do not suffer with "morning sickness;" however, it is the general consensus of opinion that "morning sickness" is one of the early signs of pregnancy, and these attacks consist of all gradations—from slight dizziness to the most severe vomiting. It is an unpleasant experience, but in passing through it we may be glad in the thought that "it too, will pass." Because of the pressure exerted by the growing uterus upon the bladder, disturbances in urination often appear, but as the uterus continues to grow and lifts itself up and away from the bladder these symptoms disappear. Chief of the later signs of pregnancy are "quickening" or fetal movements. The movements are very much like the "fluttering of a young birdling." They usually are felt by the expectant mother between the seventeenth and eighteenth weeks. This sign, together with the noting of the fetal heartbeat at the seventh month, constitute the positive signs of pregnancy. PROBABLE DATE OF DELIVERY And now our expectant mother desires to know when to expect the little stranger. From countless observations of childbirth under all conditions and in many countries, the pregnant period is found to cover about thirty-nine weeks, or two hundred and seventy-three days. There are a number of ways or methods of computing this time. Many physicians count back three months and add seven days to the first day of the last menstruation. For instance, if the last menstruation were December 2 to 6, then, to find the probable day of delivery, we count back three months to September 2, and then add seven days. This gives us September 9, as the probable date of delivery. The real date of delivery may come any time within the week of which this calculated date is the center. As a rule, ten days to two weeks preceding the day of delivery, the uterus "settles" down into the pelvis, the waist line becomes more comfortable, and the breathing is much easier. On the accompanying page, may be found a table for computing the probable day of labor, prepared in accordance with the plan just described. TABLE FOR CALCULATING THE DATE OF CONFINEMENT Jan. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Oct. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 Nov. 4 5 6 Feb. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Nov. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 Dec. Mar. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Dec. 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 Jan. April. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Jan. 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 Feb. May. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Feb. 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 1 2 3 4 5 6 7 Mar. June. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Mar. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 April. July. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 April. 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 6 7 May. Aug. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 May. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 June. Sept. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 June. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 July. Oct. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 July. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 Aug. Nov. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Aug. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 Sept. Dec. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Sept. 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 6 7 Oct. Supposing the upper figure in each pair of horizontal lines to represent the first day of the last menstrual period, the figure beneath it, with the month designated in the margin, will show the probable date of confinement. CHAPTER II STORY OF THE UNBORN CHILD To every physician in every community, sooner or later in his experience there come thoughtless women making requests that we even hesitate to write about. Their excuses for the crime which they seek to have the physician join them in committing, range all the way from "I don't want to go to the trouble," to "Doctor, I've got seven children now, and I can't even educate and dress them properly;" or, maybe, "I nearly lost my life with the last one." EMBRYOLOGICAL IGNORANCE One little woman came to us the other day from the suburbs, and honestly, frankly, related this story: "We've been married just six months, I have continued my stenographic work to add the sixty-five dollars to our monthly income. Doctor, we must meet our monthly payments on the home, I must continue to work, or we shall utterly fail. I am perfectly willing a baby shall come to us two years from now, but, doctor, I just can't allow this one to go on, you must help me just this once. Why doctor, there can't be much form or life there, it's only three months now, or will be next week, and you know it's nothing but a mass of jelly." She had talked with a "confidential friend" in her neighborhood, had been told that she "could do it herself," but fearing trouble or infection, had come to the conclusion she had better go to a "clean, reputable physician," to have the abortion performed. This is not the place to narrate the experiences of the unfortunate victims of habitual criminal abortion, but we would like to impress upon the reader some realization of the untimely deaths, the awful suffering, and the life-long remorse and sorrow of the poor, misguided women who listen to the criminal advice of neighborhood "busybodies." The infections, the invalidism, the sterility that so often follow in the wake of these practices, are well known to all medical people. THE STREAM OF LIFE And so after the patient's last statement, "It's nothing but a mass of jelly," we began the simple but wonderfully beautiful story of the development of the "child enmothered." Just as all vegetables, fruits, nuts, flowers, and grains come from seeds sown into fertile soil, and just as these seeds receive nourishment from the soil, rain, and sunshine, so all our world of brothers and sisters, of fathers and mothers, came from tiny human seeds, and in their turn received nourishment from the peculiarly adapted stream 7 8 of life, which flows in the maternal veins for the nourishment and upbuilding of the unborn embryo. Every little girl and boy baby that comes into the world, has stored within its body, in a wonderfully organized capsule, a part of the ancestral stream of life that unceasingly has flowed down through the centuries from father to son and from mother to daughter. This "germ plasm" is a divine gift to be held in trust and carefully guarded from the odium of taint, to be handed down to the sons and daughters of the next generation. Any young man who grasps the thought that he possesses a portion of the stream of life, that he holds it in sacred trust for posterity, cannot fail to be impressed with a sense of solemn responsibility so to order his life as to be able to transmit this biologic trust to succeeding generations free from taint and disease. THE PROCESS OF FERTILIZATION Just as within the body of "Mother Morning Glory" (See Fig. 18) may be found the ovary or seed bed, so there are two wonderfully organized bodies about the size of large almonds found in the lower part of the female abdomen on either side of the uterus, and connected to it by two sensitive tubes. There ripens in one of these bodies each month a human baby-seed, which finds its way to the uterus through the little fallopian tube and is apparently lost in the debris of cells and mucus which, with the accompanying hemorrhage go to make up the menstrual flow. This continues from puberty to menopause, each gland alternatingly ripening its ovum, only to lose it in the periodical phenomenon of menstruation, which is seldom interrupted save by that still more wonderful phenomenon of conception. At the time of conception, countless numbers of male germ-cells (sperms) are lost—only one out of the multitude of these perfectly formed sperms made up of the mosaics of hereditary depressors, determiners, and suppressors that so subtly dictate and determine the characteristics and qualifications of the on-coming individual—I repeat, only one of these wonderful sperms finds the waiting ovum (Fig. 1). In this search for the ovum, the sperm propels itself forward by means of its tail—for the male sperm in general appearance very much resembles the little pollywog of the rain barrel (Fig. 1). The fateful meeting of the sperm and the ovum takes place usually in the upper end of one of the fallopian tubes. It is a wonderful occasion. The wide-awake, vibrating lifelike sperm plunges head first and bodily into the ovum. The tail, which has propelled this bundle of life through the many wanderings of its long and perilous journey, now no longer needed, drops off and is lost and forgotten. This union of the male and female sex cells is called "fertilization." There immediately follows the most complete blending of the two germ cells—one from the father and one from the mother—each with its peculiar individual, family, racial, and national characteristics. Here the combined determiners determine the color of the eyes, the characteristics of the hair, the texture of the skin, its color, the size of the body, the stability of the nervous system, the size of the brain, etc., while the suppressors do a similar work in the modification of this or that family or racial characteristic. 9 Fig. 1. Steps in Early Development. Fig. 1. Steps in Early Development. THE FIRST WEEKS OF LIFE The fertilized ovum remains in the tube for about one week, when it slowly makes its way down into the uterus, all the while rapidly undergoing segmentation or division. It does not grow much in size during this first week, but divides and subdivides first, into two parts, then four, then eight, then sixteen and so on, until we have a peculiar little body made up of many equally divided parts, and known as the "Mulberry Mass" (Fig. 1). The blending of the sperm and ovum has been perfect, the division of the original body multitudinous. While this division of the united sex cells is progressing, a wonderful change is also taking place in the inside lining of the uterus. Instead of the usual thin lining, it has greatly thickened and has become highly sensitized, and as the ovum enters the uterus from the fallopian tube, this sensitized lining catches it and holds it in its folds—actually covers it with itself—holding the precious mass much as the cocoon, you have so often seen fastened to the side of a plant or leaf, holds its treasure of life. Just as soon as the new uterine home is found the baby heart begins to make its appearance, as also do many other rudimentary parts. By the end of the third week, our round mass has flattened and curved and elongated, and the nervous system and brain begin to develop, while the primitive ears begin to appear. At this time, the alimentary canal presents itself as one straight tube which is a trifle larger at the head end. And it is interesting to note that at this early date, even the arms and legs are beginning to bud and push out from the body. LATER EMBRYONIC DEVELOPMENT In the fourth and fifth weeks, the lungs and the pancreas may be found, the heart develops, the nervous system has taken on more definite form, and several of the larger blood-vessels are appearing. By the eighth week, by the most wonderful and complicated processes of overlapping, pushing out, indentation, enfolding, budding, pressing, and curving, the majority of the important structures are formed—the eyes, ears, nose, hands, feet, abdominal organs, and numerous glands. Thus, at the end of two months, almost every structure and organ necessary to life is present in a rudimentary state. 10 11 12 AT THE END OF THREE MONTHS By the close of the third month, witness the work of creation! From the blending of the two germ cells there has come forth a beautifully formed body (Fig. 1). True, it is but three and one half inches in length, but it is nevertheless a perfect body. About this time, the sex may be determined. The eyes, nose, ears, chin, arms and legs and even the fingers and toes may all be clearly distinguished. A "jelly mass" at three months? No, by no means! No! Life and form and features are all there. It really has a face, whose features may easily be delineated. In all my experience, I have yet to find the woman who wished to continue in her wicked and criminal intent after she had listened to this story of the creative development of the first three months of her "child enmothered." During the next four months, which take us to the close of the seventh, rapid growth and farther development take place to the extent, that, should birth occur at that time, life may continue under proper conditions. LAST WEEKS OF PREGNANCY Everything is now nearing completion—only awaiting further growth, development, and strength—except some of the bone development, which takes place during the remaining two months. Growth is rapid, strength is doubled, and as the two hundred and seventy-three days draw to a close, everything has been completed. It has all taken place according to the laws of creation in an infinite way and with clock-like precision. With the developmental growth of the product of conception, the uterus or room that had been particularly prepared for the "big reception" of the second week, has also grown to great dimensions. It fills almost the entire abdomen and as a result of the pressure against the diaphragm the breathing is somewhat embarrassed. The door of this "room" has been closed by a special mechanism, while, in the fullness of time, Mother Nature begins the delicate work of opening the door, through whose portals passes out into the world the completed babe. The authors feel that this discussion of, and protest against, abortions, should be accompanied by an appropriate consideration of the control of pregnancy. We are never going to eliminate the abortion curse of present-day civilization by merely preaching against it—warnings and denouncements alone will not suffice to remove the stain. Notwithstanding our feelings and convictions in this respect, we are also well aware of the fact that public sentiment is not now sufficiently ripe to welcome such a full and frank discussion of the subject of the prevention of conception as the authors would feel called upon to present; we are equally cognizant of the fact that existing postal regulations and other Federal laws are of such a character (at least capable of such interpretation) as possibly to render even the scientific and dignified consideration of such subjects entirely out of question. CHAPTER III BIRTHMARKS AND PRENATAL INFLUENCE In the preceding chapter we learned that when the two germ cells came together, there occurred a complete blending of two separate and distinct hereditary lines, reaching from the present away back into the dim and distant past. By the union of these two ancestral strains a new personality is formed, a new individual is created, with its own peculiar characteristics. HEREDITARY TRAITS Probably none of the laboriously acquired accomplishments of the present generation can be directly—and as such—handed down to our children. What we are to be and what we will do in this world was largely determined by the laws of heredity by the time we were well started on our development experience en-utero during the third or fourth week of our prenatal existence, as outlined in a former chapter. It is now generally accepted in scientific circles that acquired characteristics are not transmissible. Someone has aptly stated this truth by saying that "wooden heads are inherited, but wooden legs are not." This does not by any means imply that we do not have power and ability to fashion our careers and carve out our own destiny, within the possible bounds of our hereditary endowment and environmental surroundings. Heredity does determine our "capital stock," but our own efforts and acts determine the interest and increase which we may derive from our natural endowment. From the moment conception takes place—the very instant when the two sex cells meet and blend—then and there "the gates of heredity are forever closed." From that time on we are dealing with the problems of nutrition, development, education, and environment; therefore, so-called prenatal influence can have nothing whatever to do with heredity. 13 14 15 A father may have acquired great talent as a physician or a surgeon, in fact he may hold the chair of surgery in a medical college, but each of his children come into the world without the slightest knowledge of the subject, and, as far as direct and immediate heredity is concerned, will have to work just about as hard to master the subject as will the same average class of children whose parents were not surgeons. This must not be taken to mean that certain abilities and tendencies are not inheritable—for they are; but they are inherited through the parents—and not from them—directly. These transmitted characteristics are largely "stock" traits, and usually have long been present in the "ancestral strain." MATERNAL IMPRESSIONS A mother may sing and pray all through the nine months of expectancy, or she may weep and scold, or even curse. In neither case can she influence the spiritual or moral tendencies of her child and cause it, through supposed prenatal influence, to be born with criminal tendencies or to grow up a pious lad or become a devout minister. These tendencies and characteristics are all largely determined by the "depressors," "suppressors," and "determiners" which were present in the two microscopic and mosaic germ cells which united to start the embryo at the time of conception. The child is destined to be born, endowed, and equipped with the mental, nervous, and physical powers which his line has fallen heir to all through the past ages. Down through the ages education, religion, environment, and other special influences have no doubt played a small part in influencing and determining hereditary characteristics; just as environment in the ages past changed the foot of the evolving horse from a flat, "cushiony" foot with many toes (much needed in the soft bog of his earlier existence) into the "hoof foot" of later days, when harder soil and necessity for greater fleetness, assisted by some sort of "selection" and "survival," conspired to give us the foot of our modern horse, and this story is all plainly and serially told in the fossil and other remains found in our own hemisphere. It would appear that many, many generations of education and environment are required to influence markedly the established and settled train of heredity regarding any particular element or characteristic in any particular line or lines of hereditary tendencies. EUGENIC SUPERSTITION There is probably more misinformation in the minds of the people on the subject of "maternal impressions" and "birthmarks" than any other scientific or medical subject. The popular belief that, if a pregnant woman should see an ugly sight or pass through some terrifying experience, in some mysterious way her unborn child would be "marked," deformed, or in some way show some blemish at birth, is a time-honored and ancient belief. Such unscientific and unwarranted teaching has been handed down from mother to daughter through the ages, while the poor, misguided souls of expectant women have suffered untold remorse, heaped blame upon themselves, lived lives literally cursed with fear and dread—veritable slaves to superstition and bondage—all because of the simple fact that a certain percentage of all children born in this world have sustained some sort of an injury or "embryological accident" during the first days of fetal existence. For instance, take the common birthmark of a patch of reddened skin on the face, brow, or neck. As soon as the baby is born, the worried mother asks in anxious tones: "Doctor, is it all right, is it perfect, has it got any birthmarks?" On being told that the baby has a round, red patch on its left brow, the ever-ready statement of the mother comes forth: "Yes, I knew I'd mark it, I was picking berries one day about three months ago, and I ate and ate, until I suddenly remembered I might mark my baby, and before I knew what I was doing, I touched my brow and I just knew I had marked my baby." Do you know, reader, that that birthmark was present fully four months before she passed through that experience in the berry patch? And yet so worried and apprehensive has been the pregnant mother, that, although she can never successfully predict the "birthmarks" and blemishes of her child, nevertheless when these defects are disclosed at birth she is unfailingly able immediately to recall some extraordinary experience which she has carefully stored away in her memory and which, to her mind, most fully explains and accounts for the defect. Is it much wonder that in the very early days of embryonic existence, during the hours of delicate cell division, indentation, outpushing, elongation, and sliding of young cells—is it much wonder, I repeat—that there occur a few malformations, blemishes, or other accidents which persist as "birthmarks?" CAUSES OF BIRTHMARKS There are many factors which may enter into the production of birth-blemishes, deformities, monstrosities, etc. These influences are all governed by certain definite laws of cause and effect. A pre-existent systemic disease in the father, or a coexistent disorder in the mother, may be a leading factor. A mechanical injury, such as a sudden fall, a blow, or a kick, or certain kinds of prolonged pressure, not to mention restrictions and contractions of the maternal bony structures, may all possibly contribute something to these prenatal miscarriages of growth and development. Maternal or prenatal embryonic infections could bring about many sorts of birthmarks and malformations. These defects might also be caused by certain types of severe inflammatory disorders in the uterus during the early days of pregnancy. The same factors that produce the accidents of embryology resulting in malformations or monstrosities in the human family, are also operative in the case of our lesser brethren of the animal kingdom, for monstrosities and birth-defects are very common among the lower animals, notwithstanding the fact that the animal mother probably does not "believe in birthmarks." "It is a striking fact that during the nineteenth century, the teratologists, those who have scientifically investigated the causes of monstrosities and fetal morbid states, have almost without exception, rejected the theory of maternal impressions." Scientists 16 17 18 and physicians are coming to recognize the fact that fears and frights do not in any way act as causes in the production of monstrosities and deformities. Let us seek forever to liberate all womankind from the common and harassing fear and the definite dread and worry that, because they failed to control themselves at the instant of some terrifying sight or experience, they were directly responsible for the misfortune of their abnormal offspring. It should be remembered that there exists no direct connection whatsoever between the nervous system of the unborn child and the nervous system of the mother. The only physiological or embryological relationship is of a nutritional order, and even that is indirect and remote. ROLE OF THE PLACENTA By the end of the third month, the "cocoon" attachment described in chapter two has disappeared; the fetus is slowly pushed away from the uterus which has so snugly held it for more than eleven weeks; while upon the exact site of its previous attachment the thickened uterine membrane undergoes a very interesting and important change—definite blood vessels begin to form—which begin indirectly to form contact with the maternal vessels, and thus it is that the placenta, or "after birth" is formed; and then, by means of the umbilical cord, nourishment from the mother's blood-stream is carried to the growing and rapidly developing child. In exchange for the nourishing stream of life-giving fluid by which growth and development take place, the embryo gives off its poisonous excretions which are carried back to the placenta, from which they are absorbed into the veinous circulation of the mother; so, while the mother does, through the process of nutrition, influence growth and development in the embryo, she is wholly unable to produce specific changes and such definite developmental errors as birthmarks and other deformities. Just as truly as it would be impossible so to frighten a setting hen as to "mark" or otherwise influence the form or character of the chicks which would ultimately come forth from the eggs in her nest, it is just as truly impossible to frighten the pregnant mother and thereby influence the final developmental product of the human egg which is so securely tucked away in its uterine nest; for, when conception has occurred, the human embryo is just as truly an egg—fashioned and formed—as is the larger and shell-contained embryo of the chick which lies in the nest of the setting hen. And so we are compelled to recognize the fact that there is little more danger to the unborn child when the mother is frightened than when the father is scared. The one contributes as much as the other to the general character of the child, while neither is to blame for development errors and defects. SUGGESTION AND HEREDITY Certain fears are suggested to children. For twenty years I lived under the delusion that I was terribly afraid of snakes—more so than any other human being; for I was told when a mere child that I had been "marked with the fear of snakes," that just two months before I saw the peep of day, my esteemed mother had been terrified by a snake. Everywhere I went, I announced to sympathizing and ofttimes mischievous friends, that "I was marked with the fear of snakes and must never be frightened with them." It is needless to add in passing, that I was teased and frightened all through my girlhood days. I was a veritable slave to the bondage of snake-fear. Everywhere I went I looked for my dreaded foe, expecting to sit on one, step on one, or to have one drop into my lap from the roof. The day of deliverance came after marriage, when in a supreme effort to deliver me from the shackles of fear, the goodman of the house tenderly, but firmly, maneuvered a morning walk so that it halted in front of a large plate-glass window of the Snake Drug Store in San Francisco. Just back of this plate glass, and within eighteen inches of my very nose, were fifty-seven varieties of the reptiles, big and small, streaked and checkered, quiet and active. After much remonstrance and waiting, I came-to— gazed at the markings, beautiful in their exactness—while slowly the change of mind took place. Faith took the place of fear, calmness subdued panic, and I was wondrously delivered from the veritable bondage of a score of years. And so it is that the mother suffers and then the child suffers, ofttimes a living death, because of the superstition "I'm marked," while there is ever present the fear or dread that "something is going to happen, because I'm different from all other individuals—because 'I'm marked!'" CHAPTER IV THE HYGIENE OF PREGNANCY As soon as a woman discovers that she is pregnant, she should sit down and quietly think out the plan for the nine months of expectancy. The cessation of the menses may come as a surprise to her, and for a while she is more or less confused; she must go over the whole situation and adjust future plans to fit in with this new and all important fact. From a large experience with maternity 19 20 21 cases, I have reached the conclusion that the larger percentage of pregnancies do come as a surprise, and in many instances a complete change of program must be painstakingly thought out. This is especially true of the business woman, the professional woman, the busy club woman, or the active society woman. EARLY PLANNING Let me say to the woman who is pregnant for the first time, the experiences of the pregnant state should cause you no fear, worry, or anxiety. Giving birth to a baby is a perfectly natural, normal procedure, and if you are in reasonable health—if your physician tells you you are a fairly normal woman—then you can dismiss further thought of danger and go on your way rejoicing. For thousands of years maternity has been women's exclusive profession and no doubt will continue to be many ages hence. By far the most important and the first thing to do is carefully to select the best physician your means will allow, and place yourself under his or her care. Your doctor will help you to plan wisely and intelligently during the waiting time, for physicians have learned from experience that the better care the pregnant woman receives, the easier will be her labor, and the more speedy and uneventful the recovery. And now, we proceed to take up one by one the particular phases of the hygiene of pregnancy which touch the comfort, convenience, and health of both the mother and her unborn child. THE CLOTHING At all times and under all circumstances the pregnant woman's clothing should be comfortable, suitable for the occasion, artistic, and practical. And to be thus beautifully clothed is to be as inconspicuous as is possible. Of all times, occasions, and conditions, that of pregnancy demands modesty in color, simplicity in style, together with long straight lines (Fig. 2). For the "going out" dress, select soft shades of brown, blue, wine, or dark green. Let the house dresses be simple, easy to launder, without constricting waist bands, of the one-piece type, in every way suitable for the work at hand. Under this outer dress, a princess petticoat should cover a specially designed maternity corset (if any corset at all be worn), to which is attached side hose-supporters. A support for the breasts may be worn if desired, it should be loose enough to allow perfect freedom in breathing. The union suit may be of linen, silk, or cotton, with the weight suitable for the season. Stockings and shoes should be of a comfortable type, straight last, low or medium heel and at least as wide as the foot. There are two or three shoes on the market that are particularly good, whose arches are flexible, heels comfortable, straight last, and whose soles look very much like the lines of the foot unclothed. This style is particularly good during the maternity days. Painful feet are a great strain upon the general nervous system. Who of us has not seen women with strained, tense faces hobbling about in high-heeled, narrow-toed shoes? And if we followed them we would not only see tenseness and strain in the features of the face, but could hear outbursts of temper on the least provocation. Aching feet produce general irritability. If ease of body and calmness of spirit is desired, wear shoes that are comfortable, and the surprising part of it is that many of them are very good looking. 22 Fig. 2. The "Expectant" Costume. Fig. 2. The "Expectant" Costume. The long lines, so admirable for maternity wear are portrayed in this handsome afternoon costume. Tunic waist is made with shoulder yoke from which fullness hangs in fine plaiting with panel at back, front and under arms. The set in vest is of black-striped gold cloth trimmed with gold thread crochet buttons and with tiny waistcoat of black moire. Sleeves are of Georgette crepe. Loose adjustable girdle of black moire ribbon. Full skirt is attached on elastic to china silk underbodice. Material Crepe de chine or any other soft, clinging fabric. Toward the end of pregnancy ofttimes the feet swell, in which instance larger shoes should be worn in connection with the bandaging of the ankles and legs. During the latter days of expectancy an abdominal supporter may be worn advantageously. Much of the backache and heaviness in the pelvis is entirely relieved by the supporting of the pendulous abdomen with a well-fitted binder. An ordinary piece of linen crash may be fitted properly by the taking in of darts at the lower front edge; or elastic linen, or silk binder may be secured; in fact, any binder that properly supports the abdomen will answer the purpose. It should be within the means of every pregnant woman to have a neat, artistic out-door costume, for social, club and church occasions (Fig. 2). For no reason but illness should an expectant mother shut herself up in doors. True men and true women hold the very highest esteem for the maternal state, and the opinion of all others matters not; so joyfully go forth to the club, social event, concert, or church; and to do this, you must have a well-designed, artistic dress. The material does not matter much, but the shade and style are important. DIET There are certain laws which govern the diet at all times; for instance, the man who digs ditches requires more of a certain element of food and more food in general, than does the man who digs thoughts out of his brain. The growing child requires somewhat different elements of food than does an adult. In other words, "The diet should suit the times, occasions, occupations, etc." In the case of the expectant mother it should be remembered that the child gains nine-tenths of its weight after the fifth month of 23 24