The Day of Labor : Symptoms, Progress

The Mother and Her Child
by William S. Sadler, M.D., Lena K. Sadler, M.D.

(Page 8 of 41)

As the two hundred and seventy-three days come to a close, our expectant mother approaches the day of labor with joy and gladness. The long, long waiting days so full of varied experiences, so full of the consciousness that she, the waiting mother, is to bring into the world a being which may have so many possibilities - well, even the anticipated pangs of approaching labor are welcomed as marking the close of the long vigil. These days have brought many unpleasant symptoms, they have been days of tears and smiles, of clouds and sunshine.

The Time of Waiting

The prospective mother has thought many times, "Will my baby ever come?" But nature is very faithful, prompt, and resourceful. She ushers in this harvest time under great stress and strain, for actual labor is before us - downright, hard labor - just about the hardest work that womankind ever experiences - and, as a rule, she needs but little help - good direction as to the proper method of work and the economical expenditure of energy. In the case of the average mother this is about all that is needed, and if these suggestions come from a wise and sympathetic physician - one who understands and appreciates asepsis - she may count herself as fortunately situated for the oncoming ordeal.

In the days of our grandmothers it was almost the exception rather than the rule to escape "child-bed fever," "milk leg," etc.; but in these enlightened days of asepsis, rubber gloves, and the various antiseptics, puerperal infection is the exception, while a normal childbirth is the rule; and this work of prevention lies in the scrupulous care taken by anyone and everyone concerned in any way with the events of the day of labor.

On this day of labor, the mother, who has gone through the long tedious days of waiting, should see to it that nothing unclean - hands, sponges, forceps, water, cloth - is allowed to touch her. Above all things do not employ a physician who has earned the reputation of being a "dirty doctor." Puerperal infection is almost wholly a preventable disease and every patient has a right to insist upon protection against it.

In a former chapter will be found a detailed description of the "delivery bed." Beside this bed, or near by, are to be found the rack on which are airing the necessary garments for the baby's reception - the receiving blanket and other requisites for the first bath - together with numerous other articles essential to safety and comfort.

There should be an easy chair in the room for the mother to rest in between her walking excursions during the first stages of labor. The sterilized pads and necessary articles mentioned in an earlier chapter are, of course, close at hand.

First Symptoms of Labor

Regular, cramp-like pains in the lower portion of the abdomen which are frequently mistaken for intestinal colic, often beginning in the lower part of the back, and extending to the front and down the thigh, are often the first symptoms of the approaching event. With each cramp or pain the abdomen gets very hard and as the pain passes away the abdomen again assumes its normal condition. These regular cramp-like pains are the result of the early dilation of the cervix - the first opening of the door to the uterine room which has housed our little citizen through the developmental stages of embryonic life - and as a result of this stretching and dilating there soon appears that special blood-tinged mucus flow commonly known as "the show."

The Preliminary Bath

At this time a very thorough-going colonic flushing should be administered. The patient takes the "knee-chest" position, or the "lying-down" position, and there should flow into the lower bowel three pints of soapy water; this should be retained for a few moments; and after its expulsion, a short, plain water injection should be given. Now follows the preliminary general bath.

Just prior to the bath, the pubic hair should be clipped closely, or better shaved. Then should follow a thorough soap wash, with patient standing up in the tub, using plenty of soap, applied with a shampoo brush or rough Turkish mit. The rinsing now takes place by either a shower or pail pour. Do not sit down in the tub. This is a rule that must not be broken, because of the danger of infection in those cases where the bag of waters may have broken early in the labor.

A weak antiseptic solution, prepared by putting two small antiseptic tablets into one pint and a half of warm water, is now applied to the body from the breasts to the knee. Put on a freshly laundered gown, clean stockings and wrapper. The head should be cleansed and hair braided in two braids.

The Progress of Labor

If all the mothers who read this volume could bear children with the comfort Mrs. C. does, I should be happy, indeed.

At four o'clock one morning a very much excited father telephoned me, "Hurry, quick, Doctor, it's almost here." It was well that we did hurry, for the first sign the little mother had was the deluge of the waters - at this point the husband ran to telephone for the doctor - no more pains for thirty-eight minutes (just as we entered the door) and the baby was there. But such is not usually the case, nor will it be, as labor usually progresses along the lines of conscious dilating pains, occurring at intervals twenty minutes apart at first, later drawing nearer together until they are three to five minutes apart. This "first stage of labor" lasts from one to fifteen hours - during which time the tiny door to the uterine room which was originally about one-eighth of an inch open - dilates sufficiently to allow the passage of the head, shoulders and body of the fully developed child.

About this time the bag of waters usually bursts, and, as a rule, this marks the beginning of the "second stage of labor." The amount of water passed varies in amount. Should the rupture take place before the door is fully open, then labor proceeds with difficulty and the condition is known as "dry labor."

The head after proper rotation now begins the descent; and here the pains begin to change from the sharp, cramp-like pains which begin in the back and move around to the front, to those of the "bearing down" variety, while at the same time there begins to appear the bulging at the perineum, which means that the head is about to be born. At this time great stress is brought to bear upon the perineum and often, in spite of anything that can be done to prevent it, the perineum is more or less lacerated.

As soon as the baby is born the "second stage of labor" has passed and within thirty to fifty minutes the close of the third stage of labor is marked by the passage of the placenta or "afterbirth."

About the Author

Dr. William S. Sadler M.D. was a well-known American psychiatrist and college teacher in the school of medicine at the University of Chicago. For over sixty years he practiced his profession in Chicago, thirty-three years being associated in practice with his wife, Dr Lena Kellogg Sadler. The doctors were pioneers in the research on the mysterious Urantia Papers.