The Day of Labor : Labor Pains

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

(Page 9 of 41)

Sometimes, as long as two weeks before the birth of the child, certain irregular, heavy, cramp-like pains occur in the abdomen and back. For a half-dozen pains they may show some signs of regularity; but they usually die down only to start up again at irregular intervals. These are known as "false pains."

When the pains begin to take on regularity and gradually grow heavier and it is near the appointed time for the labor, the patient should prepare to start for the hospital; or, if it is to be a home delivery, the physician should be called. As noted above, the first subjective symptom may be the rupture of the bag of waters, and it is imperative to prepare at once for the labor. It is far better to spend the day at the hospital, or even two days waiting, rather than to run the risk of giving birth to the child in a taxicab or street car; or, in the event of a home labor, to have the child born before the doctor arrives.

What to Do In the Absence of a Doctor

It is often the case that when we need our physician the most, he is busy with another patient and cannot come, or perhaps an automobile accident detains the man of the hour. The hospital delivery always possesses this advantage over the home - physicians are always on hand. We deem it wise to relate in detail the method of procedure during the rapid birth of a child; that the husband or nurse may give intelligent and clean service.

After the patient has been given the enema and has been shaved and the bath has been administered as previously directed, the helper most vigorously "scrubs up." There are three distinct phases to the "scrubbing up": First, the three-minute scrubbing of the hands and forearms with a clean brush and green soap; to be followed by, second, the trimming and cleaning of the finger nails, for it is here, under the nails, that the micro-organism lives and thrives that causes child-bed fever or septicemia; and, third, the final five-minute scrubbing of the fingers, hands, and forearms. An ordinary towel is not used to dry the well-cleansed hands, but they are now dipped in alcohol and allowed to dry in the air.

And now if the pains are returning every three to five minutes or if the bag of waters has broken, the patient should go to bed. She will lie down on her back with the knees drawn up and spread apart. The patient, having had the cleansing bath, is now washed with the disinfectant bath (2 antiseptic tablets to 1½ pints of water), from the breasts to the knees. Another member of the family takes the outer wrappings off the sterilized delivery pad and the "clean" helper places the sterile delivery pad under the expectant mother, who is directed to "bear down" when her pains come. She may be supported during these pains by pulling on a sheet that has been fastened to the foot of the bed.

The clean, helper then sits by her constantly until the baby is born but under no circumstances should touch her until after the head appears. Immediately after the birth of the head, the shoulders usually follow with the next pain, which should to occur within two or three minutes. Occasionally the face turns blue, in such an instance, the mother is directed to strain vigorously and presses down heavily on the abdomen with both her hands, this usually hurries matters materially, and the body of the child follows quickly.

The baby should cry at once. If the child does not show signs of life, quick, brisk slapping on the back usually brings relief. During the birth of the head it is imperative that, in the event of liquid passing at the same time, no water or blood be sucked into the mouth by the baby. Great care must be exercised in this matter. Should the baby remain blue, lay it quickly upon its right side near the mother, and after the pulse of the cord has stopped beating the clean helper ties the cord twice, two inches from the child and again two inches from this tying toward the mother, and then the cord is cut between the two tying with scissors that have been boiled twenty minutes.

Should there be more difficulty with the breathing of the new born child, if slapping it on the back brings no relief, its back (with face well protected) may be dipped first in good warm water, then cold, again in the warm, again in the cold - this seldom fails. The child should then be kept very warm, lying on its right side.

Care of the Mother

All this time, a member of the family has been firmly grasping the mother's abdomen, and within an hour the afterbirth passes out through the birth canal. If the physician has not yet arrived, all dressings, the pad, the afterbirth, must all be saved for his inspection.

The inside of the thighs and the region about the vagina is now washed with bichloride solution, the soiled delivery pad removed, a clean delivery pad is placed under her; an abdominal binder is applied and two sterile vulva pads are placed between the legs, and hot water bottles are put to her feet, as usually at this stage there is a slight tendency toward chilliness. She should now settle down for rest. Fresh air should be admitted into the room.

There may be some hemorrhage, and if it is excessive, grasp the lower abdomen and begin to knead it until you distinctly feel a change in the uterus from the soft mass to a hard ball about the size of a large grape fruit; therefore contraction has been brought about which causes the hemorrhage to decrease. If the doctor has not yet arrived put the baby to the breast, and place an ice bag for ten or fifteen minutes on the abdomen just over the uterus. Should there be lacerations, the doctor will attend to their repair when he comes. One teaspoonful of the fluid extract of ergot is usually given at this time, if possible get in touch with the physician before it is administered.

Care of the Baby

After the mother is comfortable, your attention is directed to the baby; the condition of the cord is noted; should it be bleeding, do not disturb the tying, but tie again, more tightly just below the former tying, and with the long ends of the tape, tie on a sterile gauze sponge or a piece of clean untouched medicated cotton, therefore efficiently protecting the severed end of the cord. No further dressing is needed until the doctor arrives.

Grave disorders have arisen from infection through the freshly cut umbilical cord.

Should the doctor be longer delayed, one drop of twenty percent argyrols should be dropped in each of the infant's eyes and separate pieces of cotton should be used for each eye to wipe the surplus medicine away.

This application must not be long neglected, for a very large percent of all the blindness in this world might have been avoided had this medicine been placed in each eye soon after birth.

The warmed albolene is now swabbed over the entire body of the infant (this is done with a piece of cotton), the arm pits, the groins, behind the ears, between the thighs, the bend of the elbow, etc, must all receive the albolene swabbing. In a few minutes, this is gently rubbed off with a piece of gauze or an old soft towel, and the baby comes forth as clean and as smooth as a lily and as sweet as a rose.

The garments are now placed on the child - first the band, then shirt, diaper, stockings, flannel skirt, and outing flannel gown - and it is put to rest after the administration of one teaspoonful of cooled, boiled water. In six to eight hours it will be put to the breast.

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.