Pregnancy - The Convalescing Mother : Part 2

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

(Page 12 of 41)

Urination

The patient should be encouraged to urinate during the first few hours after labor; catheterization should not take place until every effort has been made to bring about normal urination; or, until there is a well marked tumor above the bony arch of the pelvis in the lower part of the abdomen. It is far less harmful to the patient for her to sit up on the jar placed on the edge of the bed, than to undergo the risk of inflammation of the bladder which so often follows catheterization.

The Bodily Fluid

The first few days the bodily fluid is very red because of the large amount of blood which it contains. After the third or fourth day it is paler and after the tenth it assumes a whitish or yellowish color. During the three changes it should always smell like fresh blood. Any foul, putrefying odor should be promptly reported to the physician.

If on getting up at the close of the second week the bodily fluid should resume its red color, the patient should return to bed and notify her physician.

The Abdominal Binder

After the tenth day, the abdominal binder may be pinned as tightly as the patient desires, but prior to the tenth day many physicians believe the exceedingly tight binder causes misplacements of the enlarged, softened, and boggy uterus. It should be pinned snugly; but not drawn as tight as possible with the idea of keeping the uterus from relaxing, for at best, it does not do it; while tight constriction may produce a serious turning or flexion of the uterus. The breast binder is applied during the first twenty-four hours to support the filling breasts, loosely at first, and as they increase in size, as the glands become engorged, the binder is drawn more tightly. A sterile piece of gauze is placed over the nipples.

The Bowels

On the morning of the second day a cathartic is usually given - say one ounce of castor oil or one-half bottle of citrate of magnesia. The bowels should move at least once during each twenty-four hours; if they are obstinate, a simple laxative may be nightly administered. Certain constipation biscuits, sterilized dry bran, or agar-agar may be eaten with the breakfast cereal. Prunes and figs should be used abundantly. Bran bread should be substituted for white bread. The enema habit is a bad one and should not be encouraged; however, the enema is probably less harmful than the laxative-drug habit. Mineral oil is useful as a mild laxative, and does not produce any bad after results.

The Diet

For the first three days a liquid and soft diet is followed such as hot or cold milk, gruels, soups, thin cereals, eggnog (without whiskey), eggs, cocoa, dry toast, dipped toast, or cream toast. There should be three meals with a glass of hot milk at five in the morning (if awake) and late at night; nothing between meals except plenty of good cold water. After the third day, if temperature is normal, a semi-solid diet may be taken, such as baked, mashed, or creamed potatoes, soups thickened with rice, barley or flour, vegetables (peas, corn, asparagus, celery, spinach, etc.); eggs, light meats, stale breads, toast, bland or sub acid fruits (sweet apples, prunes, figs, dates, pears, etc.); macaroni, browned rice (parched before steaming), etc.; ice cream, custards, and rice puddings for desserts after the seventh day. Three good meals a day, at eight and one and six, with a couple of glasses of hot milk or cocoa or an eggnog at five A.M., to be repeated at 9 or 10 P.M., with plenty of cold water between the meals, will abundantly supply the necessary milk for the growing babe. Tea and coffee are not of any special value in encouraging a flow of milk.

The constant coaxing of the mother with "Do drink this," and "You must drink this, or you won't have any milk," not only saddens her but seriously upsets digestion and therefore indirectly interferes with normal lactation.

Getting Up

Everybody should stay at home and away from the mother and her new born child until after the seventh day, and then, if our patient is normal, visitors may call, but should not stay longer than five minutes. The convalescing mother will improve faster without the neighborhood gossip, or the tales of woe so often carried by well-meaning, but woefully ignorant acquaintances.

When the hard ball-like mass can no longer be felt in the lower abdomen, when the bodily fluid has passed through the three changes already mentioned, and the flow is whitish or yellowish, scanty and odorless, the patient may sit up in a chair increasingly each day. Such conditions are usually found anywhere from the tenth to the fifteenth day. The patient first sits up a little in a chair - she has already been exercising some in bed - and this enables her to sit up with ease for a half-hour the first day, increasing one-half hour each day during the week following. At the end of three weeks, she may be taken down stairs providing there is ample help to carry her back up stairs. After another week (at the close of the fourth), if the bodily fluid is entirely white or yellow, with no blood, she may begin carefully to go about the house. There should be no lifting, shoving, pulling, wringing, sweeping, washing, ironing, or other heavy exercise for at least another two weeks, better four weeks. Any variance from this program usually means backache, lassitude, diminished milk supply, and frequently a general invalidism for weeks or months - sometimes years.

Complications

Cystitis, or painful urination, is avoided by tardy "getting up;" quietly, slowly moving about; abundant water drinking; and the avoidance of catheterization.

Hemorrhage. Notify the physician if it occurs at any time. The treatment is heavy kneading of the abdomen until the uterus again becomes like a hard ball. Cold compresses over the lower abdomen may sometimes help.

Infection is manifested by chilly sensations or a distinct chill followed by fever, usually on the third day. Take a cathartic; notify the physician at once and follow his directions.

Mastitis, inflammation or caking of the breasts. Very hot fomentations wrung out of boiling water, alternating with ice-cold compress, should be applied to the breast for an hour or more, three or four times a day. Cathartics should be administered, and eliminative measures instituted such as the hot-blanket pack.

Pneumonia. Keeping the arms and chest well protected by a long-sleeved coat of warm texture, should help in preventing this serious complication. Pneumonia complicating labor is usually the result of carelessness and exposure.

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.