Read Ebook: The Eugenic Marriage Volume 1 (of 4) A Personal Guide to the New Science of Better Living and Better Babies by Hague W Grant William Grant

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se, to be successful, it would have to bestow much material aid. I know of clubs that are self-supporting, however. Each club needs a leader to begin it; will the reader be that one in her Community?

A Mothers' Eugenic Club would of course discuss the practical side of the eugenic question: the proper feeding and clothing of children; hygiene, sanitation, housekeeping and homemaking, and the efficiency and health of each member of the home, and all other topics of interest to every wife and mother. The writer believes that in the very near future we shall have a Mothers' Eugenic Club in every community in the United States; that these clubs will be guided by, and be an instrument of, a National Eugenic Bureau, composed of women, that will co?perate and harmonize the work as a whole, so that the conservation of human life will be effected to its maximum extent; that the excessive infant mortality will be overcome, because ignorant and incompetent mothers--the greatest cause of infant mortality--will be educated and instructed in the rudiments of eugenics and will consequently, to a large extent, cease to be ignorant and incompetent; that the desecration of young wives will stop, and stop forever, because vice and disease will be branded and exposed; that the feeble-minded, the deaf-mute, the imbecile, and the insane, will no longer be allowed to propagate their kind, to the permanent detriment of the race.

When such clubs are established, and when all mothers do their individual duty in the interest of the race, we shall begin to see the dawn of a promise that will achieve its supreme success in the generations that will people the earth in the eugenic aftertime.

CHILD-BIRTH

"Solicitude for children is one of the signs of a growing civilization. To cure is the voice of the past; to prevent, the divine whisper of to-day."

KATE DOUGLAS WIGGIN.

PREPARATIONS FOR THE CONFINEMENT

THE BIRTH CHAMBER--WHAT TO PROVIDE FOR A CONFINEMENT--READY TO PURCHASE OBSTETRICAL OUTFITS--POSITION AND ARRANGEMENT OF THE BED--HOW TO PROPERLY PREPARE THE ACCOUCHMENT BED--THE KELLY PAD--THE ADVANTAGES OF THE KELLY PAD--SHOULD A BINDER BE USED?--SANITARY NAPKINS--HOW TO CALCULATE THE PROBABLE DATE OF THE CONFINEMENT--OBSTETRICAL TABLE--WHEN SHOULD A PREGNANT WOMAN FIRST CALL UPON HER PHYSICIAN--REGARDING THE CHOICE OF A PHYSICIAN--HOW TO KNOW THE RIGHT KIND OF A PHYSICIAN FOR A CONFINEMENT--THE SELECTION OF A NURSE--THE DIFFERENCE BETWEEN A TRAINED AND A MATERNITY NURSE--DUTIES OF A CONFINEMENT NURSE--THE REQUISITES OF A GOOD CONFINEMENT NURSE--THE PERSONAL RIGHTS OF A CONFINEMENT NURSE--CRITICIZING AND GOSSIPING ABOUT PHYSICIANS.

THE BIRTH CHAMBER

The room in which the confinement is to take place should be selected with care. In many cases there will be no choice for the reason that there will be only one suitable bedroom available. Where practicable however a room having the following accessories, or as many of them as is possible, should be given the preference.

If the house is a private one the room should be on the second floor. If the home is in an apartment house the confinement chamber should be as far removed from the living-room as circumstances will permit,--especially if there are other children who will make more or less continuous noise.

All unnecessary furniture, pictures and draperies should be taken out of the room a few days before the confinement is due; the room itself, and everything left in it, should be thoroughly cleaned and aired. A small table for holding instruments, sterilizing basins, etc., should be provided and in readiness.

WHAT TO PROVIDE FOR A CONFINEMENT.--The following articles should be in readiness at all confinements:--

The physician will direct that certain additional articles be provided according to his individual taste and custom. These will include an antiseptic and ergot; any other requisite found necessary can be sent for, or the physician can supply it, as he invariably has in his bag whatever may be required in complicated cases or in an emergency. All the items enumerated in the above list are absolutely essential, they may not all be used but it would not be safe to undertake a confinement without providing the essential requisites. Many maternity outfits are prepared ready for use and can be obtained at the larger drug stores, costing from to . The articles in the above list can be bought for about , not including those articles which the patient is assumed to have. The following are samples of the ready-to-purchase outfits:

READY-TO-PURCHASE OBSTETRICAL OUTFITS

OUTFIT NO. 1 1 Sterilized Bed Pad . 2 dozen Sterilized Vulva Pads. 2 Sterilized Mull Binders . 5 yards Sterilized Gauze. 1 pound Sterilized Absorbent Cotton . Rubber Sheet, 1 1/2 yards by 2 yards, Sterilized. Douche Pan, Sterilized. 1 Tube K-Y Lubricating Jelly. Sterilized Nail Brush. Boric Acid, Powdered. Tinct. Green Soap. Bichloride Tablets. Lysol. Tube Sterilized Tape. PRICE .00.

OUTFIT NO. 2. 2 Sterilized Bed Pads . 2 dozen Sterilized Vulva Pads. 2 Sterilized Mull Binders . 6 Sterilized Towels. 10 yards Sterilized Gauze. 1 pound Sterilized Absorbent Cotton . Rubber Sheet, 1 yard by 1 1/2 yards, Sterilized. Rubber Sheet, 1 1/2 yards by 2 yards, Sterilized. 4 quart Sterilized Douche Bag with glass nozzle. Douche Pan, Sterilized. Sterilized Nail Brush. 2 Agate Basins, Sterilized. Safety Pins. 2 Tubes Sterilized Petrolatum. 1 Tube K-Y Lubricating Jelly. Boric Acid, Powdered. 100 grms. Chloroform . Fl. Ext. Ergot. Tinct. Green Soap. Bichloride Tablets. Lysol. Tube Sterilized Tape. Sterilized Soft Rubber Catheter. Sterilized Glass Catheter. Stocking Drawers, Sterilized. Talcum Powder. Bath Thermometer. PRICE .50.

These materials, being cleansed and sterilized, are ready for use at any time.

These complete outfits are packed in neat boxes, thus enabling the contents to be kept intact until needed.

THE POSITION AND ARRANGEMENT OF THE BED.--The bed should be a substantial single bed. If a double one is used, prepare the side for the confinement which will permit the physician to use his right hand,--that will be the right side of the patient as she lies in bed. One objection to a double bed is its tendency to sag. This tendency can be obviated however by placing an ironing board under the spring from side to side, or by using shelves from a book case. This expedient will support the mattress, thereby rendering the bed firm and free from any sagging tendency. The position of the bed in the room should be such that the patient will not directly face the window light, nor be in a direct draught between the window and the door. It should be so arranged that the nurse can get easily to either side, consequently it must not be pushed against the wall.

HOW TO PREPARE THE ACCOUCHMENT BED.--Over the mattress place the rubber sheet so that its center will be exactly under the hips of the patient. Pin with large safety pins each corner of the rubber sheet to the mattress; now put the sheet on exactly as you do when making an ordinary bed. On top of the sheet, and in the middle of the bed , place a draw sheet. A draw sheet is a sheet folded once, placed across the bed, and pinned tightly with large safety pins to the mattress at each side. The advantage of this sheet is, that it can be removed when necessary, leaving the original clean sheet on the bed, without disturbing the patient. Be particular not to have the top of the draw sheet higher than the middle of the patient's back. Place the pad,--previously prepared for the purpose,--on the draw sheet and level with the top of the draw sheet.

After the confinement is over and the patient is clean, remove the Kelly pad, and the pad below if necessary, or the pad and newspapers if these are used,--place a clean pad under the patient and you are ready to place the binder on if a binder is to be used.

SHOULD A BINDER BE USED?--Medically a binder is not necessary, neither is it objectionable from a medical standpoint. It is supposed to hold the flaccid, empty womb in place. This it does not do and we are of the opinion, that it, in many instances, according to how it is put on, compresses the womb out of place. The binder is certainly appreciated by most patients because of its snug, comfortable feeling; and in cases when the abdominal wall is fat and the muscles soft, it holds them together in a way that is impossible by the use of any other device. To claim that the binder prevents hemorrhages is absurd. Our personal rule is to put one on if the patient wants one, or if she has previously had one. To be effective, in any sense, the binder should extend from the waist line down to halfway between the hips and knees and should be snugly, but not too tightly pinned.

SANITARY NAPKINS.--These can be purchased already prepared in most drug stores, or they can be made in the following manner: Take an ordinary grade of cheese cloth, wash it, and when dry, cut it into half yard squares. In the center of each square place a strip, six or eight inches long, of absorbent cotton and fold the gauze lengthwise over it so as to make a pad. These can be used as napkins, and after they are soiled can be burned. It is absolutely wrong to use rags or any old cloths for napkins, as the patient can be infected and made seriously sick by this procedure.

HOW TO CALCULATE THE PROBABLE DATE OF THE CONFINEMENT.--The duration of pregnancy extends for 280 days from the end of the last menstruation. Add seven days to the date of the last menstruation, and from that date count ahead nine months, or backward three months and you may have the probable date of the confinement. Should you pass this time you will probably go on for two additional weeks. The reason for this is that the most susceptible time for conception to occur is either during the week following menstruation or a few days before menstruation. If, therefore, you pass the above probable date which was calculated from the end of the last menstruation, it shows that conception did not take place during the week following that menstruation; and the assumption will be that it took place a few days before the next menstruation, which will be about two weeks later than the date as calculated above.

If, for example, a pregnant woman was last sick from January 1st to 5th we add seven days to the 5th, which is the 12th, to which we add nine months, which will give us, as the probable date of confinement, October 12th. Should she go a few days over the 12th, the probability is that the confinement will take place on October 26th.

The foregoing table affords us a handy means of finding the probable date of confinement at a glance.

Find the date of the last day of the last menstrual period in the upper row; the date immediately below it is the probable date of confinement.

For example if the last menstrual period was from Jan. 1st to 5th, we find January 5th and below it we note October 12th as the probable date of confinement.

WHEN SHOULD A PREGNANT WOMAN FIRST CALL UPON HER PHYSICIAN?--The earliest indication of pregnancy is the interruption of menstruation. When menstruation fails to appear at its regular time in a young married woman whose past menstrual history is good,--i.e., she has been sick every month regularly and without pain since she began menstruating as a girl,--the assumption would naturally be that she was pregnant. Menstruation may however "miss" one month for other reasons than pregnancy just at this time, as is explained elsewhere, so it is wise to defer a positive assumption on such an important matter. When the second menstruation does not appear, and there are no specific reasons for its failure to appear, it may be safely assumed that pregnancy has taken place. A visit to the family physician one week after the second menstruation should have appeared, or at least long enough to feel absolutely certain that the sickness is not coming around, is not only necessary, but is the essential and correct step to take for a number of very good reasons. If a woman for example has not had a baby, how does she know she can have one? It is quite possible to become pregnant and yet it may be wholly impossible to give birth to a child. It is necessary to be constructed normally, or as near what is regarded as normal as is possible, in order safely to assume the responsibility of carrying a pregnancy to a successful completion. No one but a physician, who is skilled and familiar in the knowledge of what constitutes the proper size, and shape, and quality, and relations, one with another, of your bones, and ligaments, and muscles, can tell whether you can safely be permitted to carry a pregnancy to term or not. If the anatomical conditions are not just right; if circumstances from a medical standpoint are not favorable; if your personal risk is too hazardous; if, in other words, medical science should decide that you are one of the very few women who cannot have a baby, is it not of very great importance that you should know this as soon as possible? Does not that fact alone render your early call upon your physician imperative? A physician can bring out facts, relating to the personal and family history, and habits, of the prospective mother, which will enable him to formulate advice which will prove of the highest value from the very beginning of pregnancy. Instructions carried into effect at this early date, as to personal conduct, exercise, diet, etc., will have a distinctly beneficial influence, not only on the patient's health and the character of her confinement, but on the physical vitality of the coming baby.

REGARDING THE CHOICE OF A PHYSICIAN.--This is a matter that should receive the most careful consideration. While it is just to admit that every physician is capable of successfully conducting maternity cases, there are certain characteristics in the individual temperament that would seem to indicate that some physicians are better adapted to this special work.

Trustworthiness is an imperative essential in a physician who assumes the responsibility of confinement engagements. He must be clean in his personal habits as well as morally. He should possess the virtue of patience and be tactful, and above all he should be made to feel that he has your implicit confidence. If you will analyze these qualifications you will understand just what they imply. The physician who has the reputation of having the largest practice is not necessarily the man you want, nor does it imply that he is the best fitted to conduct your case to your satisfaction. The fact that he is a very busy man may be distinctly detrimental to your best interests. If the physician has the reputation of being an excellent doctor, but, "You can't always depend on him,--he may be out of town, or he may send his assistant, or substitute," you don't want him; it is too important an event to you to take a chance with. Rely rather upon the man who, though his charge may be a little higher, is known to be trustworthy; who will take a personal interest in you, and is known to be patient and capable.

THE SELECTION OF A NURSE.--A choice must be made between having a trained nurse and what is known as a maternity, or monthly, nurse. The choice may be dictated by the financial means of the patient. A trained nurse is paid from to per week, while a maternity nurse usually gets per week.

A trained nurse is a graduate from a hospital where she has successfully completed a course of training. She is to be preferred, if she can be afforded, for the reason that she has been trained to obey absolutely the orders of a physician, and because she has the requisite knowledge to detect emergencies, and the necessary skill and experience to enable her to act intelligently of her own initiative in any emergency.

The maternity nurse, on the other hand, has not had an adequate training and is absolutely helpless, so far as medical knowledge is concerned, in a real emergency. Her experience is limited to what she has picked up in the various cases she has had. She, as a rule, has chosen this means of obtaining a living as a result of some domestic financial affliction. She does not understand the laws of sterilization and has not been trained to obey, without question, the instructions of a physician. The maternity nurse follows a routine which she is incapable of modifying to suit the particular case. She has old-fashioned ideas and notions which she carries out as a matter of course, and she overestimates the great importance of her experience to the extent of wholly disregarding the advice of the physician. She assumes the care of the patient and baby, and regards this as her right, and as a result she is frequently responsible for much injury to the mother and child. Despite these objections we have worked with many of these nurses who were to be preferred to trained nurses. It is the individual after all that counts, and if a maternity nurse, though technically untrained, is adaptable, tactful, and will consent to be instructed to the extent of obeying without argument, she can become invaluable, and her skill and experience will carry her creditably over many trying incidents. The objection of the medical profession to an untrained nurse is based, not so much on her lack of ability, as upon her propensity to indiscriminate and indiscreet talk,--they have not been trained to know the value of professional silence, nor have they had the necessary education which would have enabled them to acquire through their experience the knowledge that "silence is golden" at all times. A trained nurse possesses the requisite knowledge, but may have an objectionable individuality. An untrained nurse may have sufficient knowledge, and what she lacks she may make up for in being congenial and adaptable. While the trained nurse strictly attends exclusively to the mother and the baby, a maternity nurse as a rule attends to the household duties in addition. She cooks the meals of the entire family, and dresses and cares for the other children if there is no one else to do it. The duties of a maternity nurse can be specified and agreed upon, and the terms arranged when she is engaged. The duties of a trained nurse are fixed by nursing laws and medical rules and cannot be changed or modified by private agreement. These laws and rules, however, are not sufficiently arbitrary to make it impossible for the nurse to be obliging, courteous, and sincere,--qualifications which every patient has a right to expect, and a right to insist upon from every graduate nurse.

The selection of a nurse should receive careful consideration. She should be known to be honest, honorable, competent, healthy, and personally clean in habits and dress, and she should be tactful, obliging, and she should attend to her own affairs strictly. She should not be a gossip; she should not shirk her work or pry into family affairs that do not concern her; and she should not drag into the conversation her own personal or family secrets.

The nurse has certain rights which the patient should willingly recognize. She is entitled to a comfortable bed, sufficient sleep, good food, and exercise in the open air every day. These are essential in order that she maintain her own health, as well as keep at the highest point of efficiency.

When you select your physician consult with him regarding your nurse. If you know personally a capable nurse, there is no objection to selecting her, and no physician will oppose this procedure if you assume the responsibility of her capability.

There are many advantages, however, in permitting the physician to provide a nurse. He assumes the responsibility of the nurse's capability, and it is safe to assume he will not recommend one whom he knows to be personally objectionable, or professionally incapable. Every physician acquires certain individual methods in the conduct of maternity cases, which experience has taught him to be successful. A competent knowledge of these methods by the nurse greatly facilitates the details and ensures a harmonious conduct of the entire case,--facts which accrue to the comfort and the well-being of the patient.

It is not out of place here to warn a young wife against being advised by a neighbor or a busybody, as to whom she should select as physician or nurse. You must not depend upon the gossip of the neighborhood. The physician or nurse whom you are told by one of these irresponsible individuals not to take, may be the one above all others whom you should take. When you hear a gossiping woman decry a physician, depend upon it, she owes him something,--most often it is a bill, but it may only be a grudge. There is no class of men in any community who are maligned and abused so much as are physicians. They seem to be the choice victims of the enmity and spite of every malicious feminine tongue. A woman should think twice before she utters a criticism regarding the work of a physician. She would, if she but knew how quickly she brands and advertises herself as irresponsible and lacking in ordinary courtesy and good breeding, as she is not qualified to criticise the professional capability of a physician, nor is she qualified to estimate the extent of the wrong she perpetrates. There is no class of men who do more conscientious work, day after day, than do physicians, and there is no class of men who are more deserving of the commendation of the entire community than the thousands of self-sacrificing, underpaid members of the medical profession. Be suspicious therefore when you hear a criticism, and be very, very sure before you utter one,--rather give him the benefit of the doubt and you will do no wrong, and it may be at some future date you will be thankful you did not criticise.

THE HYGIENE OF PREGNANCY.

CONDUCT OF THE PREGNANT WOMAN

The young wife will arrange her daily routine according to the physician's instructions, which, by the way, she should faithfully carry out. If you are one of the fortunate many who enjoy reasonably good health, you have doubtless been told to follow a plan very similar to the one we shall now briefly outline.

For the first six months she can safely continue to do her household work. It is to her advantage to do so for many reasons, but especially because it helps to keep her physically in good condition, and because it keeps her mind engaged, thus avoiding a tendency to nervous worry. After the sixth month it is desirable to give up the heavier part of the work. Washing and sweeping should be absolutely prohibited. Moving furniture or heavy trunks must not be done by the prospective mother, but all light work can and should be indulged in to the very end. Find time to spend at least one hour and a half in the open air every day. Unless there is a medical reason against active exercise there is nothing so beneficial to the pregnant woman as walking, nor is there any substitute for it. A drive or motor ride into the country, or a car ride around town, is an excellent device against ennui and is highly desirable during this time, but not as a substitute for the daily long walk. A pregnant woman must keep her muscles strong and in good tone if she hopes to do her share toward having a short and easy confinement. She must keep active to ensure perfect action of all her organs--the stomach must digest; the bowels and kidneys must act perfectly; the heart, and lungs, and nerves must be supplied with good blood and fresh air; the appetite must be keen, and the sleep sound. Walking in the open air will do all this and nothing else can, to the same satisfactory degree.

Light passive exercise at home is desirable to those very few who cannot walk in the open air, but at best it is a poor substitute. It is necessary to avoid any exercise or any labor of the following character from the very beginning of pregnancy: stretching, lifting, jarring, jumping, the use of the sewing machine, bicycling, riding, and dancing.

She should continue to employ the same toilet privileges she has been accustomed to except the use of the vaginal douche, which must be stopped from the date of the first missed menstrual period. This is the only safe rule to follow and no exception should be made to it except upon the advice of a physician.

Bathing during the entire course of pregnancy is a highly necessary duty. It is particularly advantageous during the later months because it relieves the kidneys at a time when they are called upon to perform an excess of work. The temperature of the bath should be warm and rapidly cooled at the finish. Brisk rubbing with a course towel will ensure the proper reaction.

Sexual intercourse must be restricted during pregnancy; and it should be wholly abstained from during what would have been the regular menstrual periods, if pregnancy had not occurred, for the reason that abortion is apt to take place. It is most harmful during the early and late months of pregnancy. Sexual intercourse is distasteful to most and harmful to every pregnant woman.

CLOTHING DURING PREGNANCY.--The clothing should be so constructed as to relieve any undue pressure on the breasts or abdomen. For this reason it should be suspended from the shoulder. When it is appreciated that clothing supported by the waist crowds the growing womb, and exerts pressure upon the kidneys, and is responsible for many of the kidney complications that occur during pregnancy, no further reason need be given for discarding all clothing, except very light garments, that are not held by some device whose support is from the shoulders. A specially constructed linen waist is made and sold for this purpose. It is fashioned so that all the lower garments and the garters can be fastened to, and supported by it. Corsets should be absolutely discarded from the very first day of pregnancy.

In a large woman with a lax abdomen, a properly made abdominal support will not only be a great comfort but of real advantage. It should exert a support upward by lifting the abdomen, not by constricting it. It should therefore be obtained from a reliable dealer and be made and applied to effect the above object,--otherwise it may do more harm than good.

THE MENTAL STATE OF THE PREGNANT WOMAN.--The coming baby should be the text of many interesting, spontaneous talks between the young couple from the time when it is first known that a new member of the family is on its way. The husband should feel that he is a party to the successful consummation of the little one's journey. He can contribute enormously to this end. It should be his duty, born of a sincere affection and love, to formulate the programme of events which has for its main object the wife's entire mental environment. He should encourage her to live up to the physician's instructions, and arrange details so that she will obtain the proper exercise daily. He should read to her in the evening, and arrange his own business affairs so that he will be with her as much as is possible. In many little ways he can impress upon her the fact that they both owe something to the unborn babe and that each must sacrifice self in its behalf. His principal aim, of course, will be that she will not worry or have cause to worry. He will so direct her mental attitude that she will dwell only upon the bright side of the picture; she will thus strive to realize the hope that the baby will be strong and healthy, and she will, prompted by his encouragement and devotion, try to do her duty faithfully. Working together in this way, much can be done that means far more than we know of, and in the end the little one comes into the world a welcome baby, created in love and born into the joy of a happy, harmonious, contented home.

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