Getting ready to be a mother

How does it seem to you—the coming of a baby?

Does it seem the most amazing of miracles, so stirring in its beauty and mystery that you are eager to make ready and prepare for it fitly?

Or have you, perhaps, come to share the general feeling that motherhood is a natural state which one accepts when it comes, but need not prepare for?

This attitude seems to go back to a very old and deeply rooted conviction that, as women always have had babies and have had them through the working of one of Nature’s laws that has been operating over and over throughout the ages, they doubtless will continue to have them in the same old way, and the entire matter may well be left to take care of itself. As to the baby, when he comes, one may expect that the ability to care for him will come too.

Because of this reasoning, or lack of it, it has been a fairly general custom for the woman who expected a baby to seek her doctor’s aid only when she went into labor, or shortly beforehand, and to give no thought to the care of her baby until he was born. All too often the mother has died, because of this tardy care, been injured or become an invalid, while equally sad things have happened to the baby—and needlessly so.

But now, happily, a great change is taking place in the realm of mothers and babies. We still realize, of course, that childbearing is a natural function, but we know that conditions must be made favorable for the smooth working of this natural law if all is to be well; that for the sake of both mother and baby it is of urgent importance to give thought and care to the baby during the nine months before he is born.

There is little doubt that the most critical period in one’s life is the first ten months—the nine months before birth and the first month afterward—and that the care which is given during these months influences one’s physical state, for good or ill, throughout all the rest of life. In the light of this knowledge, women are more and more generally seeking and being given “prenatal care,” which is care before the baby is born, together with advice and instructions which fit them to assume motherhood safely and successfully.

Ideal prenatal care would really begin during the expectant mother’s own infancy, for the chances of a normal pregnancy, labor and lying-in period are greatly increased by good care during the early years of life. But for the time being we shall have to content ourselves with an effort to extend, as widely as possible, the care that is now known to be beneficial for expectant mothers from the beginning of pregnancy.

This prenatal care is undertaken in much the same spirit in which one makes a garden, for example. We know, of course, that plants which are neglected sometimes grow and blossom satisfactorily, though one would not think of depending upon them to do so. But we have learned that plants that are given the care and protection that they need are almost certain to flourish and bloom after the manner of their kind.

Experience teaches, however, that this care must be regular and sustained and always given for the twofold purpose of preserving the plants from injury as well as nourishing them. Accordingly we put them in good soil, to begin with, and then give water, sunshine or shade, according to their respective needs, and we take care to protect them from the destructive effects of harmful insects, blights, weeds or anything which may be unfavorable to their healthy progress. We do not close our eyes to the fact that these harmful conditions are possible. Instead, we are anxious to find out all about them—what causes them and how to recognize them—in order that we may prevent or remove them before they do serious damage.

Many women, nowadays, are taking just that kind of attitude toward motherhood. They begin by consulting a doctor as soon as they know that they are pregnant, because they appreciate the importance of doing so. They study eagerly the questions relating to motherhood; the structure and workings of those parts of their own bodies which are concerned with the baby’s creation; how he evolves within them; what he needs during those nine months of development; what practices, what conditions are bad for the baby and themselves; what they can do to avoid or correct these and how they can help to make things go smoothly.

The women who face the facts of motherhood in this way generally go through the entire adventure normally and successfully, as Nature intended they should. More than this, those women who place themselves under a doctor’s care from the beginning of, or early in, pregnancy, are greatly reassured to find out how much can be done to safeguard them, and they do not have that fear of the approaching birth which is suffered by so many women who do not know nor understand what is going on.

The results of the painstaking work and study which have been carried on to increase the comfort and safety of mothers and babies have made it possible for the doctors to plan something of a routine which they find advisable for their patients to adopt. To begin with, it is quite plain that the first need of every expectant mother is examination and measurement, early in pregnancy, by a good physician. The information thus obtained helps the doctor to foretell the kind of labor that his patient is likely to have, and by planning for it ahead of time he is often able to save her much harm and suffering. An early examination also enables the doctor to discover and correct any slight trouble which may exist at that time and which might grow worse if not treated, and to advise his patient about the general care which he wishes her to take of herself throughout pregnancy. In regard to this care, doctors are generally agreed that the average woman needs to do little more than observe the ordinary rules of personal hygiene, which as a matter of fact, should be followed by all of us; that is, she should live a simple, regular life as to diet, fresh air, exercise, rest, sleep, diversions, etc. This all sounds simple enough and as a matter of course, but it is usually overlooked in spite of being of the most urgent importance to both mother and baby.

This advice varies in little things, here and there, among different doctors, but in the main it is about the same the world over, where thought is being given to the care of expectant mothers. For no matter where they are or what their status, their needs in general are the same. They need a doctor’s supervision and they need to practice the principles of personal hygiene.

Accordingly, in addition to making an early examination and giving instructions about the regulation of her daily life, the doctor usually wants to see his patient and make certain observations every little while during pregnancy, just to make sure that everything is going as it should and to be in a position to discover the earliest and slightest symptoms of complications.

In the old days there were certain complications associated with childbirth which the doctors did not know how to prevent and sometimes could not cure—complications which were bad for both mother and baby. But now they know a great deal about both preventing and curing even the most serious of these complications. They have discovered, for one thing, that many conditions which give serious trouble during labor, or soon afterwards, actually have their beginnings during pregnancy, and sometimes very early.

Quite evidently, then, it means a great deal to the expectant mother to have the doctor discover and treat these complications before they have had time to become serious. But he can give early treatment only if he knows about the symptoms of the trouble when they first appear. Some of these symptoms may be detected by the expectant mother herself after they have been explained to her, but some of them can be discovered only by a doctor or a nurse. That is why it is important for the doctor to see his patient at frequent intervals during pregnancy; about once a month during the first half and every two weeks afterwards.

He sees her for much the same reasons that the housewife looks over the contents of her darning basket—not once and for all time, but regularly, once a week, over and over and over. She searches each time not for holes alone, but for thin places, too; an occasional broken thread or the beginning of a “run,” knowing how much trouble she will save herself, later on, by promptly repairing the smallest break or evidence of wear. She knows quite well that there are no more holes because she looks for them, than there are if she does not, and that failure to look for them will not keep the holes from being there nor from growing larger. No more does the expectant mother develop a complication because she is examined, nor does an existing condition cease to exist because she is not examined; and yet some women still take just that illogical attitude toward examinations and supervision during pregnancy.

One factor which keeps some expectant mothers from seeking medical care is the well-meaning but dangerous counsel so freely offered by older women who claim fitness to advise by virtue of having had several children of their own. Their lack of success, as evidenced by miscarriages, stillbirths, children dying in early infancy, as well as injuries and disabilities of their own, is usually overlooked as they press their superstitions and remedies upon the inexperienced and bewildered younger woman. When disaster follows, as it so often does, it is very likely to be ascribed to the will of God, and the mother’s needless sacrifice does not even serve as a warning to others who are in line for the same kind of advice.

Another obstacle to adequate prenatal care is sometimes found in the husband who considers it entirely reasonable to secure expert advice upon the subject of cattle-raising, let us say, or the care and running of his automobile or about his investments, but who has a conviction that it is normal and natural for women to have children without making what he considers a fuss about it. He may cherish, too, a suspicion that it is not altogether good for his wife to be thinking too much about her condition. His mother never began bothering until the baby came.

On the other hand, many husbands show the tenderest solicitude for their wives throughout pregnancy and would be only too eager to have them enjoy all the benefits of prenatal care, if they only knew and understood about it. The expectant mother will be wise, therefore, if she undertakes to convince her husband, if need be, that her occupation of bearing and rearing children merits quite the same thoughtful attention as his work, to which he devotes his best powers.

How easy and worth while this may be was demonstrated a couple of years ago at a county fair which was attended by a very intelligent farmer and his wife. The farmer was interested in hog-raising and both he and his wife accepted without question the fact that success in this enterprise could be achieved only through serious study and the most painstaking care. But as to childbearing, if they thought of it at all, they looked upon it as simply one of those natural functions which always had and doubtless always would take care of itself.

When this couple reached the fair the farmer entered one of his fine animals in a prize-winning contest and as there was a baby contest, too, the wife entered their little son. In due time the judges inspected the various contestants and it was found that point by point the farmer’s hog measured up to all of the standards of perfection for his kind and easily won the first prize. Not so with the baby; point by point he fell below even a moderate average of what a baby should be and was outranked by many of his more robust infant competitors.

As various admirers discussed hog-raising with the farmer, it became quite evident that he had carefully studied the question and had applied to his occupation the most approved methods of which he could learn. But when the doctors and nurses at the baby contest talked with the crestfallen mother about her baby, who had seemed right enough to her, they found that she knew little or nothing of the business of being a mother; that it had never occurred to her nor to her husband that she might profit by care and instruction about herself and her baby both before and after he was born. As might be expected, she had been unable to nurse him and on the whole he proved to be a pretty poor specimen of a baby, with a dismal outlook as to health.

Since the mother was then in an early stage of another pregnancy, the doctor talked it all over with her and her husband. He convinced them that such thoughtful and painstaking care as they had devoted successfully to hog-raising were equally effective when applied to baby-raising. As a result, the expectant mother, with her husband’s whole-hearted approval, placed herself under the care and supervision which she found were available through a prenatal clinic in her vicinity.

The happy sequel to that story is that when another fair was held, a year later, the farmer entered another one of his hogs and the wife her new baby, and that this baby held his own with the hog by taking a prize, too.

So sincerely do doctors now believe in the urgency of having all maternity patients under supervision and care during the nine months before the baby comes and the first several weeks afterwards, that they not only care for those women who come to their offices, but also give of their knowledge and skill to organizations engaged in prenatal and maternity work. These organizations may be visiting nurse associations, prenatal clinics, health centers or dispensaries. As the doctors are assisted by nursing staffs they are able to offer protection, through these channels, to a very large number of mothers and babies.

Among the women who are cared for by such organizations, or by doctors in their private practice, there is an enormous reduction in the occurrence of convulsions, for example, abortions, miscarriages, stillbirths, infections (childbed fever), and prolonged and difficult labors. Or, to put it the other way round, good care started during early pregnancy and continued throughout labor and the lying-in period gives both mother and baby enormously increased chances to live and enjoy good health. One reason why the baby is so much better off is that good care practically always enables his mother to nurse him, for, except in extremely rare cases when there is a definite physical disability, as tuberculosis for example, every mother can nurse her baby if she really wants to and if she, the doctor and nurse bend all their energies to accomplish this happy end. A baby who is not breast-fed is defrauded of a protection which is rightfully his, and usually because someone has failed to do all in his or her power.

Organizations which include doctors and nurses who can give skilled care to maternity patients are increasing in scope and number throughout cities, towns and rural districts in all parts of the country. This makes us hope that before long good care during pregnancy, childbirth and young motherhood will be available to every woman in the land. But quite as earnestly do we also hope that every woman in the land who is looking forward to motherhood will seek this care. Certain it is that the expectant mother who does seek care, whether from a doctor in his office or through a prenatal clinic, is approaching her motherhood in the only way that is safe for herself and her baby. She should realize, however, that although the doctors can accomplish a great deal through examinations and advice, they can give the full benefits of their skill only to those women who do their part by following instructions faithfully, week after week, throughout nine months. The doctor cannot live his patient’s life for her; he can plan and advise her ever so wisely, but this counts for very little unless she lives as he directs.

The young woman who sees her motherhood as a coveted privilege, crowded with happy possibilities, who is willing to bear its inconveniences and take the necessary precautions to insure a satisfactory outcome, is very likely to go through her experience in good health and buoyant spirits. And in the end she will have not only the ecstasy of possessing a beautiful, well baby who has every prospect of continuing so, but as the years pass she will have the satisfaction of knowing that she is a better, more helpful, more companionable mother because of being in good health herself.

That is the point of good maternity care—future well-being as well as immediate safety for both mother and baby—and it rests with each woman to decide for herself if she is to have such care.