CHAPTER II
SIGNS THAT A BABY IS COMING
The woman who wants a baby and is in a position to have one is usually eager to know how she can tell when a baby is coming. She wants to know because the baby’s coming means so much to her and also in order that she may know when to consult a doctor.
I am sorry to have to admit, at the outset, that making this important discovery is far from being a simple matter. One would suppose, after all these ages, during which countless babies have been born and countless pregnancies have been observed by doctors and others, that there would be some known way of finding out definitely, at an early date, whether or not a baby was coming. But strangely enough, there is no positive evidence of the baby’s existence within his mother’s body until eighteen or twenty weeks after his life there has begun.
On the other hand, so many symptoms of pregnancy are known to women, the world over, that very often an expectant mother is correct when she suspects at an early date that she is pregnant, particularly if she has already had a child. But as the well-known symptoms are much like those of various conditions other than pregnancy, even experienced mothers sometimes believe themselves pregnant when they are not. The reverse is true also, for we occasionally hear of a woman who fails to recognize the meaning of the changes which she notices in herself, and is unaware of being pregnant up to the very time of going into labor.
And so we find that there are some signs of pregnancy which are only possible, since they may be caused by some other conditions; others which may be accepted as probable, and a few signs which are positive because they are never due to any cause but pregnancy.
The possible signs can all be detected by the expectant mother, herself, and may be described as follows:
1. Stopping of Menstruation. This is usually the first symptom noticed. Although it is possible for the periods to be stopped by any one of several other causes, the missing of two successive periods, after intercourse, is a strong indication of pregnancy in a healthy woman of the childbearing age, whose menses have been regular.
2. Changes in the Breasts. These, also, occur early. The breasts usually increase in size and firmness, and many women complain of throbbing, tingling or pricking sensations and a feeling of tightness and fullness. The breasts may be so tender that even slight pressure is painful. The nipples become larger and more prominent; they and the colored circle of skin around them grow darker, while the veins and the glands that feel like little lumps under the skin become more noticeable. If, in addition to these symptoms, it is possible for a woman who has not had children to squeeze from her nipples a pale yellowish fluid, called colostrum, she may feel almost certain that she is pregnant. But it must be remembered that these symptoms, also, may be due to causes other than pregnancy; that even milk in the breasts may be present in a woman who has borne children, for months, or possibly years, after the birth of her last baby.
3. “Morning sickness,” as the name suggests, is nausea, sometimes accompanied by vomiting, from which many expectant mothers suffer the first thing in the morning. This varies from a little nausea, when first raising her head, to repeated attacks of vomiting during the day and even during the night. As a rule, however, the discomfort is experienced during the early part of the day only. Morning sickness may set in immediately after conception, but begins about the sixth week, as a rule, and lasts until the third or fourth month. It occurs in about half of all pregnancies and is particularly common among women who are pregnant for the first time. On the other hand, one must not forget that many non-pregnant women suffer from nausea in the morning; many women go through pregnancy without any such disturbance, while others are entirely comfortable in the morning but nauseated during the latter part of the day.
4. Frequent Urination. There is usually a desire to pass urine frequently during the first three or four months of pregnancy, after which the tendency disappears, but returns during the later months. The desire may be due in part to nervousness, but is largely caused by pressure made upon the bladder by the growing baby, and not by kidney trouble, as is sometimes believed. For pressure on the outside of the bladder gives much the same sensation as is experienced when the bladder is full of urine. After the baby grows to such a size that he pushes up into the abdomen (we shall describe this later), he does not press upon the bladder and therefore ceases to create a desire to urinate until the last month or six weeks before he is born when he sinks back into the pelvis.
5. Increased discoloration of the colored parts of the skin is another early symptom of pregnancy. In addition to the deepened tint of the nipples and the circles around them, a dark streak appears upon the lower part of the abdomen, extending upward toward the umbilicus, or navel. There are also the yellowish, irregularly shaped blotches which sometimes appear upon the face and neck; dark circles under the eyes and pinkish or bluish streaks on the abdomen.
6. “Quickening” is the name which is commonly given to the mother’s first feeling of the baby’s movements. It occurs about the eighteenth or twentieth week, and is regarded by some doctors as a positive sign of pregnancy and by others as merely a possible sign. The sensation is compared to a very slight quivering, or tapping, or to the fluttering of the wings of a bird as it is held in one’s hand. Beginning very gently, these movements grow more vigorous, as time goes on, until they become very troublesome toward the latter part of pregnancy, amounting then to sharp kicks and blows. Women who have had children can usually distinguish between quickening and the somewhat similar sensation caused by the movement of gas in the intestines; but a woman pregnant for the first time may be deceived.
There are many other possible symptoms of pregnancy, but their value is very uncertain and as we have seen, even the ones described above are not entirely dependable. But if you have missed two periods; if your breasts have grown larger and firmer; if your nipples are stiffer and more prominent and you can squeeze colostrum from them, you may be reasonably certain that a baby is coming.
The probable signs of pregnancy are more apparent to the doctor than to the expectant mother, but there are two which you may easily detect:
1. Enlargement of the abdomen, which is a very important sign, may be noticed about the third month. At this stage a rounded mass may be felt in the abdomen which steadily increases in size as the weeks and months slip by. Rapid enlargement of the abdomen in a woman of childbearing age may be taken as fair, but not positive, evidence that she is carrying a baby. However, complete reliance cannot be placed in this sign, since it is possible for the abdomen to be enlarged by a tumor, by dropsy, or by fat.
2. Painless contractions of the uterus (or womb, within which the baby lies) begin during the early weeks of pregnancy and occur at intervals of five or ten minutes throughout the entire period. The expectant mother may not be conscious of these contractions during the early months, but later she can detect them by placing her hand upon her abdomen and feeling the uterus, beneath it, grow first hard and then soft, as it contracts and relaxes. But the probable signs of pregnancy, like the possible symptoms, may occur in women who are not pregnant, and accordingly the appearance of any one of them alone, is not of great significance.
The positive signs of pregnancy, of which there are three, are not apparent until the eighteenth or twentieth week. They relate to the baby, but with one exception they cannot be detected by the expectant mother. However, they are of such moment that you will be interested to know what they are.
1. Hearing and counting the baby’s heart beat is unmistakable evidence of the baby’s existence. The doctor sometimes hears this by resting his ear upon the mother’s abdomen and sometimes by listening through a stethoscope.
2. Ability to feel the outline of the baby’s body is also a positive sign of pregnancy, if the head, buttocks, back and extremities are unmistakably made out through the mother’s abdominal wall.
3. Feeling the movements of the baby is accepted as a third positive sign of pregnancy. There is some difference of opinion concerning the value of “quickening,” alone, as a positive sign, but if the baby’s movements are felt by the doctor, also, through the mother’s abdominal wall, or by vaginal examination, there can be no doubt that a baby is there. Feeling these movements some time after the eighteenth or twentieth week, by placing a hand upon the abdomen, is the one positive sign which the expectant mother may detect for herself.
Some Other Changes in the Mother’s Body While the Baby Grows. In addition to the signs and symptoms which we have just described, there are a good many other changes which will take place in your own body, in the course of the baby’s development, and you will want to learn about some of them in order that you may know what to expect.
The abdomen. Of course, the steady enlargement of the abdomen and the alteration in its shape, as pregnancy advances, is the change that you will be most conscious of. As the abdomen grows larger, the skin which covers it is stretched more and more tightly with the result that the tissues just under the surface sometimes give way, or split and form pale pink or bluish streaks. These streaks, which are called striæ, grow white and glistening after the baby is born, so that the abdomen of an expectant mother who has had children, will show silvery streaks from earlier pregnancies and also the bluish ones recently formed. These streaks are of no consequence and I mention them simply because you are almost certain to notice them and may wonder what they are. They may appear upon the hips, thighs and breasts as well as upon the abdomen, if the skin over these parts is greatly stretched.
The umbilicus (navel) is deeply indented during about the first three months of pregnancy, but afterwards the pit steadily grows shallower and by the seventh month, it is level with the surface of the abdomen. After this time the navel may protrude, in which state it is described as a “pouting umbilicus.”
An increase in the vaginal discharge is another change which you may notice during the latter months of pregnancy.
The changes in the skin consist chiefly of the increased discoloration over various parts of the body, which was mentioned among the possible signs of pregnancy. The degree of this discoloration varies with the complexion of the individual, as blonds may be tinted but slightly more than usual, while the discolored areas on a brunette may become almost black. As the skin glands become more active, there is also an increase in perspiration and sometimes the hair becomes much more luxuriant during pregnancy.
Changes in the digestive tract are the morning sickness already described, and constipation. The latter is suffered by at least one half of all pregnant women and is due chiefly to pressure made upon the intestines by the enlarged uterus, though weakening of the stretched abdominal muscles may be one cause. Constipation is most troublesome during the latter part of pregnancy. There may be, also, heartburn, acid stomach and intestinal indigestion giving rise to gas, diarrhea and cramps. The so-called “cravings” of pregnancy are not so common in real life as they are in rumor, but the expectant mother may show unexpected likes and dislikes for certain dishes, possibly because of her tendency to be nauseated. Her appetite may be very capricious during the early weeks and become almost ravenous later on.
The bones and teeth may grow softer during pregnancy, if the expectant mother does not eat proper food, and as a result we hear of the old beliefs that each baby costs the mother a tooth and that broken bones heal slowly during pregnancy. Both of these occurrences are entirely unnecessary, and may be prevented by eating suitable food, as will be explained in the chapter on nutrition.
The carriage, or mode of walking, is somewhat affected by pregnancy because of the increased size and weight of the abdomen. In an effort, to hold herself erect, the expectant mother throws back her head and shoulders and finally assumes a gait that may be described as a waddle, being particularly noticeable in short women.
You hear a good deal about the thyroid gland these days, so you may as well know that it is very often enlarged during pregnancy and thus may form a swelling on the front part of the neck. If you notice it you might tell your doctor but it need not worry you for it will almost certainly return to its normal size after the baby comes.
When to Expect the Baby. Now that you are familiar with the most apparent changes which will take place in your body during pregnancy, you are probably on tiptoe to find out as nearly as possible the date upon which to expect the baby. Unfortunately we cannot foretell the exact date, for the very simple reason that we have no way of knowing just when pregnancy begins. Quite evidently, then, not knowing when it begins we cannot figure out the exact date upon which pregnancy will end in the baby’s birth. But we do know that labor usually begins about ten lunar months, or forty weeks, or from 273 to 280 days, after the beginning of the last menstrual period. Thus the approximate date of the baby’s arrival may be estimated by counting forward 280 days or backward 85 days from the first day of the last period. Or, what is perhaps simpler and amounts to the same thing, one may add seven days to the first day of the last period and count back three months. For example, if the last period began on June 3, the addition of seven days brings us to June 10, while counting back three months from this, indicates March 10 as the approximate date upon which the baby may be expected.
This is probably as satisfactory as any method of estimation, but at best it is only approximate, being accurate in about one case in twenty. However, it comes within a week of being correct in half the cases; and is within two weeks of the actual date in eighty per cent. of all pregnancies.
Still another method is to count forward twenty or twenty-two weeks from the day upon which you first feel the baby move. This “quickening,” as we have seen, usually occurs about the eighteenth or twentieth week, but is so irregular that it is not wholly reliable. The possibility of figuring out the date of the baby’s arrival is made still more uncertain by the fact that there is evidently considerable variation in the length of entirely normal pregnancies. Many healthy children are born before ten lunar months have elapsed since the last menstrual period, while more births occur after than on the expected date. The first pregnancy is usually shorter than later ones, and women who are well nourished and well cared for usually have longer pregnancies than those who are not.
Taking it as a whole, the average woman has unusually good health during pregnancy. She may feel some weariness during the first few months and she may lose a little weight, but during the latter part of the period her general health is improved and there is an increase of flesh, not alone in the abdomen, but over the entire body, sometimes amounting to twenty-five or thirty pounds. She loses about fifteen pounds of the increased weight when the baby is born, and still more during the weeks immediately following, when her body returns to about its original condition. But very often the experience of pregnancy is so beneficial that the improved state of health and nutrition which accompany it become permanent.