The Mother and Her Child

For many years the call for a book on the mother and her child has come to us from patients, from the public, and now from our publishers—and this volume represents our efforts to supply this demand.

The larger part of the work was originally written by Dr. Lena K. Sadler, with certain chapters by Dr. William S. Sadler, but in the revision and re-arrangement of the manuscript so much work was done by each on the contributions of the other, that it was deemed best to bring the book out under joint authorship.

The book is divided into three principal parts: Part I, dealing with the experience of pregnancy from the beginning of expectancy to the convalescence of labor: Part II, dealing with the infant from its first day of life up to the weaning time; Part III, taking up the problems of the nursery from the weaning to the important period of adolescence.

The advice given in this work is that which we have tried out by experience—both as parents and physicians—and we pass it on to mothers, fathers, and nurses with the belief that it will be of help in their efforts at practical and scientific "child culture." We believe, also, that the expectant mother will be aided and encouraged in bearing the burdens which are common to motherhood by the advice and instruction offered.

While we have drawn from our own professional and personal experience in the preparation of this book, we have also drawn freely from the present-day literature dealing with the subjects treated, and desire to acknowledge our indebtedness to the various writers and authorities.

We now jointly send forth the volume on its mission, as a contribution toward lightening the task and inspiring the efforts of those mothers, nurses, and others who honor us by a perusal of its pages.

William S. Sadler.
Lena K. Sadler.

Chicago, 1916.

PART I

THE MOTHER

THE MOTHER AND HER CHILD

PART I

There can be no grander, more noble, or higher calling for a healthy, sound-minded woman than to become the mother of children. She may be the colaborer of the business man, the overworked housewife of the tiller of the soil, the colleague of the professional man, or the wife of the leisure man of wealth; nevertheless, in every normal woman in every station of life there lurks the conscious or sub-conscious maternal instinct. Sooner or later the mother-soul yearns and cries out for the touch of baby fingers, and for that maternal joy that comes to a woman when she clasps to her breast the precious form of her own babe.

MOTHERHOOD THE HIGHEST CALLING

Motherhood is by far woman's highest and noblest profession. Science, art, and careers dwindle into insignificance when we attempt to compare them with motherhood. And to attain this high profession, to reach this manifest "goal of destiny," women are seeking everywhere to obtain the best information, and the highest instruction regarding "mothercraft," "babyhood," and "child culture."

In an Indiana town not long ago, at the close of a lecture, a small, intellectual-appearing mother came forward, and, tenderly placing her tiny and emaciated infant in my arms, said: "O Doctor! can you help me feed my helpless babe? I'm sure it is going to die. Nothing seems to help it. My father is the banker in this town. I graduated from high school and he sent me to Ann Arbor, and there I toiled untiringly for four years and obtained my degree of B. A. I have gone as far as I could—spent thousands of dollars of my unselfish father's money—but I find myself totally ignorant of my own child's necessities. I cannot even provide her food. O Doctor! can't something be done for young women to preparé them for motherhood?"

MOTHERCRAFT PREPARATION

The time will come when our high and normal schools will provide adequate courses for the preparation of the young woman for her highest profession, motherhood. This young mother, who had reached the goal of Bachelor of Arts, found to her sorrow that she was entirely deficient in her education and training regarding the duties and responsibilities of a mother. In every school of the higher branches of education that train young women in their late teens there should be a chair of mothercraft, providing practical lectures on baby hygiene, dress, bathing, and the general care of infants, and giving instruction in the rudiments of simple bottle-feeding, together with the caloric values of milk, gruels, and other ingredients which enter into the preparation of a baby's food.

Young women would most enthusiastically enroll for such classes, and as years passed and marriage came and children to the home, imagine the gratitude that would flood the souls of the young mothers who were fortunate enough to have attended schools where the chairs of motherhood prepared them for these new duties and responsibilities.

EARLY MEDICAL SUPERVISION

Just as soon as it is known that a baby is coming into the home, the expectant mother should engage the best doctor she can afford. She should make frequent calls at his office and intelligently carry out the instruction concerning water drinking, exercise, diet, etc. Twenty-four hour specimens of urine should be frequently saved and taken to the physician for examination. In these days the blood-pressure is closely observed, together with approaching headaches and other evidences of possible kidney complications. The early recognition of these dangers is accompanied by the immediate employment of appropriate sweating procedures and other measures designed to promote the elimination of body poisons. Thus science is able effectively to stay the progress of the high blood-pressure of former days, and which was so often followed by eclampsia—uremic poisoning.

In these days of careful urine analysis, expertly administered anaesthetics, and up-to-date hospital confinements, the average intelligent woman may enter into pregnancy quite free from the oldtime fears, whose only rewards were grief and cankering care. All fear of childbirth and all dread of maternal duties and sacrifices do not in the least lessen the necessary unpleasantness associated with normal labor. It lies in the choice of every expectant mother to journey through the months of pregnancy with dissatisfaction and resentment or with joy and serenity. "The child will be born and laid in your arms to be fed, cared for, and reared, whether you weep or smile through the months of waiting."

THE RESENTFUL MOTHER

A little woman came into our office the day of this writing, saying: "Doctor, I'm just as mad as I can be; I don't want to be pregnant, I just hate the idea." As I smiled upon this girl-wife of nineteen, I drew from my desk a sheet of paper and slowly wrote down these words for the head of a column: "Got a mad on," and for the head of another, "Got a glad on;" and then we quickly set to work carefully to tabulate all the results that having a "mad on" would bring. We found to her dismay that its harvest would be sadness of the heart, husband unhappy, work unbearable, while all church duties as well as social functions would be sadly marred. Then, just as carefully, we tabulated the benefits that would follow having a "glad on." Her face broke into a smile; she laughed, and as she left the office she assured me that she would accept Nature's decree, make the best of her lot, and thus wisely align herself with the normal life demands of old Mother Nature. This view of her experience, she came to see, would bring the greatest amount of happiness to both herself and husband. She left me, declaring that she was just "wild for a baby;" and there is still echoing in my ears her parting words: "I'm leaving you, Oh, such a happy girl! and I'm going home to Harold a happy and contented expectant mother."

There often enters on the exit of a discontented and resentful expectant mother, a woman, very much alone in the world—perhaps a bachelor maid or a barren wife, who, as she sits in the office, bitterly weeps and wails over her state of loneliness or sterility; and so we are led to realize that discontentment is the lot of many women; and we are sometimes led to regret that ours is not the power to take from her that hath and give to her that hath not.

EARLY SIGNS OF PREGNANCY

Among the first questions an expectant mother asks is: "What are early signs of pregnancy?" The answer briefly is:

1. Cessation of menstruation.
2. Changes in the breast.
3. Morning sickness.
4. Disturbances in urination.

Menstruation may be interrupted by other causes than pregnancy, but the missing of the second or third periods usually indicates pregnancy. Accompanying the cessation of menstruation, changes in the breast occur. Sensation in the breasts akin to those which usually accompany menstruation are manifested at this time in connection with the unusual sensations of stinging, prickling, etc. Fully one-half of our patients do not suffer with "morning sickness;" however, it is the general consensus of opinion that "morning sickness" is one of the early signs of pregnancy, and these attacks consist of all gradations—from slight dizziness to the most severe vomiting. It is an unpleasant experience, but in passing through it we may be glad in the thought that "it too, will pass."

Because of the pressure exerted by the growing uterus upon the bladder, disturbances in urination often appear, but as the uterus continues to grow and lifts itself up and away from the bladder these symptoms disappear.

Chief of the later signs of pregnancy are "quickening" or fetal movements. The movements are very much like the "fluttering of a young birdling." They usually are felt by the expectant mother between the seventeenth and eighteenth weeks. This sign, together with the noting of the fetal heartbeat at the seventh month, constitute the positive signs of pregnancy.

PROBABLE DATE OF DELIVERY

And now our expectant mother desires to know when to expect the little stranger. From countless observations of childbirth under all conditions and in many countries, the pregnant period is found to cover about thirty-nine weeks, or two hundred and seventy-three days. There are a number of ways or methods of computing this time. Many physicians count back three months and add seven days to the first day of the last menstruation. For instance, if the last menstruation were December 2 to 6, then, to find the probable day of delivery, we count back three months to September 2, and then add seven days. This gives us September 9, as the probable date of delivery. The real date of delivery may come any time within the week of which this calculated date is the center.

As a rule, ten days to two weeks preceding the day of delivery, the uterus "settles" down into the pelvis, the waist line becomes more comfortable, and the breathing is much easier.

On the accompanying page, may be found a table for computing the probable day of labor, prepared in accordance with the plan just described.

TABLE FOR CALCULATING THE DATE OF CONFINEMENT

Supposing the upper figure in each pair of horizontal lines to represent the first day of the last menstrual period, the figure beneath it, with the month designated in the margin, will show the probable date of confinement.