We cannot reason with our cells, for they know so
much more than we do that they cannot understand us;
but though we cannot reason with them, we can find out
what they have been most accustomed to, and what therefore
they are most likely to expect; and we can see that
they get this, as far as it is in our power to give it them,
and may then generally leave the rest to them.
Samuel Butler.
To far too many women the time when they
are carrying a child is a period of strain
and semi-invalidism, a time filled not
only with surprises and difficulties, but too
often coloured with actual distress and ill-health.
This should not be. The time of prospective
motherhood should be one of buoyancy, health,
physical activity and mental vitality. The low
standard of health which the modern woman
tolerates is deplorable.
But to whom can the young mother-to-be
turn for advice and assistance? Such healthy,
happy, prospective motherhood does not come
by instinct in our city life. Those around her,
older than she, who have had children of their
own may perhaps be able to give her a hint
here and a little piece of advice there, which to
some extent may alleviate her difficulty or pierce
with a faint shadow of light the gloom of perplexity
in the ever deepening unknown into
which she is entering for the first time; but
nearly all such women have themselves gone
blindly and individually through this period of
immense significance and mystery without having
had any rational help from one devoted to the
maintenance of health.
Almost every book written to advise the
coming mother is written by a doctor of disease,
with very few exceptions by doctors who tolerate
what is, in my opinion, a disgracefully low
standard of general health in women. A distinguished
gynecologist who, in cross-examination
before a commission persisted in maintaining
that the “daily morning sickness”
which is so prevalent in women who are carrying
a child is “physiologically right and natural”
(indeed, he implied almost that it was necessary)
represents an attitude of mind very general and
capable of far-reaching hypnotic injury to the
community as a whole.
By far the best and sanest book available for
healthy women is one to which I have already
referred, namely Tokology, by Dr. Alice Stockham,
but this book has its inaccuracies and its drawbacks,
and even its pages are too much occupied
with the wretched and handicapping troubles
which women do experience in large numbers,
but which should not be.
Nevertheless, to allow a young girl or woman
to enter upon these months of trial without
making clear to her what she has to face, is cruel
indeed. For a sensitive woman the experience,
even at its best, and when most free from incapacities, is yet
incredibly and penetratingly
more terrible than she anticipated. The more
sensitive and more conscious she is, the deeper
and profounder may be her joy in her coming
motherhood, but, at the same time, the more
intense the physical experiences through which
she must pass.
The modern sensitive young woman does
not take things blindly and patiently and with
resignation, with a pious belief in her own
inferiority, which may have helped to dull and
moderate the sensations of her grandmothers.
The more evolved she is, the more she may be
willing to bow to natural law, but the less is
she content to suffer wanton cruelties imposed
upon her by ignorance, stupidity or coercion.
Many are the midwives, maternity nurses
and medical practitioners with whom I have
discussed such matters, and from whom, often
incognito, I have asked advice. I may say
that none gave all the necessary advice, not one
gave one-tenth of what is in this book, only
one or two gave any necessary simple advice
in the sympathetic and understanding fashion
desirable, and only one or two appeared to have
any clear generalizations or scientific understanding
of the facts about which I asked. The
resignation, the shrugging of the shoulders in
the face of things which would otherwise make
one weep, or the cheerful braving out or pretending
that things are not as bad as they are,
which is the general attitude of mind of the
maternity nurse is little more helpful than that
of the practitioner. Concerning many of the
practical facts of the later months of pregnancy
and actual birth, and the succeeding weeks of
recovery, the properly trained midwife seems
on the whole wiser than the average general
practitioner, wiser even than the specialist who
may come at a crisis, but who does not watch
his patient through the succeeding weeks.
Many young women who have recently been
mothers have told me of the mental and physical
horror which they then experienced, and of the
added horror that they should feel horror. They
have asked me to generalize, if it is possible,
from their cases in such a way as to help others
who enter upon maternity’s difficulties for the
first time, so that they may at least be spared that
terrible sense of isolation and of exceptional
failure when they experience one by one the
things which are inevitable, or the things
which are, by our artificial lives, so frequently
imposed.
The bearing of a child very often may be
complicated by actual disease, and then requires,
of course, expert medical attention. With those
who are in any sense actually ill, and who should
be in the hands of a doctor, I am not here dealing,
for, in this respect, as throughout my other
books, I desire only to write of health for the
healthy so that they may have sufficient knowledge
to maintain their health and raise the
vitality of the race.
I may say here that, even for the healthiest,
it is very advisable, not only for her first, but
for every succeeding pregnancy, that a woman
should be examined and measured by some
wise and healthy-minded medical practitioner
or midwife at least once during the first three
months and twice again during the last three
months, but that, for the first baby, it would
be better to go at least every month for examination.
In that way, the various insidious disturbances
of the excretory system, and other
fundamental things which may go a little wrong,
even in an otherwise healthy woman, can be
detected immediately and dealt with. Many
however, find a great difficulty in bringing
themselves to do this.
Undoubtedly it is much better for the prospective
mother to go to a specialist, old enough
to be wise and experienced and mellow, and yet
young and virile and active enough to be acquainted
with modern knowledge, and healthy
and clean enough to look for and to desire health
and normality in those who come for advice.
This should pre-eminently be the special
field for women doctors, but there is not nearly
a sufficient body of them with the necessary
qualifications to meet the requirements of the
community, and I should like to see a new
profession created for women who, to the
experience and the training of first-class midwives,
have added a sufficient training in general
medicine to be specialized to advise the healthy
prospective mother, and to be able to detect at
once anything which should necessitate handing
her on to the doctor of disease. Such practitioners
should rank in status somewhere between
the cultivated midwife of gentle birth (such as
a Queen Charlotte’s Hospital nurse) and the
medical woman. Thus the prospective mother
would be spared that hard and bitter contact
with one who has become myopic in the observation
of disease, and would be able to go to
someone specially trained to encourage health.
Meanwhile, as this is but a bright picture of
what may come in the future (and that will
come if women make a sufficient demand for
it) it may spare many women distress if I set
out the physical difficulties and peculiarities
which are most liable to occur with a healthy
woman.
From the welter of accounts of the effects of
pregnancy, I have disentangled into three groups
those which normal women may have to face.
The difficulties are:—
(1) Those nature-imposed; these are essential;
they cannot be avoided by the healthiest
woman. They can be perhaps, to some extent,
mitigated. They are things which the coming
mother must be helped through and over; she
cannot be saved from them.
(2) Those entirely artificial; these are quite
needless and are the results of either ignorance
or our gross disregard of known facts, and can
be entirely eradicated.
(3) Those which are to-day very usual, but
which knowledge and a better mode of life may
entirely conquer.
Now to consider first the third group: those
which are general, but which a knowledge could
or should conquer.
One of the first signs that she is to become
a mother, and one of the most usual experiences
of a young woman when this time begins, is
the daily recurrence of that penetrating nausea
and sickness usually after she has risen in the
morning, called “Morning Sickness.” This is
so usual that medical practitioners rely on it
to some extent as a sign of pregnancy. It is
described in almost every book for the prospective
mother, and, as I have mentioned (p. 72),
it is sometimes even maintained by distinguished
gynecologists as a physiological function, i.e.,
a normal function.
Now this is a very nauseating and wretched
experience to the majority of women, and it
is one which, I maintain, is entirely imposed
by ignorance, wrong living and the general
hypnotic effect of others’ perverted views on the
woman’s system. In those women whose internal
organs are improperly placed or somewhat malformed,
it occurs as a physiological result of
pressure or other disturbance. In true health
there is no physiological reason whatever for the
morning sickness, and a woman who lives as she
should live during the time of her coming
motherhood need not experience it. This should,
in the next generation, be entirely conquered,
because it is to a very large extent caused by
allowing, even forcing to wear corsets, girls when
they are still unformed and developing. Those
women who have never worn corsets in the
whole of their lives, and who dress as they
should dress, and do as they should do during
the months when they are becoming mothers,
seldom experience morning sickness. Though
there are some who, when they know the child
is coming, discard their corsets too late, and
these may still experience this unpleasant feature.
The extraordinary adaptability and vitality in a
woman’s system, however, is a remarkable thing,
and even those who begin later in life than
they should to train for motherhood may yet
accomplish much.
Granted a healthy, well-formed body, a
previous life of normal activity, sensible attention
to the following points will insure complete
freedom from morning sickness in all but the
exceptional and pre-disposed:—
(a) Discard every scrap of heavy or constricting clothing,
wearing only the lightest garments hung from the shoulders
entirely.
As I said in Married Love the standard of
dressing for the prospective mother, whose
garments should be of the lightest wool and
silk if possible, and should be so lightly hung
that a butterfly can walk the length of her body
without tearing its wings.
(b) Discard all rich, heavy and over-cooked foods, such
as pastries and hot cakes, dried peas and beans, rich game
or highly seasoned dishes, and live as much as possible on
uncooked foods and simple milk puddings, stewed fruit, lightly
cooked meat and fish, with the largest obtainable quantity of
very fresh ripe fruit.
(c) Start the day not with tea, but with the juice of two
or three oranges squeezed into a tumbler.
If she does these things a normal woman
may go through the whole nine months without
experiencing one single moment of nausea,
as many a woman has done.
A retardation of the action of the bowels or
constipation is very frequent, and is a cause of
many other ill-effects. A right diet such as I
advise, adding for this purpose honey and
brown bread, does much to prevent it; if it
exists in spite of this, take suitable bending
exercises (see also page 72), even a warm
hydrostatic douche (using a douche-can with
a little common salt in the water), but do not
take regular drugs or “aperients.”
Another of the very frequent experiences of
the mother who is carrying a child, particularly
towards the later months, is the enlargement of
the veins of the legs and ankles and the formation
of varicose veins. These may become
very serious if neglected, and even if the
woman is being doctored, unless, at the same
time, she regularly follows the proper healthy
method of dieting and living. In addition to
the dieting and clothing described above, which
will make her almost certain to be immune
from varicose veins, she should take warm
comfortable sitz baths every evening, and
she should lie down for at least half an hour
or an hour in the middle of the day or early
evening with her feet raised a few inches above
the level of her head.
One of the most serious difficulties, felt even
by those who avoid all other drawbacks, is
sleeplessness, particularly in the last month or
two when the activities of the child may be
very disturbing. In this, much depends on
the position in which the child is lying, and
sometimes the position of the child can be
improved by massage and manipulation by a
trained midwife or doctor. Something also can
be done by the mother herself through her
mental attitude and hand touch on the child,
and also by taking hot sitz baths nightly before
going to bed. Still more, however, is accomplished
by right diet, clothes, exercise and
happiness (see also Chapter XII).
The habit of taking aspirin regularly or in
large quantities, which too many women indulge
in if sleepless during this time, is extremely
bad both for the child and for the mother.
Drugs of any sort should not be appealed to.
If it is possible during these later months, sleep
will be much more refreshing, and the advantage
will be very great both to the coming child
and the mother, if her bed can be arranged on
a verandah or out of doors, but it must not
be forgotten that towards the end of the period
the expectant mother ought not to be out of
ear-shot of someone.
Now to consider the second group of disabilities;
those entirely the result of artificial
outlook and condition. Among these must be
classed the inability to walk any distance or to
take part in active work of any sort. This is
partly imposed by the hesitation of a woman
to be seen at this time, and particularly to face
the vulgar and leering attitude of the general
public, and it is partly also due to the general
heaviness or strain on the muscles or to the
presence of varicose veins. If these have, by
the methods just described, been almost or
entirely avoided, she will find that her natural
activity is much less reduced than it would
otherwise be. To walk a mile or two, or even
three miles the day before or even the day of
the birth is not at all beyond what can be expected
from an ordinary healthy woman who lives as
she should.
The necessity perpetually to be fussing, to
be taking tonics or drugs or medicines, to be
thinking only of herself and never of any general
or greater theme, is also eliminated when the
general health is improved, and any mental or
bodily activity which the mother can indulge in
without a sense of strain is advantageous to
the child as well as to herself.
The highly nervous condition and overstrained
state of so many modern women during this
time is due entirely to the artificial social lives,
involving late hours, which they try to lead.
The mother-to-be should give up almost all
social engagements which keep her out of bed
after 9 o’clock. Sleep, fresh air, exercise under
the healthiest natural conditions she can command,
coupled with the right diet, will
secure her health and strength throughout the
time.
The difficulties, however, about which help is
most needed are the first group, those nature-imposed
and inevitable difficulties which the
woman has to face, and which, without instruction
in the things she might do to mitigate them,
often lead her to suffer intensely, though needlessly,
and tend to have life-long effects on her
health and appearance. Simple and sometimes
obvious precautions are required, and yet these
are almost unknown to the generality of advisers
to whom the prospective mother can turn.
The first and most obvious inmost change
that affects her is that felt in the muscles below
the waist, particularly those which run vertically,
and which support, by their elasticity and strength,
the whole front of the body. As the months
pass and the child and its attendant tissues
grow, there is a slowly increasing strain on these
muscles. As the enlargement proceeds the
skin will also stretch, and the under-skin and
tissues beneath it are finally stretched almost
to breaking-point, stretched sometimes so that
they do break apart and leave ultimate permanent
little scars under the skin of the mother. Few
apparently know, but all should know, that this
can be almost entirely avoided (by fortunate
women entirely avoided), if the skin and tissues
immediately below it are kept supple by daily
rubbing with olive oil from the fifth month.
Perhaps from the fourth month once a week,
and certainly from the fifth month daily, the
mother should rub the lower part of her body
and her breasts with a little olive oil. This
will not only have a soothing effect upon
the skin, but will assist its elasticity in such
a way that she may return to her virgin
condition without leaving those tell-tale scars
which so often mark a woman, and which
many, even highly trained maternity nurses
and doctors, seem to think are inevitable.
Such scars are not inevitable, and this very
simple precaution, coupled with exercise, will
frequently be sufficient safeguard for the woman
who desires to avoid them altogether.
The same internal growth which enlarges the
muscles and strains the skin will also sometimes
press apart the two main vertical muscles
in such a way that there is a tendency for
inner tissues to project, and for the last month
or two this may be very uncomfortable without
in any way being dangerous. It is then advisable
to wear a small stiff pad over this and
fasten it in place with a narrow, soft elastic
band. The use of a localized plaster very often
strains the skin and leaves scars or makes it
sore. It is wise to have the small hard central
bandage wherever there is a tendency to localized
projection as will be self-evident to anyone who
experiences it.
The natural darkening of the colour of the
skin when it is strained and stretched as it must
be is very displeasing to the eye and, particularly
to a young girl whose beautiful body has been
her delight, may be a cause of great distress
and self-repugnance. It is well that she should
be helped over this most anxious time of self-detestation
by the reliable assurance that it is
only a temporary phase, and that if she keeps
in good health, and rubs herself with pure
oil for two or three months after birth as
well as before, the skin will be entirely freed
from any stained or discoloured appearance,
and will return to its normal condition.
As the months pass, the actual physical
weight of the body will increase, gradually
becoming a greater burden, so that long distance
walking and any acute activity such as running
or tennis-playing must become impossible.
Nevertheless if the diet and mode of living
suggested above is followed out this will be
very much less embarrassing than is usually
experienced.
Many forms of support or maternity corsets
are advertised or medically recommended to
assist supporting the weight at such times, but,
unless the woman has any actual slipping of
the position of the organs or any deformity,
she is very much better not to take such proffered
assistance for they will form a broken reed,
and, as one knows, “the broken reed pierces
the hand.” It is much better for her to
strengthen her own muscles by slow and careful
exercise, bending forward until she touches the
ground or as nearly touches the ground as
possible; also lying on her back on the ground
and rising without touching the floor with her
hands and arms; also slowly raising the feet
forward above the head while lying on the back,
and then allowing them to drop slowly to the
ground, this last exercise being very strengthening
to the central muscles of the body wall
(detailed accounts of other useful exercises will
be found in Dr. Alice Stockham’s Tokology).
So long as there is no strain upon her, she
should exercise throughout the whole of the
time. She would then not need any artificial
support, and would be much better without it.
I have never seen it elsewhere clearly stated,
but I have discovered that one very important
reason against corsets is that, however well
shaped and loose they may be, they tend to
touch and exert some slight pressure on the
soft tissues at the back of the waist; they must
do so, merely to remain upon the body without
dropping off, and this amount of pressure is
sufficient to induce morning sickness (see p. 88)
for the following among other reasons. As
the womb grows in the centre of the body it
pushes aside and to the back the many yards
of soft tubular alimentary canal which normally
lie coiled in the front of the body, and, if there
is no constriction or pressure, these tend to
find room for themselves round the waist line
and to the back, so that there appears what
seems almost like a coil or roll of fat round
the waist. This disposition is very advantageous,
however, and should not be interfered
with in the way any corset must interfere, and
it greatly reduces the ungainly frontal size
and helps to keep the body better balanced
(see p. 91).
At first the breasts will become firmer and
larger and will support themselves more readily
than at any time, but later on their shape
somewhat changes and they tend to fall. They
should then have carefully slung and properly
arranged supports looped over the shoulder.
Neglect of this often results in the final and
lifelong loss of the beauty of the bosom, and it
is indeed a cruel thing that the average doctor
or nurse appears not to be capable of giving
any useful advice on this point, so that hundreds
of thousands of women have not only lost their
beauty, but have been told that it is an inevitable
and natural result of having borne a child.
That it is well-nigh inevitable under modern
unaided conditions, may be true. With proper
support, proper massage and treatment afterwards,
the ugly breasts need not have been, and
need not be.
A thing which often distresses girls, but
which however unsightly it is while present
is a temporary and passing phenomenon, is
the sudden appearance of freckles, even large
patches of brown colouring matter, on the skin
during the time the baby is forming. So far
as I am aware nothing can be done to prevent
it, and if as sometimes happens these brown
patches even appear on the face, it is a misfortune
which must be endured as stoically as
possible, encouraged with the knowledge that
it will entirely pass.
Another curious thing I know one woman
experienced, and about which I am awaiting
further evidence, was the apparent transplantation
by the child in the mother of the strong
black body hairs of the father. The result was
that during the later months of carrying and
for a few months after birth, the mother’s lower
limbs and forearms had a thick growth of
masculine-like hair, which nearly all fell off
within six months after the birth.
The tendency that the coming child has to
extract nutriment from the mother’s tissues
often results in the loss or temporary spoiling
of two of her beauties, the beauty of her nails
and the beauty of her hair. These are apt to
suffer unless she is warned in time and protects
them. The injury to them probably depends on
the withdrawal of the proper quantity of fat
from the tissues. It is, therefore, advisable for
the mother-to-be to rub her nails and hair with
some suitable natural oil. Refined paraffin,
almond oil or castor oil for the hair are by far
the best, and for the nails some animal grease
such as lanoline, or perhaps simple vaseline.
Expensive concoctions, very much advertised
and claiming wonderful properties, generally
owe anything which they may contain to these
ingredients, but more frequently contain little
or nothing of any value, and are often harmful.
The more fundamental, and, alas, almost
inevitable result of bearing a child is that it
extracts not only the fat from the system, but
the hardening matter from the teeth. This
indeed is, so far as I am aware, a theft from
the mother by the next generation which no
knowledge of its liability can prevent, and
which can only be met by a careful supervision
of the mother’s teeth both before and after
birth. Women differ in the amount they lose,
but it is, alas, one of the almost inevitable things
that there shall be a certain weakening of the
teeth. Sometimes this will right itself and
teeth which shook in their sockets immediately
after the birth may apparently harden again
and refix themselves firmly, but if the weakening
takes the form of actual decay, they must be
attended to.
In this respect the diet recommended by Dr.
Stockham in Tokology, which advocates the
elimination of all calcareous food is perhaps
inadvisable if strictly followed out, because the
growing child insists on mineral matter, and
it simply takes it from the mother’s structure
if it does not get it in other ways. I have,
therefore, thought it advisable not entirely to
eliminate the wheat and other bone making
materials from the usual diet as Dr. Stockham
recommends, but to maintain a certain proportion
of wheat, especially whole wheat, in the
food. Her advice to replace rich dishes by
simple rice, stewed fruits, etc., is certainly wise,
and still more important is it to follow her warm
recommendation to eat large quantities of fresh
fruit.
One of the perfectly natural, but to the young
mother rather unexpected, results of the changes
of the later months is the alteration which
gradually comes in the position of the centre
of gravity of her whole body. She is of course
scarcely conscious of this, and yet it is a point
of some importance, because it results in a
certain liability to slip and to fall, particularly
coming downstairs. The danger of such a fall
is less to the child, which is safely surrounded
by a buffer of fluid and by the mother’s protective
muscles, but more to the mother herself, who,
in falling, may strain or injure herself. The
growth which results in this change in the
centre of gravity comes too rapidly for the
system quite perfectly to adjust itself to it. It
will be remembered how long it takes a baby
to learn to balance itself upright upon its feet;
the adult mother-to-be has had a whole lifetime
knowing just how to balance, and every muscle
has become adjusted to the centre of gravity
in its accustomed place. The change in the
distribution of weight changes the position of
the centre of gravity to some extent, sufficiently
at any rate to throw the co-ordination of many
years somewhat out of gear, and it is, therefore,
wise for the expectant mother to take particular
care not to slip or stumble unexpectedly. The
sudden and active movement of the child which
may kick or turn with no warning may
cause her quite to lose her balance, particularly
if she is on a steep staircase. It is well, therefore,
to make a special point of keeping guard
against this possibility by always having a firm
grip on the handrail when going up or down
stairs during the later months of carrying a
child.
However well and full of a sense of power
and creative vitality she may be, a woman
should take long hours of rest: to bed at nine
each evening and not up till eight o’clock in
the morning and taking at least one hour lying
down during the day. During the nine months
of bearing the unborn child, she should remember
she is providing it with vitality every
second of the twenty-four hours of each day,
and she should neither have forced upon her,
nor should she desire to do, work which ever
tires her, though she should live an active, full,
healthy, happy existence and should be capable
of nearly all her normal work and enjoyments.
If she is wise she will work in direct contact
with sun-lit earth. Gardening ensures the truest
sense of physical well-being.