Practical motherhood

Front matter

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BOROUGH OF BARRY>

Thl« book, which w»» glyen during the Borough's 6o«k A^-^oal ct-.Tios to you with the best wishes of di«3 poopit- of uair/.

Preface

The writing of this book and its addition to the list of handbooks already published for the use of mothers was originally the outcome of a suggestion to embody in some more permanent form the sheets of notes on the management of pregnancy, feeding of infants, &c. which I have been in the habit of issuing, I believe with success, to mothers in the course of my practice ; and I have endeavoured to include in it such hints as may make it a ready help and really practical guide to mothers in England and the Colonies in the care and training of children, and also in the correct management of pregnancy.

The question of artificial feeding as applied to the healthy infant, I have dealt with as fully and as simply and practically as possible. We are, I think, a little too much inclined to think of infant feeding as a side branch of medicine ; forgetting that its practical application in all normal cases must inevitably belong to mothers. I have been struck, in practice, by the number of educated women who have really wished to understand this subject, and also by the facility with which misconceived ideas and the many existing popular prejudices relating to it were dispelled when explanations were given. Writers on pediatrics sometimes suggest that it is the duty of the general practitioner to educate the mother in regard to the feeding of her infant, but this actually takes more lime than the busy practitioner can spare, since it must necessarily involve written instructions to cover the whole period of the child’s infancy. The nourishment suitable for the infant at three weeks old will not be suitable a few months later, and it has been my experience to find babies still being fed on the weak mixtures medically prescribed many months earlier.

I am of opinion that the practical knowledge which we owe to the work of our several pediatrists in so far as it concerns the feeding of the healthy infant should belong to every mother, and that if its

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PREFACE viii

essentials were universally realised difficult feeding cases would be much more rare. The falling-off of breast-fed infants, or first signs of indigestion at the weaning period, is a common experience in practice, like the chronic indigestion and disordered nutrition due to improper feeding of older children. For all these reasons it seems to me that a sound knowledge, not only of the proper management of lactation and of the suitable feeding of older children, but of the essential points of uifant nutrition and its relation when imperfect not only to premature death but to the survival of unhappy, fretful babies with enfeebled constitutions and irritable nervous systems, is more essential perhaps to the mother than any other consideration of nursery management. Under this heading I have included the essential points concerning a pure and suitable milk supply, and its relation to the preservation of infant life ; the correct modification and use of cow’s milk, and the disadvantages and dangers incidental to rearing a child entirely on patent foods ; and those more general lines upon which mothers may best manage hand-feeding, where, in the absence of illness, such is a difficulty. And I have entered as fully as possible into the arrangement of the dietary during the first six years.

Believing that the book would serve a more useful purpose if it included the care of the sick as well as the healthy child, I have tried to convey the importance of the early recognition of commencing illness and the significance of certain symptoms essentially requiring medical care ; and I have described, remembering especially those mothers in the Colonies who live often at some distance from a doctor and out of easy reach of trained help, the ordinary principles of the nursing of sick children. And I have also included in the course of the book such elementary physiological facts as appeared to me necessary to the clear understanding of the subject.

The field of child care is a wide one, for besides an acquaintance with the normal development of child life, we are beginning to realise that not only the dietary and the dress and all those hygienic principles involved in the maintenance of perfect bodily health and growth, but also the “ opening mind of childhood,” must be governed by definite and special knowledge on the part of those who have to deal with this interesting and fascinating undeveloped human material, and not left to chance instinct or affection or the old-fashioned rule-of-thumb methods of training.

PREFACE

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To Froebel, and those who have written on and explained his great philosophy to us, and to Darwin and later writers on evolution who have given us a scientific basis for the development of a child’s mind, we owe the most fruitful seeds of the study of the psychology of the child and the correct training of its mind. And now that child literature is so voluminous, and that societies, comprising mothers, medical men and women, and teachers, which have for their object child study, have been added to other sociological associations in England and different parts of the world, one may, encouraged by the trend of modern thought, hope for a time in the not far distant future when the study of children and their care will find an important place in the education of every woman of every class ; and when special training-schools for children’s nurses are organised, not only in London but in all our big towns, on the lines of that attached to the Babies’ Hospital in New York.

The question of child care is an old one, yet it was never more new than to-day, I think, in the light of the clearer understanding of it which we owe to the advance of science and to a more cultured womanhood. It is also by far the most important Woman’s Question of the day, in that it must inevitably lie to a great extent at the root of those other much-discussed problems of Physical Degeneracy, Social Morality, and the National Welfare and Progress generally, for it is a well-known fact that the vast majority of children are born healthy, and that even delicate babies may often be reared into perfectly healthy adults ; and in the hands of mothers lies the all-important task of the first education of the child, in the wider sense of the word : “As the child is, so is the man,” and “ Give imagination its fleetest and strongest wing, it can never conceive a task so well worth the doing.”

In view of the great importance of the subject, my first and ruling principle in the writing of the book has been to remember those to whom it is addressed. And my first aim, in so far as space would allow, has been to make it entirely practical, because I have felt that only so can it be of any real service to those who bear the “gravest of all responsibilities,” though also the sweetest — the bringing up of a little child.

In conclusion, I must express my great obligation to my friend and colleague. Dr. Anne F. Cleaver, for her invaluable assistance with the subject-matter of the book ; to Dr. E. N. Burnett for his

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PREFACE helpful criticism and suggestion and careful revision of the proofs; and to my brother, Clifford Campbell, for his help with the secretarial work it has involved.

I have also to tender my sincere thanks to Mr. R. L. Esson of Johannesburg, at whose suggestion the book was undertaken, for his kindly assistance and cordial co-operation in reference to its production ; and to Dr. E. P. Baumann, who read the original manuscripts.

H. Y. C.

London, October 1910.

Part I The Hygiene Of Pregnancy, Infancy

AND CHILDHOOD

Chapter I

Signs of Pregnancy — Obstetrical Table — Physiology of the Reproductive Organs — Development of the Child — Quickening — Necessity for Examinations during Pregnancy — Mental State — Diet — Exercise — Rest —

Fresh Air — Infectious Diseases — Clothing — Bathing — Bowels — Kidneys — Breasts— Sexual Intercourse — Nausea or Vomiting— Flatulence — Heartburn — Toothache — Cramps — Backache — Pain — Discharge — Bleeding — Douching — Enemas — Causes, Symptoms, and first Management of Miscarriage ....... 3-28

Chapter II

Necessaries for Confinement — Preparation of Sanitary Pads, Bed Pads, and Long Stockings — The Lying-in Room — The Last P'ortnight — Labour — Management of a Birth in the Absence of .Skilled Help — Care of the New-born Baby ....... 29-42

Chapter III Preparation For The I3ahy

The Baby’s Outfit — Essentials in the Clothing of Later Infancy and Early Childhood — The Cot and .Accessories — The Baby’s Basket and Accessories— The Baby’s Bath and Accessories — The Nursery — The Nurse —

The .Mother’s Diary ....... 43-55

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Chapter IV Page

Importance of Regularity in Management, and the Formation of Habits — Bathing and Dressing the Baby — Bathing in Later Infancy— Weighing — Summary of Factors in the Life of a Healthy Infant and Landmarks in its Progress — Weight and Height in Older Children— Sleep in Infancy and Early Childhood — Fresh Air — Muscular Exercise — Napkins — Stools, Character of Healthy and Unhealthy Motions — Bowel Habit — Control of the Bladder — Drink — Nervous System — Kissing — Hot Weather — Journeys — Comforters — Modern Fads . . . 56-73

Chapter V

Advantages of Breast Feeding — Causes of Inability to Nurse — Mental State — Diet — Fresh Air and Exercise — Rest — Bowels — Drugs during Nursing — Influence of Monthly Period and Pregnancy — Illness — Nursing of Twins — Wet Nursing — Nursing Corsets — Care of the Breasts — Cracked Nipples — Method of Feeding — Supplementary Bottle Feeding — Weaning ...... 77-88

Chapter VI

INFANT NUTRITION AND PROPERTIES AND ESSENTIALS OF FOODS FOR ARTIFICIAL FEEDING

Physiology of Nutrition, Digestion, and Absorption — Properties of Foods — Necessity for and Meaning of a Pure Milk Supply — Management of Cows and Milking — Care of Milk before delivery to the Consumer — Composition of Milk — Properties of Cow’s and Human Milk contrasted— Digestion of Milk — Essentials in the Use of Cow’s Milk for Infant Feeding — Diluents — Use of Citrate and Bicarbonate of Soda — Ihe Heating of Milk — Sterilisation — Scalding — Pasteurisation — Application of Methods at Home— Ass’s Milk— Goat’s Milk— Koumiss- Condensed Milk, Sweetened and Unsweetened Brands — Starch, its Sources and Nature — Starchy Foods — Digestion of Starch — Unchanged xiii

Starch and Piedigested Starch — Classification of Patent Foods — Disadvantages of Patent Foods — Temporary Uses of Patent Foods —

Risks of Continued Use of Patent Food .... 89-121

Chapter VII

Ordinary Bottle-feeding Apparatus — Special Apparatus — Cleansing of Bottles and Teats — Method of Feeding — Quantity at a Feed — Intervals between Feeds — Table of Feeding — Night Feeding — Use of Top Milk — Home Care of Milk after Heating — Cow’s-milk Mixtures — Regulation of Strength of Cow’s Milk : Feeding with Diluted and Undiluted Milk — Cow’s-milk Mixtures during the first Three Months of Life —

Use of Tables of Cow’s-milk Mixtures — Making up Mixtures — Alterations in Mixtures — Domestic Measures — Tables of Cow’s-milk Mixtures for Twenty-four Hours and for Single Feeds, with and without Cream — Tables of Cow's-milk Mixtures for first Three Months of Life with Egg-white, with and without Cream — Use of Sugar — Use of Lime Water — Use of Additional Fat ; Cream, Butter Emulsion, Yolk of Egg. Virol and Cod-liver Oil — Use of Starchy Food : Cereal Jellies and Malted Foods — Use of Fresh P'ruit Juice — Introduction of Cow’s Milk after Condensed Milk and Patent Food or Breast Feeding: Methods and Tables of Suitable Mixtures for Different Ages — Supplementary Bottle Feeding — Feeding after Weaning — Difficult Feeding : Scheme where Suitable Cow’s Milk cannot be Obtained — Cream and Whey Mixture — Egg-white and Cream Mixture — Humanised Milk —

Table of Unsweetened Condensed Milk Mixtures — Table of Sweetened Condensed Milk Mixtures — Table of Glaxo Mixtures — Llenger’s Food Feeding after the Fourth Month — Recapitulation of Important Points in Bottle Feeding ....... 122-192

Chapter VIII

Necessity for Careful Regulation of the Diet during the Second Year — Feeding and Suggested Diet for rwclfth to Thirteenth Month — I*'or Thirteenth to Fifteenth Month — P'or Fifteenth to Eighteenth Month — Eighteen Months to Two Years — I'wo to Three Years — Three to Six Years — At the Sixth Year — Essential Points to remember in I'eeding a Child under the Age of .Six Years — .Suitable Sweetmeats — Parties — Recipes for Ordinary Diet — Recipes for Special and Invalid Diet . . . . . . . . 19J 223

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Chapter IX

Possible Causes of Crying — Flatulence, Stomache-ache, Colic — Castor-oil Dosage — Sudden Twist of the Bowel — Earache — Salt Bags — Excessive Return of Food — Vomiting — Constipation — Massage of the Abdomen — Descent of the Bowel — Dosage of Salts — Diarrhoea: Simple and Infective — Wasting — Rickets — Scurvy — Thrush — Sore Buttocks — Scurf on the Scalp — Prickly Heat — Nettlerash — Eczema — Teething — Vaccination — Convulsion .... 227-260

Chapter X Recognition And Management Of Commencing Illness And Home Nursing

Importance of Early Recognition of Illness and Early Advice in certain cases — Use of a Clinical Thermometer — Use of a Temperature Chart — Sponging — The Cold Bath — The Hot Bath — The Mustard Bath — The Cold Pack — Brandy Dosage — The Hot Pack — The Ice-bag — Administration of Medicines — Injections — Nutrient Enemas — Irrigations — Method of Counting the Breathing — Signs and Treatment of Difficult Breathing — Sal-volatile Dosage — The Steam-tent — Calomel Fumigation — Method of Counting the Pulse — Signs and Treatment of Collapse — Methods of Treatment of the Throat — Syringing of the Ear — Douching, Syringing, and Spraying of the Nose — Poultices — Fomentations — Bran Bags — Mustard Plasters — Leeches — Examination of the Throat and Glands of Neck — Examination of the Motions — Recognition of Commencing Illness — Ring-worm — Inflammation of the Eyes — Headache in Childhood — Adenoids — Management of Feverishness — Feverish Colds — Influenza — Acute Indigestion — Chronic Indigestion — Brine Baths — Worms — Dysentery in Older Children — Inflammation of the Tonsil — Poppy-head Fomentations— Inhalation of Medicated Steam — Croup — Child Crowing — Bronchitis — Pneumonia — St. Vitus’ Dance — Rheumatic Fever — Rheumatism in Childhood — Infectious Diseases : Causes and Modes of Infection — Incubation Periods, and Isolation Periods — Nursing of an Infectious Case — Complications of Scarlet Fever — Disinfection of

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Room and Contents— Disinfectants — Diphtheria — Whooping-cough — Measles — Chicken-pox — Mumps — Typhoid Fever— Consumption — Prevention of Malaria — Fractures — Bed-sores — Bed-making and Changing of Sheets in Illness — Management of Convalescence . 261-327

Chapter XI

Requisites for the Medicine Cupboard — Recent Wounds — Unhealthy Wounds, Sores, Boils, Gatherings and Breakings-ouL — Abrasions, Bruises and Squeezed Fingers — Burns and Scalds — Clothing on Fire — Scalds of Mouth and Throat — Shock — Sprains — Sunstroke — Fainting —

Fits in Older Children — Head Injuries — Choking — Artificial Respiration— Drowning — Bleeding from the Nose — Bleeding after Tooth Extraction — Snake bite — Stings of Insects — Foreign Bodies in the Eye, Nose, Ear, Swallowed — Recognition and Treatment of the Commoner P'orms of Poisoning ..... 328-349

Chapter XII

Sketch of Evolution, Physical, Mental, and Moral, and the Child’s Place in the Scheme — First Lessons in Morality — Punishment — Training of the Will and Lessons in Self-control — Emotional Outbreaks — Truthfulness— Purity — First Religious Teaching . . . 353~372

Chapter XIII E A R I, Y Education

The Child’s first Natural Education — flur Part in the Child’s first Education — The Meaning of Education —The Child’s Instincts — The Child’s Needs — The Child’s Means of Development — The Inllucnccs which should be brought to hear on the Child — The Meaning of Play — The Possibilities of Play — Play during Early Infancy — Play at Six Months — Play at One Year — Walking — Talking — Play at Two Years — •

XVI

Play at Three Years — Scrap-book Making — Play at Four Years — Story-telling — Clay-modelling — The Sand Pile — Acting — Music and Singing — Children’s Songs — Cycling — Stamp Collecting . . 373~388

Chapter XIV

Value of the Teaching of Science — Pets and Gardens — Suggestions for the first Nature Teaching— Collections of Specimens — More Advanced Nature Study — Value of Child’s First Drawing . . . 389-404

Chapter XV

Sketch of the Brain and Nervous System — Development of the Child's Brain and Nervous System — Disadvantages and Risks of too early School Attendance — Information Talks or Object Lessons — First Teaching of Geography — First Teaching of History — First Teaching of Scripture — First Teaching of Arithmetic — First Teaching of Writing— P'irst Teaching of Reading — First Teaching of Languages 405-431

Part V The School Age Chapter XVI

General Considerations of the School Period — Boarding and Day Schools — Preparatory Boarding Schools — Co-education — Physical Culture — School Hours — Homework — School Attendance — Influence of Altitude and Climate — Corporal Punishment — Diet — Alcohol — Smoking — Bowels — Teeth — Clothing — Bathing — Care of the Hair — Chilblains — Cracked Lip — Sleep — Breathing — Eyesight — The Nervous System —

Chapter XVII

The Mother Temperament — Reproof — Self-respect — Orderliness and Punctuality — Special Training of the Boy — Special Training of the xvii

Girl — Home Culture — Holidays — Hobbies — Reading — Suggestions for the School Child’s Library — Conversation — Truthfulness — The Will — Religious Teaching ...... 47 1-49 1

Chapter XVIII

Meaning of Puberty — Physiology and Signs of Puberty in the Girl — Management of Puberty in the Girl— Physiology and Signs of Puberty in the Boy — Necessity for Sex Training — Suggested Method of Sex Training— Self-abuse — The Care and Training of Nervous Children — Hysteria ... ..... 492-513

Appendix—

Recipes for Ordinary and Invalid Diet .... 515-522

LIST OF ILLUSTRATIONS

NO. PAGE

2. The Womb, Tubes and Ovaries . . . . 7

3. The Child in the Womb at the End of Pregnancy . 10

4. Douche Apparatus . . . . . -24

5. Flannelette Stocking . . . -31

6. Knee-elbow Position . . . . -33

7. Method of Grasping the Womb after Delivery 40

8. Room Thermometer . * . . . . -50

9. Bath Thermometer . . . . . -57

10. Application of Baby’s Binder . . . -58

11. A Suitable Weighing Machine for Infants . . 60

12. A Good Weighing Machine for Infants . . 61

14. Breast Suction Apparatus . . . . .88

15. Human Digestive Tract . . . . .90

16. Medicine Glass and Drop Measure . . ■ 123

17. Graduated Quart Jug (Enamel) . . . .123

18. Graduated Eight-ounce Mea.suring Glass with Lip . 124

19. Amater Feeding-bottle . . . .125

20. Soxhlet Steriliser Set . . . . .126

21. Brevet(; Meat Juice Press ..... 213

22. Massage of the Abdomen ..... 238

23. Application of Vaccination Drf:ssing . . . 258

24. Clinical Thermometer . ... 264

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LIST OF ILLUSTRATIONS

NO.

25. Temperature Chart ....

26. Irrigation Apparatus

27. Steam Tent and Kettle

28. Feeling the Pulse ....

29. Treatment of the Throat .

30. Artificial Respiration— First Movement

31. Artificial Respiration— Second Movement

Part 1 The Hygiene Of Pregnancy, Infancy, And Childhood

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A

C H A I' T E R I

“ Is there a stale more blessed than that of Pregnancy ? To do everything we do in the silent belief that it must needs benefit that which is generating in us? That it must raise its mysterious worth, the thought of which fills us with ecstasy ? . . . We refrain from much ... we suppress an angry word ... we shrink from our own harshness ... as though it might instil a drop of evil into the life-chalice of the beloved unknown . . . ‘ A greater than we are is coming to life,’ such is our secret hope: for him we prepare everything, that he may successfully come to light : not only all that is useful, but also the crowning love of our souls.” — Friedrich Nietzsche, The Dawn of Day, Fifth Book.

Pregnancy is the first chapter in the narrative of a child’s life and history, though these are as yet inseparable from those of its mother. Its life commences with its conception, and is unfolded and nurtured during this period until it is sufficiently mature for separate existence.

Since the child’s first physical development takes place during this time, and the first lines are laid down upon which all its functions will be organised, this period is one of very great importance.

Signs of Pregnancy. — The first and most constant sign of the existence of pregnancy is the cessation of the monthly flow, and therefore if a young wife in whom this has hitherto occurred regularly misses a period, she should always suspect the probability of pregnancy. She should not in any way attempt to bring on the flow, and should order her life quietly, and avoid with especial care those possible causes of mi.scarriagc mentioned on p. 26. If she mis.ses two more periods, and experiences some degree of nausea or sickness, especially on first rising in the morning, and also sensations of tender fulness and tingling in the lireasts, similar to those

which in many women precede the monthly period, she may feel more certainty, and will be well advised to visit and place herself in the care of a physician in whose skill and sympathy she feels she has complete confidence.

She may reckon the approximate date at which to expect the child by consulting the Obstetric Table on the opposite page. The columns in the table read from left to right. Taking the date of the first day of her last monthly period she should find it in the upper row of figures in the columns ; the date immediately below this figure in the column gives the approximate date of birth.

The nurse should be engaged soon after the doctor. It is important that the mother should like her; that she should have received a thorough training in her particular duties; and, if the mother has engaged her on her own responsibility, that the doctor should have had an interview with her before final arrangements are concluded. This is very essential, and as much in the interests of the mother herself as of the doctor, and will be understood and readily acquiesced in, as also to her own advantage, by a competent and conscientious nurse.

Pregnancy is a normal bodily function, and in no sense a malady. It is important to realise this, and that healthy women who live healthily should be as well during pregnancy as at any other time. Many of us do not live hygienically, especially as regards our diet and supply of fresh air, partly owing to ignorance and partly to the fact that we drift and do not trouble about these considerations unless unfavourable symptoms call our attention to an unhygienic mode of life. Many women feel better during their pregnancies than ever before in their lives, merely because for the first time they turn their attention to living healthfully in the interests of the expected child. Most women perhaps experience varying degrees of discomfort and a slight sense of physical incapacity, especially during the later months, but such does not constitute ill-health. Some women, usually those who have not the best health ordinarily, experience the actual disorders which may arise in pregnancy, and for these last, which I do not write about, I would advise no home treatment, especially the taking of medicines which have to be administered with particular caution and knowledge during this period, but rather that the mother should seek the advice of her doctor. It is of the greatest importance not only to live healthily, but to maintain each organ and function of the tubes and a pair of ovaries^ the womb, and the vagina (or front passage). The accompanying diagrams show the several parts. Fig. I shows in the lower part of a human skeleton the position of the pelvis ; Fig. 2 shows the arrangement of the tubes and ovaries and womb in the body.

We shall best understand what the pelvis is like if we imagine a fair-sized bony basin with the bottom knocked out ; open above into the abdomen, and below — by means of the front passages, viz. the vagina and the smaller passage which conducts the water from the bladder; and the back passage, which is the lower end and opening of the bowel — to the outside of the body. Within the basin are slung certain organs which are, taken in order from behind forwards, the rectum or lower end of the bowel, the womb, and in front the bladder, the last two being suspended in the pelvis by thin bands and folds of supporting material which are known as their “ ligaments.” When we thus see the close relation of these organs in the body we can appreciate how continual constipation, which means a hard swollen bowel, will press upon the womb, and by pushing it out of its place help to cause displacements ; how also at the monthly period, when the womb is enlarged and heavier, and also tender because its blood-vessels are filled with extra blood, the same pressure will cause pain ; and how much standing or e.xcessive exertion then will further increase the strain on the delicate supporting bands and folds, again causing pain, and in the latter case tending again to cause displacements. In the upper part of the basin, attached to it by thin filmy folds of supporting material called the “ peritoneum,” and also enveloped themselves in it, lie on either side of the womb a lube and ovary. The ovaries are two little rounded bodies each about the size of a pigeon’s egg.

In these are manufactured the microscopic “egg-cells,” from one of which when fertilised (that is, united after sexual intercourse with the ,male element) originates the child. The tubes are shaped like tiny curved trumpets ; the broad end of each is connected with the ovary, while the narrow end opens into the upper part of the womb. The canal of the tube is so fine that only a bristle will pass through it, and it is lined with tiny filmy “ hairs ” which have a constant undulating movement in the direction of the womb, a movement that has been likened to the waving of the corn as the wind blows over a cornfield. The tubes act simply as connecting passages, along which pass the egg-cells, directed by the motion of the “ hairs,” from the ovary into the womb. The womb is in size and shape like a small pear, with its inside hollowed out to form a cavity, and hanging with its narrow end downwards in the pelvis. The large upper part of the pear is called the body, the narrow lower end the neck, and where the stalk of the pear would be is a small, rounded, mouth-like opening which leads from the inside of the womb into the vagina, and this opening is called the jnouth of the womb. The walls of the pear consist of thick fleshy muscle, and though they possess a wonderful power of stretching when necessary, they are usually, when the womb is not pregnant, collapsed together like the sides of a thick indiarubber-ball from which the air has escaped, and similarly the mouth of the womb in its ordinary state is so tightly squeezed together as to be firmly closed.

When the child has been conceived and commences to grow within the womb this enlarges to accommodate it. It not only stretches, but grows from its two and a half inch length to be an organ from twelve to fourteen inches long. After the baby’s birth it commences to shrink ; the extra material put on in its growth, now unnecessary, is by a wonderful physiological process dissolved and removed, until in about two months it has returned to almost the size it was before pregnancy began. It was at one time thought necessary to lie up for some weeks after confinement, but there is a growing opinion now among medical authorities that cautious earlier getting up after confinement is in healthy women preferable, in that the natural discharges which follow a delivery drain away more quickly and completely in the sitting than in the lying position, and also because the important “tone” of the womb is better preserved if a due amount of movement is allowed. The doctor will, however, always advise as to the best day for getting up in every case, and every sensible woman will appreciate the necessity for avoiding exertion, or excessive standing, for some weeks after confinement — that is, while the womb is still larger and heavier than usual.

During the first three months of pregnancy there is little appreciable increase in the size of the mother’s abdomen, and this is because the womb is still small enough to remain in its usual position inside the basin of the pelvis, hence during this period little harm will be done by wearing loose corsets. After the third month, however, it, as it enlarges, begins to grow upwards out of the pelvic basin, and coincidently the abdomen increases in size up till the end of pregnancy, and therefore no corsets whatever can be worn during this period without injurious pressure on both child and womb.