The first indication of pregnancy likely to attract attention is the cessation of menstruation. When this occurs, without other sufficient cause, as taking cold at the menstrual period, or as the result of disease, there are good grounds for suspecting that conception has taken place, and the period of gestation or pregnancy begun. It should be remarked, however, that pregnancy may occur without the menstrual function ever having made its appearance. It should also be remarked that a periodical flow resembling menstruation, though probably really different in character, is occasionally present during the whole period of pregnancy.

A very early symptom is morning sickness, which may occur the first week after conception, and frequently continues for six or eight weeks. Some do not suffer at all from this symptom. Others suffer with extreme severity. Cases occasionally occur in which the vomiting continues without interruption in spite of all remedies which can be employed, sometimes wearing out the life of the patient before the pregnancy is completed. The vomiting at this period is considered to be sympathetic.

At the end of six or eight weeks the breasts begin to enlarge, the nipple becomes more prominent, and the dark ring about it becomes much more distinct, especially in persons of dark complexion. The little protuberances about the nipple also become much more prominent. In some cases, dark spots appear upon the face, hands, and other parts of the body. At this time, the womb, having become abnormally heavy on account of its increasing size, settles down in the pelvis, causing the abdomen to appear flat.

Between the third and the fourth month the fetus becomes developed to such an extent that its heart-beats may be distinguished by placing the ear to the abdominal walls. It is recognized by its very rapid character and the fact that it does not agree with the pulse of the mother. The pulse will generally be found to be 120 to 140 per minute. In male infants the heart-beat is less frequent than in females.

Quickening

Motions of the child, popularly known as quickening, are generally felt at about four or four and a half months. The supposition that at this time the fetus acquires individual life is a popular error. The fetus makes movements of various sorts long before this period; but they are not usually strong enough to be felt by the mother, and hence are not noticed. The motions are sometimes so strong as to be exceedingly disagreeable, especially to patients of a nervous temperament. They can generally be readily felt by placing the hand upon the abdominal wall. If they do not happen to occur in a short time, they may be excited by dipping the hand into cold water and laying it upon the abdomen.

This is one of the best signs of pregnancy, and yet it is not an invariable indication, as women often imagine that they have felt motions, when none at all have been experienced, or nothing more than the move ments of the intestines from indigestion and moving of gas in the bowels. On the whole, however, this may be considered as a very good indication of pregnancy.

At the end of four months the enlargement can be easily distinguished through the abdominal walls. As the uterus increases in size, it rises out of the pelvis, and often inclines toward the right side.

In the latest stages of pregnancy, vomiting again returns in consequence of the pressure upon the stomach. Toward the conclusion, there is profuse leucorrhoea, and at the very last the uterus settles down into the pelvis again as much as possible.

During this process the uterus increases to more than twenty times its normal size. When fully developed, the fetus generally weighs about seven pounds. The usual variation is from four to ten pounds.