The mother's cordial, mentioned in this work, should be taken two or three weeks previous to confinement. If costive, take enough of the pills No. 1, to keep the bowels regular. If troubled with acidity of the stomach, take the anti-dyspeptic powder after eating. Take half a teaspoonful of valerian and as much composition, occasionally at bed time.
When labor commences, which may be known by the regular 'bearing-down pains," send for the most experienced woman in your vicinity; if she will not take the responsibility, let the husband take it himself, provided he or the woman know how to proceed. If neither know any thing about it, get the best Thomsonian physician you can find, and in case there is none near, get the regular that gives the sick the least medicine. The physician or midwife should first ascertain whether the pains are true or false. True pains may be known by their location, being more concentrated in the portion of the bowels, through the loins and hip, returning every ten or fifteen minutes, leaving the woman comparatively easy in the intervals.
It will be proper for the midwife, at this period, to examine, in order to ascertain what part of the child presents, which may be done by passing the largest finger, dipped in sweet oil or slippery elm mucilage, up the vagina, and the nature of the presentation can be determined. In ninety-nine cases in a hundred, the presentation will be natural, the head presenting. If the feet or breech presents, the labor should be allowed to progress without turning, as the most experienced midwives admit that more danger and suffering attends an interference, than when nature is left undisturbed. If the arm or shoulder present, the delivery is not impossible, but difficult, until the infant be turned, and the feet brought down into the passage.
When it is ascertained that the labor is natural, or that there are no impediments or obstacles, there will be but very little more to do than to superintend the person. It will be necessary to give instruction to the attendants to have every thing required in readiness. The usual custom is to turn the feather-bed back towards the head, and lay a folded coverlet or rug upon the under bed; the woman should lie on the left side, near the edge of the bed, with her feet in contact with the bed-post, and a pillow between the knees. The attendants should be cheerful, not exciting the fears of the woman by ominous looks or the relation of unfavorable cases of the kind. If the pains are severe and protracted, let the bed be immediately arranged, and all necessary provision made for the birth of the child. If labor progresses slowly, add a teaspoonful each of composition cayenne and valerian to a pint of strong raspberry leaf tea, and give in half cupful doses. If the pains continue severe, in consequence of a rigidity of the muscles and but little is accomplished there by, administer an injection, composed of two teaspoonfuls of the injection powder, and give the emetic powder, prepared the same as for an emetic, in small quantities, until the system becomes relaxed. Local relaxation may also be produced by applying warm baths to the parts. Dr. Burns, in his work on Obstetrics, remarks, "A fundamental principle in midwifery is, that relaxation or diminution of resistance is essential to an easy delivery; and could we discover any agent capable of effecting this rapidly and safely, we should have no tedious labors, except from the state of the pelvis or position of the child." The agent so earnestly desired by Dr. Burns, is found in the lobelia inflata, which "rapidly and safely" relaxes the muscular system, without producing permanent debility; the use of which will render unnecessary the barbarous steel, so frequently used by the faculty to kill the unborn child.
In the last stage of labor, the hand may be kept near the parts, to know the moment when the head of the child presents, as some little assistance at this time is called for, to remove the obstruction arising from the clothes, to support the head of the child in its passage and in the interval of pains, and keep it from pitching downward, and to detach the umbilical cord from the neck, when found around it. After the birth of the head, the pains follow each other in quick succession until the child is born.
Tying and cutting the navel STRING.--After the birth of the child, and all pulsation has ceased in the navel string, it should be tied with two ligatures, one about an inch, and the other two inches from the body, cutting the cord midway between the ligatures. The child should then be handed to the nurse to be washed clean and dressed.
Management of the placenta or after-birth. --After the delivery of the child, the mother should take some warm porridge, and be allowed to remain quiet, until the labor pains are renewed, when the navel string may be gently drawn, and the placenta will be expelled. If it should be retained more than an hour, administer an injection the same as before, which will generally produce the desired effect in a few minutes. If the operation of the injection does not expel it, give the emetic powder as before directed, which will increase nature's efforts, and never fail to accomplish the object, without the necessity of manual force.