Part 16 (2/2)
CARE OF CORD.
If it is found all around the neck once or more, you must slip finger down neck and loosen cord to let blood pa.s.s through the cord till next pain comes, in order to ward off asphyxia of child.
When pain comes, gently pull child's head down toward the bed. There is no danger of hurting the perineum now since the head has pa.s.sed the soft parts. At this time the danger is suffocation of child. Never draw child too far away from mother's birth place by force, as you may tear navel string from the child and cause it to bleed to death. If you value the life of the child, then you must be careful not to place the navel end of the string in any danger of being torn off. Now you have made a good job for both mother and child so far. The child is in the world; and you want to show the mother a living baby for her labor and suffering of the past nine months. The baby is born and the mother is not torn, but the baby has not yet cried. Turn it on its side, face down, run your finger in its mouth and draw out all fluids, thick or thin, to let the breath pa.s.s to the lungs. Then blow cold breath on its face and breast to cause its lungs to act.
SEVERING CORD.
Baby cries, all is safe now. Baby is born safely and cries nicely, but still has cord fastened to afterbirth. It has no further use for cord, as life does not depend upon blood from the afterbirth any longer. Take the cord about three inches from the child's belly, between thumb and finger, and strip towards child to push bowels out of the cord if there should be any in it, as a safeguard for bowels, then tie a strong string around cord, first three inches from child's belly, second, four inches; take the cord in your hand and look what you are doing. If baby's hand should fall back to cord, you might cut off one or two fingers, or wound the hand or arm very seriously. Cut cord between the two ties just made on navel string. Look out for your scissors; pa.s.s the child over to the nurse to be washed and dressed, while you deliver the afterbirth from pelvis or womb.
PUTTING ON BELLY BAND.
When the child's s.h.i.+rt is on, cut a hole the size of your thumb in a doubled piece of cloth, five inches long by four wide, put the hole two inches from one end, and run the cord through the hole. Lay the cloth across the child's belly, then fold the cloth lengthwise over the cord, which must lie across the child so it will not stretch cord by handling or straightening child out. Now you are ready to finish the delivery of the afterbirth. You have a plug of soft and tender flesh to get out of the womb and v.a.g.i.n.a.
DELIVERY OF AFTERBIRTH.
As the afterbirth has been grown tight to the womb during all the days of mother's pregnancy, and furnished all the blood to build and keep the child alive in the womb for nine months, it has done all it can do for the child, and is now ready to leave the womb.
You are there to a.s.sist it to get out of the place it has occupied so long. You must begin first to rotate or roll the placenta first one way and then another, up, down and across the v.a.g.i.n.a, by gently pulling the cord. Look out or you will pull the cord loose from the placenta; then you will have made your first blunder,--no cord to pull placenta with, and the mother bleeding and faint from loss of blood. Now is the time and place to save life. Pa.s.s your hand forward into the soft parts to get your fingers behind the placenta; now give a rolling pull and bring it out with the hand. You will find it an easy matter to get your hand into the v.a.g.i.n.a and womb after the birth of the child. Get all the placenta out, then take a wad of cloth or rags as large as the child's head, and press it under the cross bone of the pelvis; push the cloth under and up, so as to completely plug the pelvis. Now pull the hair gently over the symphesis, which will cause the womb to contract by irritation.
PREPARING FOR MOTHER'S COMFORT.
All is now done but to provide for the mother's comfort, which is your next duty. Draw her chemise down her back and legs until it is straight, then with safety pins, pin the chemise on inner side of thighs so that the chemise will go around both thighs separately. Now you have the s.h.i.+rt fast to keep it from sliding upwards, and you are ready to make a band of the chemise to support the womb and abdomen. Bring the chemise tightly together for two or three inches above the pelvis to form a band. Previous to pinning, draw the lump (womb) you feel above symphesis, up, then pin, and the belt you have made of the chemise will support the womb. All is safe now, but you must not leave for two hours.
You may have delivered a feeble woman, who may flood to death after delivery of the child, if you do not leave her safe. I have in mind one case who flooded all of two quarts at a single dash. The first symptom was a pain in the head.
POST-DELIVERY HEMORRHAGE.
I know of only two causes that would produce hemorrhage or bleeding after the child is delivered. One is when the afterbirth (placenta), is separated from its attachment to the womb and still retained in the womb or v.a.g.i.n.a, or when a part is separated and still lies in the womb, that retention of placenta prevents the natural circular contraction of the womb, to close on itself and retain it, with force enough to prevent the further discharge of blood, would give a chance for a continued stream. Then should the patient bleed profusely after the placenta has been removed, another cause would be in pulling away the afterbirth, as part of the upper portion of the womb may be pulled to an inverted position, which would be like a hat if you press the top down with the hand. Then there is a chance for leakage because of this unnatural fold made in the womb.
TREATMENT FOR.
My method of relief is to insert the hand, and with back of fingers smooth out all folds. Before you draw the right hand from the womb place left hand on abdomen, catch the womb between the thumb and finger and withdraw hand. With the left hand pull the hair above symphesis or scratch the flesh just above across the region of the symphesis, just enough to make an irritation. After the hand is out of v.a.g.i.n.a pa.s.s a small bundle of cloths as far under the symphesis as would be necessary to hold everything up, then fasten chemise; beginning at symphesis draw it tight for about two inches above symphesis and with strong pins fasten it. Be sure you keep garment tight by pulling down between limbs.
The coa.r.s.er the chemise the better, as you want to make a strong bandage at that point so as not to push the womb down into the pelvis. If the patient's general health is fairly good let her tell you what she wants to eat, and go and get it. Let her diet be after her usual custom. You must remember she has just left the condition of a full abdomen. Lace her up, fill her up and make her comfortable for six hours; then change her bedding.
FOOD FOR MOTHER.
Remember this, if you stop digestion on her for some hours with teas, soups and shadows to eat, you carry her to the condition where it would be dangerous to give her a hearty meal. My experience and custom for forty years has been crowned with good success. I never lost a case in confinement. I have universally told the cook to give her plenty to eat.
TREATMENT FOR SORE BREAST.
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