Mr. Roscoe - "The Butterfly's Ball and the Grasshopper's Feast"

Arthur J. Rees - "The Shrieking Pit"

Various - "Scientific American Supplement, No. 430, March 29, 1884"

Benjamin Disraeli - "Coningsby"

Annual Bibliography of Commonwealth Literature 2007
This paper argues that discourses of love in Ghanaian market literature for youth offer a view into complex negotiations of agency and empowerment. Drawing on Deborah Durham's notion of youth as "social `shifters'" and Francis Nyamnjoh's conception of the "interconnectedness" of agency, I take Ghanaian market literature as one specific case of how African literature for youth foregrounds questions of continuity and change as African societies enter into increasingly complex global relations. In this literature for youth, received notions of love, often constructed out of impressions from American pop and hip hop music, carry new notions of agency that compete with existing "domesticated" forms. Authors like Ike Tandoh and Evelyn Tay employ discourses of love to offer youth alternative avenues for empowerment in a context of socio-economic disenfranchizement. In a creative process of "straddling", this writing both reveals and reproduces the contradictions that obtain in youth configurations of agency.

The Mother and Her Child

W >> William S. Sadler >> The Mother and Her Child







CHAPTER VII

PREPARATIONS FOR THE NATAL DAY


Two months before baby is to arrive, the expectant mother should pay
particular attention to the conservation of her strength. The woman
who is compelled to leave her home for the factory, the laundry, the
office, or other place of employment, should stop work during these
last two or three months. The active club woman should pass the
burdens on to others, and the woman of leisure should withdraw from
active social life with its varied obligations. During the final weeks
of pregnancy, the prospective mother needs the same hygienic care
regarding fresh air, exercise, diet, and water drinking, as outlined
in a former chapter.


THE FINAL WEEKS

As the gravid uterus rises higher in the abdomen, increased pressure
is exerted on the stomach, the lungs, and upon the nerve centers of
the back; and it is because of this situation, that the duties and
obligations of the prospective mother should be reduced to a minimum,
that she may feel at liberty to lie down several times during the day
on the porch or in a well-ventilated room, in the midst of the best
possible surroundings. Sexual intercourse should be largely
discontinued during the last months of pregnancy.

I sometimes wish the prospective mothers in our dispensary districts
might have some of the care and the kind treatment which is bestowed
upon an ordinary prospective mother horse, which at least enjoys a
vacation from heavy labor, and whose food is eaten with calm nerves
and in the quietness of a clean stall. While the state of the mother's
mind does not materially influence the child; nevertheless, the state
of the mother's body, the weary over-worked muscles and nerves of
hot, tired women, bending over cook stoves, laundry tubs, or scrubbing
floors, does materially derange the mother's health and digestion,
which in turn, reflexly interferes with the growth and physical
development of her child. Extra strength is required for the day of
labor, and since the baby doubles its weight during the last two
months, the mother is living for two, and should, therefore, avoid
extreme fatigue, over tiring, and irksome labor during these final
weeks of watchful waiting.


SELECTION OF THE HOME

It may or may not be within the province of prospective parents to
rearrange, rebuild, or otherwise change the home. Usually the size of
the pocketbook, the bank account, or the weekly pay envelope decide
such things for us. The home may be in the country or suburbs, with
its wide expanse of lawns, its hedges of shrubbery, and with its
spacious rooms and porches; or it may be a beautifully equipped,
modern apartment on the boulevard of a city, with its sun parlors,
large back porches, conveniently located near some well-kept city
park, or it may be one of those smaller but "snug as a bug in a rug"
apartments, in another part of the city, where usually there is a
sunny back porch; or again some of my readers may themselves be, or
their friends may be, in a darkened basement with broken windows, illy
ventilated rooms, with no porches, no yards, no bright rays to be seen
coming in through windows--and yet into all of these varied homes
there come little babies--sweet, charming little babies, to be cared
for, dressed, fed, and reared. And we must now proceed to the subject
of making the most of what we have--to create out of what we have, as
best we can, that which ought to be.


SANITARY PREMISES

In both the country and city place, yards and alleys should be cleaned
up. Garbage--the great breeding place of flies--should be removed or
burned. The manure pile of the stable or alley should also be properly
covered and cared for. In this way breeding places for flies are
minimized and millions and billions of unhatched eggs are destroyed.
In the large cities, provision is made for the prompt disposal of
garbage, and laws are beginning to be enforced regarding the covering
and the weekly removal of manure, and thus in many of our large cities
flies are diminishing in numbers each year. Fly campaigns and garbage
campaigns are teaching us all to realize the dangers of infection,
contagion, and disease as a result of filth; while through the
schools, the children of even our foreign tongued neighbors take home
the spirit of "cleaning up week." Even in the rural districts we hope
for the dawning of the day when filth, stagnant pools, open manure
piles, and open privies, will be as much feared as scorpions or
smallpox.


ENGAGING THE DOCTOR

As suggested elsewhere, as soon as the expectant mother is aware that
she is pregnant, she should engage her physician. And since these are
days of specialists, he may or may not be the regular family doctor.
The husband and friends may be consulted, but the final choice should
be made by the prospective mother herself. "The faith which casts out
fear, the indefinable sense of security which she feels in her chosen
physician, supports her through the hours of confinement." Twenty-four
hour specimens of urine should be saved and taken to the physician
twice each month and oftener during later months of pregnancy. The
chosen physician's instructions and suggestions should be carried out
and counsel should be sought of him as to the place of confinement.


THE PLACE OF CONFINEMENT

There are a number of factors that enter into the selection of the
place of confinement. In the first place, if the home be roomy,
bathroom convenient, if the required preparation of all necessities
for the day of labor can be effected, and it is further possible to
prepare a suitable delivery-room at home with ample facilities for
emergencies and complications, and you can persuade your physician to
do it--then the best place in the world for the mother to be confined
is within the walls of her own home. But such is the case in but one
home out of hundreds, and I regret that time and space will not allow
me to describe and portray the many untimely deaths that might have
been avoided if this or that supply had only been ready at the moment
of the unexpected complication of delivery. Why should we needlessly
risk the lives of prospective mothers, when, in every up-to-date
hospital delivery-room, all these life-saving facilities are freely
provided? Here in the modern hospital, the mothers from small homes
and apartments, the mothers who live in stuffy basements, as well as
those from the average home in the average neighborhood, can come with
the assurance of receiving the best possible care and attention. Every
woman who can arrange or afford it, should plan to avail herself of
the benefits, comforts, quietness, and calm of a well-equipped
hospital and the surgical cleanliness and safety of its aseptic
delivery-room.

Fortunately, the mother of the basement home may have the same clean,
sterile dressings used upon her as does the mother of the boulevard
mansion. The maternity ward bed at $8.00 to $10.00 a week can be just
as clean as the bed of the $40.00 a week room. The methods and
procedures of the delivery-room can be just as good in the case of the
very poor woman as in the case of the magnate's wife. In no way and
for no reason fear the hospital. It is the cleanest, safest, and by
far the cheapest way. The weekly amount paid includes the board of the
patient, the routine care, and all appliances and supplies of every
sort that will be used. Under no circumstances should a midwife be
engaged. Any reputable physician or any intellectual minister will
advise that. Let your choice be either the hospital or the home; but
always engage a physician, _never_ a midwife.


THE NURSE

After selecting the place of confinement, the question of the nurse
may next be considered. If it is to be the hospital, you need give
little further thought to the nurse, for your physician will arrange
for the nurse at the time you enter the hospital. She will be a part
of the complete service you may enjoy. You will find her on duty as
you, quietly resting in your room, awaken in the sweet satisfaction
that at last it is all over--at last your baby is here.

A competent nurse is a necessity, if the confinement takes place in
the home. She may be a visiting nurse, who, for a small fee, will not
only come on the day of labor, but will make what is known as
"post-partum calls" each day for ten or twelve days. These are short
calls, but are long enough to clean up the mother and wash and dress
the babe. She is not supposed to prepare any meals or care for the
home. Then there is the practical nurse--women who have prepared
themselves along these lines of nursing, whose fees range from $12.00
to $18.00 a week. If your physician recommends one to you, you may
know she is clean and dependable. The trained nurse, who has graduated
from a three years' course of training, is prepared for every
emergency, and will intelligently work with the physician for the
patient's welfare and comfort. Her fees range from $25.00 to $35.00 a
week.

Both the practical and the trained nurses are human beings, and
require rest and sleep the same as all other women do. One nurse,
after having faithfully remained at her post of duty some sixty hours
reminded the husband and sister of the patient that she must now have
five hours of unbroken rest and they replied in a most surprised
manner, "Why we are paying you $30.00 a week, and besides, we
understood you were a _trained_ nurse."

The physician usually makes arrangement with the family for competent
relief for the nurse. She should have at least one to two hours of
each day for an airing, and six hours out of the twenty-four for
sleep.


PREPARATIONS FOR A HOME DELIVERY

The supplies should all be in the home and ready, as the seventh month
of pregnancy draws near. In the first place, select the drawer or
closet shelf where the supplies are to remain, untouched, until your
physician orders them brought out. The supplies requiring special
preparation and sterilization are:

Three pounds of absorbent cotton.
One large package of sterile gauze (25 yards).
Four rolls of cotton batting.
Two yards of stout muslin for abdominal binders.
Two old sheets.
Twelve old towels or diapers.
One yard of strong narrow tape for tying the cord.
Three short obstetrical gowns for the patient.
Two pairs of extra long white stockings.
Four T-binders.

Other articles needed by physician, nurse, and patient are:

Fifty bichloride of mercury tablets (plainly marked "_poison_").
Four ounces of lysol.
Two ounces of powdered boric acid.
One half ounce of 20% argyrol.
One quart of grain alcohol.
One pound jar of surgeon's green soap.
One half pound of castile soap.
One bottle white vaseline.
One drinking tube.
One medicine glass.
One two-quart fountain syringe.
One covered enamel bucket or slop jar.
One good sized douche pan.
Three agateware bowls, holding two quarts each.
Two agateware pitchers, holding two quarts each.
Two stiff hand-brushes.
One nail file.
One pair surgeon's rubber gloves.
One and one-half yards rubber sheeting 36 inches wide.
Two No. 2 rubber catheters.
Two dozen large safety pins.
Small package of tooth picks, to be used as applicators.
Six breast binders (Fig. 5).
Six sheets.

Just before confinement send for one ounce of fluid extract of ergot
and an original pint bottle of Squibb's Chloroform.


THE PREPARATION OF THE SUPPLIES

1. _The sanitary pad_ is used to absorb the lochia after confinement,
and needs to be changed many times during the day and night; fully
five or six dozen will be required. They are usually made from cotton
batting and a generous layer of absorbent cotton. If made entirely
from absorbent cotton they mat down into a rope-like condition. They
are four and one-half to five inches wide and ten inches long. The
sterile cheesecloth is cut large enough to wrap around the cotton
filling and extends at both ends three inches, by which it is
fastened to the abdominal binder. With a dozen or fifteen in each
package these vulva pads are wrapped loosely in pieces of old sheets
and pinned securely and marked plainly on the outside.

2. _Delivery pads._ These pads should be thirty-six inches square and
about five inches thick, three or four inches of which may be the
cotton batting and the remainder absorbent cotton. Three of these are
needed. Each should be folded, wrapped in a piece of cloth and
likewise marked.

3. _Gauze squares._ Five dozen gauze squares about four inches in size
may be cut, wrapped and marked. These are needed for the nipples,
baby's eyes, etc.

[Illustration: Fig. 5. Breast Binder]

4. _Cotton pledgets._ These are cotton balls, made as you would a
light biscuit with the twist of the cotton to hold it in shape. They
should be about the size of the bottom of a teacup. These are thrown
in a couple of pillow slips and wrapped and marked.

5. _The Bobbin._ Cut the bobbin or tape into four nine-inch lengths
and wrap and mark.

6. The _tooth picks_ are left in the original package and do not
require sterilization.

7. _Sterilization._ Before steaming and baking, wrap each bundle in
another wrapping of cloth and pin again securely. Mark each package
plainly in large letters or initials. These packages may be sent to
the hospital for sterilization in the autoclave or they may be
steamed for one hour in the large wash boiler, by placing them loosely
into a hammock-like arrangement made by suspending a firm piece of
muslin from one handle of the boiler to the other. The center of the
hammock should come to within five inches of the bottom of the boiler
which contains three inches of boiling water. The cover of the boiler
is now securely weighed down and the water boils hard for one hour, at
the end of which time they are removed and placed in a warm oven to
dry out. The outer wrapping may be slightly tinged with brown by this
baking. After a thorough drying they are allowed to remain in the same
wrappings into which they were first placed and put away in a clean
drawer awaiting the "Natal Day."


REQUISITES FOR THE HOSPITAL

Each hospital has its own methods and regulations for caring for
obstetrical patients and it is well for the expectant mother to visit
the obstetrical section, the delivery-room and the baby's room, that
she may personally know more about the place where she is to spend
from ten days to two weeks. Here she may ascertain from the
superintendent just what she will need to bring for the baby. Many of
the hospitals furnish all the clothes needed for the baby while in the
hospital; in such instances, the hospital also launders them. Other
hospitals require the baby's clothes to be brought in, in which case
the mother looks after the laundry. The mother always takes her toilet
articles, a warm bed jacket with long sleeves, several night dresses
and a large loose kimono or wrapper to wear to the roof garden or
porch in the wheel chair. Warm bedroom slippers and a scarf for the
head completes the outfit.


BABY'S NECESSITIES

Baby's basket on the day of confinement should contain:

One pound of absorbent cotton.
One pint of liquid albolene.
One half ounce of argyrol (mentioned in the mother's list).
Safety pins of assorted sizes.
A powder box containing powder and puff.
An old soft blanket in which to receive the child after birth.
A soft hair brush.
Three old towels.
Small package of sterile gauze squares.
Scales.
Diapers.
A silk and wool shirt (size No. 2).
An abdominal band to be sewed on with needle and thread.
A pair of silk and wool stockings.
A flannel skirt.
An outing flannel night dress.
A woolen wrapper.


THE CONFINEMENT ROOM

By special preparation, the ordinary bedroom may be fashioned into a
delivery-room. Carpets, hangings and upholstered furniture must be
removed. Clean walls, clean floors, and a scrupulously clean bed must
be maintained throughout the puerperium. Bathroom, and if possible, a
porch should be near by. In the wealthy home, a bedroom, bathroom and
the nursery adjoining is ideal; but I find that real life is always
filled with anything but the ideal.

The dispensary doctor is compelled to depend upon clean newspapers to
cover everything in the room he finds his patient in. The only sterile
things he uses he brings with him, and should he have to spend the
night, the floor is his only bed. A student who was in my service told
me that there was not one article in the entire home, which consisted
of but one room, that could be used for the baby. He wrapped his own
coat about it and laid it carefully in a market basket and placed it
on the floor at the side of the pallet on which the mother lay and by
the aid of a nearby telephone secured clothes from the dispensary for
the babe.

Always select the best room in the house for a home confinement. If
the parlor is the one sunny room, take it; remove all draperies,
carpet, etc., and make it as near surgically clean as possible. While
sunshine is desirable, ample shades must be supplied, as the eyes of
both mother and babe must be protected.


THE BED

A three-quarter bed is more desirable than a double bed. If it is low,
four-inch blocks should be placed under each leg, the casters having
been removed to prevent slipping. The bed should be so placed that it
can be reached from either side by the nurse and physician. The
mattress may be reenforced by the placing of a board under it if there
is a tendency to sag in the middle. Over this mattress is securely
pinned the strip of rubber sheeting or table oilcloth. A clean sheet
covers mattress and rubber cloth and at the spot where the hips are to
lie may be placed the large sterile pad to absorb the escaping fluids.
The floor about the bed is protected by newspapers or oilcloth. Good
lighting should always be provided. Much trouble and possible
infection may be avoided by clean bedding, plenty of clean dressings,
boiled water, rubber gloves, and clean hands.




CHAPTER VIII

THE DAY OF LABOR


As the two hundred and seventy-three days come to a close, our
expectant mother approaches the day of labor with joy and gladness.
The long, long waiting days so full of varied experiences, so full of
the consciousness that she, the waiting mother, is to bring into the
world a being which may have so many possibilities--well, even the
anticipated pangs of approaching labor are welcomed as marking the
close of the long vigil. These days have brought many unpleasant
symptoms, they have been days of tears and smiles, of clouds and
sunshine.


THE TIME OF WAITING

The prospective mother has thought many times, "Will my baby ever
come?" But nature is very faithful, prompt, and resourceful. She
ushers in this harvest time under great stress and strain, for actual
labor is before us--downright, hard labor--just about the hardest work
that womankind ever experiences--and, as a rule, she needs but little
help--good direction as to the proper method of work and the
economical expenditure of energy. In the case of the average mother
this is about all that is needed, and if these suggestions come from a
wise and sympathetic physician--one who understands and appreciates
asepsis--she may count herself as fortunately situated for the
oncoming ordeal.

In the days of our grandmothers it was almost the exception rather
than the rule to escape "child-bed fever," "milk leg," etc.; but in
these enlightened days of asepsis, rubber gloves, and the various
antiseptics, puerperal infection is the exception, while a normal
puerperium is the rule; and this work of prevention lies in the
scrupulous care taken by anyone and everyone concerned in any way with
the events of the day of labor.

On this day of labor, the mother, who has gone through the long
tedious days of waiting, should see to it that nothing unclean--hands,
sponges, forcep, water, cloth--is allowed to touch her. Above all
things do not employ a physician who has earned the reputation of
being a "dirty doctor." Puerperal infection is almost wholly a
preventable disease and every patient has a right to insist upon
protection against it.

In a former chapter will be found a detailed description of the
"delivery bed." Beside this bed, or near by, are to be found the rack
on which are airing the necessary garments for the baby's
reception--the receiving blanket and other requisites for the first
bath--together with numerous other articles essential to safety and
comfort.

There should be an easy chair in the room for the mother to rest in
between her walking excursions during the first stages of labor. The
sterilized pads and necessary articles mentioned in an earlier chapter
are, of course, close at hand.


FIRST SYMPTOMS OF LABOR

Regular, cramp-like pains in the lower portion of the abdomen which
are frequently mistaken for intestinal colic, often beginning in the
lower part of the back, and extending to the front and down the thigh,
are often the first symptoms of the approaching event. With each cramp
or pain the abdomen gets very hard and as the pain passes away the
abdomen again assumes its normal condition. These regular cramp-like
pains are the result of the early dilation of the cervix--the first
opening of the door to the uterine room which has housed our little
citizen through the developmental stages of embryonic life--and as a
result of this stretching and dilating there soon appears that special
blood-tinged mucus flow commonly known as "the show."


THE PRELIMINARY BATH

At this time a very thorough-going colonic flushing should be
administered. The patient takes the "knee-chest" position, or the
"lying-down" position, and there should flow into the lower bowel
three pints of soapy water; this should be retained for a few moments;
and after its expulsion, a short, plain water injection should be
given. Now follows the preliminary general bath.

Just prior to the bath, the pubic hair should be clipped closely, or
better shaved. Then should follow a thorough soap wash, with patient
standing up in the tub, using plenty of soap, applied with a shampoo
brush or rough turkish mit. The rinsing now takes place by either a
shower or pail pour. _Do not sit down in the tub._ This is a rule that
must not be broken, because of the danger of infection in those cases
where the bag of waters may have broken early in the labor.

A weak antiseptic solution, prepared by putting two small antiseptic
tablets into one pint and a half of warm water, is now applied to the
body from the breasts to the knee. Put on a freshly laundered gown,
clean stockings and wrapper. The head should be cleansed and hair
braided in two braids.


THE PROGRESS OF LABOR

If all the mothers who read this volume could bear children with the
comfort Mrs. C. does, I should be happy, indeed.

At four o'clock one morning a very much excited father telephoned me,
"Hurry, quick, Doctor, it's almost here." It was well that we did
hurry, for the first sign the little mother had was the deluge of the
waters--at this point the husband ran to telephone for the doctor--no
more pains for thirty-eight minutes (just as we entered the door) and
the baby was there. But such is not usually the case, nor will it be,
as labor usually progresses along the lines of conscious dilating
pains, occurring at intervals twenty minutes apart at first, later
drawing nearer together until they are three to five minutes apart.
This "first stage of labor" lasts from one to fifteen hours--during
which time the tiny door to the uterine room which was originally
about one-eighth of an inch open--dilates sufficiently to allow the
passage of the head, shoulders and body of the fully developed child.

About this time the bag of waters usually bursts, and, as a rule,
this marks the beginning of the "second stage of labor." The amount of
water passed varies in amount. Should the rupture take place before
the door is fully open, then labor proceeds with difficulty and the
condition is known as "dry labor."

The head after proper rotation now begins the descent; and here the
pains begin to change from the sharp, lancinating, cramp-like pains
which begin in the back and move around to the front, to those of the
"bearing down" variety, while at the same time there begins to appear
the bulging at the perineum, which means that the head is about to be
born. At this time great stress is brought to bear upon the perineum
and often, in spite of anything that can be done to prevent it, the
perineum is more or less lacerated.

As soon as the baby is born the "second stage of labor" has passed and
within thirty to fifty minutes the close of the third stage of labor
is marked by the passage of the placenta or "afterbirth."


FALSE LABOR PAINS

Sometimes, as long as two weeks before the birth of the child, certain
irregular, heavy, cramp-like pains occur in the abdomen and back. For
a half-dozen pains they may show some signs of regularity; but they
usually die down only to start up again at irregular intervals. These
are known as "false pains."

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