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1. Do not take too much exercise.—You may get relief from some of your ailments by lying down considerably during the day. If there is leucorrhœa (whites), strangury (a frequent inclination to void the urine), incontinence (an inability to hold the water), pain in the hips with numbness of the inferior (lower) extremities—if the veins of the leg become varicose—if there are anasarcous swellings of the inferior extremities—if there is a pendulous belly, the woman ought not to so exercise as to produce fatigue. She may get some relief by sitting or reclining in the way that is most agreeable.

2. Use means to harden the nipples.—Those women who have never had children ought to observe, before labor, whether there is a depressed condition of the nipples; whether they contract as the breasts increase in size. If they do, the condition can be corrected by wearing nipple shields on them. And to harden the nipples: For at least a month before labor, two or three times a day, rub them between the thumb and finger, and bathe them in tincture of myrrh or cologne water, in which a little alum has been dissolved. This will render the skin less sensitive, and avert the distress occasioned by the tenderness of the nipples. If there is especial reason to apprehend excoriated nipples, as there is when they are rough and nodulated like a strawberry or raspberry, make a solution of sulphate of zinc, one grain to the ounce of rosewater, in a wide-mouth bottle, and tilt the bottle upon the nipple, and allow it to remain there for a few minutes, several times every day (F. 198, 217.) It is necessary also to protect the part from the pressure of stays and the friction of the flannel vest. The stays may be removed entirely, or the nipple may be protected by laying a soft linen rag, wet with water and cologne, around it so that the pressure will not be directly on the nipple. If the breasts are swollen or painful, the soreness will subside of itself before the commencement of labor. It may be well, however, to foment them with flannel wrung out of hot water, and support them as in a sling by a broad handkerchief, passing over the opposite shoulder.

3. Pay no attention to the chilling and “horrifying tales of gossiping beldames.”—A cheerful flow of spirits which arises from the hope of a happy event, inspires a woman with activity and resolution, and is the best preparation for the pains of labor. Do not give way to gloomy and melancholy forebodings or indulge in idle reveries. Any person is your enemy who would exaggerate to you the dangers of labor; and let me here say to you, that if you read in this book of certain unfavorable contingencies, do not let your mind dwell upon them; they occur very rarely indeed, and I hope I have given such advice and instruction, and that you have been so cautious and careful that your chance is unusually favorable.

4. Do not expose yourself at this time to wet and cold.—Do not go out in bad weather, and do not go to theatres and other crowded places at all. You are especially liable at this time to renal difficulties, and if you take cold, it will cause congestion of the kidneys, and more or less urinary difficulty. It is easier to prevent such complaints than to cure them.

5. Take but little medicine.—In general you may rest in the hope that all your troubles will vanish after your confinement, and you can hardly hope to cure them sooner. But keep your bowels loose. If you cannot have daily passages by eating fruits, bread made from unbolted flour, or other laxative diet, take saline waters, compound licorice powder, etc., (F. 108.) If your bowels are constipated at the time that labor commences, take at that time an active cathartic (F. 109).

6. Seek and engage the best possible physician.—I do not know but the educated monthly nurse of the future may be well qualified to do all that is necessary in an ordinary natural parturition. But heretofore very few nurses trained in this country are thus prepared; perhaps the popular sentiment is against such an education. But you must always select a physician that you can confide in and trust if an operation is necessary, or there is unusual difficulty.

7. It is generally well to have your physician see you a month before the time that you expect to be confined.—Indeed, I would have you consult with your physician during the whole period of your pregnancy. You may get very full directions from this book, but still, where it is practicable, I advise that you consult with some skilled medical friend, who knows your idiosyncracies, and can suggest modifications of the directions as your own case demands. Specimens of your water should be analyzed each week during the last month, if there are any signs of albuminaria, etc., (especially if the face and ankles are bloated.) If there is inability to pass the water, it may be necessary to draw it with a catheter.

8. Submit yourself entirely to the direction of your physician.—Do not indulge in any opinion that may clash with his, even if that opinion is founded upon what is here written; you cannot expect to know more than he. It may be that he will wish to examine you by palpation, etc., to know if the fœtus lies as it should do, as something may be done to correct a malposition by external manipulation if the effort is made early. No good physician will permit that your sensibilities should be shocked by an unreasonable demand. If you have studied this book diligently you will be prepared to converse intelligently with your physician, and you will understand and appreciate any directions that he may give. If you have taken any medicine prepared from formula herein inserted, you know, and can inform him what the medicine is; this is better than it would be if you had taken patent medicine, of the ingredients of which you are ignorant. Consult with your physician in regard to the choice of a nurse, as he will be likely to know those that understand their business, and that are in the habit of following the doctor’s directions, or he may know whether the one you selected is now attending a woman that has contagious disease.

9. Choose a good nurse.—You should have the best possible aid that the nature of circumstances will permit. Do not get a fine lady nurse that requires to be constantly waited on by a servant, and do not get a croaker that discourses of the sad and dreadful cases that have occurred in her experience. Do not get any one that is addicted to intemperance, or a potterer that is devoid of method and efficiency; that does the wrong thing in the wrong way, and that is always out of her proper place. Get a nurse that will not dose and medicate either the mother or child when they are under the care of a physician, or assume any duty or responsibility that belongs to him; that admits that the doctor is the one to give orders. Get one that never reveals the private concerns of her former employers; one that is not a mischief-maker, causing dissention and disagreement in the household. Do not get one that is young, if she is giddy and thoughtless and inexperienced, nor one that is old, if she is deaf and stupid. Get, preferably, a married woman or a widow; one that has at some time had the care of infants; one that has a pleasant countenance, and is naturally cheerful; one that has calmness and self possession, and firmness, and at the same time is gentle, kind, good-tempered and obliging; she should have a light step, a pleasant voice, a cheering smile, a dextrous hand, a gentle touch, and be gifted in cooking for the sick. By preference, engage a monthly nurse; she will not be so likely to come to you from a case of scarlet fever or erysipelas, or other contagious disease.

If you can find a nurse of the kind described above, and if she be properly instructed and educated, she will be invaluable to you, and if she devotes her talents and her best energies to you and your infant, she should be liberally paid. But there are many such women all over the country, or will be when we can induce them to qualify themselves by study and special effort. But, as really good nurses are full of engagements, it may be necessary for you to engage her in the early months of your pregnancy; only stipulate in the start that you will be obliged to dispense with her services, if it happens that immediately preceding your confinement she had been attending a woman that had puerperal fever.

I do not say that you should necessarily engage a nurse that is educated as a midwife. But such a one is to be preferred even if you have a physician, and then the latter need not be detained from his patients for so long a period of time; and if the last stage of the labor is so rapid that the child is born before the doctor arrives, there need be no trepidation; she will know well what to do. Thousands are born in this country without the slightest assistance from a doctor, he not being at hand nor not being in time, and yet both the mother and babe do well almost invariably. As a rule the nurse that has studied and learned the most is the best prepared to discharge the duties resting upon her.

A NURSE MAY PROPERLY BE IN ATTENDANCE A WEEK OR MORE BEFORE THE TERMINATION OF PREGNANCY, if circumstances permit or require it. If present she will attend to the following things: Choose a good airy room for the lying-in chamber—one that can be well ventilated, where the temperature can be kept at from 60° to 65°; one that is removed as much as possible from noise and disturbance, and where the patient need not be exposed to draughts. Provide needed articles of clothing for mother and child, and dressings for the bed; short gowns to wear over the chemise or ordinary night gown; a proper bandage of heavy muslin, as much as one and a quarter yards in length and fourteen inches in width. I prefer to have it of several thicknesses, and if it is quite long so that the ends meet to be folded it keeps in place better, and if it is gored it should be in such a manner that it is narrower at the lower edge than it is two inches above, so as to prevent it when adjusted from sliding upwards; the child’s binder, preferably some woolen material about five inches in width and fourteen inches in length; the child’s shirt (woolen or cotton, not starched); both a long and a short petticoat; a frock or slip; a shawl or flannel blanket; napkins and muslin diapers; also pieces of old muslin to be used to absorb blood and water. Provide also for dressing the bed, a piece of impervious oiled cloth, oiled silk, or rubber cloth; old sheets and comfortables; a piece of carpet; have in readiness a pair of shears or scissors, a small box of prepared lard or vaseline or a flask of salad oil, a package of pins one and a half inches in length, besides ordinary pins; tape, bobbin or wrapping twine; fine toilet soap; fine sponge for washing the child; soft linen or carbolated cotton for dressing the naval; a box of unirritating powder; a pile of towels, and a little aromatic ammonia or brandy to be used in an emergency. Let every thing be placed in such order that either may be found without hurry or bustle at a moment’s notice. Hot and cold water should always be in readiness.