Women and Abortion

Abortion, or miscarriage, means, in plain language, a woman losing her child previous to the seventh month of her pregnancy; that is, before its due time. When this occurs after that period it is called

PREMATURE LABOR

Miscarriage involves pain and weakness in addition to the loss of offspring, and is often a severe trial to the maternal constitution. It may occur at any period of pregnancy, but particular stages are more liable to the accident than others. These are generally considered to be about the time of the first menstruation after conception; again at the twelfth week, and toward the seventh month; and the liability is increased at those times which correspond to the menstrual period. When abortion has once taken place it is more likely to occur again, and some have so strong a tendency to it that they never go beyond a certain stage, but then invariably miscarry.

THE CAUSE OF ABORTION

may exist in the constitution of the female herself, being the result of weakness and irritability, or of an overfull habit or a diseased condition of the womb; or the fœtus, or child, may die or be deficient in development, when it is cast off like a blighted fruit. Suckling after conception has taken place is not infrequently a cause of miscarriage. Active diseases occurring during pregnancy, such as fevers, severe inflammation, eruptive fevers, etc., are almost certain to occasion the expulsion of the uterine contents. Continued diarrhœa and the action of strong purgative medicines, particularly the aloetic, are dangerous. This is a very good reason for those who are pregnant avoiding all quack aperient medicines; they almost all contain aloes, and may be very injurious. 

All undue exertion or agitation of body or mind, sudden jerks or jumps, riding on horseback in the early stage, or in a shaking carriage in the latter stages of pregnancy, may any of them bring on miscarriage. To these may be added: exertion of the arms in doing anything on a level above the head; costive bowels and straining consequent therein; sexual indulgence, or, in plain language, too much connection with your husband; and luxurious habits. Those who have once suffered from abortion ought to be extremely careful during succeeding pregnancies, and all ought to bear in mind the possibility of the occurrence.

THE SYMPTOMS OF THREATENED ABORTION

vary with the constitution. In the strong and plethoric it is often preceded by shivering and febrile symptoms and by a feeling of weight in the lower bowels. In the weak there is languor, faintness, flaccidity of the breasts, general depression, and pains in the back and loins. Intermittent pains, and discharge of blood from the passage, tell that the process has begun. If miscarriage occurs within the first month or two after conception, the process may be accomplished with so little inconvenience as to escape notice and be mistaken for a menstrual period. More generally, however, the severity of the pain and an unusual clotted discharge of blood render the case evident. 

The pain, the discharge, and, at the same time, the danger of an abortion, are in proportion to the advancement of the pregnancy. When a miscarriage goes on, the pains increase in force and frequency, and continue, with discharge of blood, fluid or in clots, until the ovum, or first formation of the child, is expelled; after which both become moderated till they cease altogether and the red flow gives place to a colorless one. It is very important that those in attendance upon the patient should examine every clot that comes away. If large, tear it in pieces, that they may ascertain whether the contents of the womb are expelled or not, for there is no safety or rest, where miscarriage is progressing, till it has taken place and everything is cast off.

AS SOON AS A FEMALE

experiences threatenings of abortion she ought at once to retire to bed, upon a mattress, and keep perfectly quiet till every symptom has disappeared. Sometimes this simple measure, promptly adopted, is sufficient to avert the threatened evil. If there is much feeling of fullness, and the patient is of full habit generally, eight or a dozen leeches may be applied to the lower part of the bowels; if there is fever, saline medicines may be given, such as the common effervescing draft of carbonate of soda and tartaric acid or lemon juice; or, if the bowels are much confined, seidlitz powders, assisting the action by cold clysters, if necessary.

 When the pains are severe, particularly in the weak and irritable, twenty or thirty drops of laudanum should be given, and may be repeated in a few hours if the symptoms are not improved. In the case of profuse discharge, the patient should be kept very lightly covered, movement avoided, and every article of food or drink given cold, or iced if possible, provided the vital powers are not excessively reduced. Cloths dipped in cold or iced water should also be applied to the lower part of the body and frequently changed. Acid drinks, with cream of tartar, may be freely given. Ten or fifteen drops of elixir vitriol may be given in a wineglassful of water every two or three hours. Should slight faintness come on, it is better not to interfere with it, but use outward remedies—camphor, cold water, vinegar, etc.—as they maybe salutary.

 If it reaches to an extent to threaten life, stimulants, as brandy and water, and others, must be had recourse to. Profuse and continued discharge, though it may not threaten life, must occasion a weakness which will take a long time to overcome, and which may ultimately, if not properly attended to, promote the development of other diseases of the womb.