This subject is presented to the readers of "The Woman's Voice" by Dr. Philip A. Ashkar, specialist in obstetrics and women's diseases at the American University. Once the readers of The Woman's Voice know the deep medical learning that Dr. Ashkar enjoys, they will be able to know the value of this subject in their lives.
It is a term meaning the care of the woman during pregnancy, at delivery, and after childbirth throughout the whole period of nursing.
(1) The care of the pregnant woman is a form of preventive medicine, and its success depends on the existence of medical centers to which the woman may turn for consultation or treatment, and on the encouragement given by public opinion, so that the benefit spreads among all people, whatever their class and their financial means.
The medical center is directed by a specialist physician, assisted by a registered nurse and by another nurse who visits the women in their homes and so is able to learn their material and social condition, their sanitary surroundings, and their ability to carry out what the doctor advises. The doctor gives the pregnant woman a thorough general examination, making certain that she has no disease that might pass to her child and that her principal organs are sound, so
that pregnancy will not affect their functioning; in the successive visits he makes certain that the pregnancy is proceeding normally, and in the ninth month he ascertains whether the delivery will be easy or difficult. The medical center must be equipped with a modern laboratory for carrying out all the tests that aid diagnosis; and the nurse advises the pregnant woman on what she should eat and wear, and on the exercise, rest, and recreation she needs.
Within the pregnant woman grows a body that needs for its growth all the nutritive substances—protein, vitamins, calcium, phosphorus, iron, iodine, and the rest—so her food must be sufficient and varied. All these necessities are found in the ordinary foods, chief among them meat, milk, wheat bread, fish, vegetables, and fruit; these are plentiful in our country, and we can dispense with tonics and drugs except in certain exceptional cases.
(2) The care of the woman during delivery, and attention to her safety and the safety of the child. If the doctor finds that the delivery will be easy, he directs that it be completed in the mother's home at the hands of a registered midwife trained in the methods of sterilization and complete cleanliness; otherwise he directs that the delivery take place in the hospital, where all the modern means are at hand—the means of anesthesia, blood transfusion, and the performance of the necessary operations.
(3) Attention to the mother and her infant after delivery, by continuous supervision of the child's growth and care for his food, his clothing, and his cleanliness, and care of the mother until she regains her activity and strength.
Following such a system for the well-being and safety of the mother has brought brilliant results: the death rate among women and children during childbirth has fallen, the period of convalescence after delivery has been shortened, and the death rate among children caused by neglect in the matter of their feeding has declined. But a system of so wide a field demands tremendous efforts and vast sums of money, and it cannot become general unless the medical institutions, the charitable societies, the municipal councils, and the governments cooperate. In the Arab countries there is pressing need for such work, and the distribution of pamphlets among women is not enough by itself. And if it is not possible to establish the work on the pattern described, then the existence of a health center under the supervision
of a registered nurse, to which women may come for guidance in what will bring them good and safety during their pregnancy, would fill a gap that we need filled; and around this nucleus there will no doubt grow up in the future a medical unit concerned with all that brings the mother well-being and safety from every side.