Care for the pregnant woman is a branch of preventive medicine. Its purpose is attention to the mother during her nine months of pregnancy, so that she preserves her health and vigor; complete watchfulness over her in the hours of delivery, so that she escapes its dangers; and supervision of the days of her confinement, so that it may be normal and short in duration and she may regain her strength and vitality, and so nurse her child and feed him the nourishment he needs.
Yes, pregnancy, which is among woman's most sacred functions, is a natural physiological event; but it produces in the mother's body certain changes in her organs which demand complete attention, for the difference between health and illness is very slight and may escape the discernment of the ordinary woman. Especially in pregnancy, this small divergence between health and the morbid state may lead the expectant mother into a grave illness, and perhaps to the loss of her life, or the life of the fetus, or both together.
Accordingly, attention to the pregnant woman's physiological condition, and watchfulness over the changes that may come upon her, has become a very necessary matter. And who is worthier than the physician to attend to it, to care for her affairs and take note of every symptom that may appear in her? He can do this only if the mother consults him at the beginning of the pregnancy and places all her confidence in him; then he can look after her, and after what she eats, drinks, and wears, and the rest, sleep, and exercise she needs.
It is not enough to attend to the pregnant woman during her months of pregnancy alone; she must be brought to the hours of labor strong and sound, so that she bears a strong, sound child, able to feed on her milk and draw from her an immunity that enables him to overcome the infectious diseases to which he is exposed. Experiment has shown
that strong, regular contractions of the womb during delivery are a principal cause of overcoming many of the difficulties of child
birth, and these contractions are closely bound to the mother's state of health and the kind of food she eats. Attention to the pregnant woman's diet is therefore very necessary, and her diet differs from ordinary diet not in quantity but in kind.
The first and most important of the foodstuffs are the albuminous substances — that is, the proteins. If they are lacking in an individual, he feels general weakness, low vigor, emaciation, and quick fatigue, and becomes prey to infectious diseases through weakened immunity. The pregnant woman needs a large quantity of these albuminous substances. The enlargement of the womb and the swelling of the breasts require proteins, and when the child is born there are 500 grams of them in his body, most of which he takes from his mother in the last months of the pregnancy. The mother herself needs, over and above this, a reserve of 500 grams; protein must therefore be given to the pregnant woman in large quantities. These albuminous substances are found in milk,
cheeses, meat, fish, and bread.
As for the starches, they are easy to digest and a source of bodily heat. In the pregnant woman the rate of metabolism rises, especially in the last months of her pregnancy, to 25 percent. Fortunately, a lack of starches seldom occurs except in cases of severe hunger, since they abound in ordinary foods, particularly when the proteins in the diet are high.
The fats are needed by the body only because they contain vitamins A and D, since fats can be built up from the starches; and since the pregnant woman is prone to stoutness, there is no need to eat fats unless a loss in her weight is observed. Fats are found in milk, oil, butter, and meat.
As for the mineral salts, the most important are calcium, iron, phosphorus, and iodine, with a little copper. The growth of the bones depends on the calcium
that reaches them by way of the bloodstream. Every seven weeks calcium substances are deposited in and withdrawn from the bones