What Do You Advise the Expectant Mother?!

Q — Doctor, ever since the first week of my pregnancy my mother's instructions to me have multiplied: not to move about, to take to my bed, to sleep and rest. She has forbidden me to climb stairs or to ride in automobiles — so much so that I have grown very weary of this situation, and I should like to ask you: is there any scientific justification for all these precautions?

A — The first thing I want to assure you of, Mrs. Fakhoury, is that pregnancy is a natural condition; it is not a burden upon the expectant mother, nor is it a state of illness. The expectant mother should go on with her life as it was before the pregnancy, carrying out all her household affairs — except at certain times.

Q — What are these times?

A — They are the dates on which the menses would have been due, during the first four months. At these dates only must the expectant mother avoid carrying heavy things and riding in automobiles over long distances. As for housework, the expectant mother continues to do it as before — provided, of course, that her health is normal as before. But if she has previously felt pain or abnormal symptoms, then in that case she must consult the doctor and keep to her bed.

Q — I often hear from my women friends of the severity of the morning sickness that struck them in the first period of pregnancy, and I was surprised when I had my own experience and felt no change at all — my life now differs in nothing from before. Does this mean that my friends, and the other women who are stricken with morning sickness, are under a psychological influence, or that it is a matter of "coquetry" — or is morning sickness a scientific fact?

A — You, Mrs. Fakhoury, are fortunate not to have felt any dizziness or change in your life. Morning sickness is not all coquetry or delusion; many cases of it are genuine.

Q — And what, I wonder, is the cause of these cases?

A — Some cases of morning sickness have medical explanations, such as nervous symptoms, and the fetus's secretion of various toxins that affect the kidneys... Yet in most of these cases we are able to treat the expectant mother and to stop the dizziness and vomiting by modern medical means.

Q — The second question that has occupied my mind of late is this: when should I visit the hospital and undergo general examinations? ... I feel that consulting a specialist is a necessary thing, but whenever I mention it before my mother she says to me: "The name of God be about you! What do you want with the doctor? Take your time — wait for the seventh month..." So I should like to ask you, Dr. Abouchdid: when should the expectant mother consult the doctor who is to supervise her throughout the pregnancy, and who will accordingly be responsible for her delivery?

A — You put it well in that last phrase, for it is essential that the expectant mother place herself, from the very beginning, at the disposal of a specialist who undertakes to supervise the development of her condition and to give her the necessary scientific guidance. Consultation of this doctor begins from the moment the pregnancy is confirmed, when the doctor performs the various analyses and examinations... After that, the expectant mother visits her doctor's clinic once a month during the first seven months, once every two weeks in the eighth month, and once every week in the ninth month... The task of the doctor who supervises the expectant mother is to prepare her for a sound, natural delivery.

Q — And what, Doctor, are the dangers to which the expectant mother may expose herself by neglecting this matter and contenting herself with the opinions of old women and neighbors?

A — The dangers to which the expectant mother is exposed are many. In some instances the doctor discovers certain cases of blood pressure, or diseases of the heart, or tuberculosis, or diabetes, or diseases of the kidneys, without any previous signs, through the analyses, examinations, and X-rays he performs upon the expectant mother. It is then easy to treat her while the disease is still in its first stages, to care for the fetus and its position, and to secure safety and health for it and for its mother.

Q — There is another matter that occupies my mind a great deal. Before the pregnancy my teeth were strong — I never once had to visit my dentist or felt an ache; yet all through the past week I have noticed that my teeth twinge, contrary to the usual. Has this condition anything to do with the pregnancy?

A — Of course — and I am glad you raised this question, for it is very important. The expectant mother gives her fetus, during its formation, of her own bodily strength, especially the calcium matter that builds the skeleton and, later on, the teeth... It is therefore natural, as a result of this deficiency that befalls the mother's body, that certain signs of want should show themselves in the mother, and it is a very ordinary thing for the expectant mother to feel twinges and aching in her teeth. My counsel to her is to take plenty of calcium foods, such as milk, laban, cheese, and butter — and to visit the dentist.

Q — But my mother, and everyone else, assure me that an expectant mother must not visit the dentist, because there is danger in it to the fetus. Is their opinion exaggerated, then?

A — It is the habit of mothers and old women to exaggerate with unnecessary precautions, and to treat the expectant mother as though she were ill, whereas pregnancy is a natural condition, as I have already said. Nevertheless, I admit that there are exceptional cases, when the doctor forbids the expectant mother to have teeth extracted; but this is not a rule — only an anomalous circumstance.

Q — Thank you, Doctor; then I shall visit the dentist tomorrow, and without the least hesitation... My next question: I feel a good appetite for food — may I eat as I please?.. My mother-in-law presses me to eat a great deal, saying: "You must eat double what you ate before the pregnancy." Is this scientifically correct? And what is the average increase in an expectant mother's weight?

A — In answer to your question, Mrs. Fakhoury, I say: the expectant mother must make certain that her weight does not increase, over the whole period of pregnancy, by more than ten kilos. Half of this increase occurs, naturally, in the last three months... I would therefore call the attention of expectant mothers to this: let them consult their own doctor if their weight increases, in the first three months, by more than two kilos.

Q — And in the event the weight increases more than this, what do you advise the expectant mother to do?

A — In the event of more increase in weight than is needful, the expectant mother must cut down her eating of starches, above all chocolate and sweets of every kind; and if she goes on gaining, let her lighten her use of salt and take to walking in the open air.

Q — And in what period of the pregnancy, Doctor, do you advise plenty of walking?

A — Naturally, walking in the last two months is more necessary than in the preceding months, to ease the delivery and to lighten the fat and the child's weight.

Q — Another question, Dr. Abouchdid: in which emergency cases must the expectant mother hasten to consult her own doctor — I mean the cases in which there is danger to the safety of the mother or her fetus?

A — Yes, there are emergency cases whose signs the expectant mother must not neglect; rather, she must consult her doctor at once: when she feels a sharp headache, or a pain in the lower abdomen, or in the back or the stomach, or if the vomiting grows severe upon her.

Q — And now, what is the Doctor's opinion of the notion of the "craving" — that is, the belief of our grandmothers that if an expectant mother craves something, cherries or mulberries for instance, and scratches some spot on her body, the image of the thing she craved will be drawn, on the fetus's body, at the spot she scratched?

A — What I know is that the notion of the "craving" current among our grandmothers rests on no scientific foundation.

Q — I have often wondered to myself what kinds of bodily exercise I may practice, and in which months it is allowed.

A — That is a personal question, and every expectant mother has her own particular instructions. I do not forbid an expectant mother accustomed to dancing, tennis, and swimming from practicing these sports in moderation, up to the sixth month; after the sixth month, however, I prefer that the expectant mother take plenty of moderate walking, as I have already said.

Q — And finally, what is your opinion of wearing the girdle, or corset — do you advise the expectant mother to avoid it?

A — No, not at all. There is no objection to wearing the corset for those accustomed to wearing it — again, up to the sixth month, for wearing it in this case prevents pain in the lower back. In the final months, however, the corset must be suited to the shape of the abdomen, so that it does not press upon the fetus.

Q — I am most grateful, Dr. Abouchdid, for your counsels, which have opened before me horizons of knowledge beyond all price!