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fœtus so that the blood can flow back and forth between the fœtus and placenta.

By the end of the third month the limbs have definite shape, the nails being almost perfectly formed. During the next month the sexual distinctions of the external organs become well marked.

By the last of the fifth month the weight has increased to one pound and the length to eight inches. Active fœtal movements begin, that is, the fœtus begins to move around and not lie quietly as before. This is what is usually spoken of as "feeling life," or as "quickening." There is life from the very beginning but during the first four or five months the fœtus does not move about and so the mother does not "feel life." This has caused the erroneous idea that there is no life before the fifth month.

By the end of the sixth month the weight is two pounds and the length twelve inches. The eyebrows and eyelashes have begun to grow and the lobule of the ear is more characteristic.

By the end of the seventh month the weight is three pounds and the length fourteen inches. The surface of the body, which has appeared wrinkled, now appears more smooth owing to the increase of fat underneath.

By the end of the eighth month the weight is four to five pounds and the length twenty inches. The nails have grown to project beyond the finger tips. Up to this time the body has been covered with a fine hair called lanugo. This now has begun to disappear and the skin becomes brighter and is covered with a white, cheesy material called the vernix caseosa. This almost entirely disappears during the next month, but frequently there are portions of it remaining on the body at the time of birth. The fœtus is fully developed by the end of the ninth month. Then its average weight is six or seven pounds and the length twenty inches.

If we could look into the womb just before the time of labor we would find the fœtus attached by the cord to the placenta and floating in a sac of water. This sac is formed partly of the placenta and partly of the membrane; the side of the placenta opposite to the child being attached to the womb. Just before labor the child takes a position with its head downward, its lower limbs flexed and its arms folded upon its breast. This allows it to come in the usual way, head first. But sometimes, for various reasons, it does not take this position and some part other than the head, for instance, the feet, may be born first.

Labor pains are caused by the contraction of the muscles of the womb in an effort to expel the fœtus. The muscles, contracting, push the fœtus downward to the mouth of the womb but push ahead of it a portion of the membrane enclosing some of the water. This is called the "bag of waters." As it presses against the mouth of the womb it causes it to dilate so as to allow the fœtus to pass through into the vagina. The fœtus, preceded by the bag of waters, then descends through the vagina or birth canal until it comes to the external opening of the vagina. This it must dilate before it can pass through it. The bag of waters should rupture normally while it is being pushed through the external opening. Sometimes the bag does not rupture directly in front of the descending head but further up along the side. Then a portion of the membrane may be over the face of the child when it is born. This is what is called being "born with a veil" or "born with a caul."

The bag of waters helps dilate the parts much easier than the fœtus could do it alone. When the bag breaks the water lubricates the parts so as to make the passage of the child easier. When it breaks, as it sometimes does, at the beginning of labor we have what is termed a "dry labor." This usually is much slower than it would be otherwise. The majority of the cases of labor extend over a period of from twelve to twenty-four hours.

Sometimes the external opening of the vagina does not dilate enough to allow the passage of the child. As the head presses hard against the perineum it tears it. This tear should be repaired immediately after completion of labor.

When the baby is born it is fully formed but its lungs have never contained air. At the first cry the air rushes into the lungs and expands them. At birth there is a change in the circulation of the blood of the baby. Before this time, the blood has passed to and from the placenta through the cord but now this is stopped. Before birth there was an opening between the right and left sides of the heart but this closes during the first few days of the child's life. To assist in this closure, it is wise to keep the child on its right side for a few days. Rarely, this opening never closes and we have what is called a "blue baby," which seldom lives very long.

In a great many cases, painless childbirth could be a possibility by a little attention to diet, exercise and other hygienic measures during the last few months of pregnancy. Knowing this, it seems inconceivable that any woman would neglect to so fully inform herself on these matters that both she and her child could have all benefit of the investigations of science.

CHAPTER IX ABORTIONS

Sometimes through an accident or on account of disease, the womb expels the fœtus before it is fully developed. If this occurs before the end of the third month we call it an abortion; if it occurs between the third and seventh months we call it a miscarriage; while if it occurs after the seventh month but before the normal time of labor we call it a premature labor.

Formerly it was considered that there was no possibility of the child living if it were born before the seventh month. Now, by the aid of incubators, even those born at five months have a chance to live. By that time the body is fully formed, so the chief requirements are a steady temperature and proper care and food. Great care must be exercised, as a slight cooling of the air may result in the death of the babe.

Abortions are either accidental, criminal, or justifiable, that is, brought on to preserve the life of the mother. Accidental abortions may follow a sudden fall or a sudden shock, either mental or physical, to the mother. They may be due to some disease either of the mother or of the fœtus. Of the diseases responsible for abortions the one with the largest percentage is syphilis. It is estimated that this disease is responsible for forty per cent. of accidental abortions and miscarriages. Whenever a physician has for a patient a woman who gives a history of having had several abortions without any apparent cause and all at about the same age of the fœtus, he immediately becomes suspicious of syphilis either of the father or the mother. It is a peculiar fact with this disease that it may be transmitted to the offspring without the mother ever actually having the disease. This is an instance of "visiting the sins of the fathers upon the children unto the third and fourth generation." Many a weak frame owes its condition to a dissipated father, grandfather or even great-grandfather. It is possible, though, for a man or woman who has had this disease to have a healthy child if the disease has been properly treated.

Under some circumstances, especially with a deformed pelvis, if pregnancy were allowed to proceed normally it probably would result in the death of the mother. Then, it is considered justifiable for the physician in charge of the case to produce an abortion in order to save the life of the mother. Those cases are rare and such a procedure never is undertaken except in extreme cases.

Criminal abortions are those brought on simply because the woman does not desire to have a child. These often are produced by the woman herself by means of drugs that set up uterine contractions (labor pains) or by means of something introduced into the uterus. In either case it is a dangerous procedure. Infections may be carried into the uterus by means of whatever is introduced into it. This may set up an inflammation that may result in the death of the woman. It is a dangerous procedure to introduce anything into the womb. Some women are extremely foolish or reckless and use anything that may be handy. Sometimes grave harm results. Instances are on record of women who have punctured the walls of the womb by the use of hatpins or other sharp instruments. If an abortion is produced by either drugs or instruments there is danger that all the products of conception may not come away. If even a small portion remains in the uterus it may cause a hemorrhage or, becoming decomposed, produce a poison that may result in the death of the woman.

It would be impossible to estimate the number of abortions performed on unmarried girls, as well as married women, during one year by midwives, unscrupulous physicians and by many respected family physicians. We never hear of one of these except through the occasional one who is so unfortunate as to meet death. We cannot entirely blame the one who performs the abortion. Sometimes it is performed because of the sympathy of the physician. It is very hard to refuse some cases. Let me read you a letter to illustrate my meaning.

"I have just finished reading your article on 'Woman's Inhumanity to Woman' and wish to say that every word impresses the truth as read. My reason for writing you is because I am one of those who have sinned through love, with one I have known all my life only to find too late that he did not love me; and the sin is killing me. I do not want to bring into this world a little child to have no father. I am not bad at heart. My only hope is to get something that will bring me all right. If you are a doctor you can give me medicine that will help me miscarry this, as I have only missed two months. Nothing would please me more than to be the mother of a little one, but, oh, not one born without a name. Dear madam, if you can help me, or show me some way that my people cannot suspect me of this sin, for the love you bear all girls, help me. I am the only one at home to care for an aged father and one of the dearest brothers that ever lived. If he knew I had sinned as I have, it would break his heart. My God in heaven, help me! is my prayer, and through his love you can help me. I am almost desperate and before I will live and bear this sin I will take my own life, which will bar me from heaven and my angel mother's face. Be gracious, kind doctor, and help me. I will repay you if it takes the remainder of my life and give my solemn promise that I will sin no more. Erring through the love of a man is my only excuse and, oh, I am the one to bear the blame. He would be forgiven. I am so nervous and ruined in mind that I hardly can

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