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Motherhood at Home

After nine months of planning and one week in the hospital, the moment for you to return home with your baby has finally arrived. It is a triumphant, exalting, memorable event. Don't mess it up.

The First Day

The Return. Returning home is an event to be shared and cherished with your husband - no one else. If you happen to live in a three-room, walk-up apartment and your parents or your in-laws beg you to bring the baby home to their twenty-room country estate, take the baby to your own three rooms. Learn to love him and live with him and raise him by yourself. If Grandma wants to come over to your place and help you cook or clean or do the laundry, fine; but you take charge of the baby.

The Siblings. If you have other children at home, your return should be planned in advance with their tender feelings in mind. They want to see you, not the baby. No matter how convincing they may be to the contrary, they are going to hate the baby - most especially on this crucial day. So shower them with attention and show them the baby later, with a minimum of fuss and a maximum of reassurance that you still love them too.

The Fatigue. The first day home will be emotionally and physically exhausting. It's best not to go home until midday. Don't tackle the housework yet. Don't invite your friends over yet. Enjoy your family and get to bed early.

Help

The Family. Lots of women manage beautifully during the first few weeks at home with no help other than the little they receive from their husbands. Some self-sacrificing new fathers plan their vacations to coincide with the due date for this reason. In many other cases one of the new grandmothers lends a helping hand. Any hand is helpful during the first few weeks, especially if the hand is properly used.

Nurse or Maid? If none of these alternative sources of assistance is available to you, you may be in the market for a baby nurse. It has become very fashionable to hire these professional nannies to take over the early baby care. You can usually find one through a friend or through an agency. Sometimes you'll get a registered nurse, more often a practical nurse, and most often a specialized baby sitter.

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What happens when you hire a baby nurse? Most likely you will find that she takes over the baby while you take over the housework. Fewer and fewer baby nurses these days deign to wash a dish or mop a floor.

The disadvantages of such a setup are apparent. If this is the only kind of baby nurse you can get, you will be better off with a part-time maid. The baby is yours. Take care of him yourself.

Activities

Taboos. The advice given to patients varies from doctor to doctor, but in general it will include abstinence from tub baths, douches, and sexual intercourse. You may be asked to refrain from baths for two weeks, douches for four, and sex for six. There is difference of opinion on this subject, that it is simpler for the patient to avoid all three of these activities until her first postpartum visit in six weeks. If you are bleeding wear a pad, not a tampon, for the first two weeks. If you want to wear a girdle, go ahead, though it is usually not necessary.

Daily Doings. Showers and shampoos are permissible. Lifting and climbing should be limited as much as is feasible. As for the everyday activities of housework, driving, shopping, and socializing, it seems ridiculous to me to lay down any specific rules. Most new mothers can feel their own way in this regard; they vary tremendously in their desires and abilities to recuperate. The same instructions, for example, could hardly be given to women with four other children and no help and to women with four servants and no other children.

Obviously you will not want to go out the day you get home and play three sets of tennis or move the furniture. If you overdo, you will tire. Nature will help you set the proper pace. Take a nap every day, if you possibly can, especially while the baby is getting you up at night. By and large it is preferable to devote most of your first week to care of the baby. This will keep you plenty busy. Your mother, nurse, maid, friends, or - if worst comes to worst - your husband can help with the housework. The second week you will probably begin to feel cooped up. If so, there is no reason why you can't go out for a short while. By the third or fourth week you should feel as good as new.

Calisthenics. Flabbiness of the abdominal wall is a universal complaint which becomes louder after each successive pregnancy. The modem woman wants to know what can be done about it. Any form of abdominal exercise will help to remedy the situation and every new mother is inevitably involved in plenty of bending and stooping in connection with her daily chores. But if you want to feel that you are making a more definite effort in this direction, any calisthenic which tightens the abdominal muscles will fill the bill. Lie fiat on your back and lift your legs stiffly, one at a time, and then together. Or, if you really want to suffer, lie on your back, and with your knees unbent lift your heels about one inch off the floor; then inscribe tiny circles in the air with your toes without letting your feet touch the ground.

Diet

After delivery the mother can usually resume her normal eating habits. If you haven't lost as much weight as you had hoped, however, you will want to reduce your calories accordingly. You will know now the importance of beginning your next pregnancy at your ideal weight. Nursing mothers require the same scrupulous dietary regulation as they did before delivery. They should continue to eat well-balanced meals with emphasis on protein, iron, calcium, and vitamins. Continue to take your prenatal capsules as long as you're nursing, and drink at least two glasses of milk a day. No food you eat while nursing will adversely affect the baby, but you should check with your doctor before taking any drugs.

Menstruation

Most non-nursing mothers have their first menstrual period within eight weeks. It may appear any time after the first month, and this first period is apt to be peculiar. It may be profuse or prolonged, scanty, or intermittent. Nursing mothers, on the other hand, may not have any periods at all as long as they continue to nurse. There are many exceptions, though; it is not unusual for the first period to occur about four months after delivery. It has long been thought that it is impossible to become pregnant again while nursing. Lactation does, indeed, provide protection against pregnancy which is fairly reliable, but not completely so. In other words, don't count on it. It is also widely believed that a pregnancy which develops during the nursing process will be adversely affected. Not so.

Complications

It is unusual for complications to arise more than a week after delivery. When unexpected symptoms do develop, however, it is good to know what they mean First on the list of possibilities is bleeding. Delayed hemorrhage may occur any time during the first month Occasionally it is due to retention in the uterus of a small fragment of placental tissue, which must then be removed by curettage. More often it is due simply to involution of the site of placental attachment and requires no specific treatment, except perhaps for Ergotrate, an oxytocic drug which your doctor will prescribe.

Infection is likewise rare after leaving the hospital. The most common sites of infection at this stage are the breasts, the urinary system, and the womb. Fever is common with all three conditions. Breast infection (mastitis) will manifest itself through tenderness and reddening of the breast. Infections of bladder (cystitis) or kidney (pyelitis) may be associated with frequency of urination and a burning sensation while voiding. Infections of the uterus (endometritis) will usually cause foul-smelling vaginal discharge. Any such symptoms should, of course, be reported immediately to your doctor.

When you stop nursing, you may be troubled with some degree of breast engorgement. The breasts may become hard and painful. As mentioned in connection with the non-nursing mothers, there is no specific treatment for this condition. The best remedies include good round-the-clock breast support, aspirin, and ice bags. Limit unnecessary fluids but continue to drink as usual at mealtime. The swelling will subside in two or three days.

Baby Care

Taking home the first baby is a somewhat frightening experience. Such complete responsibility for a human life will seem a little overwhelming at first. But pregnancy and labor were strange new challenges only nine months ago and you have survived them, probably with greater equanimity than you expected. Baby care can hardly be any more difficult, in view of the millions of mothers who seem to have mastered it. Of course you want your child to surpass all others in the emotional, intellectual, and physical spheres. And you want to assure these assets to him from the very first month.

No matter what you desire for your child's future, right now it is vitally important that you understand the capabilities and the limitations of a newborn infant. As for his capabilities, they are pretty limited: he can suck, wiggle, cry, urinate, defecate, and that's all. His powers of sight and cerebration are very, very limited. He can feel you, but he can't see you. He has lain curled up in your womb so long that he can hardly extend his arms and legs, and he can't coordinate his muscles enough to reach out for something he wants. Above all he will instinctively cry from pain or hunger, but he will not cry, at this age, because he is scheming for attention.

A newborn baby needs only four things: warmth, food, sleep, and love. The warmth is easy. Bundle him well in winter weather; a light blanket will do in a well-heated room; a shirt should suffice in the heat of summer. There is no reason the food should be a problem. He will cry when he's hungry. It will soon become apparent that he is hungry every four, or sometimes every three, hours. If he cries at shorter intervals and he's not lying on an open safety pin, don't try to read any diabolical motive or frightful malady into his cry. No one can interpret a baby's every cry; don't try. It is to be expected that an infant will cry without reason for one or two hours a day.

As for love, you cannot give a newborn baby too much love. You can't spoil a baby this soon. The most propitious time to demonstrate your love is, of course, at feeding times. Whether you breast feed your baby or bottle feed him, cuddle him, kiss him, hug and caress him. Food is a baby's greatest physical need. Mealtimes are his most wakeful moments. Let him associate the fulfillment of this need and his earliest awareness of the world with love.

The Postpartum Visit

Your doctor will probably want to see you in his office four to six weeks after the delivery. In many ways this may be regarded as the most important appointment since the very first one, nine months ago. He will want to know all that has transpired in the past six weeks with regard to your breasts, your menstruation, your general health, and your baby. Your weight, breasts, abdomen, and genitalia will be rechecked to see what effect the pregnancy has had upon them.

The Pelvic Exam. Pelvic examination at this time is important. The opening of your vagina may be more relaxed because of the delivery or, if you had a proper episiotomy, it may actually be a little tighter than before. It is almost routine at this time to discover an erosion or “sore” on the cervix, indicating that this organ has not yet completely healed. Further healing may occur spontaneously, it may be hastened by warm vinegar douches, or it may eventually require treatment with cautery.

Another common and even less significant finding at this time is retroversion or tipping back of the uterus. This is a normal condition before pregnancy in many women. Fifty years ago retroversion was held by the medical profession to be responsible for all sorts of female troubles from backache to sterility. It is now known to be a harmless variation in anatomy which has no more medical significance than brown eyes. Some doctors prescribe the “knee-chest exercise” to help “correct” this condition. The patient is told to position herself in bed with her shoulders flat against the mattress, the knees flexed under her and spread about a foot apart, the buttocks up in the air. Assuming this position for twenty minutes twice a day will bring the uterus forward for forty minutes a day.

Birth Control. Now is the time to discuss family planning with your obstetrician. There is no valid medical reason why a healthy woman cannot have her pregnancies one right after the other. Some women prefer it this way, so that their children will grow up together and the parents will finish with diapers once and for all. Others prefer to space their children two, three, or more years apart. If you decide on the latter course, you should be prepared to choose a birth-control method at this postpartum visit.

In order for you and your husband to reach a more intelligent decision on what type of birth control you want, I shall briefly describe the more popular methods. You will then, of course, want to discuss your preference with your obstetrician, for there may be medical reasons why a particular method may not be suitable for you.

The Pill. Taken as directed - for twenty, twenty-one, or twenty-eight days a month (depending on the type of pill) - oral contraception is 100 per cent effective. It works by preventing ovulation. If you are nursing your baby, don't take the Pill until lactation is well established. The Pill is not for you if you have bad veins, migraine, fibroids, hypertension, diabetes, or liver disease. For healthy young women, however, the Pill is practically harmless.

The I.U.D. Made of plastic or other inert materials and designed in a variety of modernistic shapes, the intrauterine device is inserted by the obstetrician and allowed to remain in place indefinitely if it does not cause trouble. Sometimes it causes the menstrual periods to be heavier; occasionally it falls out. For many women, though, it provides excellent protection without requiring interference with the sex act.

The Diaphragm. This is the method your mother probably used. The diaphragm is a thin sheet of rubber stretched over a collapsible metal ring. It can be obtained, on prescription, after the doctor determines your size. Smeared with a spermatocidal cream or jelly, the diaphragm is inserted into the vagina before intercourse and removed six or more hours later. Although about as reliable as the I.U.D., its insertion can interfere with foreplay and many find it messy.

The Condom. The fourth and last of the reliable methods, the condom is the only one under the man's control. It is especially effective when used in conjunction with a spermatocidal jelly. Its chief disadvantage is a lessening of the perception of sexual sensation by both partners.

Jellies, Creams, and Foams. Although easy to use and available without prescription, these methods are inferior to the four described above. If your sex life is sporadic, you need extra lubrication, and/or you don't demand nearly complete protection, try them. Otherwise, conquer your fear of the Pill or the I.U.D. and go modern.

Rhythm. The only method approved by the Roman Catholic Church, rhythm entails abstaining from sex around the time of ovulation. With regular periods this means sleeping alone for seven to ten days a month – longer, of course, if your periods are unpredictable. You doctor will help you work out a schedule. Practiced religiously by regular women it does work.

Lactation. It is widely believed that it is impossible for a woman to get pregnant while she is nursing. This is not true. Nursing does have some contraceptive effect (through suppressing ovulation), but not nearly enough to rely on.

The End. After your final examination you will return to your obstetrician's office to hear whether you have completely mended, to ask whatever last-minute questions you have, and to revel in the satisfaction of what you've accomplished. If you are back to normal, you will be allowed to resume tub baths, intercourse, and all your usual activities. You can lead a normal life again - better, bigger, busier, and more rewarding. Take good care of that baby and come back next year for your checkup.

Health | Reproduction | Pregnancy


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