One quart of grain alcohol.

One pound jar of surgeon's green soap.

One half pound of castile soap.

One bottle white vaseline.

One drinking tube.

One medicine gla.s.s.

One two-quart fountain syringe.

One covered enamel bucket or slop jar.

One good sized douche pan.

Three agateware bowls, holding two quarts each.

Two agateware pitchers, holding two quarts each.

Two stiff hand-brushes.

One nail file.

One pair surgeon's rubber gloves.

One and one-half yards rubber sheeting 36 inches wide.

Two No. 2 rubber catheters.

Two dozen large safety pins.

Small package of tooth picks, to be used as applicators.

Six breast binders (Fig. 5).

Six sheets.

Just before confinement send for one ounce of fluid extract of ergot and an original pint bottle of Squibb's Chloroform.

THE PREPARATION OF THE SUPPLIES

1. _The sanitary pad_ is used to absorb the lochia after confinement, and needs to be changed many times during the day and night; fully five or six dozen will be required. They are usually made from cotton batting and a generous layer of absorbent cotton. If made entirely from absorbent cotton they mat down into a rope-like condition. They are four and one-half to five inches wide and ten inches long. The sterile cheesecloth is cut large enough to wrap around the cotton filling and extends at both ends three inches, by which it is fastened to the abdominal binder. With a dozen or fifteen in each package these v.u.l.v.a pads are wrapped loosely in pieces of old sheets and pinned securely and marked plainly on the outside.

2. _Delivery pads._ These pads should be thirty-six inches square and about five inches thick, three or four inches of which may be the cotton batting and the remainder absorbent cotton. Three of these are needed. Each should be folded, wrapped in a piece of cloth and likewise marked.

3. _Gauze squares._ Five dozen gauze squares about four inches in size may be cut, wrapped and marked. These are needed for the nipples, baby's eyes, etc.

[Ill.u.s.tration: Fig. 5. Breast Binder]

4. _Cotton pledgets._ These are cotton b.a.l.l.s, made as you would a light biscuit with the twist of the cotton to hold it in shape. They should be about the size of the bottom of a teacup. These are thrown in a couple of pillow slips and wrapped and marked.

5. _The Bobbin._ Cut the bobbin or tape into four nine-inch lengths and wrap and mark.

6. The _tooth picks_ are left in the original package and do not require sterilization.

7. _Sterilization._ Before steaming and baking, wrap each bundle in another wrapping of cloth and pin again securely. Mark each package plainly in large letters or initials. These packages may be sent to the hospital for sterilization in the autoclave or they may be steamed for one hour in the large wash boiler, by placing them loosely into a hammock-like arrangement made by suspending a firm piece of muslin from one handle of the boiler to the other. The center of the hammock should come to within five inches of the bottom of the boiler which contains three inches of boiling water. The cover of the boiler is now securely weighed down and the water boils hard for one hour, at the end of which time they are removed and placed in a warm oven to dry out. The outer wrapping may be slightly tinged with brown by this baking. After a thorough drying they are allowed to remain in the same wrappings into which they were first placed and put away in a clean drawer awaiting the "Natal Day."

REQUISITES FOR THE HOSPITAL

Each hospital has its own methods and regulations for caring for obstetrical patients and it is well for the expectant mother to visit the obstetrical section, the delivery-room and the baby's room, that she may personally know more about the place where she is to spend from ten days to two weeks. Here she may ascertain from the superintendent just what she will need to bring for the baby. Many of the hospitals furnish all the clothes needed for the baby while in the hospital; in such instances, the hospital also launders them. Other hospitals require the baby's clothes to be brought in, in which case the mother looks after the laundry. The mother always takes her toilet articles, a warm bed jacket with long sleeves, several night dresses and a large loose kimono or wrapper to wear to the roof garden or porch in the wheel chair. Warm bedroom slippers and a scarf for the head completes the outfit.

BABY'S NECESSITIES

Baby's basket on the day of confinement should contain:

One pound of absorbent cotton.

One pint of liquid albolene.

One half ounce of argyrol (mentioned in the mother's list).

Safety pins of a.s.sorted sizes.

A powder box containing powder and puff.

An old soft blanket in which to receive the child after birth.

A soft hair brush.

Three old towels.

Small package of sterile gauze squares.

Scales.

Diapers.

A silk and wool shirt (size No. 2).

An abdominal band to be sewed on with needle and thread.

A pair of silk and wool stockings.

A flannel skirt.

An outing flannel night dress.

A woolen wrapper.

THE CONFINEMENT ROOM

By special preparation, the ordinary bedroom may be fashioned into a delivery-room. Carpets, hangings and upholstered furniture must be removed. Clean walls, clean floors, and a scrupulously clean bed must be maintained throughout the puerperium. Bathroom, and if possible, a porch should be near by. In the wealthy home, a bedroom, bathroom and the nursery adjoining is ideal; but I find that real life is always filled with anything but the ideal.

The dispensary doctor is compelled to depend upon clean newspapers to cover everything in the room he finds his patient in. The only sterile things he uses he brings with him, and should he have to spend the night, the floor is his only bed. A student who was in my service told me that there was not one article in the entire home, which consisted of but one room, that could be used for the baby. He wrapped his own coat about it and laid it carefully in a market basket and placed it on the floor at the side of the pallet on which the mother lay and by the aid of a nearby telephone secured clothes from the dispensary for the babe.

Always select the best room in the house for a home confinement. If the parlor is the one sunny room, take it; remove all draperies, carpet, etc., and make it as near surgically clean as possible. While sunshine is desirable, ample shades must be supplied, as the eyes of both mother and babe must be protected.

THE BED

A three-quarter bed is more desirable than a double bed. If it is low, four-inch blocks should be placed under each leg, the casters having been removed to prevent slipping. The bed should be so placed that it can be reached from either side by the nurse and physician. The mattress may be reenforced by the placing of a board under it if there is a tendency to sag in the middle. Over this mattress is securely pinned the strip of rubber sheeting or table oilcloth. A clean sheet covers mattress and rubber cloth and at the spot where the hips are to lie may be placed the large sterile pad to absorb the escaping fluids.

The floor about the bed is protected by newspapers or oilcloth. Good lighting should always be provided. Much trouble and possible infection may be avoided by clean bedding, plenty of clean dressings, boiled water, rubber gloves, and clean hands.

CHAPTER VIII

THE DAY OF LABOR

As the two hundred and seventy-three days come to a close, our expectant mother approaches the day of labor with joy and gladness.

The long, long waiting days so full of varied experiences, so full of the consciousness that she, the waiting mother, is to bring into the world a being which may have so many possibilities--well, even the antic.i.p.ated pangs of approaching labor are welcomed as marking the close of the long vigil. These days have brought many unpleasant symptoms, they have been days of tears and smiles, of clouds and sunshine.

THE TIME OF WAITING

The prospective mother has thought many times, "Will my baby ever come?" But nature is very faithful, prompt, and resourceful. She ushers in this harvest time under great stress and strain, for actual labor is before us--downright, hard labor--just about the hardest work that womankind ever experiences--and, as a rule, she needs but little help--good direction as to the proper method of work and the economical expenditure of energy. In the case of the average mother this is about all that is needed, and if these suggestions come from a wise and sympathetic physician--one who understands and appreciates asepsis--she may count herself as fortunately situated for the oncoming ordeal.