The Prospective Mother | Page 6

of miscarriage. Since

miscarriage often occurs about the time a menstrual period would ordinarily be expected,
there is unusual opportunity for confusing the symptoms. At all events women err much
more frequently in suspecting that they are pregnant than in overlooking the condition.
Indeed, pregnancy is not likely to be overlooked unless menstruation has been irregular
or suppressed for a month or more previous to conception. Thus, in the case of nursing
mothers in whom menstruation is already suppressed and who are, moreover, deprived of
certain evidence that the breasts give, pregnancy may sometimes advance several months
before it is recognized.
The Changes in the Breasts.--Various sensations in the breasts are accepted by women as
a reliable sign of pregnancy; thus throbbing, tingling, pricking, or a feeling of fullness
will be mentioned by one mother or another as having given her the first intimation that
she was pregnant. A few women also find their breasts become tender immediately after
they have conceived; this may be so marked that they cannot bear pressure. But unless
such symptoms are accompanied by definite, visible changes, they have no value as signs
of pregnancy.
About the end of the second month the nipples become larger and more erectile, and
deepen in color. The pigmented, circular area of skin which surrounds the nipple, called
the areola, also darkens. The shade that the areola assumes will vary according to the
complexion of the individual, growing darker in brunettes than in blondes. Ultimately,
within this pigmented circle a number of elevated spots appear about the size of a large
shot. These spots betray the presence of tiny glands always located there which, on
account of the better state of nutrition during pregnancy, grow larger, and generally
become visible.
Usually, after two menstrual periods have been missed the breasts increase in size and
firmness, and often the veins which run just beneath the skin stand out conspicuously.
Before very long it is possible to squeeze from the breasts a fluid which many persons
believe to be milk, though it is really colostrum, a substance that resembles milk but very
slightly. At first colostrum is a clear, white fluid, but in the later months of pregnancy it
becomes yellow and cloudy.
None of the changes in the breasts are absolutely characteristic of pregnancy; even the
secretion of colostrum has been noted in association with various other conditions.
Furthermore, as a sign of pregnancy the presence of colostrum is totally deprived of value
in the case of a woman who has recently nursed an infant, for a small quantity of milk or
colostrum often remains in the breasts for months after the infant is weaned. In general,
however, women who have not been pregnant before should assume that they have
conceived if, after missing a menstrual period, they note the characteristic changes in the
breasts.
Morning Sickness.--Soon after conception many women suffer from nausea and vomiting,
especially on rising in the morning. "Morning sickness" usually passes off in a few hours,
although it may be more persistent. Perhaps this manifestation occurs more frequently in
the first than in subsequent pregnancies, but certainly one-half, and probably two-thirds,
of all prospective mothers suffer from it. Usually the nausea begins just after a menstrual

period has been missed, and ceases about the third month or a little later.
But morning sickness is never counted an indication of pregnancy unless taken in
conjunction with other symptoms, for individuals who are not pregnant may also suffer
from nausea in the morning. On the other hand, a number of prospective mothers escape
morning sickness altogether, and a few experience nausea at other times of day.
Disturbances in Urination.--It is not an uncommon belief that some characteristic change
occurs in the urine shortly after conception. But this is not true; at least no change is
revealed by any method of analysis known at present. Yet there are symptoms associated
with the passage of the urine which appear very promptly and prevail for several weeks.
Chief among these is the desire to empty the bladder frequently; some patients also have
difficulty in urination, and a few experience discomfort with it. All the bladder symptoms
gradually disappear about the fourth month, but become prominent again toward the end
of pregnancy.
Since the inclination to empty the bladder more often than usual may be due merely to
nervousness or to many other conditions, this symptom taken alone cannot be regarded as
a definite sign of pregnancy. Indeed, it is mentioned, not because of its importance, but to
point out that it is in no way connected with the kidneys, as patients are sometimes led to
believe. It is a direct and natural result of pregnancy. Since the womb enlarges and tilts
forward at a more acute angle than formerly, it presses against