The Prospective Mother | Page 6

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 the bladder, giving the same sensation as when the bladder is distended with urine.
Although the presumptive signs which we have considered by no means exhaust the list, all the others are totally untrustworthy. Each of the more reliable symptoms, as we have seen, must be accepted cautiously; but taken altogether, except in very unusual cases, they may be relied upon. _If, for example, menstruation has previously