XIV SIGNS AND SYMPTOMS: AFTER-EFFECTS

I have already in a previous chapter remarked upon the noticeable differences which arise between male and female pregnancy.

A boy may possibly cause a difficult first confinement not only because he comes into the world with a larger head, but also because his average weight is one pound more than that of a girl. It is some compensation to know that the after-effects of a boy-confinement frequently prove more pleasant and straightforward than those which attend upon the birth of a girl.

It is often said that the majority of still-born babies are boys, though this has never been fully proved, probably because so many still-born illegitimates are not registered; my own experience is rather to the contrary. “Placenta prævia” more often occurs with female issue, and it is generally due to the fertilised ovum embedding itself in the anterior or posterior wall of the uterus near the cervix. It may be that the position of the left ovary, which is on a higher level in the pelvis during intercourse, accounts for this frequent aberration of the ova.

Phlebitis, or inflammation of the veins, is likewise a more common complaint with girl-confinements. It is explained by the fact that any activity on this side more directly affects the functions of the heart. After the advent of a girl-baby, obstinate backache and symptoms of depression are also frequently noticeable, owing to the weaker ovary having greater difficulty in the healing of the corpus luteum and in the control of its own more obstinate discharge. Attention is called to this by the provision in Leviticus “If a woman have conceived seed, and borne a man-child, then she shall be unclean seven days ... she shall then continue in the blood of her purifying three and thirty days ... but if she bear a maid-child, then she shall be unclean two weeks ... she shall continue in the blood of her purifying three score and six days.”⁠[23] The Jews thus made allowance for the discharge lasting twice as many days after the birth of a female child as after the birth of a male.

There is no doubt whatever, that, even if the left ovary is not rendered hors de combat more easily than the right, it will always give the maximum of trouble on the smallest pretext. During pregnancy there may sometimes be a slight “show” at the ninth week, and sometimes after, which, though generally fairly trifling, is sufficient to be alarming. With a boy-pregnancy this may occur in the fifth week, but should it happen later on, it would mean a mishap. With a girl-pregnancy, however, it may often happen, and does not necessarily impede the satisfactory development of the female fœtus. Brierre de Boismont states that out of 1,200 cases, eight showed menstruation during the second, third and fourth months after conception, three showed menstruation occurring throughout the whole period of pregnancy, and one was the case of a woman who menstruated throughout her eight pregnancies.⁠[24] Dr. Nicholson, writing from St. John’s Island, says: “A regular monthly discharge during pregnancy is not an infrequent occurrence in this island, particularly with the whites of a sanguine temperament.”⁠[25] It would be safe to say that the result of such an anomaly would be the birth of a girl, for I do not know of a single case of a boy living longer than a few days, or possibly weeks, after such a gestation.

The first sure symptom of parturition with a female child is generally a “show.” In the case of male issue, in normal circumstances, this is rarely observed until after the waters are discharged. In fact, in practically 80 per cent. of all cases, the parturition of boys begins with the breaking of the waters. A similar proportion of girls herald their advent with a slimy mucus followed by red discharge. These facts go far to confirm the old French saying that “the sanguine temperament begets boys, and the lymphatic begets girls.” It may be that the male child assimilates more red globules and sanguineous tissue in its composition, whilst the female feeds readily on the lymphus and white particles of blood nutriment.

As time goes on experience teaches that the condition of the blood when a girl is carried has different characteristics from those in a male pregnancy. The quantity of fat and albumen is rather increased in the former and the proportion of fibrin and hæmatoglobulin possibly greater in the later. Certain deductions, as to these points of difference, have been gathered by the presence of fatty tissue all over the body affecting even the finger tips during pregnancy of a female child, whilst the contrary condition exists in the state of male pregnancy.

“Flooding” is more frequent after the birth of a girl than that of a boy, and the wearisome symptoms of over-profuse menstruation, appearing for months or even years after childbirth, are infinitely more persistent when a girl-baby has produced the weakness. Again, the displacement of the womb, and its inability to return to its normal size after confinement, is a distressing trouble due to the greater inherent weakness of the left side.

It is important to bear in mind that many unhealthy and delicate mothers would miscarry with a male fœtus whilst a girl-pregnancy might go full time.

As regards the actual labour, the first pangs, with a female child, are more apparent in the back and left groin, and the advent of the discharge soon makes the mother willing to lie up. With a boy, however, the pains are more apt to be felt in the stomach and down the right thigh, and it is easier to keep up and about until the last moments. A curious anomaly is that “after pains,” generally supposed to be unknown at a first birth, are frequently present in first girl confinements. I have not heard of a single instance where “after pains” accompanied the birth of a first child who was a boy. In a tedious labour, it is the first stages that are lingering and difficult with a girl, with a boy the latter stages are the worst.

One cannot sufficiently reiterate to all young women the criminal idiocy of attempted abortion. As a result of my clinical experience I have come to the most definite conclusion that the right ovary, lying as it does lower down in the pelvis, is the most easily damaged. Any adverse conditions affecting the womb may interfere seriously with its functions; such an occurrence as bleeding, as the result of an abortion, may so react on the right ovary and the Fallopian tube as to paralyse them and prevent all subsequent activity.

Where this occurs the left ovary straightaway takes upon itself the functions of both and with redoubled activity, discharges its ova, “capturing the trade” of its rival, so to speak. As we have seen, this ovary produces only female ova; so, henceforth, as a natural consequence, only female offspring will be produced by the damaged womb.

After a first fatal abortion, whether accidental or voluntary, too often a trail of girls will ensue, and I could tell of countless such instances. A lady, pregnant of her first child, slipped downstairs; as a result she gave birth to a still-born boy; the next six children were all girls. I know of another case where eleven daughters followed the premature advent of a male child. In yet another case sheer folly brought about the miscarriage at first pregnancy of a male fœtus; only after many years was the woman in question able to give birth to three children—all girls. In each of the above instances the birth of an heir was of the utmost importance in view of title or estates.

A lady who had given birth to seven daughters had subsequently five mishaps, each at four months, and every time she proved to have been pregnant of a male. Another lady consulted me, because after eight girls, she longed for a son; she became pregnant but miscarried at four months of a boy. I learnt that she had had two similar mishaps before her daughters were born.

It is safe to say that 80 per cent. of all miscarriages are the result of male pregnancies. I am able to give such a figure and to be positive as to its accuracy in my own wide experience, because of the possibility of diagnosing the sex of a fœtus at a very early stage. A striking demonstration of what can be done in this direction was given by Nagel, who distinguished a testicle in the youngest embryo ever successfully analysed with reference to sex; it was exactly five weeks old. And any abortion younger than that does not need to be considered in relation to sex determination.

All women then should be warned early in married life against any risk of miscarriage, that they may be on their guard against such deplorable results, the bane of motherhood. “Fore-warned is fore-armed,” and a huge percentage of the waste of life and energy which now prevails could be prevented if only a more sensible and normal view could be taken on the question of initiating young girls and women into the wonderful, yet simple, laws of maternity, on which all human welfare depends.