Sex efficiency through exercises : special physical culture for women / by Th. H. van de Velde ; [photos, by E. Steinemann].

CHAPTER XIV EXERCISES AFTER CHILD-BIRTH Two benefits should accrue from these exercises. They should have a general healing and restorative effect on circu- lation, respiration and metabolism, thus helping to com- pensate for the very high organic demands of pregnancy and birth, and to counteract the peculiar perils following delivery. And, in the second place, they should help the involution, the return to normality of the stretched and slackened body, especially of the abdominal and perineal muscles, so that no lasting harm ensues. Both purposes are of equal value. But first and foremost: exercises after child-birth should not defeat their own purpose : they must not harm, instead of helping. Therefore, there should be no strain, nothing convulsive and perhaps even more urgently, there should be no rigid, cast-iron standardisation. Body and mind of the patient should give the keynote. All depends, e.g., on whether she is in good condition or weakened by considerable loss of blood; whether her delivery was easy or had to be com- pleted by artificial means after prolonged labour ; whether there have been lacerations of the genital tissues or not; whether there is risk of post-partum haemorrhage ; whether there is any rise of temperature—all these considerations are highly important. To mention only one example, whose significance must be obvious : if there is no laceration of the perineum, direct exercises of the muscles of the pelvic floor should begin on the third day ; but, if there are perineal tears, these exercises should not begin before the first week is at an end. Of course, only the physician is able to judge all these factors adequately. Sometimes, the midwife is able to take over responsibility, but she should ask expert advice in case H9