SIGNS OF PREGNANCY 295

without being pregnant may miss their menstrual periods for some time
after illicit intercourse simply from, fear and nervousness. In married
women an, intens^-desjre for pregnancy jtnay stop menstruation for some
time. Pregnancy may occur in a^oman^who has never menstruated. It
has already been mentioned that pregnancy has occurred in some cases even
after the climacteric period. It may also occur in a woman during the
amenorhhcea of lactation. When a woman suckles her child she does not
usually menstruate for the first isixmonths afterfjdeliyery, but it is quite
possible for her to be impregnatSctlffij^ relates the

case of a woman who was delivered of a healthy full-term female child on
February 2, 1929. The child was breast-fed and the mother never men-
struated. She was again delivered of another fully developed female child
on December 1, 1929.

In rare cases menstruation may occur for the first two or three periods
after conception until the decidua vera and decidua reflexa are separate.
They generally adhere to one another about the twelfth week of pregnancy.

Lastly, a woman may practise deception on the medical jurist by
denying the stoppage of the monthly course, and imitating the catarnenia by
blood, if she wants to conceal pregnancy. Similarly, she may conceal
menstruation if she feigns pregnancy.

2. Morning Sickness.—Nausea or vomiting, usually as a sign of preg-
nancy, most frequently occurs soon after the woman rises from bed in the
morning. It commences about the beginning of the second month, and lasts
generally till the end of the fourth month. It may, however, commence
soon after conception. It is not a reliable sign, as it may occur in gastric
troubles or chronic alcoholism, irrespective of pregnancy.

3. Sympathetic Disturbances.—Salivation, perverted appetite in the
form of longings or cravings for very strange and even disgusting articles of
food, and irritable temper are a few of the conditions which are caused
reflexly by pregnancy.

4. Quickening.—The first perception of the foetal movement felt by the
mother is known as " quickening ". It is attributed to the uterus coming
into contact with the abdominal wall, and occurs at any time between
fourteen and eighteen weeks. When quickening is felt, the woman is said
to be " quick with child ". The sensation of quickening may be simulated
by flatulence and peristaltic movements of the intestines, especially in a
nervous or hysterical woman, who is anxious to have children, although she
is not pregnant.

None of the above signs are reliable, and the medical jurist should
never venture an opinion on these signs alone.

OBJECTIVE SIGNS

These are—

1. Mammary changes. 7. Intermittent uterine

2. Pigmentation of the skin. contractions.

3. Changes in the vagina, «• Fcetal movements.

4. Changes in the cervix uteri. -J Ff^f so™ ,

- o, Pj_ . T ., .,,, r 10- -bsetal heart sounds.

5. Softening and compressibility of n Ballottement.

the lower segment of the uterus. 12. X-Ray examination,

6. Enlargement of the abdomen. 13. Biological Test.

1. Mammary Changes.—From the very commencement of
the breasts become full and tender, and by the second month

_ _ ••..._ - - •._•..

4. Brit. Med. Jour., April 11, 2981, p. 652.