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Classical Obstetrics

The art of classical obstetrics is really interesting to me. I have a keen interest in medical history in general, but combine that with my natural love of babies and the process of growing them? It's a winning combination.

Once upon a time, if you can believe it (!), there was no way to declare a woman positively pregnant in the early weeks of her pregnancy. Physicians relied on various physical changes for their diagnosis, and as you will see, they are not absolute by any means.

On various internet forums or bulletin boards you might come across a post from a woman asking about Chadwick's sign because she swears her vagina is purple. Or perhaps someone is wondering about her softened cervix - is that a sign of pregnancy or pending AF? she wonders. Read on and see if there is any truth to these "old-fashioned" clues and find out exactly what a doctor had to observe or discove to declare you pregnant.

Chadwick's Sign

French physician Etienne Joseph Jacquemin (1796-1872) is responsible for this discovery. It is also known as Hyperpigmentation of Pregnancy and is a bluish discoloration of the vaginal tissue, vulva and cervix. Its cause is venous congestion (which simply means extra blood flowing through the veins in the area). It can be visible as early as 6-8 weeks following conception - which as you may know would not be what we would consider an "early" sign of pregnancy.

It also must be noted that impending menstruation can also give the cervix a blue or purple hue. How's that for rude? So if you are actually able to view your cervix, noting its color will not do you a bit of good.

Goodell's sign

I couldn't find the source of this sign, but all you really need to know is that it is when the uterine portion of the cervix (as well as the vagina) soften. This also tends to occur at 6-8 weeks, but can occur earlier.

Everything I have read on the subject indicates that you cannot count on the softness or firmness of your cervix to indicate pregnancy - only ovulation. However, from personal experiences that I have read, many pregnant women do report this as something they did experience, but it cannot be considered a definitive sign of pregnancy.

Hegar's sign

Now, this is one that probably even the most talented and motivated woman couldn't find on her own (and I do not recommend trying), but I wanted to include it anyway as it is also one of the signs that doctors relied on "in the old days" to diagnose pregnancy.

Hegar's sign was first described by German physician Ernst Ludwig Alfred Hegar in 1895. The lower portion of the uterus (just above the cervix but below the fundus, which is the very top of the uterus) gets significantly softer during the first trimester and can be noted via bimanual examination (something only a doctor can do). It is described as feeling as though the cervix is actually separate from the uterus.

Again, as with all of these three signs, pregnancy cannot be definitely diagnosed with this sign present, and its absence doesn't exclude it.

Fetal Heart Tones

Another way doctors of the past would determine if a pregnancy existed would be by listening for a fetal heart rate. This hasn't always been as simple as it is today.

After the invention of the monaural stethoscope in the early 1800's by a French physician - Rene Theophile Hyacinthe Laennec, if you were curious - the technology soon expanded to cater to different uses and needs. Monaural, by the way, means using one ear (as opposed to the stethoscopes we are familiar with today which employ the use of two ears). One of which was for the purpose of listening for fetal heart tones and is known as a Pinard, or Pinard's stethoscope.

Heart tones can be heard via this method usually after 20-24 weeks, so again, not an early pregnancy sign, but if present, and can be differentiated from the maternal heartbeat, then you have a definite pregnancy!

Ballottement

By definition, ballottement refers to a technique for detecting or examining a floating object in the body. In pregnancy, this of course refers to a baby, and near 16 to 20 weeks the baby can be felt to "bounce back" and tap on the physician's fingers after being pushed on from the vagina.

In Conclusion

Well, to sum it up, personally I am glad I simply have to pee on a stick in the privacy of my own home - and the best part is that you can generally tell you are pregnant close to the day you miss your period.