of pregnancy are and when they appear, but also how far the evidence
that they give is reliable.

The signs of pregnancy may be classified, according to their
reliability, as presumptive, probable, and positive. The doubtful
evidence appears first and the infallible proof last. No one need be
surprised, therefore, if, when her suspicion is first aroused, she is
unable to decide positively whether she is pregnant. Physicians of
broad experience, possessed of facilities for observation which their
patients cannot employ, may find it necessary to make more than one
examination before they commit themselves to a definite opinion; in
some cases, though very rarely, they must wait for two or three
months to be able to do this.

THE POSITIVE SIGNS.--The earliest absolutely trustworthy
manifestation of pregnancy is the motion of the fetus. The perception
by the mother of these movements, which is spoken of as "quickening,"
generally occurs toward the eighteenth week, if she has been told to
watch for them; otherwise they may pass unnoticed until the twentieth
week or later. At first the motion, felt in the lower part of the
abdomen, is very gentle; it has been variously likened to tapping, or
to quivering, or to the fluttering of a bird's wings. As time goes on
the movements grow stronger and occur more frequently; they are,
however, perceived but rarely throughout the day and seldom interfere
with sleep. Occasionally women are annoyed by the sensation and
complain that the child is hardly ever quiet. Even these troublesome
movements are never a cause for anxiety; but prolonged failure to
feel motion after it is once well established should be reported to
the doctor.