NATURAL LAB0171.
In this division of labour there arafour stages, according to the mode in which its progress is usually contemplated. The first stage is that in which the head of the child enters the pelvis, passing down as far as it can move without changing its position. The second includes the peri od of the child's head passing through the cavity of the vagina and os externum. The third, the change taken place in the vagina and os externum. The fourth, the delivery of the body of the child, and the expulsion of the placenta. In one of the two first stages the os uteri dilates, and. in one of the three first the membranes are ruptured.
In the regular process of natural la bour, the head, by the contractions of the Uterus, is forced down and passed through the os externum. The uterus, after an interval of rest, again contracts, by which effort the shoulders are expelled. The breech and lower epretnities presently follow. During the progress of expulsion the uterus contracts around the remain ing parts of the child, and at the time the placenta only remains, the uterus is only sufficiently large to contain it. The next effort of the uterus, therefore, by contracting its internal surface, not only assists in pressing out the placenta, but jhbecomes the cause of the separation; Wwbile the same power, which separates the placenta and throws it oft, prevents the occurrence of any serious hemor rhage. This is a most beautiful illustration of the mercy and power, as well as wis dom of the Almighty.
At the commencement of this process there is almost always a discharge of mu cus, tinged with blood, from the vagina, and the blood is sometimes intermixed in considerable quantity, a fact, however, which is of no consequence. There is at this time also, very generally, an uneasy oppression about the pracordia: and as the pains increase in violence, vomiting will often arise from the extreme disten tion of the os uteri, while the pulse gene rally augments in strength and frequency. At the same time the progressive pres sure of the child's head expels almost in voluntarily both the urine and faces; while, from .the vicinity of the sciatic nerve, cramp and paralysis occasionally take place from the same cause.
In labours of every kind there are ma ny things to be attended to, which, though seemingly frivolous, are yet of great importance, and, in general, are on ly manageable by practice: first, then, the bed should be so made that the woman may lay comfortable both in labour and after labour, and that she may lay in the best way with regard to our convenience.
If she be used to a mattress she may lie on one, it being the best sort of bed; but if she be afraid of a mattress, she may be allowed to lay on a feather bed, first mak ing it as nearly as possible a mattress by beating the feathers all away to the other side of the bed. Upon the feather bed a blanket should be laid and a sheet, and upon these a common red sheep skin, or instead of it a piece of oil-skin or oil cloth ; over this a blanket doubled to four thicknesses; and lastly, a sheet upon this four times doubled, only lengthwise : this last sheet is to be laid across and secured to the bedstead by tapes. When the os the membranes breaking it would receive the apex of the head, the patient should be put to bed, but not before ; for, with some women who have had children, it is astonishing how fast the os uteri will di late itself; it sometimes takes place with such prodigious rapidity, that there is on ly time to get the woman on the bed be fore the child is born.
The woman should be undressed be fore getting into bed; het shift had bet ter be tucked up around her; and, instead of a shift below, a petticoat will do much better, as it saves the linen. When plac ed on the bed she must lay as near as pos sible to the edge, and in the posture be fore described. This is equally proper in the easiest and most difficult labours. The lying-in room should be as airy as possible ; and upon this principle it is that the poor people in the country get about sooner after lying-in, than the same class of inhabitants of this in the generality of cottages it is not ne cessary to be very anxious about this, there are few of them so air tight but that they will do without a ventilator. If food be proposed during labour, we should generally speak rather against than in favour of it ; for if food be taken. it must be either digested or undigested: in either case it is productive of mischief: if digested it becomes the fuel of if it remain undigested, the stomach and bowels are all the worse for it ; the pro per refreshment is tea with dry toast, as this will do no harm.