NATURAL LABOUR presupposes the vertex to be the presenting part, the occiput situated toward the acetabulum, and consequently the face towards the opposite sacro-iliac synchondrosis; nature completing the delivery without manual interference.
Labour is divided into three parts, or stages: 1st, the opening or dilatation of the os uteri; 2d, the birth of the child; and 3d, the expulsion of the placenta.
At the commencement of labour, the patient complains of pain3 in the bock, shooting through the abdomen, and frequently extending to the upper and inner part of the thighs; there is great irritability of the bladder, causing a frequent desire to pass her urine; her mind is desponding, and she becomes restless and fidgetty; the stomach frequently sympathizes, producing nausea and vomiting; a degree of shuddering, in some cases amounting to a rigor, is experienced, though in very many instances there is no sensation of coldness. The pains are usually of short duration, and the intervals between them uncertain: after a longer or shorter period, the os uteri begins to dilate, tbe mucous plug, by which it is naturally closed during gestation, cornea away, usually streaked with blood from the ruptured decidual vessels; this appearance of bloody mucus is by nurses termed "the shew." If we examine, per vagiitam, after the detachment of this plug, we find the bag containing the liquor atnnii gradually insinuating itself between the opening lips of the os uteri, and, by thus acting upon the principle of a wedge, greatly assists in its further dilatation. The os uteri being now dilated, the pains assume a very different character; the abdominal muscles strongly assist the contraction of the uterine fibres, producing an involuntary forcing-down effort on the part of the patient; the bag bursts, and the waters are discharged; the pains increase; the womb contracts closely round the body of the child, and by repeated efforts expels it through the os externum: and this completes the second stage.
If the labour has been properly conducted, the third stage occupies but a very short time, the contractions of the uterus being speedily renewed, by which the secundines (the placenta and membranes) are soon detached.
Previous Next
From Charles Waller
Elements of Practical Midwifery: Or, Companion to the Lying-in Room, 1829
