Childbirth or Labor. Delivery.
The expulsion, at full term, of the child, the after birth, the membranes, and the fluids, constitutes labor, or delivery. It is supposed to occur about two hundred and eighty days after the last menstruation; but authors reckon it differently; in truth, it is not possible to fix it exactly, for it evidently varies in different cases.
When the time of her lying in arrives, let every woman meet it with calmness and undoubting confidence. There is every reason to encourage this state of mind. '
Let her resist the temptation to a feeling of haste. Nature will often proceed more evenly and more speedily if allowed to take her own time. A hurry to get through is a great obstacle to successful delivery; it always puts things back.
Symptoms. One of the first indications that labor is about to begin is, that the woman finds herself smaller, the child having sunk down lower in the abdomen, and she accordingly breathes easier. The genital organs become relaxed and moist, and mucus escapes, which is called , the shows." The woman finds herself disposed to be nervous and fidgety, and perhaps a little depressed in spirits.
When labor has fully set in, it is marked by lowness of spirits, flashes of heat and cold, a great desire to empty the bowels and to make water, and grinding, cutting pains, which grow stronger and more continuous, with intervals of ten or fifteen minutes' ease between. Vomiting in the early stages of labor often occurs, and may be regarded as favorable, indicating the softening and opening of the mouth of the womb.
Treatment of Labor. When labor begins, the attention should be directed to the state of the bowels and bladder. The child's head begins early to press upon the bladder and lower bowel, causing the desire to make water, etc.; and these should be immediately emptied to make room for the head to pass more easily. The bowel may be freed by a dose of castor oil (10), if there is time for it to operate, but more surely, and more satisfactorily, by an injection. Relief in the bladder may, perhaps, be obtained by a different position of the woman in the act of making water. It is the pressure of the child's head upon the water pipe which causes the trouble; and to relieve it, the woman should get upon her hands and knees, with her shoulders lower than the hips, so as to throw the child upward and forward towards the cavity of the abdomen. Thus situate~ she may often find it easy to make water, when in the ordinary position it would be impossible. If, however, this maneuver does not succeed, and the bladder becomes greatly distended, the catheter must be used.
The Bed and Habiliments. In the next place, fix the bed and the patient's habiliments. Reject feather beds; use the mattress. Cover this with a rubber cloth, if convenient, and then with folded sheets to absorb the discharges, and protect the bed. Let the woman be arrayed in the same garments she expects to wear after the completion of the labor, and let these be well tucked up under her arms, and let the lower portion of her body, from the waist downwards, be enveloped in a sheet. This sheet can be easily removed, and the clean clothes pulled down without greatly disturbing the patient when in the exhausted state which follows labor, and when it would subject her to great fatigue to be,, obliged to sit up in bed to have her clothes changed. Let her lie upon her left side, with her body shortened by bending forward, so that the muscles may be relaxed; let her head be placed in the middle of the bed, and her feet press against the right foot post. Around this post a shawl or towel may be fastened, upon which she may be allowed to pull during the pains.
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