A treatise on the science and practice of midwifery . action of the head will bealmost a matter of necessity. In the majority of cases, after thebirth of the first child there is a tem-porary lull in the pains, which soonrecommence, generally in from ten totwenty minutes, and the second child israpidly expelled, for on account of thefull dilatation of the soft parts there isno obstacle to its delivery. Sometimesthere is a considerable interval before thepains recur, and instances arc recorded in which even several iy- haveelapsed between the births of the two children. Treatment.—In most cases
A treatise on the science and practice of midwifery . action of the head will bealmost a matter of necessity. In the majority of cases, after thebirth of the first child there is a tem-porary lull in the pains, which soonrecommence, generally in from ten totwenty minutes, and the second child israpidly expelled, for on account of thefull dilatation of the soft parts there isno obstacle to its delivery. Sometimesthere is a considerable interval before thepains recur, and instances arc recorded in which even several iy- haveelapsed between the births of the two children. Treatment.—In most cases the management of twins does not differfrom that of ordinary labor. Ajb sood ;i- we are certain of the exist-ence of a second foetus, we should inform the bystanders, bu1 notnecessarily the mother, to whom the news might prove an unpleasantand even dangerous shock. Then, having taken care to tie the cord ofthe first child for fear of vascular communication between the placentae,our duty is to wait for a recurrence of the pains. If these come on. T\vin Pregnancy, Breech andPresenting. rild 364 LABOR. rapidly and the presentation of the second foetus be normal, its birth ismanaged in the usual way. Management when there is Delay after the Birth of the First Child.—If there be any unusual delay, we have to consider the proper course topursue, and on this the opinions of authorities differ greatly. Someadvise a delay of several hours, and even more, if pains do not recurspontaneously ; while others—Murphy, for example—recommend thatthe second child should be delivered at once. Either extreme of prac-tice is probably wrong, and the safest and best course is doubtless themedium one. The second point to bear in mind is, that in multiplepregnancy, on account of the extreme distension of the uterus, there is atendency to inertia, and consequently to post-partum hemorrhage, andthat, therefore, it is better that the birth of the second child should bedelayed, even for a considera
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectobstetrics, bookyear1
