. The science and art of midwifery. ough they are often inappreciablein primiparae. They very commonly begin in the evening hours andcontinue till toward the middle of the night. Very often they are as-sociated with a dragging sensation between the sacrum and symphysis,and a feeling of tension in the abdominal region. Sometimes theyexpand the os internum to a considerable extent, but never in such a* Naegele, Lehrbuch der Geb., p. 163. 138 LABOR. way that any portion of the cervical canal contributes to the enlarge-ment of the uterine cavity. Actual labor has been divided, as a matter of clini
. The science and art of midwifery. ough they are often inappreciablein primiparae. They very commonly begin in the evening hours andcontinue till toward the middle of the night. Very often they are as-sociated with a dragging sensation between the sacrum and symphysis,and a feeling of tension in the abdominal region. Sometimes theyexpand the os internum to a considerable extent, but never in such a* Naegele, Lehrbuch der Geb., p. 163. 138 LABOR. way that any portion of the cervical canal contributes to the enlarge-ment of the uterine cavity. Actual labor has been divided, as a matter of clinical convenience,into three stages, as follows : First stage, or stage of dilatation of the cervical canal. Second stage, generally termed the stage of expulsion, comprisingthe period from the dilatation of the cervix to the expulsion of thechild. Third stage, or stage of the placental delivery. 1. The First Stage—Dilatation of the Cervix.—The advent of truelabor is characterized by painful contractions, which render the patient. placenta orif. ut. int. rectum. orif. ut. ext. liq. amnios. Fig. 80.—Section through a frozen corpse. Stage of expulsion. (Braune.) restless, and dispose her either to bend forward with clinched hands,or to seek some firm support for the sacrum to ease her , in the beginning of labor, women prefer the sitting posture,which enables them to press with the forearm against the sacrum dur- THE PHYSIOLOGY OF LABOR AND ITS CLINICAL PHENOMENA. 139 ing the pains. The pain of labor begins with the dilatation of theinternal os. In true labor the dilatation progresses gradually. As theos internum opens, the contractions cause the membranes to descendand press upon the cervical canal. With the advance of labor, thepains increase in intensity and frequency. During their persistencethe external os is put upon the stretch, so that the border becomesthin and sharply defined.* As the pain subsides, the os relaxes andthe membranes retreat. Each -ne
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