A treatise on the science and practice of midwifery . be pressed, andnot drawn, out of the uterus, we owe to Crecle and other Germanwriters; and it is only of late years that this practice has become atall common. Those who have not seen placental expression prac-tised, find it difficult to understand that, in the large majority ofcases, the uterus may be made to expel the placenta out of the va-gina; but such is unquestionably the fact, A little practice is nodoubt necessary to effect this satisfactory; but when once theknack has been learnt, there is little difficulty likely to be ex-perienc
A treatise on the science and practice of midwifery . be pressed, andnot drawn, out of the uterus, we owe to Crecle and other Germanwriters; and it is only of late years that this practice has become atall common. Those who have not seen placental expression prac-tised, find it difficult to understand that, in the large majority ofcases, the uterus may be made to expel the placenta out of the va-gina; but such is unquestionably the fact, A little practice is nodoubt necessary to effect this satisfactory; but when once theknack has been learnt, there is little difficulty likely to be ex-perienced. Importance of not Removing the Placenta Hurriedly.—Before de-scribing the method of placental expression, a word of caution maybe said against undue haste in attempting expression of the placenta,a mistake that is often made, and which, I believe, tends to increase obstetric works, -which represents the accoucheur as withdrawing the placenta by trac-tion, and which I insert as an illustration of what ought not to be done (Fig, 102). Fig. Usual Method of Removing the Placenta by Traction on the Cord. 280 LABOR. the risk of post-partum hemorrhage. So long as we satisfy ourselvesthat the uterus is fairly contracted, so as to avoid the possibility ofits distension with blood, a certain delay after the birth of the childis useful, from its giving time for coagula to form within the uterinesinuses, by which their open mouths are closed up. The importanceof this point has been specially dwelt upon by MClintock, who laysdown the rule that 15 or 20 minutes should be allowed to elapse,after the birth of the child, before any attempt to after-birth is made. This is a good and safe practical rule, as it givesample time for the complete detachment of the placenta, and the co-agulation of the blood in the uterine sinuses. Mode of Effecting Expression of the Placenta.—During this inter-val the practitioner or nurse should sit by the bedside, with the handon the uterus
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