A treatise on the science and practice of midwifery . the long diameter of the uter-ine cavity (Fig. 91). In this way it is expelledinto the vagina, and during the process little orno hemorrhage occurs. When the placenta isdrawn out in the way too generally practised, itobstructs the aperture of the os, and, acting likethe piston of a pump, tends to promote hemorrhage. The corol-laries as to treatment drawn from these facts will be subsequentlyconsidered. I am anxious, however, here to direct attention to na-tures mechanism, because I believe there is no part of labor aboutthe management of wh
A treatise on the science and practice of midwifery . the long diameter of the uter-ine cavity (Fig. 91). In this way it is expelledinto the vagina, and during the process little orno hemorrhage occurs. When the placenta isdrawn out in the way too generally practised, itobstructs the aperture of the os, and, acting likethe piston of a pump, tends to promote hemorrhage. The corol-laries as to treatment drawn from these facts will be subsequentlyconsidered. I am anxious, however, here to direct attention to na-tures mechanism, because I believe there is no part of labor aboutthe management of which erroneous views are more prevalent thanthat of this stage, and none in which they are more apt to lead toserious consequences ; and unless the mode in which nature effectsthe expulsion of the placenta, and prevents hemorrhage, is thoroughlyunderstood, we shall certainly fail in assisting her in a proper man-ner. In the large proportion of cases, when left entirely to them-selves, the placenta would be retained, if not in the uterus, at any rate. Mode in which the Placenta is Xaturally Expelled. (After Duncan.) Edin. Med. Jour., April, 1871. 25-1 LABOR. in the vagina, for a considerable time—possibly for several hours—and such delay would very unnecessarily tire the patience of thepractitioner, and be prejudicial to the patient. It is, therefore, ourduty in the majority of cases, to promote the expulsion of the after-birth ; and when this is properly and scientifically done, we increase,rather than diminish the patients safety and comfort. But, in orderto do this, we must assist nature, and not act in opposition to hermethod, as is so often the case. After-pains.—When once the placenta is expelled, the uterus con-tracts still more firmly, and, in a typical case, is felt just within thepelvic brim, hard and firm, and about the size of a cricket for several hours, or even for one or two days, it occasion-ally relaxes and contracts, and these contractions g
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