. The science and art of midwifery. r 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 l
. The science and art of midwifery. r 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 -new pain increases the dilatation, andforces the membranes somewhat deeper. The softening, the relaxa-tion, and the hypersecretion of the soft parts become more and more placent duodenum orif. tub. jJig. 81.—The uterus and parturient canal. Foetus removed. (Braune.) decided. As the borders of the os yield to pressure, lacerations form,which tinge the mucous discharges with blood. When the dilatationhas reached a certain limit (usually by the time the diameter of the * In multipara this resistance of the external os may be entirely lacking. 140 LABOR. external os is three to three and a half inches), the protruding mem-branes remain tense in the intervals between the pains, and are thenready for rupture. After rupture, which usually occurs spontaneously,the water in front of the childs head escapes, though the greater partof the amniotic fluid is retained within the uterus by the valve-likepressure of the presenting part. After a short pause the head descendsinto the cervix, the walls of which are stretched to the pelvic borders,and finally become so far dilated that cervix and vagina form one con-tinuous canal. In case the presenting part do
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Keywords: ., bookcentury1800, bookdecade1890, bookidsci, booksubjectobstetrics
