A textbook of obstetrics . in a very large proportion f his cases. There is,consequently, a prevalent idea that almost all confinement cases occur at night. As a matter of fact, fortyper cent, only are delivered between the hours of 11 r. M. and 7 , according to the statistics of West, based on 2019 cases ( Amer. , [85 LABOR AND THE PUERPERIUM. of affairs lasts about fifteen hours, when a marked changemay be observed in the womans action. If she were leftentirely to herself she would be very likely to assume asquatting posture in bed or upon the floor,—a position assumedby the wom
A textbook of obstetrics . in a very large proportion f his cases. There is,consequently, a prevalent idea that almost all confinement cases occur at night. As a matter of fact, fortyper cent, only are delivered between the hours of 11 r. M. and 7 , according to the statistics of West, based on 2019 cases ( Amer. , [85 LABOR AND THE PUERPERIUM. of affairs lasts about fifteen hours, when a marked changemay be observed in the womans action. If she were leftentirely to herself she would be very likely to assume asquatting posture in bed or upon the floor,—a position assumedby the women of many savage tribes during the latter stage oflabor. Now, as a pain comes on the woman draws a deepbreath, clinches her teeth, fixes her diaphragm, and evidently,from her behavior, calls into play the action of the abdominalmuscles with all her might Her face is suffused, the eyebrowsknit, and beads of perspiration stand out upon her brow. Aslone as the breath can be held this straining action is continued,. Fig. 180.—The bag of waters or pouch of membranes until the air is suddenly expelled from the Lungs with a charac-teristic grunting sound, the diaphragm is again relaxed, and theabdominal muscles eease for a moment to act until a full in-spiration is taken, when the straining again begins, and continuesuntil the uterine contraction passes off. If one made a vag-inal examination at this time, he would find a good reason for thechange in the clinical aspect of the case. It would be foundthat the os is fully dilated and that the presenting part is begin-ning to descend, either carrying the membranes before it or else-,as is more common, the membranes rupture just as the os isfull)- dilated and the childs presenting part is driven throughthe rent m the amnion and chorion. In this condition ot affairs LABOR. -93 is found a good explanation for the action of the abdominalmuscles ; so long as the presenting part acts simply as a wedge,dilating the os, but not descending t
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