762 PLAIN EACTS 



The first and second stages of labor are generally 

 considerably prolonged. Some women, especially those 

 who have broad hips and are well adapted to child- 

 birth, pass through the process of labor in a much 

 shorter space of time, in some cases not more than 

 thirty minutes or an hour being occupied. In women 

 who have not borne children before, especially those 

 who are somewhat advanced in life, labor is often 

 greatly prolonged. 



Various obstacles frequently arise to delay the proc- 

 ess; such as, inactivity of the womb, rigidity of the 

 neck of the womb or of the perineum, and contracted 

 pelvis. 



Management of Labor.— In the first place, the 

 services of a competent attendant should be secured. 

 The attendant should, if possible, be a thoroughly 

 trained physician. This is a field in which woman as 

 a physician can fill a very useful sphere. Under no 

 circumstances, except in emergencies, should the im- 

 portant process of parturition be placed wholly in the 

 hands of a midwife whose qualifications, such as she 

 may possess, are wholly derived from experience at 

 the bedside, no matter how large may be the number 

 of cases she has attended. No one person could by 

 practical experience alone in a lifetime acquire all the 

 knowledge necessary to meet the urgent emergencies 

 which are liable to arise at any time in childbirth. The 

 science and art of obstetrics have been developed by 

 a very slow process, and as they exist at the present 

 day, are the result of the combined experience of phy- 

 sicians during the last two thousand years. Thorough 

 theoretical knowledge is indispensable as a foundation 

 for practical skill. This, of course, must be supple- 

 mented by actual experience. 



