OBSTETRICS, OR MIDWIFERY 763 



As soon as the first labor pains make their appear- 

 ance, the physician should be promptly notified, and 

 also the nurse, if the latter is not already present. The 

 room in which the patient is to be confined should be 

 a light, airy, and pleasant one. But few persons should 

 be allowed to be present, and these should be such as 

 are desired by the patient, and no others. 



So far as consistent, all her wishes should be com- 

 plied with, so that she may be in a pleasant state of 

 mind, no mental influence present as an obstacle to 

 prevent the completion of the process in which her 

 physical and nervous powers will be taxed to the utter- 

 most. No remark of a discouraging nature should be 

 uttered in the presence of the patient, but hope and 

 confidence should be inspired. 



During the first stage the patient need not go to 

 bed. In fact, 'it is better that she should sit up, as the 

 sitting posture favors the progress of labor. This need 

 not be required, however, if the patient prefers to be 

 in bed. During this stage the patient should quietly 

 allow nature to carry on the work without any attempt 

 to hasten matters by ' ' bearing down, ' ' as she may often 

 be encouraged to do by ignorant friends. These vol- 

 untary efforts are of no consequence until the neck 

 of the womb is fully dilated. The patient should be 

 allowed to drink cold water or weak lemonade as 

 freely as desired; but stimulants should not be given, 

 as they produce a feverish state of the system without 

 giving any real strength. Hot teas are also better 

 withheld. If the bowels have not moved freely, they 

 should be relieved by a full enema. 



During the first stage, the bed should be made in 

 readiness. The feather bed, if in use, should be re- 

 moved and replaced by a moderately hard mattress. 



