OBSTETRICS, OR MIDWIFERY 765 



strained, to avoid rupture by giving the tissues time 

 to dilate. As soon as the head passes out, the cord 

 should be felt for, as it is sometimes wound around 

 the neck in such a way as to interrupt the circulation 

 as the strain is brought to bear upon it. It also some- 

 times happens that knots are tied in it, which being 

 tightened by the strain may cut off permaturely the 

 supply of blood from the child. If the body is not 

 speedily expelled, the child may be withdrawn by mak- 

 ing traction with the finger placed in the armpit. 



As soon as the child is born, the hand of the nurse 

 should be placed upon the abdomen of the mother in 

 such a way as to grasp the upper part of the womb, 

 firm pressure being made for the purpose of secur- 

 ing contraction of the organ. This pressure should 

 be continued until the after-birth is expelled and the 

 bandage applied. 



The child should be brought to the edge of the 

 bed as soon as it is born, and examined. Generally 

 it utters a cry immediately, which indicates that its 

 lungs are filled with air. In case it does not cry, but 

 breathes feebly, or only gasps, the hand should be 

 dipped in cold water and placed upon its chest, or the 

 chest may be slapped with the hand. This will gen- 

 erally be sufficient to start the respiration. If the child 

 is limp and pale, and makes no efforts whatever at 

 respiration, it should be immediately inverted, being 

 held with the head downward, and hot flannels should 

 be wrapped about it. Efforts should be made to ex- 

 cite respiration by compressing the chest at intervals 

 of a few seconds. Care should also be taken to see 

 that the mouth is cleared of mucus, though this is not 

 likely to be necessary, unless the child has begun to 

 breathe just as the head is being born and has drawn 



