NUES2N0. 285 



The contractions of the ■womb now cease for a short time, varying from 

 five to ten or twenty minutes, when a little pain is again felt, and the after- 

 birth and membranes are discharged, along with a small quantity of blood, 

 with which a few clots are generally mixed. 



Such is a brief account of the order of events in a perfectly natural labor. 



DUTIES OP A NTJIISE DURING LABOR— Articles Needed 

 in the Lying-in Room — Preparation of the Bed— Personal 

 Clothing of Patient— Number of Persons in the Room— 

 Caution in Conversation— Attention to the State of the 

 Bladder — Food — Vomiting— Cramp— Fomenting the Per- 

 ineiim in First Labors. 



If the nurse is not already in the house, the appearance of the first dis- 

 charge or "show " is a sufficient warning that she should be summoned. No 

 time should be lost in obeying the call, for many women, especially if they 

 have borne children previously, pass through all the stages of labor very quickly. 

 On arriving at the house the nurse should make the necessary changes in her 

 dress, and appear before the patient ready for duty. An opportunity will soon 

 occur of forming a judgment as to whether the patient is really in labor, and, 

 if so, how far it has advanced. If labor has actually commenced, the patient 

 will, before long, cease speaking, suddenly grasp the nurse's arm, or the back 

 of a chair, or whatever happens to be at hand, and exhibit other signs of suf- 

 fering. The nurse will know, by the characters enumerated on a previous 

 page, whether this is a genuine labor-pain or not, and will observe how long it 

 lasts and the degree of its severity. "When it is over, she should inquire when the 

 pains began, how often they return, whether the waters have been discharged, 

 and other similar questions, in order that she may know what kind of message 

 she is to send to the medical attendant, who ought at once to be informed that 

 his patient is in labor. 



Let me now suppose that the nurse has made sure that her patient is in 

 labor, and that she has acquainted the medical attendant. 



If the bowels have not been freely opened within the last six hours, it will 

 be desirable to give a simple enema of soap and water. The emptying of the 

 lower bowel -vvill facilitate the labor, and will save both the patient and attendant 

 the annoyance caused by the passing of faeces during a later stage. This hav- 

 ing been attended to, the patient may be allowed to sit up in a chair or walk 

 about the room, according to her inclination, provided it is clear that the labor 

 has not yet reached its second stage. If it is night-time, however, it is better for 

 her to remain in bed, in order that she may, if possible, get a few moments' 

 sleep between the pains. During the early stage of labor it is of no use for 

 patients to "hold their breath and bear down" during each pain, as they are 

 often urged to do by untrained and inexperienced nurses. It must always 

 be left to the medical attendant to decide when bearing-down efforts hav® 

 become desirable and ought to be encouraged. 



