64 



OBSTETRICS. 



CONDUCT OF A LABOUR. 



The conduct of a labour includes all that is done for a parturient 

 patient from the beginning of her pains till the uterus is emptied, 

 and the safety of both mother and child secured. It is not to be 

 understood by this, that the accoucheur is to substitute himself for 

 nature ; on the contrary, he really has little to do in most cases, 

 except to receive and protect the child, to deliver the placenta, and 

 watch over the mother and her offspring for some hours after the 

 delivery. 



Whilst thus he is ready to let nature assist herself, he must be 

 prompt to recognise and avert any danger that may arise. 



It is well for the practitioner always to be provided with a lancet 

 and an elastic male catheter ; and if he live in the country, with a 

 little laudanuni. The first duty of the attendant is, to ascertain her 

 present condition^ whether in labour or not, and if so, how long she 

 has heeji in labour, the nature of the presentation, the rate of pro- 

 gress, and probable termination. 



The first conditions will be readily discovered, by examining the 

 skin, pulse, tongue, &c. ; then directing the attention to the pains, 

 noting their character, frequency, duration, &c., the character of the 

 outcry, the gestures of the patient, and the state of the vaginal dis- 

 charge. By these symptoms he will be enabled to judge of the 



existence of labour or 

 Fig. 17. not, the stage and rate 



of progress, and also 

 of the necessity for a 

 more particular ex- 

 amination. 



One of tlie first 

 duties of the practi- 

 tioner, after the above 

 inquiries have been 

 attended to, is to dis- 

 cover the condition of 

 things by a per vagi- 

 nam examination ; 

 this, it need hardly 

 be said, should al- 

 ways b*3 proposed in 

 the most delicate 

 manner. There is 

 much information to 

 be gained during the 

 first examination (and 

 it should never be 



