CONDUCT OF A LABOUR. 67 



The wet sheets, &c., may now be removed from under her, and 

 the patient covered over to prevent chilliness, and then left to have 

 an hour's rest before she is made comfortable in bed. 



The child should be put to the breast as soon as the mother is 

 sufficiently rested. It is not only useful to the child by supplying it 

 with the early secretion, which is laxative, but it is also beneficial to 

 the mother, inasmuch as it excites contraction of the uterus. 



The diet of a woman lately delivered should be as light as possi- 

 ble, consisting mainly of the farinaceous articles ; and she should be 

 kept in a strictly horizontal position till all danger of hemorrhage 

 has passed. 



About half an hour after the labour is completed there often occur 

 a succession of painful contractions called after-pains. During their 

 presence, the discharge from the uterus increases and coagula are 

 frequently expelled ; their operation is salutary within certain limits, 

 they prevent hemorrhage, diminish the size of the uterus and expel 

 its contents ; they are rare in primiparous women. If very severe 

 they may be diminished by small doses of camphor and opium. 



The lochia is the name given to the discharge that continues after 

 labour is completed. For some days it retains the character of blood ; 

 but it finally loses its firmer portions and red globules, in conse- 

 quence of the continued contractions of the uterus, and becomes of a 

 greenish tint. It comes from the patulous orifices of the vessels on the 

 uterine surface where the placenta was attached, and disappears as 

 these become compressed by the uterine contractions. It usually 

 lasts three weeks, though sometimes longer. 



General directions have been given for the management of the 

 child after birth ; it sometimes happens that it requires further atten- 

 tion at the hands of the practitioner, owing to some pathological con- 

 dition into which it may have fallen. For instance, when born it 

 may be in a state of defective vitality^ asphyxia, or apoplexy. The 

 first condition may be produced by excessive uterine hemorrhage, 

 by too early a detachment of the placenta, or by defective nutrition. 

 This will be recognised by the feeble efforts at respiration and the 

 weak and irregular action of the heart. Under these circumstances 

 no advantage is gained in preserving the connexion between the 

 mother and child ; the cord should be tied and cut and the infant 

 immersed in a warm bath of the temperature of 97° or 98° Fahr. 

 If after a few minutes, the child does not gasp, and we observe that 

 the heart is acting less forcibly, a longer continuance in the bath 

 will do harm ; it should, therefore, be removed, and cold sprinkling 

 tried, or what is better, gentle stimulation by means of frictions 

 over the general surface, and if necessary, artificial respiration. 



In the second condition^ the child is sometimes asphyxiated by 

 pressure upon the cord, or by being delayed in the passage in a 

 tedious labour. Here it would be obviously improper to cut the cord ; 



