PELVIS POSITIONS. 479 



1078. Admitting, however, that the case may occur, this is the 

 advice given by the authors: the right branch of the forceps is to be 

 introduced first, and conducted with the ordinary precautions, in 

 front of the right sacro-iUac symphysis, as high up as the forehead; 

 then the ends of the first fingers of the left hand are placed under 

 its convex edge, and in concert with the right hand move it from 

 behind forwards and from right to left, until its concave edge is 

 turned towards the left iliac fossa, and the blade has arrived upon 

 the right parietal protuberance. The handle, strongly depressed, 

 is then given to an assistant, who holds it against the woman's left 

 thigh. 



1079. The left branch is held in the left hand, and passed up 

 along the posterior part of the pelvis until its point is above the su- 

 perior strait, and the pivot even with the mortise that is in the other 

 branch. After having joined them and dislodged the head, if it be 

 still in the superior strait, and forced the occiput to descend into 

 the excavation, provided it were not already there, the concave 

 edges of the instrument are gradually brought to the front, and the 

 remainder of the operation is conducted as in the occipito-pubic 

 positions. 



§. IV. Ri^ht Occipito-iliac Position. 



What I have just now said of the left occipito-iliac position is en- 

 tirely applicable to the right occipito-iliac position; they only differ 

 from each other in regard to the application of the forceps, in doing 

 which the left branch is to be introduced first. 



§. V. Positions of the PelTis. 



It may happen that after the child has been drawn down by its 

 pelvic extremity, great difficulty shall be experienced in attempting 

 to disengage the head. The same thing may be met with at the 

 close of a pelvis labor which up to that moment had exhibited no- 

 thing peculiar; if the fingers and hands do not suffice for the deli- 

 very of the woman, it will probably be found that it is occasioned by 

 a contraction of the pelvis, more or less considerable, in which case 

 the forceps may be of little avail. However, it must be tried, rather 

 than resort to symphyseotomy or the cesarian operation, particularly 

 provided the head is below the superior strait. 



If the occiput is in front or a little to one side, an assistant should 

 raise the trunk upwards, and first the left branch, then the right is 

 introduced, following the same rules as if the head had descended 

 first. 



If it is behind, and it be found impossible to turn it round to the 



