HKDiirKA] PHYSIOLOGICAL AND MEDICAL OBSERVATIONS 59 



Especially relial)le inforination was obtained in this line among the 

 Pima from an old midwife known as Mary, sister of the chief, Antonio 

 Azul. She comes from a family of chiefs and learned her vocation 

 from her mother and sister. She is in every way comparable to a 

 country midwife among the whites, and is called on to aid in most of 

 the confinements in her neighborhood. According to this woman the 

 |)reparations for labor among the Pima are very simple. The woman 

 at term is directed to walk as long as possible, as the delivery will be 

 easier than if she takes to her bed on the approach of the first pains. 

 When walking becomes impossible she is placed in a sitting posture 

 on a little bedding or merely a cloth. If the progress is then satis- 

 factory she is let alone until the child is born. In some cases the 

 patient sits on the ground with the knees drawn up, and inclining 

 slightly backward on a helping woman, who sits behind her. Occa- 

 sionally a depression is made in the ground in front of the woman to 

 receive the baby. The practice differs with different families. If the 

 birth does not take place promptly, the midwife squats or kneels, 

 takes the woman on her lap, puts her arms around her abdomen, 

 and bears down with all her strength. When the patient writhes a 

 little, she shakes her moderately from side to side, and if satisfactory 

 progress is not made the midwife goes in front while the husband 

 from behind presses on the abdomen of his wife with all his strength. 

 The midwife never examines the patient internally, and she does not 

 pull on the child, as this would be contrary to custom. My informant 

 never had a case where success did not attend the expedients men- 

 tioned, although the time might be long. If the placenta does not 

 follow the. birth directly or within a short time, as it usually does, 

 the cord is tied and the midwife commences pressing on the uterus 

 and kneading it — a practice which is usually successful. She does 

 not ])ull on the cord or introduce her hand. In one instance a 

 peculiar treatment for retained placenta was administered by a 

 female helper. The confined woman was made to pull herself uj) 

 on a rope suspended from above. When she was nearly erect, she 

 was told to open her mouth and into this the midwife quickly intro- 

 duced, as far as she could, one of her fhigers. The object was to in- 

 duce a violent effort at vomiting while the woman was in that 

 peculiar position, with the muscles of the upper part of her body, 

 as well as those of the abdomen, well contracted. The effort, 

 whether by inducing great and sudden pressure on the uterus or a 

 reflex relaxation of the os uteri, succeeded, the afterbirth being 

 ])romptly expelled. The placenta is buried by the women. 



Attentions to the Pima mother after labor are also very simple. 

 If she is in good health and seems well, as is often the case, she is 

 left entirely to herself. For the first few hours she receives no food 



