Application of Traction 591 



Haste in traction upon a fetus is only very rarely justifiable, 

 and the maternal parts should be allowed to dilate gradually as 

 the fetus slowly advances in the form of a wedge. In posterior 

 presentation, when a supposedly live fetus is well advanced in 

 the pelvis so that the umbilic cord is impinged between the fetal 

 body and the maternal pelvis, hasty extraction of the fetus may 

 be warranted in order to save its life. Very rarely, possibl5r, other 

 ■conditions arise to warrant hasty extraction of the fetus. 



Traction should, if possible, only be, applied during the expul- 

 sive efforts of the mother, since at these times it is very much 

 safer, and more efficient. Traction applied in the absence of ex- 

 pulsive efforts constantly tends to drag the uterus along with the 

 ietus, with danger of uterine rupture. 



Expulsive efforts of the mother may usually be artificially 

 aroused by slight traction upon the fetus or by the operator 

 passing his hand between the fetus and the vaginal walls. When 

 these effoirts have been aroused they should promptly be seconded 

 by firm traction, to be regulated in amount according to the cir- 

 ■cumstances in each case. Before traction is applied, and as far 

 as possible during its continuance, the birth canal should be kept 

 moist and well lubricated by means of oil, fat, or warm lysol so- 

 lution. 



While traction should be applied, as a rule, only during expul- 

 sive efforts, in some cases, when the animal is exhausted or under 

 the influence of an anaesthetic, the expulsive powers may be 

 partly or wholly wanting and forcible extraction made necessary. 



The general rules for the application of traction — the direction, 

 amount and method — are essentially the same whether the fetus 

 presents anteriorly or posteriorly. 



The developnient of the required amount offeree, when 

 applying traction to the fetus, may be brought about in a variety 

 of ways. 



We have already suggested that the difficulties increase as the 

 Tiumber of men increases, because a large number of men is diffi- 

 cult to control. They are almost always excited and tend to exert 

 their force in an irrational manner. Since they necessarily work 

 behind the operator's back, he has little opportunity to watch 

 them, while giving proper attention to the progress of the fetus. 

 In some cases the men who are at the command of the operator 



