Place a pillow between her knees, which should be bent, and let her feet press against the foot-board.
Take a napkin, and press gently 'between the vagina and the rectum during the pains; not enough, however, to pre- vent the descent of the child, but to prevent a possible rupture of the soft parts. If her exertions cause her to perspire, dry her face with a handkerchief, or fan her a little; if she is faint, give her volatile-salts or cologne to smell.
Should the pains subside, and become weaker during this stage, give her a cup of hot tea.
This stage, sometimes, is very short. Many instances have occurred in my practice, particularly amongst healthy and strong women, where it consisted of one pain, pro- longed until the child was expelled. With some women, it requires several pains, particularly when the parts are rigid. Encourage patience. In cases where the infant's head is very large, or the outlet of the mother rather nar- row, the head is to be moulded, as it were, to the proper proportions, and the resistance will cause some delay.
It is during these pains, that she should pull at a towel fixed to the bed or in the hands of an attendant.
The patient should not be discouraged if several severe pains, at this stage, do not cause the child to be bom. As long as the presentation is right she need have no fear for the result, even if no physician be present.
When, at last, the result begins to appear, and the head is expelled, it should be supported in the palm of the right hand, but no traction made.. If the pain ceases, and the cord is twined around the child's neck, pull the cord gently until it is loosened; and, if it is sufficiently long, pass it around the child's head until it is disentangled. If the pain delays, and the child's face looks congested and
