Delivery (birth)

“ A skillful practitioner will bear in mind all these circumstances, and form a rule out of all of them, as it were, to guide him in each individual case; and I wish you to remember, that although you may consider the principal part of delivery is accomplished at the time when the child comes into the world, it is to be remembered that its real danger has not yet commenced, and that the birth of the placenta is a most important part of the process. ”

“ Sir Anthony Carlisle, late President of the Royal College of Surgeons, assures us that child-birth, like parturition in the lower animals, is purely a natural process, the safety of which Divine Providence has most wisely secured; and consequently that it is always mischievous to tamper with pregnant women, under the pretence of hastening, easing, or retarding their delivery. ”

“ An objection to this practice is, that in consequence of the sympathy that exists between the breasts and the womb, exciting the former before the time of the full period of pregnancy might, or, rather, would cause pains in the latter before the proper time; in other words, premature labor would be likely to result. Besides, it is the order of nature that drawing the breast be practiced only after the birth has been accomplished. Nothing whatever can be gained by drawing the breast before delivery. ”

“ A temporary sterility often follows the first delivery. It is well known that the birth of boys is in general more difficult than the birth of girls; Pfannkuch collecting information regarding the first and second deliveries of 300 married women, ascertained that after 166 of the first deliveries, in which boys were born, the average lapse of time to the second delivery was 30.2 months, whereas after 134 of the first deliveries in which girls were born, the average lapse of time to the second delivery was only 27.4 months. ”

“ That the suffering is at all essential to the mother's love for her child I cannot believe. Under certain circumstances, as for example when the Cesarean operation is performed before the onset of labor, the delivery is painless ”

“ After [Pg 97] the delivery she contracts, compresses, and closes up the part of the infant to which it adheres; and by intercepting the blood and the life which gives it subsistence, she soon causes it to wither and dry up, without any prejudice to the child. ”

“ Perhaps the root of the difficulty lies in the fact that childbirth, as well as the attendant suffering and death, are so familiar that they are regarded as being normal incidents in the ordinary course of affairs.
One of the most dramatic of all human events, the birth of a new being, is accepted casually, almost without concern, because it is so frequent—so commonplace. ”

“ Preternatural labor, or cross-births, are those in which some other part than the head presents. We cannot in general assign any reason for such occurrences, nor can the woman, by any sensation of her own, be assured that the presentation is unusual. Apprehensions of this kind should not be indulged in. If the feet or breech present, the delivery is to be accomplished by properly accommodating the position of the child to the capacity of the pelvis, but no force should be employed; and though there is always some risk to the life of the infant, yet there is none to the mother. ”

“ But see the beautiful, and at the same time wonderful operation of nature in the mechanism of parturition. At first, some days before labor is to come on, the abdomen begins to subside, showing that the uterus, with its contents, is gradually sinking downward in preparation for the greater struggle that is to take place at the birth. Probably, too, the womb at the same time begins to contract itself more firmly upon the child, and, as it were, begins to gather strength for the contest which it is about to engage in, namely, that of forcing the child into the world. ”

“ When requested to see a woman supposed to be in labor, it is always advisable to be prompt in paying the visit, because delivery sometimes comes on suddenly and unexpectedly, and both mother and [223] child may be in great danger if no one is near to assist. ”

“ If there is no hemorrhage, or other cause of alarm, there is no more reason for giving assistance to deliver the placenta than if only one child had been present; we ought either to wait for the spontaneous operation of nature, or, at most, give very little assistance, precisely as we would in a case of single birth. ”

“ GROWTH AND PHYSIOLOGY OF THE FETUS Although the fetus at term is in many respects simply a diminutive, immature man, or woman, its anatomy and physiology present certain characteristics which have adapted it to a protected existence in a sac of fluid. Some of the fetal structures and functions become increasingly active after birth, while others subside and disappear. ”

“ When she is in labour, her husband shampooes his own abdomen, while praying to the gods for her safe delivery—a custom which seems to suggest the couvade. As soon as his wife is delivered, he offers thanks to the gods “for having got the baby out.” ”

“ It is now proved that the giving of medicine to a babe immediately after birth is unnecessary, nay, that it is hurtful—that is, provided he be early put to the breast, as the mother's first milk is generally sufficient to open the bowels. ”

“ Through this first stage of labor, the mother does not have to work to help the baby be born. She should not try to push the baby down, but should try to relax her muscles. She can help do this by taking deep breaths with her mouth open during each tightening.
[Illustration: A. At full term, or after 40 weeks of pregnancy, the baby is ready to be born. The cervix through which baby must leave the uterus is shown clearly here, still closed. The contractions of the muscles of the uterus will open the cervix, and force the baby down through the vagina, or birth canal, to the outside.] ”

“ Duty of Nurse Immediately Following Birth of Child.—As soon as the child is born the nurse should sit by the side of the mother and hold the womb until the after-birth is expelled. The womb can be easily felt in the lower part of the woman's abdomen as a hard mass. ”

“ The significant fact upon which an understanding of the nature of only-child-sterility must be based, is that the first delivery is the one which entails the greatest dangers to the mother, and that the subsequent sterility is attributable to the difficult delivery, and to the illnesses that follow in its train. ”

“ Childbirth
When a woman is in labour she squats down with her legs apart holding to the bed in front of her, while the midwife rubs her back. If delivery is retarded the midwife gets a broom and sitting behind the woman presses it on her stomach, at the same time drawing back the upper part of her body. By this means they think the child will be forced from the womb. Or the mother of the woman in labour will take a grinding-stone and stand holding it on her head so long as the child is not born. ”

“ Childbirth
When the woman returns from the seclusion-hut after the urvatpimi ceremony she lives in her usual home with the rest of the family and does her usual work, and she is delivered there. It seemed that any one might be present, and that there was no special ceremony connected with delivery.
During delivery, the woman kneels with her head resting on the breast of a man, usually her husband, who clasps his hands behind her neck. She is tended by a woman, usually by one noted for skill in these matters. ”

“ It is, nevertheless, worth while to note this tendency (see the analysis of Kleiner Hans, p. 5) .
The childbirth occurred early in the morning in the presence of a physician and a midwife. When all remnants of the birth, including some blood traces, were cleaned up, the father entered the room where the little one slept. She awoke as he entered. He imparted to her the news of the advent of a little brother which she took with surprise and strained facial expression. The father took her in his arms and carried her into the confinement chamber. ”

“ The due term of labor is past and as a consequence fetuses grow too large within the uterus, greatly increasing the difficulties of parturition and adding to the risk of both mother and child. It is the custom to announce with pride the birth of twelve- and fifteen-pound babies, but it is doubtful whether nature intended that growth to this extent should take place before birth. ”

“ When the appointed day arrives, the woman sits in her room propped up and with a cloth round her, in the attitude commonly adopted during delivery. The child is pushed forward from behind between the woman's legs, and, if it is a young child, it is put to the breast and encouraged to suck. ”

“ The accoucheur may be consulted by a mother anxious to know whether the pelvis of her daughter is such as to justify marriage. His opinion may also be desired by a female pregnant for the first time, in whose mind there may exist fears as to the formation of her pelvis. In this case, he will have to reply to the following questions:
Is delivery at full term compatible with the safety of the child? What influence will the deformity have on pregnancy? What precautions are necessary to guard against 178accident until the completion of gestation, and to facilitate delivery? ”

“ Nature can but very seldom effect the delivery of the Fœtus herself, and even when she does it is with the greatest risk, both to it and the mother. The accoucheur should always assist therefore, if he can, because even if nature can complete the delivery it is with such danger. The means of assisting, by turning, will be described in another Chapter. ”

“ It is equally unwise for inexperienced persons to press upon the womb in the hope of pushing out the placenta. To encourage the mother to strain just as she did in assisting the birth of the child would always be a safer plan. ”

“ Conception Soon After a Preceding Pregnancy.—Conception sometimes follows birth (or abortion) with astonishing rapidity, and some women seem for a period of their lives either always pregnant or with infants at their breasts. This prolificity is often alluded to, and is not confined to the lower classes, as often stated, but is common even among the nobility. Illustrative of this, we have examples in some of the reigning families in Europe to-day. A peculiar instance is given by Sparkman in which a woman conceived just forty hours after abortion. ”

“ And all this only comes to prove it's permitted by its mother's shechita, like other fetuses found in it. But if that beast then gives birth, also that limb that was emerged and retracted is permitted, as its own shechita permits everything. ”

“ It is an obstetrical axiom, that in labours with the head presenting, the labour pains continuing strong, the woman not deformed, the pelvis sufficiently capacious, the constitution sound, not exhausted by labour pains nor weak, there is the strongest reason to expect that nature will be adequate to the task of delivery. ”

“ In Europe it is quite common, and nothing has tended so much to do away with those disgusting and horrid operations, on mother and child, which were formerly absolutely necessary in cases of deformity. If it is found at the first delivery of a female, or before, that she cannot bear a living child at full term, artificial delivery is accomplished at seven or eight months, thus avoiding all the danger to the mother, and frequently preserving the child. ”

“ She will be careful not to touch the dress of any woman who has had a miscarriage. She will not cross running water, as it might cause premature delivery, nor go near a she-buffalo or a mare lest delivery be retarded, since a mare is twelve months in foal. ”

“ It is quite possible to become pregnant and yet it may be wholly impossible to give birth to a child. It is necessary to be constructed normally, or as near what is regarded as normal as is possible, in order safely to assume the responsibility of carrying a pregnancy to a successful completion. No one but a physician, who is skilled and familiar in the knowledge of what constitutes the proper size, and shape, and quality, and relations, one with another, of [69] your bones, and ligaments, and muscles, can tell whether you can safely be permitted to carry a pregnancy to term or not. ”

“ An experienced practitioner can sometimes predict with tolerable certainty, when called to a labor, how long it will be before it is over; but this is seldom the case, and most frequently his success is owing more to chance than to judgment. If the mouth of the womb be well dilated, the contractions powerful, and the patient vigorous, with the presentation natural, he is of course justified in predicting a speedy delivery ”

“ Among the peasant women of the mountains in Austrian Silesia, childbirth is regarded in a very different light from that among the women of our own country. They are exceedingly hardy and robust, and seem to care as little about giving birth to a child as if it were an everyday occurrence. ”

“ When delivery is near, the midwife must wait patiently until the child's head, or some limb, bursts the membranes, for if the midwife through ignorance, or through haste to go to some other woman, as some have done, tears the membrane with her nails, she endangers both the woman and the child ”

“ After the placenta and the sacs which enclosed the fetus, which together constitute what is known as "the afterbirth," have passed away, the recuperating and renewing powers with which God has so wonderfully endowed the body of the mother beyond that of the father become active. ”