Rotunda midwifery for nurses and midwives / by G.T. Wrench.

  • Guy T. Wrench
Date:
1908
Catalogue details

Licence: In copyright

Credit: Rotunda midwifery for nurses and midwives / by G.T. Wrench. Source: Wellcome Collection.

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    often quite blue. To see it you should ask your patient to lie on her left side with her legs drawn up and gently separate the lips of the vulva. I do not think you should do more than this. I do not think any of your examiners would expect you to make a vaginal examination, and so I will not describe what a doctor feels when he makes a vaginal examination. Increase in Size in the Uterus.—The uterus increases in size very rapidly, but you cannot feel it for the first three lunar- months of pregnancy because it stays in the pelvis, which is surrounded by bony walls. Wliat is the pelvis ? If you look at the diagram on p. 15, which represents a woman cut in half down the middle so as to show her inside, you will see that a dotted fine has been drawn from the top of a bone called the sacrum to the top of a bone called the pubes. Below this imaginary line the part down to the fine joining the external open- ings of the back passage, the vulva, and the urethra, is called the pelvis. The part above this line up to the dia- phragm is known as the abdomen or abdominal cavity. The diaphragm separates the abdomen from the chest. For the first three months of pregnancy then, the uterus is surrounded by the bones that form the walls of the pelvis. But in the fourth lunar-month it grows up into the abdomen and you can usually feel it through the skin and muscle that form the abdominal wall. You feel it, in short, by pressing your hands into the loAver part of the stomach, and it feels hke a round lump rising just above the top of the pubic bone. At the end of the fourth lunar-month the top of the womb reaches up to a height about half-way between the top of the pubic bone and the umbilicus {umbilicus—Lat. the navel). At the end of the fifth month you can feel it about two fingers’ breadth below the umbilicus. The Breasts.—The breasts are so intimately connected with the child that you will not be surprised to hear that changes are noticeable in them even in the early months of pregnancy. They get larger, the veins under the skin over them are fuller, like those on the back of your hand, 2
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