Gynæcology for nurses and gynæcological nursing ... / by Sir Comyns Berkeley.

  • Comyns Berkeley
Date:
1941
Catalogue details

Licence: In copyright

Credit: Gynæcology for nurses and gynæcological nursing ... / by Sir Comyns Berkeley. Source: Wellcome Collection.

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    The Third Stage of Labour. From the expulsion of the child to that of the placenta and membranes. Uterus.'—On the expulsion of the child the retraction of the uterus becomes more marked, so that on placing a hand on the abdomen over the uterus the latter feels hard and round, and has always been compared to the feel of a cricket ball. Then the uterus, to rest, relaxes somewhat, and obtains more nourishment (blood), and this contraction and relaxation continues at frequent intervals, but in the intervals of con¬ traction there still remains retraction. The object of the contractions is to expel the placenta when it is separated and with the addition of retraction to prevent post-partum haemor¬ rhage. The Placenta and Membranes.—Since the placenta is not elastic it cannot shrink. Retraction results in the shrinking of the placental site ; it is obvious, therefore, that the placenta must gradually become separated. The expulsion of the placenta and membranes can be effected by Nature if the patient is left alone, which may take an hour or more. The placenta having once separated and in the vagina, hut only then, it is customary to hasten its expulsion, for the comfort of the mother, by squeezing the top of the uterus with the hand on the abdomen (thumb in front, fingers behind the uterus), and pushing the uterus downwards and forwards to expel it out of the vagina. If the placenta has separated but not left the uterus, the pressure must be applied first downwards and backwards to get it out of the uterus. The Auxiliary Muscles.^—After the birth of the child, when the pains gradually return, the woman will use her auxiliary muscles to assist the uterus in expressing the placenta and membranes. The Child.—After the birth of the child, and when the pulsation in the umbilical cord has ceased, the cord should be ligatured with sterilized thread, one ligature being applied 2 inches from its umbilicus and the second i inch further along the cord, which should then be divided with sterilized scissors between the ligatures, care being taken to ensure that the piece of cord attached to the child is not bleeding, and
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