A short practice of midwifery : embodying the treatment adopted in the Rotunda Hospital, Dublin / by Henry Jellett.

  • Henry Jellett
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: A short practice of midwifery : embodying the treatment adopted in the Rotunda Hospital, Dublin / by Henry Jellett. Source: Wellcome Collection.

    98/442 page 72
    As tlie head travelled tlirougli the pelvis, the shoulders became engaged in the brim in the dia- meter at rig]\t angles to that in which the head^ engaged. Tlius, in a first position, the shoulders engagfe in the left oblique diameter of the pelvis. As they descend, the anterior shouldei', being slightly lower than the posterior one, rotates in front, so as to lie in the antero-posterior diameter of the pelvis. It is this movement that causes the com- pletion of external rotation, the already delivered head rotating to suit the new position of the shoulders. Usually the head rotates in such a manner as to return, to its former position ; i. e, in a first position, it rotates with the occiput pointing to the mother's left thigh ; in a second position, with the occiput pointing towards the right thigh. When the anterior shoulder has rotated in front, it becomes fixed under the pubic arch. The posterior shoulder then sweeps over the perina3um, and is born. The arms follow, folded upon the chest; and the rest of the body, being smaller than that which has gone before, is born without further difficulty. It is interesting to note that these different move- ments are, so to speak, complementary to one another. Thus first occurs flexion of the head ; then internal rotation ; then extension, the complement of flexion ; then external rotation, the complement of internal rotation. In the first position with the back posterior (fourth position of Naegele), the mechanism of delivery is the same as the foregoing with the single exception that during internal rotation the head rotates through three eighths of a circle instead
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