ut of a bowl of hot water placed
handy on a chair, should be held constantly against the perineum to hasten
the softening and dilatation of these tissues. Plenty of hot water and
small towels should be at hand. The head advances with each pain and again
recedes until the parts are properly dilated, and the perineum slips
backward over the child's face.

[534 MOTHERS' REMEDIES ]

If torn, it should be sewed before the physician leaves, as it can be done
easily and without pain to the mother. As the head of the child emerges,
the anesthetic should be pushed, or the woman told to open her mouth and
cry out. This lessens the pain and the child's head emerges slower, and
the perineum is saved. The child's head should be received in the hand.
After the head is born, there is a lull for a few moments. Then the
shoulders rotate into the proper position and are easily born. There may
then be a flow of watery fluid for a few seconds. Before this time the
physician has examined to see whether the cord is around the child's neck,
released it if it has been, and also cleaned out the child's mouth. The
child usually cries a little about this time and it is soon seen whether
it needs quick attention. The perineum should be guarded also while the
shoulders are being born as it can be torn by them. The shoulders are
generally born without any help. The child's head is held in the
physician's hand. As soon as the body is born, the child should be laid
upon the bed behind the mother's thighs, and the cord pulled down to
prevent it pulling upon the after-birth. After the beating in the cord has
ceased, generally from five to ten minutes have elapsed, the cord is then
tied, tight enough so it will not bleed afterward, about one or one and
one half inches (some say more) from the body and tied a second time an
inch or so from the first ligature, and the cord cut between the two
ligatures. Care should be taken so as not to cut a finger or toe of the
baby. If the cord is very thick it is best to pinch it at the point of
tying and the contents stripped away before the first ligature is applied.
After the cord is cut it should be wiped off to determine that bleeding
from the vessels has been permanently cut off, and if not it should be
tied again. The child is now taken up by placing the back of its neck in
the hollow between the thumb and forefinger, and the other hand over the
backbone. It should then be placed in a warm receiving blanket, and