the family takes the outer
wrappings off the sterilized delivery pad and the "clean" helper
places the sterile delivery pad under the expectant mother, who is
directed to "bear down" when her pains come. She may be supported
during these pains by pulling on a sheet that has been fastened to the
foot of the bed.

The _clean_, helper then sits by her constantly until the baby is born
but under no circumstances should touch her until after the head
appears. Immediately after the birth of the head, the shoulders
usually follow with the next pain, which ought to occur within two or
three minutes. Occasionally the face turns blue, in such an instance,
the mother is directed to strain vigorously and presses down heavily
on the abdomen with both her hands, this usually hurries matters
materially, and the body of the child follows quickly. The baby should
cry at once. If the child does not show signs of life, quick, brisk
slapping on the back usually brings relief. During the birth of the
head it is imperative that, in the event of liquid passing at the same
time, no water or blood be sucked into the mouth by the baby. Great
care must be exercised in this matter. Should the baby remain blue,
lay it quickly upon its right side near the mother, and after the
pulse of the cord has stopped beating the clean helper ties the cord
twice, two inches from the child and again two inches from this tying
toward the mother, and then the cord is cut between the two tyings
with scissors that have been boiled twenty minutes.

Should there be more difficulty with the breathing of the new born
child, if slapping it on the back brings no relief, its back (with
face well protected) may be dipped first in good warm water, then
cold, again in the warm, again in the cold--this seldom fails. The
child should then be kept very warm, lying on its right side.

CARE OF THE MOTHER

All this time, a member of the family has been firmly grasping the
mother's abdomen, and within an hour the afterbirth passes out through
the birth canal. If the physician has not yet arrived, all dressings,
the pad, the afterbirth, must all be saved for his inspection.

The inside of the thighs and the region about the vagina is now washed
with bichloride solution, the soiled delivery pad removed, a clean
delivery pad is placed under her; an abdominal binder is applied and
two sterile vulva pads are placed between the legs, and hot water
bottles are put to her feet, as u