ould be avoided. We are glad to be able to truthfully state that
this type of woman is vastly in the minority.

When the second stage has advanced far enough, the patient will decide to
go to bed. It may be necessary to put her in bed earlier, if her pains are
very strong, as there is always a possibility of suddenly expelling the
child under the influence of a strong pain. She will, as previously stated,
discard all clothing, except her night gown, which can be folded up to her
waist line and let down as far as necessary after the confinement is over.
The obvious advantage of this arrangement is that the gown remains [99]
unsoiled, and saves what would be needless trouble if it proved necessary
to change the night gown at a time when the tired-out patient needs rest.
Much aid may be afforded the woman at this stage by twisting an ordinary
bed sheet and putting it around one of the posts or bars of the foot of the
bed. The patient may then pull on the ends during the pain; she may also
find much comfort and aid by bracing her feet on the foot of the bed while
pulling. It is desirable to instruct the nurse to press on the small of the
back during these pains. Some women appreciate a hot water bottle in this
region. If the pains are hard the patient may perspire freely; it is always
refreshing occasionally to wipe the face and brow off with a cloth wrung
out of cold water. Cramps of the limbs may be relieved by forcibly
stretching the leg and pulling the foot up toward the knee. From this time
until the child and after-birth are born the physician will take active
charge of the case.

THE MANAGEMENT OF THE ACTUAL BIRTH OF THE CHILD.--Near the end of the
second stage of labor it will be observed that the pains have grown strong,
expulsive, and more frequent. Very soon the advancing head will begin to
push outward the space between the front and back passage; the rectum is
pushed outward and the lips of the vagina open. If an anesthetic is to be
used these are the pains that call for it. A few drops may be dropped
singly on a small clean handkerchief held up by the middle over the nose,
its ends falling over the face. A few drops will just take the edge off the
pains, and render them quite bearable. As soon as the pain is over the
patient should rest, relax completely, and not fret and exhaust herself
worrying about the pains to come. It is astonishing how much actual rest a
woman can get between pains if she will only t