degree. They are never given any attention at the time of the
confinement, unless under extraordinary circumstances, such as a more or
less complete rupture of the womb, and this is such a rare accident [117]
that most physicians practice a lifetime and never see or hear of one
single case. Those on the outside are always attended to immediately after
labor, or should be, unless they are very extensive and the patient is not
in condition to permit of any immediate operative work. In such a case it
is best to leave it alone until the patient is in condition to have it
operated on at a later date.

It is distinctly preferable to have it attended to immediately after labor
when it is possible, and it is possible in a very large percentage of the
cases. The explanation of this is because it is practically painless then,
owing to the parts having been so stretched and bruised that they have
little or no feeling. If it is left for a day or two and then repaired, it
will be more painful, because the parts will have regained their
sensitiveness. Another good reason in favor of immediate repair is that a
much better and quicker union will take place than if postponed.

When a patient is torn, but not to the degree necessary to stitch, it is to
her advantage to be told to lie on her back and keep her knees together for
twelve hours, thus keeping the torn edges together and at rest, thereby
favoring quick and healthy repair of the tear. Some physicians go as far as
to bind the patient's knees together so she cannot separate them during
sleep.

It is the custom of every conscientious physician to request every woman he
confines to report at his office six or eight weeks after labor. The reason
for this is to find out by examination the character and extent of the
lacerations of the mouth of the womb. No physician can tell at the time of
labor just how much damage has been done, because the mouth of the womb, at
the time of labor, is so stretched and thinned out, that it is impossible
to tell. After the womb has contracted to about its normal size, it is a
very simple matter for any physician to tell exactly the character and
extent of the lacerations. Most of these tears need absolutely no
attention; there are a few however that do. This is a very important matter
for two very good reasons.

1st. Every woman should know, and is entitled to know, just what [118]
condition she is in, because if she has been torn to an extent