DIVISIONS OF LABOR.
Dr. Conquest has disposed of labors in the following manner:
“The division of labors originally made by Hippocrates into: 1st. Natural; 2d. Preternatural, is sufficiently comprehensive, while it forcibly recommends itself by its simplicity and perspicuity. Natural labor supposes four things: 1st. That the vertex presents; 2d. That there is sufficient room in the pelvis to admit of the ready descent of the head of the child in that direction which permits the occiput to emerge under the arch of the pubis; 3d. That there is parturient energy adequate to the expulsion of the contents of the uterus without manual interference, and without danger either to the mother or child; and, 4th. That the process of parturition is completed within a moderate time.
“Preternatural labor embraces all the varieties not comprehended in the class of natural labor, whether they respect difficulty, duration, or danger, and may be included in the following six orders: 1st. Protracted labors; 2d. Those labors in which any other part than the head may present; such as the breech, feet, hands, penis, etc.; 3d. Labors with a plurality of children; 4th. Labors attended with convulsions; 5th. Labors with uterine hemorrhage; 6th. Labors in which laceration of the uterus or contiguous parts may occur.”
Dr. Denman’s division of labors is probably as good as any one, and has the recommendation of being simple and easy to comprehend. It consists of the following classes: 1. Natural; 2. Difficult; 3. Preternatural; 4. Anomalous.
Under one or other of these distinctions, every kind of labor which can occur, is to be placed.
Natural labor “is that which consists in a gradual enlargement of the mouth of the womb, and the diametus of the vagina, so as to suffer the child to pass away when urged from above by a repetition of expulsatory contractions of the uterus and all the surrounding muscles.” This kind of labor is by far the most frequent, and indeed takes its name from its frequency; and in the great majority of labors there is no danger however painful and distressing they may be. Natural labor lasts usually from two to twelve hours, seldom happening sooner than the first or later than the last. Dr. Good places the average at about six hours. If I were to speak of the average duration of labor from memory, in regard to the cases which I have attended, I should consider that six hours was too low a number, and should think that eight or ten would be a nearer approximation to it.
Dr. Maunsel, of Dublin, has given the records of 839 cases of labor which occurred in the Wellesley Institution. In these,
| 347 | terminated in | 6 | hours. |
| 300 | „ | 12 | „ |
| 87 | „ | 18 | „ |
| 59 | „ | 24 | „ |
| 37 | „ | 48 | „ |
| 3 | „ | 56 | „ |
| 5 | „ | 60 | „ |
| 1 | „ | 72 | „ |