(a) Uterus must be contracted.
(b) Uterus must be in median line.
(c) Bladder must be empty.
If not successful, wait ten minutes and then repeat maneuver. Never make traction on the cord. Never use ergot until uterus is empty.
If placenta does not come away within an hour, manual removal must be considered. In case of hæmorrhage, it must be removed at once.
Carefully inspect placenta and be sure it is complete. (See Post Partum Hæmorrhage, p. [232].)
When the patient is put to bed, the bloody sheets and towels are put to soak in cold water, and after several rinsings, may be sent to the laundry. Drapings stained with fæcal matter must be cleansed separately.
CHAPTER X
THE NORMAL PUERPERIUM
The puerperium is the name given to the period succeeding the birth of the child as far as the time of the complete restoration of the genitals. It may last from six to ten weeks, or even longer if complicated.
When the labor is completed, the most urgent desire of the patient is for rest. She is thoroughly exhausted in nerves and body. A post partum chill may appear,—a slight shiver that may last a quarter of an hour. Since the pulse and temperature remain unaffected, this phenomenon may be regarded merely as a sign of prostration or nervous revulsion.