PLATE XXXVII.
Descent of the shoulder and trunk at a still later period.
The whole Trunk is now fully delivered, folded almost double, and the legs and feet are turned up against the face. They speedily follow however, and then nothing is left but the head, and perhaps one or both arms, placed against the sides of it, as shown in Plate XXXVIII.
PLATE XXXVIII.
The Trunk has fully descended, and only the head is left, with one arm.
The arm is generally very easily brought down, or it may remain and come with the head. The delivery of the head is effected the same as in presentations of the pelvis, and is seldom attended with much difficulty, the parts having been so much distended. The body always rotates so that the back comes in front, and the chin passes into the curve of the Sacrum.
This is the way in which the delivery is effected by nature in such cases, and it will readily be conceived how dangerous it is to both mother and child, and how seldom it can be accomplished. If the Fœtus be of a full size, and the mother's pelvis no larger than ordinary, it is almost impossible for this spontaneous evolution to take place; and even when it does, it is with the greatest difficulty, the mother suffering in an extreme degree, and running great risk, not only of the most serious after results, but even of death. To the child the danger is equally great, owing to the severe and long-continued compression it receives, and the unnatural position it assumes. M. Velpeau tells us that in one hundred and thirty-seven such cases, one hundred and twenty-five of the children died. The number of the mothers also, who either died or were made sufferers all their future lives, was undoubtedly great, though unknown.