Holding, as I do, that pain is a natural condition of the puerperal state, you can understand why it is that I am opposed to the use of ether and chloroform under such circumstances. We ought never to counteract a law of nature. If we do, we are certain of being injured to a greater or less degree; and it is no wonder at all to me that people sometimes lose their lives in the use of these anesthetic agents. The only wonder is that they do not oftener sink under them. I am not now saying that I would never recommend even the risk of using chloroform, but only that I would not recommend it in labor, because that is a natural process, and one which should not be unnecessarily interfered with by art.
LETTER XXV.
MANAGEMENT OF LABOR.
Its Premonitory Signs—Progress of Labor—Its Different Stages—Age as Affecting it.
It is very common for women to experience a manifest improvement in all their symptoms some days before labor is about to come on.
Some days previous to its commencement, a remarkable subsidence of the abdomen and diminution in the size of the body takes place. This is occasioned by the sinking of the womb, and, of course, its contents with it move into the brim of the pelvis. It is possible, likewise, that the walls of the uterus begin at this time to bring themselves into closer contact with the child, thus rendering the abdomen somewhat smaller. At all events we know, that the fact does occur in most cases, and the circumstance is always to be looked upon as a favorable one.
Just before labor a sort of general distress arises in the patient’s mind, owing, no doubt, in part, to the state of the body, and in part to the natural apprehensions of pain and the danger which she is to pass through. “This,” as Dr. Denman observes, “does not seem to be confined to the human species, but to be common to all creatures, as they universally show signs of dejection and misery at this time, though they suffer in silence; and even those animals which are domesticated, strive to conceal themselves, and refuse all offers of assistance.”
STAGES OF LABOR.
Labor may be appropriately divided into three stages, which are the following:
1. That which includes “all the circumstances which occur, and all the changes made, from the commencement of the labor to the complete dilatation of the os uteri (mouth of the uterus), the rupture of the membranes, and the discharge of the waters.”
2. This stage includes those circumstances which occur between the first stage and the expulsion of the child.