1. Entire obliteration of the hymen.—This is no proof of actual delivery.
2. Destruction of the fourchette.
3. The vagina dilated, and free from rugæ.
4. Dark colour of the areola round the nipples.—This varies among women; and cases are known where there was no areola either during pregnancy or after delivery.
5. Skin of Abdomen.—Due to the great distension of the abdomen, the skin appears streaked with silvery lines varying in breadth. These markings in some cases may be scarcely perceptible, especially if the female has worn a tight abdominal belt during her pregnancy. The same appearance may be produced by dropsy, or the prolonged distension of the abdominal walls, the result of other causes. Attention to the other signs present will assist the diagnosis. After the lapse of seven to ten days the recent delivery of a woman cannot be certainly proved by an examination of the living woman, especially if it be known that she had previously borne children. In primiparæ the pink-coloured streaks on the abdomen, and the transverse condition of the os uteri, may strongly point to recent delivery.
2. Signs of Recent Delivery in the Dead
Should the woman die immediately after delivery, the external parts will present the same appearance as just described in the living. On opening the abdomen, the uterus will be found fat and flabby, between nine and twelve inches long, and with the os uteri wide open. The cavity of the uterus may contain large bloody coagula, and its inner surface be lined by the decidua. The attachment of the placenta is easily detected by its dark colour, and by the semi-lunar openings of the arteries and veins on the surface of the uterus.
Of course all the appearances just described will be greatly modified by the time that has elapsed between delivery and death.
Delivery after Death.—The fœtus has been known to have been expelled from the uterus by the force of the gases generated by putrefaction. Dr. Aveling, in a paper published in the Obstetric Transactions, 1873, arrives at the conclusion that post-mortem delivery is possible even where no symptoms of parturition were noticed before death. He also thinks that the child may live in utero for some hours after the death of the mother.
Table showing the Size of the Uterus at
Different Periods after Delivery