The clean, helper then sits by her constantly until the baby is born but under no circumstances should touch her until after the head appears. Immediately after the birth of the head, the shoulders usually follow with the next pain, which ought to occur within two or three minutes. Occasionally the face turns blue, in such an instance, the mother is directed to strain vigorously and presses down heavily on the abdomen with both her hands, this usually hurries matters materially, and the body of the child follows quickly. The baby should cry at once. If the child does not show signs of life, quick, brisk slapping on the back usually brings relief. During the birth of the head it is imperative that, in the event of liquid passing at the same time, no water or blood be sucked into the mouth by the baby. Great care must be exercised in this matter. Should the baby remain blue, lay it quickly upon its right side near the mother, and after the pulse of the cord has stopped beating the clean helper ties the cord twice, two inches from the child and again two inches from this tying toward the mother, and then the cord is cut between the two tyings with scissors that have been boiled twenty minutes.
Should there be more difficulty with the breathing of the new born child, if slapping it on the back brings no relief, its back (with face well protected) may be dipped first in good warm water, then cold, again in the warm, again in the cold—this seldom fails. The child should then be kept very warm, lying on its right side.
CARE OF THE MOTHER
All this time, a member of the family has been firmly grasping the mother's abdomen, and within an hour the afterbirth passes out through the birth canal. If the physician has not yet arrived, all dressings, the pad, the afterbirth, must all be saved for his inspection.
The inside of the thighs and the region about the vagina is now washed with bichloride solution, the soiled delivery pad removed, a clean delivery pad is placed under her; an abdominal binder is applied and two sterile vulva pads are placed between the legs, and hot water bottles are put to her feet, as usually at this stage there is a slight tendency toward chilliness. She should now settle down for rest. Fresh air should be admitted into the room. There may be some hemorrhage, and if it is excessive, grasp the lower abdomen and begin to knead it until you distinctly feel a change in the uterus from the soft mass to a hard ball about the size of a large grape fruit; thus contraction has been brought about which causes the hemorrhage to decrease. If the doctor has not yet arrived put the baby to the breast, and place an ice bag for ten or fifteen minutes on the abdomen just over the uterus. Should there be lacerations, the doctor will attend to their repair when he comes. One teaspoonful of the fluid extract of ergot is usually given at this time, if possible get in touch with the physician before it is administered.
CARE OF THE BABY
After the mother is comfortable, your attention is directed to the baby; the condition of the cord is noted; should it be bleeding, do not disturb the tying, but tie again, more tightly just below the former tying, and with the long ends of the tape, tie on a sterile gauze sponge or a piece of clean untouched medicated cotton, thus efficiently protecting the severed end of the cord. No further dressing is needed until the doctor arrives.
Grave disorders have arisen from infection through the freshly cut umbilical cord.
Should the doctor be longer delayed, one drop of twenty per cent argyrol should be dropped in each of the infant's eyes and separate pieces of cotton should be used for each eye to wipe the surplus medicine away.
This application must not be long neglected, for a very large per cent of all the blindness in this world might have been avoided had this medicine been placed in each eye soon after birth.