Obstetrics for nurses / by Joseph B. De Lee.

  • De Lee, Joseph B. (Joseph Bolivar), 1869-1942.
Date:
1933
Catalogue details

Licence: In copyright

Credit: Obstetrics for nurses / by Joseph B. De Lee. Source: Wellcome Collection.

    78/708 (page 72)
    All three stages of labor are characterized by pains. These pains represent uterine contractions, and the two terms are used synonymously. Uterine contraction in all languages is expressed by the same word that means pain— for example, in German, Wehen; Italian, dolores; French, douleurs. The Labor=pains.—The uterus contracts at irregular intervals throughout pregnancy, but there is no pain. Late in pregnancy there may be some pain, but usually when the uterine contractions become painful labor has begun, and this is our most reliable outward sign of the advent of labor. When the “pains” begin and become rhythmic we consider the woman in labor. If one observes the abdomen when a pain comes on—that is, when the uterus contracts—one feels the organ harden all over; it rises toward the ribs and stands out more prominently. With a strong pain the uterus becomes almost board-like in hardness. As the pain goes away the uterus softens and loses its sharp contour, and the abdomen flattens. In the beginning of labor the pains are short, weak, and far apart, but as it progresses the strength and length increase and the intervals decrease gradually, being one hour, thirty minutes, fifteen, ten, six, five minutes, until, toward the very end, one pain follows almost immediately after the other. The nurse may judge the rapidity of the labor by the frequency, strength, and length of the pains. The parturient feels the pains at first in her back (the “kidney pains” of the French), and they are not so painful, but as labor goes on they are felt more to the front and are severer. The contractions last thirty and ninety seconds and between them the parturient is usually quite com¬ fortable. When the woman is well on in the first stage she describes the pains as grinding, later as cutting, and in the second stage they are “bearing-down” pains. She makes more or less outcry, depending upon her ability to bear suffering. In the second stage she complains less, because,