PRESENTATION.
I will presume that every woman expecting to give birth to a child engages an accoucheur one or two months be- fore the expiration of her term. As the woman in labor is quite incapable of assisting herself, I will treat only of natural labor, to give an idea of its physiological process, and the manner in which it should be attended in case the physician is not present. Any abnormal deviation or com- plication should positively require a well-skilled accoucheur to be in attendance.
When labor has really commenced, the most important point to ascertain is the presentation. The term "presenta- tion" refers to the part of the child that presents itself to the mouth of the womb. Physicians divide presenta- tion into classes, and the classes into positions, until they have reached a rather confusing number. For the prac- tical purpose of an unprofessional attendant, four only are important, — head, foot, hreech, and hand presentation; the first three constituting natural presentations, from the fact that they do not offer difficulties, and the latter, pre- ternatural, because it offers serious difficulties to labor.
The presentation can easily be detected by introducing the index finger into the vagina as far as the womb, when, if the head presents itself, a hard, round tumor will be felt within the mouth of the womb. This presentation may be confounded with the hreech, for that also is round, and almost of the same diameter; but, in the latter, there is a feeling of elasticity, given by the fleshy buttock, that can- not be mistaken. Besides, by thrusting the finger a little higher, and feeling carefully around, the protrusions of the vertebrae of the spine, or the division of the limbs and the genital organs, can be discovered.
