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Second Stage

Categories: Obstetrics or Midwifery

The pains now become more frequent and severe and last
longer, and the patient now manifests a strong desire to expel the

contents of the womb. The woman now feels better in bed and when the pains

come she involuntarily bears down, with each contraction she sets her

teeth, takes a deep breath, fixes the diaphragm, contracts the muscles of

the abdomen and bears down hard if you allow her to do so. The knowledge

that she is wor
ing to overcome an obstacle gives her some satisfaction

and she feels that she is accomplishing something by the efforts she is

making. The physician can aid greatly by suggesting to the patient how to

use the pains and how much bearing down to do. He can tell her when not to

bear down, and so save her strength for the next real pain when bearing

down will do good. Although the pains are really harder in this stage,

nervous women suffer no more, for their mind is now concentrated upon the

work at hand. Sometimes at the beginning of this stage the patient feels

chilly or has a severe chill; a hot drink and more covering counteract

this. Another phenomena is the escape of the waters and a lull in the

pains for a little time, when they come on more effectively than before as

the womb contracts down upon the child and is not hindered by the "bag of

water." The pains keep on at intervals until the child is born and the

physician can now be of help by guiding, directing and assisting the birth

of the head. This stage averages about two hours.