"We render the shoulders also another fixed point, so as to steady the upper part of the body, by tying a long napkin, or a round towel, to the same bed-post, and desiring her to hold it in her hand. We tell her, when the pain comes on to press with her feet against the bed-post, and pull gently at the towel, cautioning her against straining violently. The consequence is she so fixes her person as to render it almost impossible for her to jump away suddenly, or to recede to any distance from us. Independently of this little manoeuvring, when the head is in any degree extending the vulva the nurse must be required to raise the right knee to some distance from the other, by which means the thighs are separated, and an increased facility given to the exit of the head through the external parts, as well as some control exerted over the patient's movements.... After having examined the uterus through the parietes of the abdomen, we must make an internal examination, more perfectly to assure ourselves in what way the placenta is disposed of. Twisting the funis umbilicalis around the first two fingers of the left hand, and bringing it to its bearing, we pass the first finger of the right hand, previously anointed, into the vagina, as in a common examination. If the placenta be entirely _in utero_, which, as just remarked, is most commonly the case immediately after the child's expulsion, we shall either not be able to touch it at all, or if it be within reach, we shall only detect a very small portion of it; we may just feel it offering itself at the os uteri; but we cannot surround its volume, nor can we probably discover the insertion of the funis. "_Removal of the Placenta._--There is no part of natural labour which requires so much judgment as the conduct of the third stage; for the slightest mismanagement of the placenta may be productive of most serious mischief, by converting a perfectly natural into a most dangerous and complicated case. As long, then, as the placenta remains _in utero_, so long we must wait, within a certain limit--provided there be no flooding--for those contractions which are to expel it from the uterus into the vaginal cavity, &c.; while we are thus watching, we shall most likely be informed of the return of uterine action, by the woman complaining of two or three comparatively trifling pains affecting the back and loins. As it is probable that under these pains the placenta may have somewhat descended, another examination may then be made _per vaginam_ to satisfy ourselves on this point, &c.