If the first stage is prolonged, the nurse should try to get the patient to rest, and she should herself snatch a few moments of repose if possible. [Illustration: Fig. 56.—Patient draped for internal examination. (Williams.)] The condition of the os and the character of the pains may make the doctor feel safe in leaving the house, but his whereabouts and telephone number should be ascertained and the exact time of his return. =Second Stage.=—During this stage, the patient should go to bed and the doctor should remain nearby. The nurse may observe the vulva at intervals and note bulging, if present, or she may press a finger against the soft parts outside the labia and see if the hard resistant head has come into the outlet. The pains are severe and all accessory muscles are called into action. Partial anæsthesia should be maintained in most cases, which should merge into complete narcosis as the head passes the vulva. The nurse may have to administer this. When this stage begins, or is well under way, the patient should be prepared. A _sterile pad_ should be placed under her, then a _sterile bed pan_. The nurse having prepared her hands and arms as previously directed for the doctor, scrubs abdomen, legs, and vulva with green soap and warm water, followed by lysol solution 0.5 per cent and a rinsing with sterile water. The cleansing of the patient should take about ten minutes. Cover with a sterile towel and put on the sterile linen. If in the hospital, the drums have been packed for sterilization so that when they are opened each article will appear in the order of its need: _No. 1._ (Beginning at the bottom.) A receiving blanket, which has a ticket, marked with the weight of the blanket, attached to it. 1 abdominal binder with pad holder attached. 1 pillow slip folded half way back. 1 gown for patient. 2 surgeon’s gowns. 3 sheets. 1 pair surgical stockings folded half way. 1 surgeon’s gown for nurse. _No. 2_ contains cotton pledgets. _No. 3_ contains strips of gauze and combination pads. =Application of Sterile Linen—Normal Case.=—Sterile linen is to be applied as follows, by a clean nurse; 1. Lay sheet across foot of bed and half way up. 2. Put surgical stocking on one foot and draw sheet up for foot to rest upon. 3. Second foot as above. 4. Lay sterile sheet across bed under patient, letting ends hang. 5. Lay sterile sheet over abdomen of patient. In many hospitals the sterile stockings and protective sheet are all made in one piece, which greatly simplifies the application of the linen. As soon as the second stage begins, the packet containing the perineorrhaphy and cord set, carefully sterilized, is brought out and placed in convenient reach of the doctor. This set contains—