8 in. forceps. 2 scissors curved on the flat. 1 dissecting forceps. 1 duck bill speculum. 1 needle holder. 1 metal catheter. 8 gauze sponges. 1 medicine dropper. 1 cord clamp, or 2 cord tapes. 2 case numbers, attached. 12 needles, 4 round, 4 half-curved cervix needles, and 4 skin needles. This is the stage of expulsion and the patient may want to pull or push on something to aid the straining effort. Unless the nurse needs time to set up the room or to get the doctor, this tendency may be encouraged. A sterile sheet may be attached to the foot of the bed and the ends (corners) given into the patient’s hands as a knot or loop to pull on, or she may push upward against the head of the bed. Under no circumstances must she be permitted to touch or contaminate the clean linen in her movements, either consciously or unconsciously. The hands should be restrained, if necessary, to avoid this. The face may be sponged and a cold towel laid across the eyes. Rubbing of the back and legs will bring great comfort, and cramps of the limbs may be removed by straightening the legs and rubbing the muscles underneath. Everything is now ready for the delivery. If the husband insists upon being in the room, he should take off his coat and vest and wear a gown, or if the labor is in the home, drop a clean night robe over his clothes. The prepared room will show at close hand-reach, the basins of solutions, the pledgets of cotton, tape or clamp for cord, scissors, nitrate of silver solution (1 per cent) for the eyes, with dropper, the sterile douche can in readiness for hæmorrhage and a large reserve of supplies. Whatever anæsthetic has been chosen for the second stage, is now administered. Throughout this stage, the heart tones of the child must be watched, as well as those of the mother, for intra-partum death may occur at any moment. A second examination may be desirable now to confirm the diagnosis and to secure an estimate of the advance. As a rule, the examinations should be as few as possible on account of the danger of infection. This is the period of greatest responsibility for the doctor whose duty it is to watch and, if necessary, to restrain the advance of the head in order to protect the perineum from rupture. This may be done at times most successfully, or in the case of too few assistants, most desirably, by _delivery on the side_. To secure this, as the head becomes more and more visible, the woman is turned upon her left side; a pillow rolled tightly and pinned in a sterile covering is placed between the knees, and a sheet flung across the body. [Illustration: Fig. 57.—Delivery in side position. The hands should be gloved and the upper leg raised on a hard cushion or pillow. (American Text Book.)]