Face and brow presentations are rare and come to the attention of the nurse only when an operation is required for their relief. Further conditions may arise, such as danger to mother or child, which demand an acceleration of the labor. If the head is engaged, forceps is the operation most commonly undertaken, and if not engaged, the problem may be solved either by an early version and extraction or by forceps later. The dangers to the mother are not usually difficult to diagnose if the case has been followed carefully. Signs of danger to child must be looked for constantly. Such are: (a) Alteration of the heart tones. (b) Retardation of pulse in cord between pains. (c) Escape of meconium is _not_ significant unless occurring in the pain-free interval, when it may signify hypercarbonization of blood and a threat of asphyxiation. The preliminaries for the performance of these operations may now be described, and the indications and conditions briefly tabulated. The _preparation_ should be standardized so that the same set-up of the room will do for all of the major obstetrical operations, except Cæsarean section. The kitchen table is generally regarded as a satisfactory operating table. Its length is sufficient for delivery when the legs are doubled up. The table should be covered with a blanket or comfort on which it laid a clean sheet. A rubber blanket or piece of oil cloth is put on, so folded above the place for the patient’s hips, and so pinned at the sides, that all drainage will flow off into a bucket or jar at the foot. In front of the table is placed a straight-backed chair with flat seat. To the right of the operator, as he faces the table, stands a bench, or two chairs, side by side; or, if possible, another table. This is covered with a clean sheet for the reception of the instruments. To the operator’s left, another table similarly prepared carries the solutions, sponges, etc. Every operation for delivery should have tape and cord scissors within easy reach, as well as facilities for the resuscitation of the child. The light should come from behind the operator and fall full upon the field of operation. The room should be warm. The patient is laid upon the table and her knees elevated in the exaggerated lithotomy position. If there are assistants enough, one can stand on either side and hold a knee, if not, a sheet sling can be made and slung round the patient’s shoulders and tied to the knees as previously described. [Illustration: Fig. 71.—Exaggerated lithotomy position. The legs are held by a sheet sling. The vulva should be shaved. (Williams.)] An anæsthetic will be required. If a doctor can not be had, this duty will fall to the nurse.