[Illustration: Fig. 74.—Forceps operation. The left blade, in the left hand, is introduced first into the left side of the mother so that the curve of the blade fits the child’s head (inside the cervix). (Hammerschlag.)] The axis traction instrument is used but seldom by good obstetricians, since the danger to mother and child in this operation is very serious and it should be reserved for emergencies of exceptional character. Pubiotomy may precede the operation with advantage in many cases. Asphyxia of the child and maternal hæmorrhage must be prepared for. [Illustration: Fig. 75.—Forceps operation. The introduction of the right blade. (Hammerschlag.)] [Illustration: Fig. 76.—Forceps operation. Locking the handles. (Hammerschlag.)] [Illustration: Fig. 77.—Forceps operation. The way the blades should grasp the fœtal head. (Hammerschlag.)] [Illustration: Fig. 78.—Forceps operation. Traction on the handles. (Hammerschlag.)] [Illustration: Fig. 79.—Forceps operation. The delivery of the head. (Hammerschlag.)] [Illustration: Fig. 80.—Version. Seizing a foot. (Hammerschlag.)] =Version (Turning).=—Version is a maneuver for altering the presentation of the child while it is still in the uterus. A vertex may be converted into a breech, a breech into a vertex or a transverse into either a vertex or a breech. [Illustration: Fig. 81.—Version. The child rotates as pressure is made upon the head and traction upon the foot. (Hammerschlag.)] Version usually means that a transverse or a vertex presentation is changed into a breech and is followed by the extraction of the child. The operation is serious and not to be undertaken without definite indications. There is always the risk of sepsis and rupture of the uterus as well as a high probability of a dead child. Perineorrhaphy is, if anything, more frequent after this operation than after forceps. [Illustration: Fig. 82.—Version is complete when the knee appears at the vulva. (Hammerschlag.)] PREPARATIONS.—The room and patient are arranged as for forceps, except that the stirrups can not be put in. The legs must be held by assistants, for the delivery of the after-coming head may be complicated and require the Walcher position, which can not be quickly obtained if the legs are fast. Only eight minutes are allowed for the delivery of the child after the navel passes the vulva, if it is expected to live. The bladder and rectum must be empty. Asepsis must be rigid and both subjective and objective. The dorsal position on a table is imperative. The diagnosis must be accurate and the anæsthesia carried to the surgical degree. Facilities for treating asphyxia neonatorum must be provided. The following summary of the indications and conditions may be convenient for reference. INDICATIONS.—Contracted pelvis. (Consider pubiotomy.) Abnormal position of the head. (Face position with chin posterior.)