Others collapse at once; they go to pieces under the slightest excuse, and frequently without as much as an excuse. As soon as the pain begins, they willfully ignore all the instructions given and desperately and foolishly try to escape what they cannot escape. In this unreasonable selfishness they resent advice, and at the same time they implore you to "do something" for them. There is absolutely no excuse for this kind of conduct; and any prospective mother who, because of a willful trait in her disposition, refuses to profit by the kindly professional advice of her physician or nurse, should at least have some consideration for her unborn babe. It may seem unkind to criticise the conduct of any woman at such a time. It is not prompted by a lack of patience or justice however. These women permit, in spite of every assurance to the contrary, an unreasonable fear to overwhelm them; and because of this fear they refuse to be guided into a path of conduct that will save them suffering and shorten the pains which they complain of. It is our conviction that if a woman would try to follow the advice of the physician at this time, at least half of all the seeming suffering would be avoided. We are glad to be able to truthfully state that this type of woman is vastly in the minority. When the second stage has advanced far enough, the patient will decide to go to bed. It may be necessary to put her in bed earlier, if her pains are very strong, as there is always a possibility of suddenly expelling the child under the influence of a strong pain. She will, as previously stated, discard all clothing, except her night gown, which can be folded up to her waist line and let down as far as necessary after the confinement is over. The obvious advantage of this arrangement is that the gown remains [99] unsoiled, and saves what would be needless trouble if it proved necessary to change the night gown at a time when the tired-out patient needs rest. Much aid may be afforded the woman at this stage by twisting an ordinary bed sheet and putting it around one of the posts or bars of the foot of the bed. The patient may then pull on the ends during the pain; she may also find much comfort and aid by bracing her feet on the foot of the bed while pulling. It is desirable to instruct the nurse to press on the small of the back during these pains. Some women appreciate a hot water bottle in this region. If the pains are hard the patient may perspire freely; it is always refreshing occasionally to wipe the face and brow off with a cloth wrung out of cold water. Cramps of the limbs may be relieved by forcibly stretching the leg and pulling the foot up toward the knee. From this time until the child and after-birth are born the physician will take active charge of the case.