In short, this mode of detecting pregnancy is one of the most certain, and the most generally applicable, that we possess. _End of the fifth month._--At this time the Uterus has increased considerably in size, and has ascended so high in the Abdomen that the Fundus is level with the umbilicus, or navel, in a first pregnancy, though somewhat lower in those who have borne children before. This rising of the womb makes the Vagina longer, and brings the neck of the womb nearer to its centre. In the previous stage the neck was thrown so far back that it was difficult to reach, but now it is much more favorably situated, though much higher. Its substance is softer than before, and the two lips are nearly on a level, and somewhat opened, particularly in those who have borne children before. Indeed, in them the point of the finger may be introduced, as seen below:-- [Illustration: PLATE XVII. Neck of the Womb in a first Pregnancy, very slightly opened. Neck of the Womb in a female who has borne children before, showing how it admits of the introduction of the finger. This is at the end of the Fifth Month, and the drawings are about one-third of the natural size.] Ballotment is now much more easily practised, and is more conclusive. A new sign is also to be distinguished, by which we are furnished with another valuable means of detecting pregnancy. The child's heart begins to beat so strongly, and its circulation is so vigorous, that the _sound_ of it can be _heard_ externally. The same means are taken to ascertain this that are used in sounding the chest of an adult. If the ear be placed on the Abdomen, over the womb, the beating of the fœtal heart may be heard quite plainly; and if the stethoscope be used it will be still more distinct. This practice is called _Auscultation_. The signs furnished by it are certainly of the greatest value, and frequently enable us to detect pregnancy with unerring certainty. Indeed, not only can we tell by them that a child is in the womb, but often even _the very position in which it lies_, and whether there be _twins_, _or more_. This is done by noting where the heart is situated, by the sound, and whether the beating is single or double. The nature of these sounds, and the manner of detecting them, require to be carefully explained. If the person wishing to notice this sign is not already familiar with the beating of the adult heart, he had better become so first. The ear should be placed on the left side of a grown up person, on the skin, just beneath the breast, and held very still. The heart will then be heard to beat very distinctly, there being two sounds, a long one and a short one, alternating with each other. When this has been listened to for some time, the ear will be able to catch any similar sound, and the auscultation may then be practised to detect pregnancy.