The womb descends during the first two months of pregnancy, this constitutes a kind of physiological falling of the womb and indeed the accompanying symptoms of a pregnant woman are often similar or identical to that diseased and permanent condition of physical suffering, namely, falling of the womb. Perhaps the most common symptoms of the descent of the uterus will be more or less frequent desire to pass water, because of the dragging of the womb on the neck of the bladder; sometimes there is also a straining or inclination to go to stool, owing to pressure on the rectum from the same cause. The umbilicus or navel becomes painful and even depressed from traction of the superior ligament of the bladder, which is attached to the umbilicus, thus illustrating the operation of cause and effect, namely, as the bladder is depressed by the descended uterus, the bladder in turn pulls on the umbilicus to which its ligament is attached. The pregnant uterus remains only the first few months in this depressed state; at the third month, as a result of its continual growth and that of the fetus, the uterus ascends out of the pelvis and as a natural consequence the symptoms of the bladder and rectum subside. Towards the end of the ninth month the womb again descends into the pelvis and with this there may be a return of the irritation of the bladder and a feeling of bearing down or tenesmus of the rectum. The descent of the uterus toward the close of pregnancy diminishes the prominence of the abdomen, and as the diaphragm has freer play, the respiration becomes easier; if there was any cough that, too, disappears, and on the whole the woman feels herself more comfortable and in happy spirits. This may even arouse suspicion in her own mind as to her condition, because she does not know the cause of the change; it may portend to her that something is not right, that she is not pregnant or that her child may be dead. In women who have borne one or more children in a natural manner, the descent of the womb is of no particular moment in the last months of gestation, because the abdominal walls having been stretched by previous pregnancies the body or fundus of the womb may fall forward and give the lungs and other organs relief from pressure, but in the first pregnancy this is never the case, because the abdominal walls are too tense to allow this normal anteversion.