The second stage of labor begins when the bag of water has broken and the waters escape; the contractions of the womb increase now in violence and become decidedly of a bearing down character. At this period the patient should be furnished with something that she may grasp with her hands; a sheet attached to the post of the bed is the best for this purpose, and with her feet steadily braced, holding her breath she bears down whenever a pain comes on; bearing down between pains, only exhausts the patient and does no good. During this stage of labor, the pain in the patient’s back will sometimes become intense, she exclaims: Oh, dear, doctor, my poor back feels like breaking! what shall I do? The greatest relief that can be given at this time is to support the back with the flat surface of the hand, or by folding a towel and placing it under the back, the two ends being held by assistants. As the birth of the child progresses and it approaches the vulva, the patient will feel an urgent inclination to go to stool; upon this she must not insist, for at this advanced period of labor she may injure herself and child. The desire is caused by the pressure of the child’s head against the rectum; any fecal matter that is thus pressed out should be at once removed by the nurse. The third stage of labor consists in the expulsion of the placenta or afterbirth. There is a natural detachment of the placenta and a natural expulsion, but one must have the patience to wait. What presumption of the officious doctor or midwife to suppose that nature was so derelict as to require some meddlesome assistant, immediately after the birth of the child, to drag or pull on the placenta: no, more than that, carry the hand up into the cavity of the womb and detach the placenta with the fingers and bring it down and out. When I first started out to practice I was foolish enough to believe and do the same thing, and afterwards I congratulated myself how wonderfully skilled I was, but now I am convinced that this procedure was due to ignorance of the laws of nature. The truth of the matter is, that the sooner and the more one pulls and feels on the placenta, the more irritable the womb becomes, and the more will the uterus contract, as though it protested against interference.