[Illustration: A. At full term, or after 40 weeks of pregnancy, the baby is ready to be born. The cervix through which baby must leave the uterus is shown clearly here, still closed. The contractions of the muscles of the uterus will open the cervix, and force the baby down through the vagina, or birth canal, to the outside.]

[Illustration: B. At the end of the first stage of labor the cervix is completely open and the baby's head is beginning to come down through the vagina. Contractions begin in the lower back and later are felt in the lower abdomen. At the time shown here contractions are probably coming every 2 minutes, lasting 40-60 seconds and very strong.]

[Illustration: C. The first stage of labor usually lasts several hours and is hard work. The mother needs to relax, rest, and be reassured. Give her water and fruit juices. In this picture the second stage of labor is well along. It is shorter than the first stage and the mother will now be pushing down with each contraction, helping to force the baby into the world. ]

[Illustration: D. The head of the baby has been partially born. This shows the usual position with the face down and the back of the head up. The bag of waters in which the baby is enclosed throughout the pregnancy may have broken at the beginning of labor, before or during the first stage. It may break now, or have to be torn with the fingers.]

[Illustration: E. Here you see the baby's head turned to the right as is usual. The shoulders are about to be born. The head must turn so that the baby's body can fit into the birth canal and come through more easily. After the birth of the baby there will be further uterine contractions and the placenta will be separated from the uterine wall and expelled.]

CHANGE OF FEELING

Gradually the time between the labour pains grows shorter and the pains increase in severity until they are coming every 2 to 3 minutes. It will not be long now before the baby is born.

At this stage the mother will notice a change. Instead of the tightness in the lower abdomen and pain across the back, she will feel a bearing down sensation almost as if she were having a bowel movement. This means the baby is moving down.

When this happens, she should lie down and get ready for the birth of the child. The tightening and bearing down feelings will come more frequently and be harder.

She will have an uncontrollable urge to push down, which she may do. But she should not work too hard at it because the baby will be brought down without her straining too hard. There will probably be more blood showing at this point.

The person attending the delivery should thoroughly scrub hands with soap and water. Never touch the vagina or put fingers inside for any reason. The mother also should keep her hands away from the vagina.

As soon as a bulge begins to appear in the vaginal area and part of the baby is visible, the mother should stop pushing down. She should try to breathe like a panting dog with her mouth open in order not to push the baby out too rapidly with consequent tearing of her tissue.

She should keep her knees up and legs separated so that the person helping her can get at the baby more easily.

MOMENT OF BIRTH

The person helping the mother should always let the baby be born by itself. No attempt should be made to pull the baby out in any way.

Usually the baby's head appears first, the top of the head presenting and the face downward. Infrequently the baby will be born in a different position, sometimes buttocks first, occasionally foot or arm first. In these infrequent situations, patience without