The Practice and Applied
Therapeutics of Osteopathy
Charles Hazzard, D. O.
It is not the object here to deal with the conduct
of a case of childbirth. That is left to special works upon the subject.
It is sufficient, within the scope of this work, to give the special osteopathic
points in connection with obstetrical work.
It is the common practice, during the early stage
of labor after the true pains have commenced, to hasten labor, if desirable,
by stimulation at the parturition center at the 2nd lumbar. This
increases circular contractions in the uterus, causes descent of the cervix,
and dilatation of the os. It is usually best to rely upon the natural process
of labor and very often this treatment is not used.
Later one may aid the further dilatation of the
os by inhibition of the clitoris. This is accomplished by pressure
over the lower part of the pubic symphysis, between the labia. Inhibition
of the round ligaments is also used for this purpose.
For severe pains in the back, desensitize about
the 5th lumbar and relax the neighboring spinal tissues.
If the bearing down pains do not come regularly
and hard enough, one should give occasional firm stimulation in the region
of the second lumbar.
As the head is descending the finger should be used
to press back the edges of the os all around the head. Also, in case
of folds in the vaginal walls, they should be kept smoothed out, and the
walls should be pressed well up and outward all around. If these
folds occur they cause great pain and headache.
To prevent laceration of the perineum, both hands
should be applied to the pelvis. One presses the tissues down over
the pubic arch and inhibits the clitoris, while the other grasps the two
tubers ischii and springs them toward each other, at the same time supporting
the perineum. As the head is born the hand makes pressure against
it, as required, to prevent its coming with too great force.
When the afterbirth is ready for delivering, slight stimulation at
the upper lumbar will aid it if necessary. If necessary, a quick
pull at the mons veneris will aid in expelling it. A cough will sometimes
be sufficient to start it.
After it is born the hand should be placed upon
the abdominal wall and support the uterus until it is well contracted and
Desensitize the clitoris to stop after pains.
It is well to flex and circumduct the limbs carefully, before
leaving a case, to see that there are no slips at the hip joints or excessive
contractures of muscles, which may lead to milkleg.