Triggering learning in midwifery

The delivery of the head with or without forceps may have been quite easy, but more commonly there has been a little difficulty in completing the extension of the head. The hairy scalp slides with reluctance. When the forehead has appeared it is necessary to press back the perineum to deliver the face. Fat cheeks eventually emerge. A double chin has hooked over the posterior commissure, to which it remains tightly opposed. Restitution seldom occurs spontaneously for the head seems incapable of movement as a result of friction with the girdle of contact at the vulva... time passes. The child's face becomes suffused. It endeavours unsuccessfully to breathe. Abdominal efforts by the mother or by her attendants produce no advance, gentle traction is equally unavailing... Usually equanimity forsakes the attendants. They push, they pull. Alarm increases. Eventually, by greater strength of muscle or some infernal struggle, the difficulty seems to be overcome... It dawns upon the attendants that their anxiety was not ill founded.