The vulvar pads should be pinned in an old napkin, in packages of half a dozen each; and one package is sterilized at a time by placing it in the oven until the outer covering is scorched.  The linen for the baby’s eyes and the cheese-cloth are treated in the same way; they are to be cut up into small pieces and sterilized as needed.

Signs of Approaching Labor.—­ About two weeks before labor there is a sinking of the womb.  At the beginning of the ninth lunar month this was at the end of the breast-bone; it now descends to a point midway between this and the navel; the abdomen becomes smaller, the pressure on the lungs is relieved, and the woman breathes more freely.  But at the same time that the woman is relieved of the pressure on the chest, she experiences increase of the troubles in the lower extremities.  There is an increase of the bladder symptoms, with a desire for frequent unrination.  Constipation becomes more troublesome, and there may be hemorrhoids; the veins of the lower extremities may become greatly enlarged.

There is an increased fullness of the external genitals and a greatly augmented amount of mucous discharge.  There is a feeling of anxiety and nervousness, with depression of spirits.

During the last two weeks of pregnancy patients are apt to have cramp-like pains in the lower part of the abdomen.  These are often mistaken for labor pains.  True labor pains are characterized by starting in the back, extending around the abdomen and toward the pubes and down the thighs; they come at more or less regular intervals of half to three-quarters of an hour, and increase in intensity with a decrease in the intervals.  A strong pain is apt to be followed by two weaker ones.  The so-called false pains are irregular in their occurrence.

Symptoms of Actual Labor.—­ First is generally the show; this is a discharge of mucous tinged with blood; at the same time the true labor pains set in.  When the patient or nurse is in any doubt as to the character of the pains, or when the show appears, the physician should be summoned at once.  Other symptoms are frequent desire to empty the bladder and bowels, and a sensation of shivering.

The Confinement-Bed.—­ A single bed is much more convenient, but it is rarely found in a private house.  The double bed is arranged as follows:  The hair mattress is covered with a large rubber sheet, which is pinned with safety-pins at the corners and tucked well under the mattress; the rubber sheet must not be drawn too tightly for fear of tearing.  Over this comes the sheet, and over the upper half of the bed, the draw-sheet; this is a sheet folded four double, which goes across the bed so as to come under the hips of the patient, and is tucked under the mattress at both sides.  The object of this is so that it may be frequently and easily changed without disturbing the patient.  The sheet, blanket, and spread which are to serve as a covering after delivery are folded back and placed on the left side of the bed.