ACCIDENTS WITH THE PLACENTA OR AFTER BIRTH.
Delivery of the placenta or after-birth is sometimes a cause of .difficulty and of danger during childbirth. In the natural way the placenta is thrown off entire, by one or more contractions of the uterus, a few minutes after the birth of the child, upon which the uterus, fully contracted and feeling like a cricket ball through the walls of the abdomen, remains in a quiescent state, whereby the act of childbirth may be said to be completed. Under less natural circumstances the placenta may be a cause of trouble from what is technically called its retention. Retention of the placenta is induced by one of three causes : (1) It may fail to be thrown off owing to stony, or want of expulsive power of the uterus. (2) It may be retained by an irregular contraction, or, as it is often designated, " hour-glass contraction " of the womb, the organ being contracted in its centre, something like an hour-glass, and holding the placenta firmly in the contracted part or enclosing it in the space above. (3) It may be detained by preternatural ad hesion to the uterine wall, and may be so adherent that consider able force has to be used in removing it from its attachment. All these difficulties are in our day met by the skill of the ob stetrician, who removes the placenta without subjecting the child bed woman to danger from its long detention.