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floor taut and tense. Therefore the pelvic floor is tautest in
flexion and loosest in suspension. Individual structure must
guide the obstetrician as to which posture best suits each
stage of each case. In some cases, it will be absolutely
necessary to open the lower bony pelvic aperture as widely
as possible by means of flexion, even at the risk of increased
tension of the muscles and tissues—which may be obviated
betimes by an incision. In other cases it will be necessary
to mitigate the intense strain on the pelvic floor, so far as
possible, by means of Watcher's suspension, without taking
the distance between the tubera ischii into account. The
obstetric art is an art which must reckon with great diversities
of structure, constitution and circumstances ; both physicians
and midwives need to do this far more than has hitherto been
customary.
But just as doctors and midwives should make full use of
change of attitude in obstetrics, so also women should help
both those in charge of their health and lives, and themselves
in their critical hours, by pelvic elasticity and efficiency
attained through exercises. By mastery of their abdominal
and perineal muscles, both in contraction and relaxation,
women will be able to bring forth their children with the
least degree of danger and of injury.
