Sex efficiency through exercises : special physical culture for women / by Th. H. van de Velde ; [photos, by E. Steinemann].
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reversed, and the expansion of the lower pelvic outlet attains its highest degree if the woman draws her legs as near as possible to her body. Therefore the emergence of the head in birth is greatly helped by a change of attitude from the horizontal (extension) and especially suspension to the flexed, which not only presses forward the head, but twists or slips back the bony pelvic girdle over it. Of course, this manoeuvre is most valuable if there are obstacles to the child's head, such as too flat and shallow pelvic structure. In that case there is the following automatic adaptation: The child's head enters the upper pelvic entrance inlet with the anterior parietal bone foremost, this is strongly curved and bent over the other, which is pressed against the pro- montory (see Plate VIII.). Thus the head is adapted, or, one might say, modelled or moulded to the maternal proportions, and pelvic movement therefore, as outlined above, may be helpful here. Sellheim(27) described this process as follows : " When there is disproportion in measurement between the maternal pelvis and the infant's skull, the pelvic aperture, dilated by means of the suspensory attitude, will take a larger skull than the usual posture for deliveries. If there is prolonged pressure or combined pressure and pull on the head in the direction of the pelvic axis, and if the mother's attitude is changed from suspensory or supine to the position of flexion, this automatically compresses the parietal portion of the skull (if the respective sizes are not too dispropor- tionate) and favours the following stages of delivery. Continuous alternate distension of the pelvis and compres- sion of the child's head, by means of appropriate pelvic movements, makes the very best of the natural adaptability of both structures, and can help to surmount difficulties of proportion in cases which are not extreme." Of course, those who stand beside the woman in travail must know how to help her here. And all who have any actual acquaintance with the difficulties generally experienced by women in travail when they attempt pelvic movements will agree that it is of the utmost advantage, both for women themselves and their accoucheurs and attendants, to have some previous knowledge of and practice