Quadripara

Just the other day I prevented a cesarean section on a woman, quadripara, with three living children, the first of which alone was at all difficult; the indication placed by the physician was that he "didn't want to tear her perineum."

Holdsworth reports one case of a quadripara of 37 in labor. To hasten labor a Champetier de Ribes dilating bag was inserted but failed to have the desired effect.