The hypothesis that massive stars form by accretion can be investigated by simple analytical calculations that describe the effect that the formation of a massive star has on its own accretion flow. Within a simple accretion model that includes angular momentum, that of gas flow on ballistic trajectories around a star, the increasing ionization of a massive star growing by accretion produces a three-stage evolutionary sequence. The ionization first forms a small quasi-spherical H II region gravitationally trapped within the accretion flow. At this stage the flow of ionized gas is entirely inward. As the ionization increases, the H II region transitions to a bipolar morphology in which the inflow is replaced by outflow within a narrow range of angle aligned with the bipolar axis. At higher rates of ionization, the opening angle of the outflow region progressively increases. Eventually, in the third stage, the accretion is confined to a thin region about an equatorial disk. Throughout this early evolution, the H II region is of hypercompact to ultracompact size depending on the mass of the enclosed star or stars. These small H II regions whose dynamics are dominated by stellar gravitation and accretion are different than compact and larger H II regions whose dynamics are dominated by the thermal pressure of the ionized gas.
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