BYthis sort ofBIRTHS, I mean such as arePreternatural, both in respect of theSituationof theCHILD, and of theWomb. Which complicatedPreternatural BIRTHis (of allothers) the most dangerous; because of anIndefinityof Accidents and Difficulties with which it is always attended, according to the many variousPosturesin which both theINFANTand theWombare found: All which to enumerate here, and to guard particularly against them, as I have done in the preceedingCases, would not only augment theBulkandChargeof thisWORK, but also be in some respect altogetherNeedless: Because if I was to content my self to treat thisChapteringeneral(without descending toparticular)TERMS, Iwould not doubt but that the ingeniousReaderwould even thence readily form a clearIDEAof all suchBIRTHS, from the many differentCasesalready stated and discussed; which if thoroughly well understood, the Rest cannot but be easily comprehended.
HOWEVER, that I may not leave the weakerCapacity, or the doubtfulMIDWIFEto the Uncertainties of her own scrupulousJudgement, I shall propose and resolve some of the most difficult and dangerousCasesbelonging to thispreternatural Subject, andthatas far as is really requisite, in manner following;viz.——
I.WEShall suppose that theINFANTis ill-turned, and presents itselfpreternaturally, withFace,Chin,Hand,Elbow,Shoulder,Breast,Back,Belly,Side,Buttock,Knee,Foot, or anyother PartorMemberfirst, in aWombtendingobliquely forwards. In thisCondition, I shallfirstshow theMIDWIFEhow, and by whatSigns, she may know and discover such perversePostures; andsecondlyhow, and by what Means,Thesemay be rectify’d, theCHILDextricated, and theMOTHERreliev’d in Life.
THENas to theFirst Point, I would have it minded, that theTouchis the onlyExpedient, by which theSituationof theINFANTin anyWomb, whetherObliqueorDirect, is to be discover’d and perfectly known. Which when theMIDWIFEfinds to bepreternatural, she needs not much trouble herself about whatprecise Partoffers or comesfirstin thePASSAGE: Because of this shortRule, which I would not have her to forget; namely, That, when theHeaddoes not present itselffirstin this complicatedCase, theCHILDis to be drawn out by theFEET. For in this illPositionof both theINFANTand theWOMB, theVersionof theCHILDsucceeds more easily than if theHeadwasforemost: Wherefore I would lose no Time, but as Soon as I had discover’d allCircumstancesaright, I would commence my Business upon this Occasion, before either theMOTHERor theINFANTare much spent, that I may perform myWork, while they bothcan mutually concur with me towards their ownRelief; That is, while theWombis yet suspended in theupper Partof thePelvis, and theMembranenot yet broken.
INorder to thisSecond Point, theWomanbeing commodiously placed, theMIDWIFEis to pass up herHandinto theVAGINA, and dispose theOrificeof theWombto open, which is now sooner done than if theHeadcamefirst:Thisbeing done dextrously, she is to put firstoneortwo Fingers, thenallof them successively into theAperture; and when that is sufficiently enlarged, she is to penetrate into theWomb, and either break theMEMBRANE, or wait itsspontaneous Breaking, as she judges best by occurringCircumstances. In the next place, she is to look for and find theFEET; and, theTOESbeing always turn’d towards theRectum, they are to be forthwith brought into thePassage: proceeding still farther in the due and regularMethodof extracting theChild, as already taught[178]and dilucidated.
II.WEwill suppose moreover, that theInfantisill-seated, and presents itselfpreternaturallywith any of the aforementionedMembers first, in aWombhangingobliquely to either Side. In thisCase, I would sincerely advise theMIDWIFE, to lose no Time in opening theWomb, breaking theMembrane, turning theChild, and extracting it by theFeet: Because in thisPostureof both theBIRTHand theWOMB, Experience has taught me that nothing can be safer and less dangerous than thisMethod, when ingeniously and presently perform’d with Dexterity.
ITis true indeed it may beobjected, that I dissent inthis Matter, from most (if not from all)Authors: To which Ianswer, in short, thatThosefrom whom I do differ, were never acquainted with thiscomplicated preternatural Condition, but always supposed theWOMBto continue in its proper Place, never dreaming of itsvariousMotion, nor suspecting itsoblique Situation; erroneously imagining allpreternatural BIRTHSto proceed merely from the illVersionof theInfant: In whichCircumstancehowever, when it happens so, I confess they are so far in the right, that theHeadis to befirstbrought into thePassage, and theChildexcluded by it with all possible Expedition.
BUTthat I may farther elucidate the trueStateof thisCase, as it becomes me to speak theTruthingenuously, it is my candid Opinion that, in anyoblique Postureof theWOMB, it is the safest, quickest, and most convenientMethodto extract theInfantby theFeet, and that presently in theBeginningof theLabour, either before or at least presently afterFlooding, as occasion requires. For this very Reason, and to this Purpose, I hope, I may farther justly lay downone certain Rule; namely, that allBIRTHSill-turn’d, in aWOMB ill-seated, are to be rightlyturn’dagain, and drawn out by theFeet. WhichRule, if duly observed, will, I am positive, save a World ofWomenandChildren, that otherwise must inevitably perish; since as for my part, I know noSituationof theInfantin anoblique WOMB, more difficult or dangerous than theHead’soffering itself first; andthatbecause theBIRTHcannot be thenturnedwithout the greatestDifficultyand most extremePains.
THIS, in short, will be readily granted by All, who do consider or conceive that theWOMB(being fixed byLigamentson both sides) is always more inclinable tofall ForwardsorBackwards, than to eitherSide, and first most commonlybends backbefore it comes to anylateral Posture; and that from hence of consequence, theWOMBisdistortedas well asobliquely situated. By reason of whichDistortion, if theCHILDcomesHead foremost, it falls down in thePelvisobliquely; and tho’ a judiciousMIDWIFEmay bring theHeaddirectly into thePelvis, yet theShouldersfollowing, must needs fall upon thePelvisa-cross, in its narrower Part; whereby of reasonable Consequence theInfantmust be distorted in thePassage.
NOWin thisCase, noPains, how violent soever, can avail to force forwards theBIRTHso fixed upon theseBones; wherefore (I say) when theWOMBis thusseated, it is most safe in theBeginningof theLABOUR, to open itsOrifice, break theMembrane, turn theCHILD, and take it out by theFEET; since by theHead’s coming nowforemost, bothLivesare at Stake and in great Jeopardy.
HOWEVERyet it may be againobjected, that I have already prescribed anotherMethodinChap.21;viz.of bringing theOrificetogether with theHeadinto thePelvis, and promoting theBIRTHin that Manner: To this Ianswer, that myReasonfor so doing, was not only to convince some People, that I knowtheir Methodas well asmy own; but also to whet or assist theJudgmentof such goodMIDWIVESas cannot forsake their own oldBy-Paths; Not that I ever design’d to recommenditto any, tho’ I must however acknowledge, that sometimes it may effect the desirableEnds; but according to theRulesof irrefragableTruth, and sound Judgment, we find that, in thisPositionof theWomb, let theBIRTHoffer itself as it will, the only laudableMethodis without Loss of Time to extract theInfant, and deliver theWomanas above-directed.
III. I observe upon the whole, that as the immediate presentCaseis applicable to either (rightorleft)Side; so what is said of the foregoingCondition, with respect to theWomb’sinclining forwards, may be easily apply’d to theCaseof itstending backwards: Only with this considerable Difference, that theoblique forward Postureof theWomb, is the most commodious of theFourmentionedExtremes, and consequently admits of a more easyExclusionof theBIRTHby theHead, than any of the rest mentioned.
NOTbut that either of these grand or complicatedpreternatural BIRTHSimply and prognosticate imminent Danger to theMOTHER, or theCHILD, orBoth; as well as incredibleLabourandFatigueto the faithfulMIDWIFE; who, in suchCases, can less distinctlyfeel, less commodiously handle, and more difficultly come at the Matter, so as to dispose theINFANT’SMembersforAttraction, than in any otherConditionofBIRTH: Hence it is, in short, that so manyMIDWIVESare liable to the most egregious Mistakes, and unaccountable Deceptions upon these unlucky Occasions. But——
AGAINfarther, I hope I may freely speak my Mind, and openly avow, that the most of theseBirthsproceed merely from want of seasonable and skilfulAssistancein the beginning of theLabour: Because theBIRTH(however well seated then) by reason of thebad Situationof theWomb, cannot possibly pass thro’ thePelvisof itself; and not being judiciously assisted at that nice Juncture, behold, from aNatural, it falls on a sudden also into aPreternatural Posture. From hence we have this extreme difficult and most dangerous sort ofPreternatural BIRTHS, as will more conspicuously appear from a deliberateReflectionupon the precedingChapters. And This much (I hope) may finally suffice any intelligentReader, to conceive the differentCircumstancesof allcomplicated PreternaturalBIRTHSwhatsoever. Whence I go on to theFourthand last Sort ofPreternatural BIRTHSproposed; namely,Thoseproceeding from interveningaccidental Causes; which because they are also different, I shall handle briefly and separately in the ensuing Manner;viz.——