UPONthis Occasion, theMIDWIFEought, in thefirst place, carefully to observe theContentsof the foregoingChapter; and,Secondly, To follow this generalRule, which I lay down out of absoluteNecessity: viz.That the Woman be delivered, and the Child brought forth into the World as soon as possible afterFlooding; andthatbecause theWombimmediately, afterThisis over, falls, shrinks, and contracts itself again, and of Consequence compresses theBIRTHvery closely.
BUTin order to effectthisMatter, as much depends upon the rightSituationorPlacingof theWoman; so I advise, in the first place, that, as soon as theWatersbegin to flow,Shebe commodiouslyplacedeither in aBed,Chair, orStool, properly adapted for that Purpose, andlaidwith great Skill and Judgment, not tooSupine, nor altogetherUpright; but (as it were) between astandingandlying Posture: having herBacka little erected for the freerRespiration, and the betterLabour; with herThighsat a due Liberty and Distance, only separated as much as possibly they may; herKneesa little elevated; herFeetstayed against somethingFirm, and herHeelsbendingBackwards.
HOWEVERI must farther observe in this place, that thePOSITIONSofparturient Womenare very various and different;somedoing thisWork(as above) in aBed,othersin aStool, andsomeagain I have seen deliver’dstanding, andleaningonly a littleForwardsupon theBed-stead. Hence, I say, that thePOSTURESin time ofLabour, differ not only according to theNecessity, but also sometimes (inNatural Easy Cases) according to theCustomof theWoman.
BEthat as it will, I would advise allLabouring Women, FIRST to makeChoiceof a dextrous and ingeniousMIDWIFEto attend them at thatcritical Juncture, since the poeticalProverb(Accidit in puncto, quod non speratur in Anno) holds as True inBIRTHas in anyCaseI know; forsome Womenafter having sundry repeated Natural easyBIRTHS, come at last to suffer by some difficult orpreternatural Accident, which may happen in aMoment of Time.
SECONDLY, I would advise allparturient Women, to give themselves over into the Hands of such aMIDWIFE, to be universallyadvisedandentirelydirected by her Conduct: And thus being under the watchfulEyeand diligentCareof the prudent and skilfulMIDWIFE, the goodWoman in her Travailhas Nothing else to do (besides followingInstruction) but only to assumeCourageandResolutionto assist her ownPAINSas she feels them coming on, bydrawingandholdingherBreath, as if she was tosoborsigh, by contracting theMUSCLESof herBelly, as much as possible; insomuch that the forcibleImpressionmay bear alike upon each side of theWomb, and depress theDiaphragma, which (of Consequence) suppresses theWomb. But then again in thisCaseI would observe briefly, that she is strictly to regard theTIMEof aright true Travail, as at that Junctureonly to usetheseher best and strongestEndeavours.
BUTnow to return to theDutyof the attendingMIDWIFE; as occasion requires, She is to direct herWoman, either tolie,sit,stand, orwalk, keeping her alwaysWarm, and as closecover’din Time ofTouchingas possible; for the least Breath almost ofCold Airmay occasionConvulsions, andothermost dangerousAccidents.
BECAUSEI have often observ’dWomento beCostiveand bound in theirBellysupon this Occasion, which is of dangerous Consequence, I would thereforeadvise in thisCaseto adhibite a gentleEmollient Clyster; not only that (by theRectumbeing so emptied) there may be the moreRoomfor the necessaryDilatationof thePARTS, but also that the unfortunateEffectsofCostivenessmay be timely prevented: And the sameMeansI would use, in Case ofHeavy,Dull, orLanguid PAINS; ordering theClysteronly in thisCaseto be made a little moreCarminative; as mentioned in the preceedingChapter.
BUTthishowever I would have done in theBeginningof theTravail, and reiterated (if need so require) before theCHILDbe advanced too farForwards.
NOWtheMIDWIFEfinding all things in aNatural Posture, and theChildin aForward way, is to advance herHandskilfully, (which at every individualTouchought to be fresh-anointed with theOilof whiteLillies,Roses, &c. orFresh-Butter,Hogs-Lard, or whatsoever of this Nature is readiest at Hand) entering theORIFICEwith theFingers-Ends, dilating it by openingthemgently as thePainscome on: Thrusting gradually theSidesof theORIFICEtowards theOCCIPUTor Hinder part of theChild’sHead, and moistening thesePassagesalso with what she uses for herHands.
WHENtheVERTEX, orCrown of the Head, appears without thePrivities, theMIDWIFEmost commonly calls out or says theChildis in thePassage; and theparturient Womanthen finding these Parts (as it were) scratch’d or prick’d withPins, often groundlessly imagines that herMIDWIFEdeals roughly byHerwithNailsandFingers; whereas thatPungencyis only occasioned by a violentDistension, or perhaps aLaceration, sometimes inevitably made, by theBulkof theHeadof theINFANT.
HOWEVERthat be, and whatever theWomanmay think or say, theMIDWIFEis only to mind her own Business, and discharge her Duty faithfully upon thisCRISIS; in order to which, it is now High Timethat she also place herself in a convenientPostureto receive theBIRTH: Which (when advanced as far as theEARS, orthereabouts) she is to take gentle hold of, byboth Sidesof theHEADwithboth Hands; so that by thisMeansshe may be ready and able, against the firstOnsetof the next goodPain, to draw forth theChild. In doing whereof, she must take specialCarethat theNAVEL-STRINGbe not entangled about theNeck, or any otherPart, lest theSecundineor theWombitself thereby suffer Violence, and consequently cause eitherFlooding, or break theString, which may render theCasedangerous and theBIRTHdifficult.
BUTin thus attracting theINFANT, theMIDWIFEmust carefully observe, not to draw theHEADstraight-forwards, but move it gently fromSide to Side, that theShouldersmay the more readily and easily take Place: Forthesemust immediately follow theHEADwithoutLoss of Time, otherways theBIRTHmay be strangled in thePassageby theWOMBshutting upon itsNeck: To prevent whichTragical Catastrophe, the Cunning ExpertMIDWIFEdirectly slides in herFingersunder theArm-Pitts, and then draws discreetly theBODYforth without any Difficulty or Danger.
THUS, in fine, We have discreetly deliver’d our goodWOMAN, inCaseof aNatural Easy Birth; but on the other Side, in difficult andPreternatural Cases, the several Conditions and Circumstances will mightily differ from the Beginning; because inthesethePAINSare not always sufficient to produce theBIRTH. Hence it is sometimes more convenient for theWOMANto bePassive, rather thanActive; especially when thePositionof either theWomb, or theInfantisPreternatural: For then it is theMIDWIFE’swhole Business tolabourmore than theWOMAN; then her ingeniousTouchis of infinite Service to thePARTURIENT, since by that only she can distinguish the Degree of theIll Situationwhether of theCHILDor theWOMB. Which being dextrously done,Sheis in the next Place, prudently to consider what kind ofPOSTURE,SittingorLying, is most convenient, that she may thebetterdischarge her own goodOfficeandDuty: Of which I shall treat more particularly in the following respectiveChapters; since it still remains here, by the way, that we also deliver our above-mentionedWomanof herAfter-Birth,&c.