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HE Case ofChild-bearingWomen is very lamentable, in the Country especially, by Reason of the Ignorance and Unskilfulness ofMidwives; for by their Negligence and perverse Management, many Mothers and Children are destroyed, to the great Misfortune of particular Families, as well as of thePublick, at a Time when it suffers by the Loss of useful Hands, from too many other Causes. It were therefore to be wished, that all Midwives were so far appris’d of their Duty, as to be able to distinguish between Cases within their Abilities, and such Difficulties as may occasion the Loss of the Mother, or Child, or both, for Want of necessary Assistance.
They who intend to practice Midwifry inPARIS,are oblig’d to attendanatomicalLectures andDissections, that their Judgments may be inform’d, by the Knowledge of the Structure of the Body, for an Undertaking so hazardous in ignorant Hands.
London, at present, affords equal Advantages of Information; for theanatomicalWax-work, with suitable Lectures, might furnish as good a Qualification, with less Offence than real Dissections; and there are not wanting those who professedly instruct both Sexes bymechanical Demonstrations.
And for the future, it is to be hoped, there will be no Necessity for Men to have Recourse toPARISforObservation, since we haveInfirmariesat Home for the Accommodation of Women in Child-bed; and tho’ they are expos’d naked to the Eye in theHotel de Dieu, it must be confess’d, that the fundamental Rules of theArtare not built on what the Eye of the Observer can possibly discover in the most expertOperators; but depend on Circumstances conceal’d from Sight, within the Body of the Patient.
But whatever AdvantagesLONDONandWESTMINSTERafford for the Instruction of Midwives, the Country is entirely destitute of them; and the best Books on the Subject, adorn’d with elegant Figures, can give but a very imperfect Notion of the Parts they represent, to any who have not attendedDissections, or seen more naturalResemblancesthan Cuts.
The Figures in Books, exhibit theBonesof thePelvis, a Variety ofSituationsof the Infant, andUterus, the Placenta and umbilical Vessels and Membranes,&c.whereas it would be no less serviceable to those, who assist Women in Travel, to be acquainted with the Viscera, liable to suffer by a difficult Labour; for theLiver,Spleen,SweetbreadandKidneys, if not the principal Contents of the Chest, may be so injured by the illPositionof the Child, Compression of the Parts, and rash Assistance, as to prove fatal, more or lets immediately; occasioningInflammations,Suppurations,Mortifications,Schirrhu’s,Cancers, orConsumptions.
The best Writers of Midwifry, such asMauriceau,Deventer,De la Motte,Heisterand others, explain the Causes of difficult Births, and the proper Methods of Assistance; but instead of improving mostCountryMidwives, fill them with Conceits of what, it is impossible, they should understand, and thereby occasion the Loss of great Numbers of Women and Children.
In order therefore that Midwives may acquit themselves with Reputation, and thatChild-bearingWomen may be the better Judges for themselves, or the charitable Part of the Sex, who are past these Dangers, the better able to assist their Friends and Neighbours, I shall endeavour to shew how far they may act with Safety under the Disadvantage of Country Practice, and describe those Symptoms, which for the most Part accompany hard Labours, very probably beyond their Abilities; when they will justly incur the Censure of Inhumanity and Rashness to depend upon their own Skill.