CHAP. XVII.
Of the True Method of LAYING the Woman.
UPON this Occasion, the MIDWIFE ought, in the first place, carefully to observe the Contents of the foregoing Chapter; and, Secondly, To follow this general Rule, which I lay down out of absolute Necessity: viz. That the Woman be delivered, and the Child brought forth into the World as soon as possible after Flooding; and that because the Womb immediately, after This is over, falls, shrinks, and contracts itself again, and of Consequence compresses the BIRTH very closely.
BUT in order to effect this Matter, as much depends upon the right Situation or Placing of the Woman; so I advise, in the first place, that, as soon as the Waters begin to flow, She be commodiously placed either in a Bed, Chair, or Stool, properly adapted for that Purpose, and laid with great Skill and Judgment, not too Supine, nor altogether Upright; but (as it were) between a standing and lying Posture: having her Back a little erected for the freer Respiration, and the better Labour; with her Thighs at a due Liberty and Distance, only separated as much as possibly they may; her Knees a little elevated; her Feet stayed against something Firm, and her Heels bending Backwards.
HOWEVER I must farther observe in this place, that the POSITIONS of parturient Women are very various and different; some doing this Work (as above) in a Bed, others in a Stool, and some again I have seen deliver’d standing, and leaning only a little Forwards upon the Bed-stead. Hence, I say, that the POSTURES in time of Labour, differ not only according to the Necessity, but also sometimes (in Natural Easy Cases) according to the Custom of the Woman.
BE that as it will, I would advise all Labouring Women, FIRST to make Choice of a dextrous and ingenious MIDWIFE to attend them at that critical Juncture, since the poetical Proverb (Accidit in puncto, quod non speratur in Anno) holds as True in BIRTH as in any Case I know; for some Women after having sundry repeated Natural easy BIRTHS, come at last to suffer by some difficult or preternatural Accident, which may happen in a Moment of Time.
SECONDLY, I would advise all parturient Women, to give themselves over into the Hands of such a MIDWIFE, to be universally advised and entirely directed by her Conduct: And thus being under the watchful Eye and diligent Care of the prudent and skilful MIDWIFE, the good Woman in her Travail has Nothing else to do (besides following Instruction) but only to assume Courage and Resolution to assist her own PAINS as she feels them coming on, by drawing and holding her Breath, as if she was to sob or sigh, by contracting the MUSCLES of her Belly, as much as possible; insomuch that the forcible Impression may bear alike upon each side of the Womb, and depress the Diaphragma, which (of Consequence) suppresses the Womb. But then again in this Case I would observe briefly, that she is strictly to regard the TIME of a right true Travail, as at that Juncture only to use these her best and strongest Endeavours.
BUT now to return to the Duty of the attending MIDWIFE; as occasion requires, She is to direct her Woman, either to lie, sit, stand, or walk, keeping her always Warm, and as close cover’d in Time of Touching as possible; for the least Breath almost of Cold Air may occasion Convulsions, and other most dangerous Accidents.
BECAUSE I have often observ’d Women to be Costive and bound in their Bellys upon this Occasion, which is of dangerous Consequence, I would therefore advise in this Case to adhibite a gentle Emollient Clyster; not only that (by the Rectum being so emptied) there may be the more Room for the necessary Dilatation of the PARTS, but also that the unfortunate Effects of Costiveness may be timely prevented: And the same Means I would use, in Case of Heavy, Dull, or Languid PAINS; ordering the Clyster only in this Case to be made a little more Carminative; as mentioned in the preceeding Chapter.
BUT this however I would have done in the Beginning of the Travail, and reiterated (if need so require) before the CHILD be advanced too far Forwards.
NOW the MIDWIFE finding all things in a Natural Posture, and the Child in a Forward way, is to advance her Hand skilfully, (which at every individual Touch ought to be fresh-anointed with the Oil of white Lillies, Roses, &c. or Fresh-Butter, Hogs-Lard, or whatsoever of this Nature is readiest at Hand) entering the ORIFICE with the Fingers-Ends, dilating it by opening them gently as the Pains come on: Thrusting gradually the Sides of the ORIFICE towards the OCCIPUT or Hinder part of the Child’s Head, and moistening these Passages also with what she uses for her Hands.
WHEN the VERTEX, or Crown of the Head, appears without the Privities, the MIDWIFE most commonly calls out or says the Child is in the Passage; and the parturient Woman then finding these Parts (as it were) scratch’d or prick’d with Pins, often groundlessly imagines that her MIDWIFE deals roughly by Her with Nails and Fingers; whereas that Pungency is only occasioned by a violent Distension, or perhaps a Laceration, sometimes inevitably made, by the Bulk of the Head of the INFANT.
HOWEVER that be, and whatever the Woman may think or say, the MIDWIFE is only to mind her own Business, and discharge her Duty faithfully upon this CRISIS; in order to which, it is now High Time that she also place herself in a convenient Posture to receive the BIRTH: Which (when advanced as far as the EARS, or thereabouts) she is to take gentle hold of, by both Sides of the HEAD with both Hands; so that by this Means she may be ready and able, against the first Onset of the next good Pain, to draw forth the Child. In doing whereof, she must take special Care that the NAVEL-STRING be not entangled about the Neck, or any other Part, lest the Secundine or the Womb itself thereby suffer Violence, and consequently cause either Flooding, or break the String, which may render the Case dangerous and the BIRTH difficult.
BUT in thus attracting the INFANT, the MIDWIFE must carefully observe, not to draw the HEAD straight-forwards, but move it gently from Side to Side, that the Shoulders may the more readily and easily take Place: For these must immediately follow the HEAD without Loss of Time, otherways the BIRTH may be strangled in the Passage by the WOMB shutting upon its Neck: To prevent which Tragical Catastrophe, the Cunning Expert MIDWIFE directly slides in her Fingers under the Arm-Pitts, and then draws discreetly the BODY forth without any Difficulty or Danger.
THUS, in fine, We have discreetly deliver’d our good WOMAN, in Case of a Natural Easy Birth; but on the other Side, in difficult and Preternatural Cases, the several Conditions and Circumstances will mightily differ from the Beginning; because in these the PAINS are not always sufficient to produce the BIRTH. Hence it is sometimes more convenient for the WOMAN to be Passive, rather than Active; especially when the Position of either the Womb, or the Infant is Preternatural: For then it is the MIDWIFE’s whole Business to labour more than the WOMAN; then her ingenious Touch is of infinite Service to the PARTURIENT, since by that only she can distinguish the Degree of the Ill Situation whether of the CHILD or the WOMB. Which being dextrously done, She is in the next Place, prudently to consider what kind of POSTURE, Sitting or Lying, is most convenient, that she may the better discharge her own good Office and Duty: Of which I shall treat more particularly in the following respective Chapters; since it still remains here, by the way, that we also deliver our above-mentioned Woman of her After-Birth, &c.