Experience teaches us, that the Womb may be also too much resupin’d; or tending with its Bottom backwards, may be pressed too much towards the Spine: So that its Orifice is not only raised too high in the Belly, but is also so obliquely seated, that it no more answers to the VAGINA in a right Line, varying more or less, according to the Proportion of this Tendency to the Back-Bone.
FROM this Posture of the Womb now, it necessarily follows, that the Head (tho’ never so well turned) falls upon, and is violently forced against the Ossa Pubis; where the tender Head sticking, often happens by its own Struggles and the Mother’s PAINS, to be grievously squeez’d and gradually crush’d, so that, until it is removed and brought into the PELVIS, the Woman can by no means bring forth her INFANT. Wherefore the diligent and careful MIDWIFE must (by due Attention) make it her Business to discern at the first Touch this ill Position of the Womb, and presently upon the first Pang of Labour, try to help both the MOTHER and the CHILD.
WHEREAS otherwise the slothful and ignorant MIDWIFE, may continue the poor Woman in an irregular Labour perhaps some Days, without perceiving the Head to be fixed upon these Bones, always erroneously imagining the INFANT only to be situated too high, (because it lies out of the reach of her shallow Touch) and that it must in due Time fall down lower within her Ken. Or peradventure otherwise, when by the Touch, she feels a kind of Roundness or Hardness, thro’ the Womb, mistaking This for the Head, she thinks the INFANT is well turned, and wants only strong PAINS to drive it forwards with Success.
THIS Ignorance is chiefly owing to her own Stupidity, in that she cannot clearly distinguish between the Womb and the Vagina by the Touch; nor the Orifice of the Womb from the Parts of the CHILD, or MEMBRANE; which (in this Case) frequently occasions the Death of many a Dear MOTHER and INFANT.
BUT here it is to be moreover noted of this difficult Situation of the Womb, that the MIDWIFE (how skilful soever) perhaps can either not touch the Orifice at all, or but very little, except it lies wide open, when she may touch at least some Part of the Circle of the Border: For the Head being fixed upon the Pubis above, the whole upper Part of the Edges of the Orifice can no ways peradventure be touched with the Fingers, which may only reach the lower Part that is Open.
UPON which, these Fingers are cautiously and prudently to be thrust in farther betwixt the Neck of the Bladder, and the Orifice of the Womb: Then being so near the Neck of the Bladder, a discerning MIDWIFE will feel a sort of a Circular Border, namely, that of the Orifice of the Womb; which if she penetrates with her Fingers, she will also find the hard Part of the Head, which is Smooth and Globular, or the opening of the Vertex; whence she may be certain, that the INFANT, as well as the WOMB, is too close to the Spine of the Back. Whereupon she ought, without loss of Time, to assist and help the CHILD in the following Manner; viz.
SHE is to hinder the Woman from labouring all this while, advising her to bear and put by her PAINS, until this Posture of the INFANT can be duly corrected: In order to which, I would First order the Woman to make Water, if she can, that the Bladder being thereby emptied, may not be hurt by the Pressure of the MIDWIFE’s Hand, or the CHILD’s Head: Secondly, if the MEMBRANE is not yet broken, and the Pains but few and faint, I would prescribe a gentle Clyster, not only to awaken These, but also to remove all Inconveniencies of the RECTUM: Thirdly, I would then advise to lay the Woman in a convenient manner, upon her Back with the superior Part of her Body lower than the inferiour, that both the Womb and the Infant may the more easily recede or give way back.
THEN taking cautiously Hold of the Border of the ORIFICE with the Fingers of either Hand, I would press and draw it back towards the RECTUM, whilst I employ’d my other Hand outwardly upon the ABDOMEN, a little above the OS PUBIS: I mean, that the Child’s HEAD ought to be thrust back a little with the Hand on the outside, pressing it discreetly down; as the ORIFICE is to be drawn back towards the RECTUM, and at the same time also downwards, with the internal Hand.
IN the next Place, as I feel the Head and the Womb mov’d a little downwards, so I would also advise the good Woman to raise the upper Part of her Body, yet so as not to stir the Lower, and to bend herself as much as possible Forwards, sitting as if she was going to Stool: Because by this Posture, she raises both the Infant and the Womb behind, and consequently drives them BOTH Forwards, whilst I would in the Interim keep my HANDS very fast placed as aforesaid, ready to depress the HEAD before, that it may fall directly into the Pelvis. In short, the HEAD being thus disengag’d, I would now advise the Woman to observe her PAINS, and mutually labour with them what she can, with her Body mostly still in a Sitting Posture, or kneeling with her Arms conveniently supported.
BUT supposing the INFANT to stick very fast upon the Pubis (which commonly happens by Loss of Time, or by misimproving a critical Minute;) and that the capable Midwife finds both the Mother and the Child in this miserable Condition, thro’ the Neglect and Ignorance of Another: In this Case I would lay the Woman altogether upon her BACK, with her HEAD low, and her BODY a little elevated; then by the abovesaid Method I would try to depress the Infant’s HEAD, observing however yet not only to press it down from above, but also first to thrust it back, and depressing it at the same Time: By thus repelling it, I would save the tender HEAD from being hurt by the Depression; since otherways these Bones would leave a Dent or an Impression upon it, if not also wound it over and above.
MOREOVER, supposing that the MEMBRANE should break by Chance, and that by enlarging the Orifice, the HEAD should be much bared: Then I would let the Border of the Womb alone, and endeavour to thrust my FINGERS betwixt the HEAD (towards its Upper Part) and the OSSA PUBIS; by which means One may most probably draw the HEAD downwards, along with the Orifice. However, in fine, this Case, (as well as all other preternatural BIRTHS) absolutely requires a sound Judgment, a quick Comprehension, a good Conduct, an easy soft Hand, and a dextrous gentle Method of treating the parturient and patient WOMAN. But, farther——
WE will again in the next Place state the CASE thus, that suppose the HEAD is too Big, and the Child so much compressed, that it cannot be brought into the PELVIS without great Trouble and Difficulty: In this Condition, before Matters come to an Extremity, I would (without Loss of Time) find out the Feet; in order to which, the Orifice (which is now commonly less open) ought to be cautiously open’d with a gentle Force, by thrusting first one, and then more Fingers upwards, which are to be gradually distended, until at last the whole HAND is entered up to the Wrist: Whereby (after prudently breaking the MEMBRANE) I would now and then thrust back the Head, and put it upon one Side, as much as possible by Art.
BUT upon This here it must be carefully observ’d by the way, that I would pass my Hand close up along the INFANT’s Body from the Orifice to the Fund of the Womb, or to the Feet, that it may not come between the SECUNDINE and the Womb, but betwixt the MEMBRANE and the CHILD: By this Method I shall neither hurt the Womb, nor the INFANT; but the HAND distinguishing clearly all the Parts of the CHILD, I cannot miss finding the Feet with the greatest Certainty. Tho’ I must acknowledge by the By, this to be the Work of a very strong and agile HAND, as well as of a sound and ready Judgment; because of the immense Labour and Difficulty, first in opening the narrow ORIFICE, and then in penetrating through it to the Bottom of the Womb, as the INFANT obstructs the Way: not to mention the great Inconveniencies also besides, which arise from the Turnings and Windings, as well as from the Length and Constriction of the Passage. However yet——
THUS having found one or both FEET, I would draw them down both together, if possible, always turning the TOES towards the FACE. Whereas if only ONE can be found to be conveniently attracted, as it often happens, I make it fast by a running Knot on a broad Ribband, or by a certain Bandage, called MITRA, or with a soft Linnen Rag about four Inches broad; which I twist together, and hold in the Hand without the Body, as I pass the other up along this LEG, duly observing whether it is the Right or the Left, that I may know which of my HANDS will most commodiously find out the other LEG; and that HAND having reached the CHILD’s Belly or Buttocks, I slide it along the THIGH to the other LEG: So that the FOOT being thus found, I bring it also down into the PASSAGE, according to the POSTURE of the INFANT.
BOTH FEET being now thus brought down, if they chance to be ill-turned, that is, with TOES up and HEELS downwards, I discreetly turn the CHILD, whilst I gradually draw forth the FEET. These, together with the BELLY, being fairly excluded, I hold the FEET with one Hand, whilst I put the other under the BELLY and BREAST, as far as possible: Or, resting the FEET in my Lap, with one Hand above, and another below, I take good hold of the BODY, attracting it gently. Upon this I advise and encourage my Woman now to labour her best, and that whether she feels any PAINS or not, since they are now no longer to be waited for with the Impatience of a happy Delivery.
BY this regular Method, in fine, the HEAD and both ARMS pass thro’ the Orifice at once, and that without the least Danger; because the Smoothness of the TEMPLES affords always sufficient Room for the ARMS, as the Orifice relaxes and dilates, as has been already observed[175]. Now this, in short, I take, with Submission, to be the only genuine METHOD of perfecting a successful DELIVERY in the present preternatural Condition, whether the BIRTH be Dead or Alive: So that hence I proceed in course to——