Every thing being thus adjusted, very little more will be necessary but to wait patiently the efforts and operations of nature. There should be but few attendants in the room, and these are not to whisper to each other, or to express any fears or doubts.
A humane midwife will use every ingenious effort in her power to quiet the useless fears, and support and comfort the patient. A crowd of frightened, hysterical women, assailing the ears of the woman with tales of woe and sad disasters that have happened should be admonished. Half a dozen midwives, each making pretensions to great skill, ambition, and competition for obstetric fame, assembled around a feeble woman when labor is of a lingering character, is always an unfortunate circumstance, and it would be much better if nearly every one were afar off.
When the pains become very severe, quickly succeeding each other, the midwife, or the person who officiates, may sit by the side of the woman, and, upon every severe pain, may keep her hand upon the parts, even though no manner of assistance can be afforded, and occasionally, when the head of the child presses hard, it may be gently touched or pressed with the longest finger, in order to ascertain the parts that prevent the progress of labor, as well as to be able to give from time to time suitable encouragement: not only so; in the last stage of labor the hand may be kept near the parts, to know the moment when the head of the child presents, as some little assistance at this time is called for; but not by supporting the perinæum, as some advise, but,
First. To remove any obstruction which often arises from the clothes.
Second. To support the child in its passage, and in the interval of pains; and to keep the head from pitching downward, and thus obstructing the labor.
Third. To detach the umbilical cord or navel-string from the neck when it encircles it, as is often the case, and which endangers the life of the child.
Fourth. To deliver the woman in case of hemorrhage or great flooding; but at the same time there must be no further interference of art; little or nothing can be done toward facilitating the delivery of the child, except when a large bag or collection of water presents and opposes, when it may be ruptured with the longest finger, which often affords much aid, although such is the ignorance and credulity of some women, that they suppose almost everything to be accomplished by art. Physicians or midwives who watch only the process of labor, and do little or nothing, are pronounced inhuman and cruel, and perhaps ignorant, because they are honest in not interfering with the simple and beautiful process of labor, or in other words, for relying upon the great resources of nature: but such is the fashion and credulity of mankind, or rather womankind, that physicians are obliged to take the advantage of such ignorance and credulity, and regulate their proceedings accordingly. We have often been obliged to stand for hours over a woman, under pretence of aiding delivery, when, in reality, we did nothing at all. The labor would have progressed just as well had we been out of the room; but this deception we have been obliged to practise, in order to satisfy ignorant, gossiping, or crying attendants. When the woman is disposed to make much noise, she should be directed to hold her breath during the pains, and aid or assist them by pressing downward as much as possible. The feet may press against the bed-post, and the woman take hold of a handkerchief and pull when a pain occurs; or she may grasp the hand of an assistant for that purpose. Sometimes, from various causes, labor is very much retarded, from rigidity of the parts, the situation of the child, debility, &c.; when this occurs, and labor is tedious and protracted, our reliance must still be upon the powers of nature. We may, however, aid her efforts, by warm fomentations of bitter herbs, often applied to the lower part of the belly, which will prove relaxing, and will facilitate the labor; warm diluent drinks may also be given, such as tansy, pennyroyal, &c.
If the labor still continues stationary, we have nothing to fear, provided there is a right presentation; but should the pains become feeble or lessened from flooding, debility, or any cause, or should they prove unavailable, after a reasonable length of time, a drachm of spurred rye or ergot may be put into a tea-cup, and a gill of boiling water poured upon it, and, when cool, a tablespoonful given every fifteen minutes. This will increase the pains, and speedily accomplish a delivery; but it should be very seldom, or never, used, except when there is a right presentation, and under the most urgent circumstances.
It is prudent, by judicious precaution and care, to remove obstructions, prevent accidents by holding or supporting the child in a proper position, and giving such aid as reason and judgment will dictate. Receiving the child, preventing its fall, securing the navel cord, assisting in the removal and disposal of the after-birth, are objects which are to be accomplished, and all in the most calm and simple manner; no hurry or excitement is necessary, but, on the contrary, they embarrass. Yet how common is it that females in general, married and unmarried, are so uninformed and ignorant, that, instead of attending to those duties, if necessary, or in cases of emergency, they are thrown into the greatest consternation, and perhaps run out of the room and let the child suffocate by the bed-clothes, or by the navel cord twisted about the neck, and die merely for the want of a little common sense and knowledge, which might be acquired in an hour. Is it not highly disgraceful, if not criminal, that farmers can, and do, attend to those duties toward their stock, and yet remain entirely ignorant of them toward their nearest relations? Young women and men are taught music, dancing, drawing, needle-work, and many ornamental branches considered so essential to a polite education; yet they are suffered to remain entirely ignorant on a subject of so much vital importance. Is there any hope or prospect of enlightening this generation, or must it be delayed till the next, and have them look back with amazement at our ignorance? We hope there is something yet redeeming in a large proportion of the community; that the people will yet awake to their own interests.
When the head is delivered, all that is necessary to do is, to support it, and wait for the pains to expel the child; except it seems livid and in danger of injury, or when the cord is twisted around the neck, when assistance must be rendered, to accomplish the delivery. The face of the child must now be turned upward, and the cord freed from the neck or body; the person who assists will pass a narrow piece of tape around the cord or navel-string, about an inch from the body, and tie as tight as it can be drawn, otherwise hemorrhage or bleeding will take place; and another must be tied at a little distance from it, above, and be separated between them with a pair of scissors. The child is then to be given to the nurse, to be washed, dried, and dressed. The woman must now be covered, and directed to lie quiet.