A Treatise on the Art of Midwifery / Setting Forth Various Abuses Therein, Especially as to the Practice With Instruments: the Whole Serving to Put All Rational Inquirers in a Fair Way of Very Safely Forming Their Own Judgement Upon the Question; Which It Is Best to Employ, in Cases of Pregnancy and Lying-in, a Man-midwife; Or, a Midwife

by Elizabeth Nihell

The natural one, is that in which the fœtus comes out in the most ordinary way, when it presents the head foremost.

It is deemed preternatural, when the fœtus presents in the passage any other part than the head.

These two kinds are again subdivided into two distinctions of labor, of easy or difficult, because both the natural and preternatural mode of delivery may be easy or difficult.

The delivery is termed easy when the fœtus comes out readily, and without the aid of art.

It is termed difficult, when the labor of it is hard, and the fœtus does not make its way out but with pain, and with the help and assistent industry of the midwife.

In the cases of a natural and easy delivery, there is little or no actual occasion for the presence of the midwife, beyond that of receiving the fœtus, tying the navel-string, giving the child to be kept warm, and then delivering the mother of the after-birth. The spirits of the patient are then to be recomposed, her agitation calmed, a warm and soft linnen cloth applied to the stomach; a warm shift and bed-gown put on her; a linnen cloth to be laid on four-fold over the belly; a double-napkin round her, and she to be placed in a bed well warmed. Such is the summary of the process to be observed in those common cases.

In the deliveries, on a preternatural labor, when they are easy, the same method takes place: there being no difference, but that in one the child will have been received by the head, in the other by the feet.

These kinds of labors are so easy, that there is no need of demonstrating their being to be terminated without the aid of instruments. When the fœtus presents itself promisingly, Nature is best left to her own action, and nothing should be precipitated in the manual function, unless some unexpected accident should intervene, and require interposition, such as a great flooding, or other exigency.

As to the preternatural delivery, the better practice is not to delay the extraction of the fœtus, after the discharge of the waters; nor stay till her strength shall have been exhausted. On the presenting of a fair hold, and a sufficient overture, no difficulty should be made of extracting.

All that is to be observed then, is not to prematurate this extraction: not to proceed, in short, like those unskilful, or inconsiderate practitioners, who are no sooner entered the patient’s room, but they want to have their operation dispatched out of hand. Nothing can be more important to the well-doing of the patient, than for no violence to be used to Nature, who loves to go her own full time, without disturbance or molestation. In this point then great caution and circumspection are requisite.