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

Of DIFFICULT and SEVERE Cases.

If an easy delivery requires nothing of extraordinary assistence; it is not so with a difficult one. All the knowledge, experience, dexterity, strength, prudence, tenderness, charity, and presence of mind, of which a woman is capable, are requisite to accomplish certain laborious deliveries.

It has been, in all times, very well known, that the most natural situation for the fœtus coming into the world, is that, in which the head presents first, it being that which commonly makes way for the rest of the body. Yet this delivery may become difficult, in proportion to the obstacles incident to it: obstacles not always surmountable, without great skill and industry employed in aid of Nature.

On the other hand, when it is felt that the fœtus presents any other part than the head, this position, called preternatural, oftenest occasions the delivery to be more laborious and hard to accomplish, in proportion to the more or less trouble there may be to search and come rightly at the feet.

Many English and French authors have given us a long enumeration of the causes which may make deliveries difficult and laborious. The curious may have recourse to them; as for me, who have not proposed to myself here a treatise compleat on all points, I shall content myself with setting forth only what tends to fullfil my proposed aim, that is to say, to take notice of those principal points, which first moved insufficient midwives to call in surgery to their assistence, to remedy their blunders, to retrieve their mischief, or to repair their omissions. I shall consider the kinds of exigencies, which the men-operators seized for a pretext of employing their iron and steel-instruments, the use of the natural hand, being yet more unknown to them than to the meanest midwife, and by this means, for the cure of confessedly a great evil, obtruded an infinitely greater one, and more extensive, in every sense, and in every point of light, that of men taking the practical part of midwifery into their own hands, or rather into their artificial ones of iron and steel, from which they derive all the authority of their introduction in the character of men-midwives.

The labors then which are generally speaking looked on the most nice, and arduous, may be comprized under the following heads.

1st. The obliquity of the uterus or womb.

2dly. The extraction of the head of the fœtus severed from the body, and which shall have remained in the uterus.

3dly. That labor in which the head of the fœtus remains hitched in the passage, the body being intirely come out of the uterus.

4thly. When the head of the fœtus presents itself foremost, but sticks in the passage.