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

[7]. A la veritê Mauriceau raporte cette mort inopineê à une Cause occulte, puisqu’il dit expressement que “ce fut un de ces fortes de malheurs de la destinée que toute la prudence humaine ne peut pas eviter.” C’est aussi l’opinion de la Motte. Levret, p. 272.

[8]. Levret, p. 269.

[9]. This will doubtless be laid hold of as one proof, that midwives have, in cases where they are puzzled, been forced to have recourse to men-practitioners: but I have no where said, there were not some midwives unequal to their business. The sequel will shew, that this most probably was one of them, and the case was not much mended by the assistent she called in. A little more patience, though I confess there is some room to think it in this so long lingering case excusably exhausted, would have prevented the murder of the child: but as the concomitant circumstances are not specified, I cannot pretend to determine that point. All I shall say is, that there is not hardly one case in a thousand, in which nature does not know her own time best, and does not take it kindly to be hurried. It has been known, that sometimes the quickest deliveries have been the most fatal, and the most liable to sudden death, by consequent hemorrhages.

[10]. Dr. Smellie has himself (p. 403.) ranked among the causes of sudden death to women by violent floodings after delivery the following one; “if in separating the placenta the accoucheur has scratched or tore the inner surface or membrane of the womb.” But if unpared nails, or the rough hands of a man, may cause such a dreadful accident, what may not be dreaded from iron and steel instruments, blindly thrust into parts of a scarce less tender texture than the apple of the eye? But of that more hereafter.

[11]. Levret’s words, p. 279.

[12]. It is among the smaller mischiefs done to the mother, that I here mention my having not unfrequently seen ruptures brought on by the practice of men-midwives, upon patients in other lyings-in, precedently to the one in which I attended them. These ruptures I have sometimes been able to remedy by good management in my laying them.

[13]. “Let the forceps be unlocked, and the blade cautiously disposed under the cloaths, so as not to be discovered”. Smellie, p. 272.

[14]. See Smellie, p. 307.

[15]. Smellie, p, 291. “When the head presents, and cannot be delivered by the labor-pains; when all the common methods have been used without success, the woman being exhausted, and all her efforts vain; and when the child cannot be delivered without such force as will endanger the life of the mother, because the head is too large, or the pelvis too narrow: it then becomes absolutely necessary to open the head, and extract with the hand, forceps, or crotchet. Indeed this last method formerly was the common practice when the child could not be easily turned, and is still in use with those who do not know how to save the child by delivery with the forceps: for this reason their chief care and study was to distinguish, whether the Fœtus was dead or alive; and as the signs were uncertain, the operation was often delayed until the woman was in the most imminent danger; or when it was performed sooner, the operator was frequently accused with rashness, on the supposition that the child might in time have been delivered alive by the labor-pains: perhaps he was sometimes conscious to himself, of the justice of this imputation, although what he had done was with an upright intention.”—This last indeed would be too uncharitable not to grant.

[16]. Smellie, p. 255. “In this case, we find, by experience, that, unless the woman has some VERY DANGEROUS SYMPTOM, the head will in time slide gradually down into the pelvis, even when it is too large to be extracted with the fillet or forceps, and the child be SAFELY delivered by the labor-pains, although slow and lingering, and the mother seems weak and exhausted, provided she be supported with nourishing and strengthening cordials.” Now in this Dr. Smellie is very right; his wrong consists in not making this conclusion more extensive, as that of his fellow-practitioners too often does, in fancying or exagerating dangerous symptoms: whereas for once that nature really occasions them, they are incomparably oftener the effects of the operator’s own mispractice: this observation I cannot, for the truth and importance of it, too often repeat.