HOWEVER, I know beforehand, that my Method of performing this Work, which I am about to lay down, will be thought a strange Innovation in Midwifery; but without any regard to that, in speaking to this Point, I shall First suppose this Body to be already loosen’d from the Womb; in which Case the Midwife has nothing to do, but to draw the STRING gently, which she holds in One Hand, twisted twice or thrice around one or more of her Fingers, while she passes the Other Hand into the Womb, following always the STRING (as her Guide) to the Place where the Burthen lies: And where, as in this Case, it naturally presents itself to the Orifice, She stretches her Hand up length-ways, taking hold of it betwixt her Fingers; and thus, by the Assistance of the other Hand always attracting softly the STRING, she brings it at last most commodiously away.
SECONDLY, I shall suppose, in the mean Time, this Body to continue fixed to the Womb, either in Part or in Whole: In which Case, if in Part, the Midwife finding by the Touch the other Loose Part, moves her Hand thither betwixt That and the Womb, shaking or stirring it gently backwards and forwards, until such time as it is entirely loosen’d, when she proceeds as Before: But if in whole, and that it sticks very Fast, then the MIDWIFE places her Hindmost Fingers on its Exteriour Part against the Womb, and her Fore-Fingers against the Inside; so that thus by pulling softly on all Sides quite round, it is easily loosen’d and extracted as Above.
THIRDLY, I shall suppose this SECUNDINE also (tho’ loosen’d successfully) to be so very Large, that it cannot pass through the ORIFICE: In this Case, I only desire my deliver’d Woman to concur with me, and behave herself as if she was forcing or expelling the CHILD; for then whilst I at the same time gently attract the STRING, it immediately follows.
I very well know that Mr. Mauriceau and all others either in and before his Time, teach quite different Methods of extruding the AFTER-BIRTH; such as are by the WOMAN’s blowing in her Fist, putting her Finger in her Throat, and the like; which when the poor Patient has done, and stood them All out ineffectually, together with their many other various uncertain Experiments to no Purpose, and none of them have succeeded (as it has often happen’d): Then at last, and not till then, they direct the aforesaid Method of the HAND to be used. But now-a-days, we know better Things than to run such indiscreet Risques, when we may go a safer Way to work; or to make use of Uncertainties, when we know more Infallible Means. As I shall, I hope, make this Method plainly appear to be; notwithstanding all the great Cautions of those Authors publish’d, and the Difficulties they make of it in our Practice of MIDWIFERY: And that I will endeavour to do from the following Considerations, viz.
I. IF after the Birth of the Infant, the Hand be presently pass’d into the Womb, it slips in together with Part of the Arm, as far as is needful, without the least Trouble or Inconvenience to the Woman; the Womb as well as its Orifice continuing always, so long as this may be done, sufficiently Open: And thus the Birth maybe skilfully accomplished or perfected, as it were, in an Instant; while others (trying their vain Projects) spend many trifling Hours about it, and it is ten to one, if at last they succeed.
II. BY these means, moreover, I presently know whether there be One, Another, or More INFANTS to follow; whether there be a dead CHILD, false CONCEPTION, or any Foreign Body whatsoever, lodged in the Womb; whether any Part, or Pieces of the Secundine, or Membranes, or Lumps of Clotted Blood, be left behind and retain’d: All which I propose to bring away either before, or after the Secundine, as Occasion serves, with the greatest Safety as well as Expedition.
III. AFTER having thoroughly searched on all Sides, and thus duly cleans’d the Womb, by continuing my Hand in it, until it contracts about that Hand, first above towards the Bottom, and then below towards the Orifice, which happens very quickly: I find myself then, by great Experience, able to rectify all Oblique and Preternatural Situations of the Womb; as in Case of a Prolapsus, (or Falling down) I can hereby move it carefully Up again: If it lies too much Backwards, by elevating it while it gradually contracts, I can easily bring it Forwards, to its Natural Position: If it hangs too much Forwards, I can quickly reduce it Backwards: If it tends to either Side, I can directly move it to its Center. And thus, in short, I hope I may be allow’d gently and gradually to restore the Womb to its Natural Place and Posture, how Preternaturally and Obliquely soever its Situation may happen to be disorder’d.
NOW This being so successfully done, I can, in fine, assure and secure any Lying-in-Woman, that her Womb is both duly purg’d, and naturally shut again as it ought to be; which I take to be the greatest Satisfaction the Child-Bed-Woman can conceive in her Condition. Whereas,
IV. THEY who leave all these Things to mere Nature, risque their Patient’s future Welfare, and very often her Life too, as innumerable Tragical Examples witness: For Nature itself most particularly requires our special Assistance in this Case. But (according to their indifferent Notions) it is Time enough to assist Nature, when it is found Deficient; and then, in Case of Extremity, they unanimously agree that there is no other way to help or save the Woman’s Life, but by this Method of Manual Operation. To which I answer, that Nature operates not in an Instant, but (in all Cases) requires a competent Time, to discharge its respective Functions; and being left too long to itself, for want of Help, is many a-time (by intervening Accidents) found at last Incapable: Upon which, then They, beginning their Endeavours to second it, generally come too late. For if the Case does not prove to be past all Remedy, it is at least (by this Protraction of Time) often rendred not only difficult, but also desperate; as will evidently appear in the Case in hand, from what follows, viz.
I. WHILE They (conformable to the general and universal Practice of common MIDWIVES) expect the Performance of Nature, or the Success of their trifling Means, in the mean time, the Orifice of the Womb is so closely shut up, that in the space of an Hour or two, it cannot be penetrated, without renovating the most severe racking Pains to the Woman, who (perhaps) has been sufficiently spent before, by the Delivery of her Infant, and is now consequently incapable of standing out the renew’d Pangs: whereby of course She must succumb at last, and give up the Ghost, for want of Timely Help; as innumerable Instances confirm for an undeniable Truth. But,