A THIRD difficult BIRTH may proceed from the Infant’s being too Big; In which Place I must previously apprize the READER, that I no ways mean a MONSTER or Hydropical CHILD, but only One full, well, or Big-grown, which is only reckoned too Big in regard of the Maternal Passages, which may be too Small in Proportion.
IN this Case, there is an absolute Necessity for Manual Assistance, since the PAINS (however penetrating or forcible) cannot effect the Work. But and if the INFANT is fallen down (well turn’d) into the Pelvis, the Midwife using her best and most skilful Endeavours to dilate the Passages below near the Os Coccygis, the Child may be easily brought forth (without any dangerous Instrument) by her dextrous Hand only accomplishing the Work. In the mean Time, however, it is to be minded always, that This is still more safely and commodiously done by the Feet, than by the Head, after carefully dilating the Os Coccygis, taking this Opportunity in the beginning of the Labour, before the INFANT is too much press’d down into the Pelvis.
NOW these are, in fine, the most common Causes on the Part of the INFANT, whence I come to touch upon difficult BIRTHS, proceeding from Causes of the Passages; which, because they are various, I subdivide into a Fivefold Diversity; viz. Difficult BIRTHS, proceeding from Causes of the Membranes, from Causes of the Pelvis, from Causes of the Bones of the Pelvis, from Causes of the Bladder and Rectum, and from Causes of the Vagina: And because all these require to be singularly explain’d, and particularly insisted upon, I shall assign them as many respective Chapters. And First——
CHAP. VII.
Of Difficult BIRTHS, proceeding from Causes of the MEMBRANES.
SUCH Difficulties as These, in BIRTH, may arise, FIRST from the Strength and Firmness of the Membranes; when they happen to be so gross, callous, or thick, that the INFANT cannot easily break through them.
In this Case, when the MIDWIFE finds the Orifice of the Womb sufficiently dilated, for the Circumference of the Head, and the Child so forward in the Passage, that it is ready for BIRTH, and only impeded by the rigid or stiff Membrane; then she has just Authority to break it gently with her Nails and Fingers; taking Care in the Act not to draw the Membrane towards her, because thereby the Secundine (of which the Membrane, tho’ distinguish’d from the Placenta, is in Effect, but the Thinner Part) would be untimely separated from the Womb, and the INFANT undone, unless presently Born.
BUT the MIDWIFE, after All, must always remember, not to attempt This, before these mentioned Signs are obvious to her Touch; otherways the Waters being too soon discharged, the CHILD is left behind, the Passages grow dry, and that which might have been an Easy and Speedy, proves a Difficult and Lingring BIRTH.
AND the self-same Consequences arise from the Weakness and Tenuity of the MEMBRANES; when they are so thin and soft, that they break, and the Waters (which are destin’d to lubricate and moisten the Passages) flow before their Time: In both which Cases, the Office of the Waters must be supply’d by proper Fomentations, and Oils, which (however costly) falls far short of the Effect of what is so Natural. However, in short, neither of these Conditions, under the diligent Hand of the expert Midwife, can differ far from the Case of an Easy BIRTH, as already defin’d; wherefore I proceed regularly to——
