I. THE Orifice of the Womb is suspended higher than usual; which she cannot Touch, by reaching, without a great deal of Difficulty.
II. SHE can only Touch the lower Border of the Orifice, and that only as the Womb hangs more or less forwards; and by no means the upper Edge, except the Orifice has begun to fall down.
III. SHE cannot at all, or very hardly, get her Finger into the opening of the Orifice, and because of that Difficulty, it must then also be crooked or bent.
IV. SHE will find the Orifice opposite to the bending of the last Vertebræ or the Os Sacrum, and feel it so strongly pressed against the said Vertebræ, when the Pains come on, that it cannot fall down: and lastly, she’ll feel the Waters (if they hang over the Passage) in a thin slender Form.
UPON This the Skilfull MIDWIFE finding these concurring SIGNS, she may be assur’d that the Womb hangs too much forwards; which Condition requires the immediate Help of Ingenuity and ART to correct this ill untoward Position, and to promote the BIRTH expeditiously. But then these Things are to be carefully perceived and distinguished in the Beginning of Labour, before the Pains have either closed up, or too much depressed the Orifice; yea, in short, even before it sensibly opens: since afterwards all those SIGNS are variously chang’d and alter’d, till at last they entirely vanish.
WHEREFORE let it be deem’d as a certain Rule, that the true Posture of the WOMB is always best discover’d by the Touch in the Beginning of the Labour: At which time may the Orifice be suspended never so high, the MIDWIFE ought to penetrate so far, until she reaches it; if not sufficiently with her Fingers, the whole Hand is to be judiciously used, and passed up that Length, because this particular Touch is absolutely Necessary for that good End: Insomuch that if any Labouring Woman be against this manual Operation or opposes it, she thereby debars her MIDWIFE of an infallible Method, of discovering the true Posture of her Womb, and consequently of taking the most immediate proper Means for Her own as well as her Infant’s Relief.
BUT now supposing, after all, the MIDWIFE to be certain that the Womb hanging too much forwards, in a prominent Belly bearing pretty much out, is deeper depressed than it ought to be; She is obliged then in this Circumstance to consider accordingly how to correct this Preternatural Situation, and assist both the Mother and Infant for the best: To which End, She ought First to endeavour that the Head may fall down into the Pelvis, even to the bending of the Os Coccygis; and then, Secondly, She is thence to advance the Head gradually, that the Exclusion of the CHILD may be expedited and intirely perfected at last.
NOW in order that the Head, together with the Orifice of the Womb, may be so discreetly brought forwards into the Pelvis, the Woman is to be placed with the upper part of her Body lower than the inferiour; I mean, with Head and Shoulders bending downwards, and the Buttocks upwards; by which Means, the Bottom of the Womb is elevated, and gives the Orifice an Opportunity of being brought more easily into the Pelvis.
THEN the parturient Woman being so placed, the MIDWIFE (using both Hands) ought to clear the Womb, together with the Head of the Infant, by putting the one up, as far as there’s occasion, into the Vagina, and laying the other upon the Woman’s Belly, in manner following: viz.——
THE Hand in the Vagina is (by having two or three of its Fingers Ends extended to the upper Border of the Orifice of the Womb) to move it a little beyond the Head of the CHILD, and to direct it into the Mouth of the Pelvis, so that it may fall the more readily down into the design’d Place. But in this critical Juncture the MIDWIFE must always take special Care not to squeeze or press the Top of the Head too much, nor to handle it too hard, lest She should thereby wound, if not also kill the Infant.