CHAP. XX.
Of Preternatural BIRTHS, from the WOMB’s inclining backwards.
Experience teaches us, that the Womb may be also too much resupin’d; or tending with its Bottom backwards, may be pressed too much towards the Spine: So that its Orifice is not only raised too high in the Belly, but is also so obliquely seated, that it no more answers to the VAGINA in a right Line, varying more or less, according to the Proportion of this Tendency to the Back-Bone.
FROM this Posture of the Womb now, it necessarily follows, that the Head (tho’ never so well turned) falls upon, and is violently forced against the Ossa Pubis; where the tender Head sticking, often happens by its own Struggles and the Mother’s PAINS, to be grievously squeez’d and gradually crush’d, so that, until it is removed and brought into the PELVIS, the Woman can by no means bring forth her INFANT. Wherefore the diligent and careful MIDWIFE must (by due Attention) make it her Business to discern at the first Touch this ill Position of the Womb, and presently upon the first Pang of Labour, try to help both the MOTHER and the CHILD.
WHEREAS otherwise the slothful and ignorant MIDWIFE, may continue the poor Woman in an irregular Labour perhaps some Days, without perceiving the Head to be fixed upon these Bones, always erroneously imagining the INFANT only to be situated too high, (because it lies out of the reach of her shallow Touch) and that it must in due Time fall down lower within her Ken. Or peradventure otherwise, when by the Touch, she feels a kind of Roundness or Hardness, thro’ the Womb, mistaking This for the Head, she thinks the INFANT is well turned, and wants only strong PAINS to drive it forwards with Success.
THIS Ignorance is chiefly owing to her own Stupidity, in that she cannot clearly distinguish between the Womb and the Vagina by the Touch; nor the Orifice of the Womb from the Parts of the CHILD, or MEMBRANE; which (in this Case) frequently occasions the Death of many a Dear MOTHER and INFANT.
BUT here it is to be moreover noted of this difficult Situation of the Womb, that the MIDWIFE (how skilful soever) perhaps can either not touch the Orifice at all, or but very little, except it lies wide open, when she may touch at least some Part of the Circle of the Border: For the Head being fixed upon the Pubis above, the whole upper Part of the Edges of the Orifice can no ways peradventure be touched with the Fingers, which may only reach the lower Part that is Open.
UPON which, these Fingers are cautiously and prudently to be thrust in farther betwixt the Neck of the Bladder, and the Orifice of the Womb: Then being so near the Neck of the Bladder, a discerning MIDWIFE will feel a sort of a Circular Border, namely, that of the Orifice of the Womb; which if she penetrates with her Fingers, she will also find the hard Part of the Head, which is Smooth and Globular, or the opening of the Vertex; whence she may be certain, that the INFANT, as well as the WOMB, is too close to the Spine of the Back. Whereupon she ought, without loss of Time, to assist and help the CHILD in the following Manner; viz.
SHE is to hinder the Woman from labouring all this while, advising her to bear and put by her PAINS, until this Posture of the INFANT can be duly corrected: In order to which, I would First order the Woman to make Water, if she can, that the Bladder being thereby emptied, may not be hurt by the Pressure of the MIDWIFE’s Hand, or the CHILD’s Head: Secondly, if the MEMBRANE is not yet broken, and the Pains but few and faint, I would prescribe a gentle Clyster, not only to awaken These, but also to remove all Inconveniencies of the RECTUM: Thirdly, I would then advise to lay the Woman in a convenient manner, upon her Back with the superior Part of her Body lower than the inferiour, that both the Womb and the Infant may the more easily recede or give way back.
THEN taking cautiously Hold of the Border of the ORIFICE with the Fingers of either Hand, I would press and draw it back towards the RECTUM, whilst I employ’d my other Hand outwardly upon the ABDOMEN, a little above the OS PUBIS: I mean, that the Child’s HEAD ought to be thrust back a little with the Hand on the outside, pressing it discreetly down; as the ORIFICE is to be drawn back towards the RECTUM, and at the same time also downwards, with the internal Hand.
IN the next Place, as I feel the Head and the Womb mov’d a little downwards, so I would also advise the good Woman to raise the upper Part of her Body, yet so as not to stir the Lower, and to bend herself as much as possible Forwards, sitting as if she was going to Stool: Because by this Posture, she raises both the Infant and the Womb behind, and consequently drives them BOTH Forwards, whilst I would in the Interim keep my HANDS very fast placed as aforesaid, ready to depress the HEAD before, that it may fall directly into the Pelvis. In short, the HEAD being thus disengag’d, I would now advise the Woman to observe her PAINS, and mutually labour with them what she can, with her Body mostly still in a Sitting Posture, or kneeling with her Arms conveniently supported.