The Female Physician / Containing all the diseases incident to that sex, in virgins, wives, and widows; together with their causes and symptoms, their degrees of danger, and respective methods of prevention and cure: to which is added, the whole art of new improv'd midwifery; comprehending the necessary qualifications of a midwife, and particular directions for laying women, in all cases of difficult and preternatural births; together with the diet and regimen of both the mother and child.

by John Maubray

THE most difficult Posture of this kind is, when the Bottom of the WOMB is placed deeper in the right Side towards the Loins, tending more to the Back than the Forepart. Which the Midwife may know to distinguish by the following Signs; namely, 1. By the Place where the Woman feels the INFANT move most. 2. By that part of the Belly which is most pointed and hard on the Outside. 3. By trying the Woman in the beginning of the Labour, before the Pains have moved the WOMB out of its Place, she will find the Orifice of the WOMB suspended higher, compressed to the Spine of the left OS PUBIS or COXENDICIS; by which means the said Orifice cannot be touched without Difficulty; and by no means the whole of it, but only the lower Border. 4. She will find the INFANT’s Head thro’ the WOMB and VAGINA (tho’ not bare) laid a-cross the PELVIS, but cannot come at the lower Part of it; only with one or more Fingers, she may sometimes penetrate betwixt the Spine of the said Bones, and touch the VERTEX.

BY these Signs the MIDWIFE soon finds her Task most heavy and perplexed; for from thence proceeds the following Difficulties.

I. IN this Posture the INFANT’s Head (as soon as it makes the lead Apertion of the Orifice) is fixed upon the Spine of the left OS PUBIS or COXENDICIS; and the Head thus fixed cannot pass forwards, because those Bones cannot give way: From hence arise the Aquæ Furtivæ, or a flowing of the Waters by Stealth, or as it were, by Distillation; the Orifice as well as the INFANT’s Head being shut up by the said Bones, so that neither the Head nor the Humours can open it; save only a little on the lower Side: Where the Waters, by pressing the Membranes downwards in an acute Form, break thro’ that acuminated Part as they also force the Head upwards, near to the Border of the said Bones.

II. IT often happens, by these means, that the right Arm is excluded, and falls down to the Shoulder in the PASSAGE, the INFANT being left dry by the unseasonable flowing of the Waters: And the Arm being thus thrust forwards into the PASSAGE, the Head is more and more forced-back upwards, so that the Neck of Consequence is so bent, that it may easily break; and the Crown of the HEAD (falling against the Spine of the PUBIS or COXENDICIS) is so pressed upon it by the violent Pains, that the BRAIN may be readily affringed, and consequently the INFANT die before BIRTH.

III. THE most deplorable Condition of all is when, after all Pains and Labours suffered in vain, the Mother herself expires, without bringing forth her Child; as it too often happens, that after a long continued and miserable Torment, the Birth is not a Jot advanced, whereby of course the wretched Woman must undoubtedly yield up the Ghost for want of effectual Help. I say for want of Help, because the Help of such Midwives as are ignorant of the various Postures of the Womb, and the Method of correcting them; and of such as do not thorowly understand the Touch, but place all their Hopes in Nature and Divine Mercy; is as nothing, and of no Effect upon this critical Occasion: Since the audacious Ignorance of such Creatures serves only to tempt God and his Providence.

HAVING thus defin’d and laid down the fatal Inconveniences of this Preternatural Situation, I come now to shew People concern’d how to correct it and dispatch a happy BIRTH: In order to which, the præliminary Articles are the MIDWIFE’S indefatigable Industry, and accurate Attention to the Circumstances of Things.

THEN supposing an INFANT to be brought forth HEAD foremost; the Woman is to be placed with the upper part of her Body a little elevated, the MIDWIFE then finding (by the Touch) the Orifice to be but moderately press’d upon the Left OS PUBIS, or COXENDICIS; in this Case, she is to be laid down full upon the right Side a little obliquely, that the Womb may fall back by its own Weight, and not relapse against those Bones.

NEXT after this I would endeavour to get my right Hand-Fingers above the upper Border of the Orifice, and thereby remove it a little, and bring it down nearer the Cavity of the Pelvis. To facilitate which Work, I would order some of the By-Standing Women to raise her right Side a little, which of Consequence raises the Womb itself; and thus I would, by raising and letting it down by Degrees, move it forwards into the PELVIS: However, always taking special Care, that the Womb, together with the Head, do not slip down too far into the crooked Sinus of the OS SACRUM, so as to stick there, (as has been already precaution’d in the preceding Chapter:) to prevent which unlucky Accident, I would advise to apply all possible Care and Pains in the Beginning, to sustain and keep up the Orifice, and to bare the HEAD sufficiently before its Descent; observing also the same Management in point of the Humours, until the Membrane breaks; which being broken, I would treat the Head in Manner as aforesaid.

NOW tho’ the HEAD in this Posture offers itself as if it were bent aside, because of the lateral Distorsion of the Womb, I would first bring it to a right Position, and then manage it as if it had presented itself directly: And besides, the HEAD being thus directed into the Pelvis, I would always take care that the Woman’s Body be bent a little towards the left Side, that the Child may the more readily be carried down by its own Weight into the PELVIS. But, in short, as to the farther Exclusion of the Infant, and After-Birth, as well as the Cleansing and Contraction of the Womb; These Things are to be perform’d, as directed by the foregoing Chapter.

HOWEVER, we will now state the Case, and suppose that the Woman is spent and tired out with continual hard Labour, before the capable MIDWIFE is sent for: Upon this Condition the BIRTH is to be hastened by all possible prudent Means. In order to which, I would (without Loss of Time) endeavour to turn the INFANT, and extract it by the Feet; Because to direct it otherways into the Pelvis, would be too tedious upon this Juncture. For to bring it Head foremost, would create vehement Pains, which infallibly would expose both Lives to extream Danger. But now, in fine, having thus at large insisted upon the various Cases of Preternatural Births, arising from the four extream oblique Situations of the Womb; It remains yet still, that I also subjoin a few Words, upon such Preternatural Cases, as may proceed from the less oblique Positions of the same Body; and that briefly in manner following——