VI. I have also seen the CHILD brought forth by the HEAD, with the Umbilical circumvolv’d, or turn’d twice or thrice round the NECK; by which means of the STRING’s being so much shortned, the BIRTH was stopped or retained in the Passage: Upon this Occasion, I endeavour’d to slacken the STRING, and so bring it over the HEAD, but finding it too strait and short to be so ordered, I tied it in two places (at about two or three Inches distance) and then cut it in two betwixt the Ligatures: That being done, it was my Business to lose no Time in attracting the INFANT and delivering the WOMAN; otherways in this Condition, it would have soon expired.
CHAP. XXV.
Of Preternatural BIRTHS, from the AFTER-BIRTH’s coming first into the PASSAGE.
ANOTHER Preternatural Accident to which the BIRTH is also sometimes liable, is the Falling down of the Placenta into the Orifice of the Womb; which of course must needs obstruct the Passage, and prevent the timely Egress of the INFANT.
NOW tho’ the ignorant Midwife often occasions this untoward Accident by her own unskilful and imprudent Treatment, or rough and indecent Usage; yet the Ingenious MIDWIFE discovers this Case in time by two certain different Ways: Namely, First, by the Touch, when she can neither feel the MEMBRANE, nor the naked HEAD; but (on the contrary) perceives a thick, soft, fleshy, boneless Substance: Secondly, by a Bloody Flooding, which constantly attends this Condition; whereby both the MOTHER and the CHILD are imminently endangered, as is already more abundantly set forth[[180]]: Unless the skilful MIDWIFE can prevent the fatal Consequence, by accelerating the BIRTH; which, however yet, is not to be rashly attempted without due Circumspection.
BUT notwithstanding the daring Difficulties, and time-serving Precautions, mentioned by most Authors of my reading and revolving, in this Case; I can conceive no extraordinary Perplexity which can attend it, if the DELIVERY be but timely or seasonably undertaken, before the Woman’s Strength and Blood be too much exhausted. I know Daventer, Peu, and some others, make long Ambages or Circumlocutions upon this Head; for some are at great Pains to teach us how to perforate the SECUNDINE with a Hair-Needle instead of our Fingers, and others how to keep it back, until the INFANT be first born: But for my part, as I already foresee sundry Difficulties that will arise in these Practices, so I shall be loth to come into them, and that because——
FIRST, in penetrating the Placenta with any acute Instrument, the CHILD (if not the MOTHER also) may be easily wounded: Secondly, supposing it to be done with the Fingers, the Hole must be dilated in proportion to the Aperture of the Mouth of the Womb, and then this mangled Mass must be dispersed to all Sides of the Orifice; by which Means, Daventer himself acknowledges, that it often perfectly congeals with Blood, and sticks so fast to the Womb or Vagina, that the Ignorant would not only take them to be grown together, but also believe them rather to be one and the same Body: Which consequently must require both great Pains and Difficulty to be separated, and at last a very diligent Scrutiny must be made, that no Fragment be left any where Behind, since in this Condition no just Conjecture can be made by the Eye: Thirdly, by retaining the SECUNDINE in the Womb, when its heaviest and most bulky Part (the Placenta) is fallen down into the Entrance, let it be never so judiciously managed and moved, it possesses a considerable deal of Room, and consequently obstructs the Operation of the MIDWIFE’s Hand, lying as a cross thwarting Impediment in her way, which at the same Time blockades or totally shuts up the Passage of the CHILD.
WHEREFORE, and considering that this Body, when so loosened and separated from the Womb, can never possibly be any more serviceable; but, on the contrary, highly detrimental to both the MOTHER and the INFANT, as aforesaid; I cannot but be of Opinion, that it is both the safest and shortest Way, to extract the SECUNDINE first; by which expeditious Step, the MIDWIFE not only gains more Room to turn the Child, but also (this being done) she can much more commodiously draw it out by the Heels: Animadverting always by the way, that in this critical Condition, the BIRTH must immediately follow the SECUNDINE, without the Loss of one Moment’s Time, and that especially for stopping the Floodings, which would otherways not only soon suffocate the weak Infant, but also in a short Space of Time effect the certain Death of the tender Mother.
