SECT. II.—How a Woman must be Delivered when the Child's Feet come first.
There is nothing more obvious to those whose business it is to assist labouring women, than that the several unnatural postures in which children present themselves at the birth are the occasions of most of the bad labours and ill accidents that happen to them in that condition.
And since midwives are often obliged, because of their unnatural situations, to draw the children forth by the feet, I conceive it to be most proper first to show how a child must be brought forth that presents itself in that posture, because it will be a guide to several of the rest.
I know indeed in this case it is the advice of several authors to change the figure, and place the head so that it may present to the birth, and this counsel I should be very much inclined
to follow, could they but also show how it may be done. But it will appear very difficult, if not impossible to be performed, if we would avoid the danger that by such violent agitations both the mother and the child must be put into, and therefore my opinion is, that it is better to draw forth by the feet, when it presents itself in that posture, than to venture a worse accident by turning it.
As soon, therefore, as the waters are broken, and it is known that the child come thus and that the womb is open enough to admit the midwife's or operator's hand into it, or else by anointing the passage with oil or hog's grease, to endeavour to dilate it by degrees, using her fingers to this purpose, spreading them one from the other, after they are together entered, and continue to do so until they be sufficiently dilated, then taking care that her nails be well pared, no rings on her fingers and her hands well anointed with oil or fresh butter, and the woman placed in the manner directed in the former section, let her gently introduce her hand into the entrance of the womb, where finding the child's feet, let her draw it forth in the manner I shall presently direct; only let her first see whether it presents one foot or both, and if but one foot, she ought to consider whether it be the right foot or the left, and also in what
fashion it comes; for by that means she will soon come to know where to find the other, which as soon as she knows and finds, let her draw it forth with the other; but of this she must be specially careful, viz., that the second be not the foot of another child; for if so, it may be of the utmost consequence, for she may sooner split both mother and child, than draw them forth. But this may be easily prevented if she but slide the hand up by the first leg and thigh to the waist, and there finding both thighs joined together, and descending from one and the same body. And this is also the best means to find the other foot, when it comes but with one.
As soon as the midwife has found both the child's feet, she may draw them forth, and holding them together, may bring them little by little in this manner, taking afterwards hold of the arms and thighs, as soon as she can come at them, drawing them so till the hips come forth. While this is doing, let her observe to wrap the parts in a single cloth, so that her hands being always greasy slide not in the infant's body, which is very slippery, because of the vicious humours which are all over it; which being done, she may take hold under the hips, so as to draw it forth to the beginning of the breast; and let her on both sides with her hand
bring down the child's hand along its body, which she may easily find; and then let her take care that the belly and face of the child be downwards; for if they should be upwards, there would be the same danger of its being stopped by the chin, over the share-bone, and therefore, if it be not so she must turn it to that posture; which may easily be done if she takes a proper hold of the body when the breasts and arms are forth, in the manner we have said, and draw it, turning it in proportion on that side it most inclines to, till it be turned with the face downwards, and so, having brought it to the shoulders, let her lose no time, desiring the woman at the same time to bear down, that so drawing the head at that instant may take its place, and not be stopped in the passage, though the midwife takes all possible care to prevent it. And when this happens, she must endeavour to draw forth the child by the shoulders (taking care that she separate not the body from the head, as I have known it done by the midwife), discharging it by little and little from the bones in the passage with the fingers of each hand, sliding them on each side opposite the other, sometimes above and sometimes under, till the work be ended; endeavouring to dispatch it as soon as possible, lest the child be suffocated, as it will unavoidably be, if it remain long in
that posture; and this being well and carefully effected, she may soon after fetch away the after-birth, as I have before directed.