This labour, though somewhat troublesome, yet is much better than when the child presents only its hands; for then the child must be quite turned about before it can be drawn forth; but in this they are ready, presenting themselves, and there is little to do, but to lift and thrust back the upper part of the body, which is almost done of itself, by drawing it by the feet alone.
I confess there are many authors that have written of labours, who would have all wrong births reduced to a natural figure, which is, to turn it that it may come with the head first. But those that have written thus, are such as never understood the practical part, for if they had the least experience therein, they would know that it is impossible; at least, if it were to be done, that violence must necessarily be
used in doing it, that would probably be the death both of mother and child in the operation. I would, therefore, lay down as a general rule, that whenever a child presents itself wrong to the birth, in what posture so ever, from the shoulders to the feet, it is the way, and soonest done, to draw it out by the feet; and that it is better to search for them, if they do not present themselves, than to try and put them in their natural posture, and place the head foremost; for the great endeavours necessary to be used in turning the child in the womb, do so much weaken both the mother and the child, that there remains not afterwards strength enough to commit the operation to the work of nature; for, usually, the woman has no more throes or pains fit for labour after she has been so wrought upon; for which reason it would be difficult and tedious at best; and the child, by such an operation made very weak, would be in extreme danger of perishing before it could be born. It is, therefore, much better in these cases to bring it away immediately by the feet, searching for them as I have already directed, when they do not present themselves; by which the mother will be prevented a tedious labour, and the child be often brought alive into the world, who otherwise could hardly escape death.
SECT. VII.—How a Woman should be delivered that has twins, which present themselves in different postures.
We have already spoken something of the birth of twins in the chapter of natural labour, for it is not an unnatural labour barely to have twins, provided they come in the right position to the birth. But when they present themselves in different postures, they come properly under the denomination of unnatural labours; and if when one child presents itself in a wrong figure, it makes the labour dangerous and unnatural, it must needs make it much more so when there are several, and render it not only more painful to the mother and children, but to the operator also; for they often trouble each other and hinder both their births. Besides which the womb is so filled with them, that the operator can hardly introduce his hand without much violence, which he must do, if they are to be turned or thrust back, to give them a better position.
When a woman is pregnant with two children, they rarely present to the birth together, the one being generally more forward than the other; and that is the reason that but one is felt, and that many times the midwife knows not that there are twins until the first is born,
and that she is going to fetch away the afterbirth. In the first chapter, wherein I treated of natural labour, I have showed how a woman should be delivered of twins, presenting themselves both right; and before I close the chapter of unnatural labour, it only remains that I show what ought to be done when they either both come wrong or one of them only, as for the most part it happens; the first generally coming right, and the second with the feet forward, or in some worse posture. In such a case, the birth of the first must be hastened as much as possible and to make way for the second, which is best brought away by the feet, without endeavouring to place it right, because it has been, as well as the mother, already tired and weakened by the birth of the first, and there would be greater danger to its death, than likelihood of its coming out of the womb that way.
But if, when the first is born naturally, the second should likewise offer its head to the birth, it would then be best to leave nature to finish what she has so well begun, and if nature should be too slow in her work, some of those things mentioned in the fourth chapter to accelerate the birth, may be properly enough applied, and if, after that, the second birth should be delayed, let a manual operation be
delayed no longer, but the woman being properly placed, as has been before directed, let the operator direct his hand gently into the womb to find the feet, and so draw forth the second child, which will be the more easily effected, because there is a way made sufficiently by the birth of the first; and if the waters of the second child be not broke, as it often happens, yet, intending to bring it by its feet, he need not scruple to break the membranes with his fingers; for though, when the birth of a child is left to the operation of nature, it is necessary that the waters should break of themselves, yet when the child is brought out of the womb by art, there is no danger in breaking them, nay, on the contrary it becomes necessary; for without the waters are broken, it will be almost impossible to turn the child.
But herein principally lies the care of the operator, that he be not deceived, when either the hands or feet of both children offer themselves together to the birth; in this case he ought well to consider the operation, of whether they be not joined together, or any way monstrous, and which part belongs to one child and which to the other; so that they may be fetched one after the other, and not both together, as may be, if it were not duly considered, taking the right foot of one and the left of the other, and