CHAPTER VIII. Difficulties occasion’d by the Navel-String.
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HE Navel-string, by a Variety of Convolutions, sometimes obstructs the Birth, for being shortned, by its Contortions about the Neck, or any Part of the Body, the Labour will become unnatural, by Reason tho’ the Pains are strong, the Navel-string, by its shortness, will pull the Child back with each Pain; and here an unskilful Management may break the String, and occasion a dangerous Flooding; but as the Woman’s Pains will prove ineffectual, notwithstanding their Strength and Force, the Midwife will, by this Means, find the Case out of her Province; I mean, where the Navel-string is very much abbreviated.
If the Navel-string comes forward before the Child’s Head, it will seldom remain, when put backward by the Hand; therefore, if the Midwife has any Regard for the Life of the Child, she ought to call for Assistance, before the Birth is further advanc’d, or it will be extremely difficult, if not impossible, to save the Infant; and she would probably be foil’d for want of sufficient Strength, had she Skill to save it.
CHAPTER IX. Difficulties from the Placenta or Secundines.
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HE Placenta or After-birth, being from any violent Shock or Accident, more or less, separated from its Seat, during any Time of Breeding, will produce a Flooding, in Proportion to its Quantity, dangerous, which is sometimes so violent, as to occasion Death in an Hour’s Time; and nothing but instant Delivery can prevent it. When the Case is not so desparate, as all the Blood in the Mother’s Body, necessary to support her own and Infant’s Life, may be drain’d away, the Consequence may be equally fatal in a more lingering Way.
The 26th Feb. 1748, I was sent for to a Woman at MOUNTAIN-DEVEREL, within about Five Weeks of her Time, in a violent Flooding; her Midwife gave her an Opiate, which she thought check’d her Flooding, excepting that once a Week, it became very violent, for about three Weeks past; when I came, the Neighbours told me she had lost a Pail full of Blood; the poor Woman was so weak, that her Pulse were scarcely perceptible, and her Voice but a Whisper; I was unwilling to meddle, for fear she should die under my Hands, but yielded to the Importunity of her Friends: It was with great Difficulty I introduced the Tops of my two Fore-fingers and Thumbs into the internal Orifice, which I gradually dilated, ’till I could pass my Hand, when by turning, I brought away a dead Child, depriv’d of its Nutriment by the great Loss of its maternal Blood; but had considerable Trouble in getting the After-birth, by Reason of its Adhesion: After Delivery, the Flooding immediately very much abated, the poor Woman reviv’d to Admiration, and I left her the next Day, as well as could be expected in so low a Circumstance, tho’ dubious of her Recovery: I heard she died five or six Weeks after; but I am well satisfied, had she had an earlier Recourse for Assistance, she might have recover’d.
In these Cases, Midwives are too apt to trust to their own Judgments, instead of calling for better Assistance; and tho’ they have Recourse to external Applications, Ligatures, and Opiates, these Things, injudiciously practis’d, are frequently more detrimental than beneficial: For Instance, should the Arteries be compress’d by too tight a Ligature of the Arms and Legs, the Flooding would become more violent.
When ignorant Midwives, by rashly pulling the Navel-string, break it, or by the Adhesion of the After-birth, find it out of their Power to bring it away, they are apt to persuade People, it will come without further Help, which seldom happens; on the Contrary it most frequently occasions Death, more or less suddenly, or Hecticks and Consumptions, when left to corrupt in the Body: The Uterus sometimes so strongly contracts about, and embraces it, that it may be impossible, after a few Hours Delay, to procure it, as I found in a Case that occur’d to me at COLEHORN, the 30th Sept. 1748, tho’ little more than four Hours passed, from the Time the Midwife broke the String close to the Placenta, for the Part of the Uterus next the Placenta was so contracted, as barely to admit the Tops of my two Fore-fingers; I endeavour’d, with all possible Caution, to make a larger Aperture, but in the ill Situation of the Uterus, at the Extent of my Reach, all my Attempts were in Vain; this Woman rested well the succeeding Night, and had no extraordinary Complaints when I left her in the Morning, first prescribing what I thought most suitable to her Condition: I afterwards heard she died with a Frenzy, succeeding a Suppression of the usual Purgations; where the Corruption of the Placenta takes Place, the Case is, at least, more Chronical, and the Secundines, gradually wasting, come away Piece-meal, the Patient labouring under a Hectick from the Contagion of putrid Humours, mixing with the circulating Fluids.