Whereas ’tis certain, that if the Mother’s Pains, strongly bearing down, the Muscles of the Belly contracting and becoming sensibly hard to the Touch, don’t manifestly promote the Birth, it must needs be owing to some Obstruction beyond the Midwife’s Skill; who in this Circumstance is apt to complain, the Pains are not sufficiently strong, ’till the poor Woman is ready to expire, from the Loss of her Strength, by her long Suffering under them; and told she must patiently wait God’s Time, who in Case he miraculously interpos’d, wants not the Midwife’s Assistance: And what still adds to this deplorable Calamity, ’tis likely she is put upon exerting her utmost Strength, assisted by Cordials; when encouraging her Labour and provoking her Pains, ’till the Obstructions in the Way of the Birth are remov’d, contribute still further to the Danger attending.
I don’t deny but that in some Cases, a tedious Labour may be owing to a Defect of sufficiently strong Pains; but as this often proceeds from Circumstances obstructing the Birth, true Labour naturally takes Place, when they are remov’d; and, by a right Management of the Hand, is more effectually promoted, without Cordials or forcing Medicines, where the Pains are deficient.
Under this Sort of unnatural Birth, may very well be enumerated, the Face presenting towards the Mother’s Belly, or the Side of the Head coming Foremost, for its Passage must be extreamly difficult in these Postures; as well as when the Face comes forward; for then by Reason of the great Tumour, about the Head, Face, Eyes, and Mouth, from Lodging between the Bones, the Infant expiring in the Birth, has been often taken for a Monster. I have often been so happy, when the Head has long remain’d, wedg’d between the Bones, as to bring the Child alive, by the Forceps, in a few Minutes, if seasonably call’d, when the Woman in Travil has been in the utmost Danger of Death.
The 5th of May, 1751, I met with as bad a Case, as most of this Kind at WIGGLETON: This Woman, by the Midwife’s Account, seem’d to be in Labour at Times near a Month, and for a Week last, almost in continual Pain, with her first Child: as I was call’d late to her Assistance, I could not judge, by early Appearances, of the Situation of the Uterus, or Infant; this is most commonly only in the Power of the Midwife to observe; her Waters had gradually drain’d away above a Week, and there still remain’d some Part of the Membranes depending like a Gut in the Vagina, the Head offer’d, firmly wedg’d in the Pelvis; the Part most obvious to the Touch, by its Softness and fleshy Consistence, seem’d to be the Cheek: The poor Woman’s Pains, for some Hours, were ineffectual for want of Strength, her Spirits being exhausted, by a Labour so fatiguing; there was no Possibility of turning the Child; I endeavour’d, with some Success, to promote the Birth, by bearing strongly against the inferior Part of the Os-sacrum, but her Weakness, depriving me of the small Benefit of her Pains, I had for a Time; there was an absolute Necessity for a speedy Delivery, for the Mother’s Sake: ’Twas with some Difficulty I overcame her Prejudice, and those Present against the Use of any Instrument, tho’ at length they yielded; when introducing a Limb of the Extractor on each Side of the Head, and Co-operating with a small Pain, encouraging the Woman to bear down as strongly as she could, I immediately brought a Daughter, with a monstrous long Head alive.
I HAVE, however, met with some Cases, which I could relieve by no better Method, than lessening the Head; but considering for whose Benefit I am chiefly Writing, and how dangerous the Use of Instruments may be in injudicious Hands, I rather choose to advise Women not to meddle with them, than pretend to relate the Method of using them.
CHAPTER XII. Difficulties from other ill Positions of the Infant.
T
HE Arm or Shoulder presenting, is so well known to be attended with Difficulty, that few Women will attempt such Deliveries, unless they are so very ignorant, as to imagine they can bring the Child by pulling at an Arm.
As our Miscarriages, or rather Misfortunes, in Practice, may no less contribute to the Information of others, by Caution, than our Success, by Example; I shall not scruple to give a candid Relation of the most fatal Occurrence, which ever fell to my Lot.
The 12th September, 1748, I was called to a Woman at TROUBRIDGE, her Matrix lay forward in a prominent Abdomen hanging very low, the Os-uteri Internum lay very much backward, both Hands presented to it, this Woman had been very ill the preceeding Week, and in extreme Misery the last Twenty-four Hours; with a great deal of Trouble, I got and drew towards me one Foot, with the Heel turn’d towards the Mother’s Belly; in drawing the Infant so far as the Arm-pits, I found the Face of the Child did not turn so readily as I expected towards the Mother’s Back; as soon as I had brought the Feet some Distance without the Vagina, while I endeavour’d to extract the Child by hold of its Thighs, the Midwife, unknown to me, officiously laying hold of the Infant’s Feet, exerted her Strength at the same Time with mine; I intended to leave the Arms according to DEVENTER, as a Security to the more safe Transmission of the Head; and while our united Strength was exerted, I found the Neck gave way, with something of an audible Crack; and with some Surprize, looking about me, saw the Midwife labouring at the Child’s Feet, and check’d her, as acting very rashly, without my Direction; thus we had really separated the Spine of the Neck, and the Head only adhering to the Body by the Skin, was with little or no Force separated from it: In passing my Hand, after a tye on the Navel-string, I found the Head fell back into the prominent Part of the Abdomen, insomuch that I could only reach the separated Part of the Neck, and I endeavour’d, in vain, to get hold of the Head by the Crotchet: While I was thus employ’d, a Flooding came on, by the Separation of the Placenta, which quick’ned my Endeavours, from the Apprehensions of her sudden Death, if she was not immediately deliver’d; but the poor Woman, much spent with Fatigue and Loss of Blood, begg’d I would desist, preferring Death to Life; in which being join’d by the People present, and not a little exhausted of Spirit and Strength myself, I was, much against my Will, obliged to leave her to her Fate.