Here I would observe, it appear’d the Body was that of a large Boy, and tho’ I find GIFFARD and others made no Scruple of leaving the Arms of a small Child, I must join with them in advising not to bring a large one, without first procuring the Arms; tho’ I will not say, whether the Method of delivering on one Side instead of the Back, the lower Part somewhat raised from the Bed, at the same Time encouraging Labour with Hopes of immediate Delivery, recommended by DEVENTER, may not occasion the Danger of leaving the Arms.
There are Variety of other wrong Situations, and Cases of Difficulty, which I could illustrate by Examples in my own Practice, and may be found in the Observations of MAURICEAU DE-LA-MOTTE, GIFFARD and others, for the Information of such as practise Midwifry, that have no Relation to the Information of Midwives, either in their own Practice, or Occasions of Assistance.
CHAPTER XIII. Of TWINS.
T
HE Case of Twins may, in many Country Places, be esteemed beyond the Skill of Women practicing Midwifry; but as they are not alike ignorant, and this Delivery, with a right Management, is attended with no great Difficulty, I shall describe it as plainly as I can.
If a Child comes naturally by the Force of the Mother’s Pains, and the After-birth does not easily follow, the Midwife, by passing her Hand to separate its Adhesion as directed in the sixth Chapter, will readily find whether another Child still remains to be born, by the Appearance of other Membranes, including Waters, &c. And as where more than one is to be born, they are generally proportionably smaller, and tho’ the first Child comes naturally, the second may not, she need not wait for the Birth of the other, by the meer Force of Nature, for this would greatly hazard the Life of the Child, and sometimes of the Mother, by a Flooding; but ought to break the Membranes, and search for the Feet, carefully preventing their being intangled with the Navel-string; and having got both in her Hand, draw them into the Passage; if the Child’s Toes point to the Mother’s Back, there will be no Danger of the Chin or Nose being hung on the Bones before, and she may draw the Feet forth with the rest of the Body, without delaying to bring down the Arms, encouraging the Mother to assist in the mean Time, by bearing down with or without Pains.
In Case the Child’s Toes should point to the Mother’s Belly, the Midwife, in drawing the Child forth from the Hips forward, must gradually turn the Belly of the Child towards the Mother’s Back, by the Assistance of the other Hand in the proceeding.
If the Woman be straiter, or the Child larger, than ordinary, when she has brought the Infant into the Passage somewhat short of the Arm-pits, she must, by introducing her Fingers, first over one Shoulder, cautiously bring down one Arm, and then in like Manner the other, and drawing the Child forward, she must make Use of both Hands to extricate the Head; the Fingers of one Hand between the Mother’s Back and Child’s Jaws, bearing and drawing them from the Back-bone, and with the Fingers of the other Hand over the Shoulders, and the flat against the Child’s Back, draw it forth, the Mother as aforesaid assisting all the while.
Writers advise putting two Fingers into the Child’s Mouth; but as great Injury has often been done that Way, it is much safer to bring the Child by bearing with the Fingers against its Jaws. If an Arm should be broke in bringing down, let it be spliced with thin Paste-board, and bound at its full Extent to preserve its right Shape.
In fetching an Infant by turning, ’tis necessary to draw its Feet into the Passage, with the Toes situate towards the Infant’s Belly, for it may be extreamly difficult, if not impossible, to draw it backwards, contrary to the natural Bent of its Thighs and Back; and a Limb may sometimes as easily be pull’d off, as the Child brought to the Birth this Way; the Midwife must therefore make Use of the right, or left Hand in doing it, which happens to be most convenient, to the natural bending of the Infant’s Body.