HIS ought to be put in Practice, as soon as, from the Symptoms given in the Third Chapter, it is reasonable to expect the Birth approaching; and a Child-bearing Person would be very much her own Enemy to refuse the only Means of giving a true Information of her Case, and the Knowledge how to do her the most effectual Service.
The Midwife, having her Nails well pared, and very smooth, and her Fingers anointed with Oil or Lard, must introduce the two fore Fingers of either Hand into the Passage or Neck of the Womb, as far as its inward Orifice, directing them with a gentle and easy Motion, somewhat upwards, as it were with a Tendency through the Passage towards the Navel; in this Search she will find the internal Orifice, joining the Passage or Neck of the Womb more or less open, relaxed, and thinner than usual; and cautiously protruding her Fingers farther, she may possibly touch the Crown of the Child’s Head; she will easily, by the Sutures, or Opening between the Bones of the Skull, distinguish the Crown: Keeping her Fingers in this Situation, during the Beginning, and Continuance of strong Pains, she will observe the Waters contain’d in the Membranes including the Child, and After-birth forming within the inward Orifice, as if something like a Bladder blown, or distended with Water, presented to the Touch, dilating the Orifice with each Throw; these Appearances presage a speedy and easy Birth.
CHAPTER VI. Of a natural Birth, and the Office of the Midwife.
A
S the Birth approaches, the Woman grows hotter and red in the Face; the Pains bear more strongly down; the internal Orifice opens; the Vagina or Passage, at its Entrance, becomes more swell’d, as the Child’s Head advances; and the Membranes are more and more tensely stretched; before the Birth, the Person is often seized with a Vomiting, and universal Tremor, without the Coldness of an Ague; and very often a Humour, discolour’d with Blood, immediately preceeds the Breach of the Membranes; when these Symptoms, or several of them, become urgent, ’tis Time to put the Woman in a proper Situation, as describ’d in the preceeding Chapter: The Midwife ought by no Means to break the Membranes, but encourage the Woman now to make the best of her Pains, by strongly bearing down, as if going to Stool; the Midwife with her Fingers well anointed, putting them gently within the internal Orifice, may cautiously, by separating them, assist its opening, and Removing it more behind the Child’s Head, thereby gradually promote its more easy Transmission, and at the same Time prevent, if necessary, the Womb from being too far protruded: After the Waters are broke, as it is called, and the Head of the Child comes into the Passage, the Midwife may lay hold on each Side of it, taking Care not to bruise it by rough Handling, and drawing it, by Waving her Hands, if necessary, to loosen it, when fixed, rather than in a strait Line, assist the Birth; and if obstructed by the Shoulders in the Passage, inserting a Finger under each Arm-Pit, extricate them by the like Action.
’Tis true, it happens, tho’ unobserv’d by Writers, as far as I remember, that many Women have no Waters breaking away, either before or after the Birth; whether absorbed or not, in Time of Labour, I shall not at present determine; this is called, by the Country People, a dry Labour, and often attended with Difficulty; however, if the Crown appear forward, the Issue may nevertheless be favourable.
The Child being born, the next Business is to tie the Navel-string with a waxed Thread, so doubled, as not to endanger cutting, about two Inches from the Child’s Body, making another Ligature near the Body of the Mother, so far distant from the former, as may be convenient for Cutting between both Ligatures, and separating the Infant from its After-birth. Midwives are too apt to leave a greater Length, which can be of no Service, but has been thought, on the contrary, by our Countryman CHAPMAN, to occasion Navel Ruptures.
After the Separation of the Navel-string, the Care to get the After-birth succeeds; this will often come by the Assistance of Nature, with a gentle Motion of the Hand gradually drawing and loosening it, by the Navel-string: But if it adheres to the Fund of the Womb, which is frequently the Case, whether from the Waters being come away before the Birth or otherwise; it must cautiously be separated, and extracted by the Hand, to prevent the most mischievous and fatal Consequences.
The Assistant holding the Navel-string with one Hand, must with great Caution introduce the other into the Womb, avoiding all Violence to any Part in the Way, ’till she reaches the After-birth, some Part of which probably, being loosened, will be found more forward than the rest; which taking between her Thumb and Fore-Fingers, she must, by an easy Motion of her other Fingers, between the Womb and After-birth, gradually separate the Parts adhering all round, ’till finding the whole free, before the Palm of the Hand and Fingers, she brings it intirely away; for should any Part remain, the poor Woman’s Labour would still continue, and occasion dangerous Floodings, requiring the immediate Assistance of an able Hand, to rescue the Patient from the immediate Hazard of Death.
Sometimes when the Womb has discharged its Waters, and the Child, by Reason of a Defect of Pains, or otherwise, remains long very forward near the Birth, the Womb so contracts about the After-birth, as to make the Separation of it very difficult; in which case Assistance is requisite, from one well acquainted with the Structure of the Body; and the longer this is delay’d, the more Danger there will be of all the bad Consequences of the Retention, and Corruption of the After-birth in the Body.