Chapter IV: THEY who leave all these Things to mere NATURE, risque their

PATIENT’S future _Welfare_, and very often her _Life_ too, as innumerable _Tragical Examples_ witness: For NATURE itself most particularly requires our special _Assistance_ in this _Case_. But (according to their indifferent _Notions_) it is _Time_ enough to assist NATURE, when it is found _Deficient_; and then, in _Case_ of EXTREMITY, they unanimously agree that there is no other way to help or save the _Woman’s_ LIFE, but by this METHOD of _Manual Operation_. To which I answer, that NATURE operates not in an _Instant_, but (in all _Cases_) requires a competent _Time_, to discharge its respective _Functions_; and being left too long to itself, for want of Help, is many a-time (by intervening _Accidents_) found at last _Incapable_: Upon which, then _They_, beginning their Endeavours to _second it_, generally come too late. For if the _Case_ does not prove to be past all _Remedy_, it is at least (by this _Protraction of Time_) often rendred not only _difficult_, but also _desperate_; as will evidently appear in the _Case in hand_, from what follows, _viz._

I. WHILE _They_ (conformable to the general and universal _Practice_ of common _MIDWIVES_) expect the _Performance_ of NATURE, or the _Success_ of their _trifling Means_, in the mean time, the _Orifice_ of the WOMB is so _closely shut up_, that in the space of an Hour or two, it cannot be _penetrated_, without renovating the most severe racking PAINS to the _Woman_, who (perhaps) has been sufficiently spent before, by the DELIVERY of her INFANT, and is _now_ consequently incapable of standing out the renew’d PANGS: whereby of course _She_ must succumb at last, and _give up_ the _Ghost_, for want of _Timely Help_; as innumerable _Instances_ confirm for an undeniable Truth. But,

II. SUPPOSING the _Woman_ to be able to undergo the _PAINS_, yet the WOMB is however contracted, and the _SECUNDINE_ bound so close up, that this _Body_, which before adher’d _Cake-ways_ to its _Bottom_ in a _smooth_ and _broad Form_, is now so squeez’d into a _small_ and _long Figure_, that it is even now a _Difficulty_ next to Impossible, to reach the _Bottom_ of the WOMB, and still a _harder Task_ to extract an entire _Secundine_, without prejudicing the WOMB.

III. THEY who altogether neglect _Manual Operation_, may (I confess) sometimes _deliver_ their WOMAN, when _Success_ accidentally answers their WISH: But without this _Mean_, they cannot possibly restore a _prolaps’d_, _fallen-down_, or an _obliquely situated_ WOMB, to its _natural Position_. No, to the Contrary, Nothing is more common among ignorant unwary _MIDWIVES_, than to _invert_ and _draw down_ the _Bottom_ of the WOMB itself, by pulling the _Navel-String_, as they foolishly intend by _means_ of it only to extract the _SECUNDINE_. Neither does the _Mischief_ always end here, but mistaking this _Body_, when so found by their TOUCH, they immediately imagine it to be the _Head_ of another INFANT; and persevering in this _false Conjecture_, they manifestly expose the poor WOMAN to the Hazard of her _Life_. Neither,

IV. POSSIBLY can _They_, without the _Use_ of the HAND, so cleanse the WOMB of the _Reliques_ of the _SECUNDINE_, which may stick up and down to the WOMB; or of the _Pieces_ or _Parts_ of the _Membranes_, which may remain there; or of the _clotted Blood_, which commonly stays behind. From hence therefore it necessarily follows, that (without the _Means_ of the HAND) _They_ cannot be Positive or Certain in any _Circumstance_, relating to the _True State of the Woman_. _They_ can neither assure Herself, nor those concern’d, that her WOMB is duly purged; if (perchance) of the _SECUNDINE_, which they may guess at by the _Sight_, yet not of the _Fragments_ of the _Membranes_, nor of the _clotted Blood_, which they can never be certain of, but by this METHOD. I mention these _Things_, because the _least Part_ of EITHER being retain’d, or left _Behind_ in the WOMB, may cost the WOMAN her _Life_, as innumerable _Precedents_ do testify. Nor,

V. CAN they possibly secure the _Woman_, that her _WOMB_ is _duly shut and contracted_; much less can they (without these _Means_) affirm that it is orderly _situated_ in its _proper natural_ CENTER: By the Neglect or Fault of which _Condition_, she is not only rendred _Barren_ afterwards, but also most infirm all the Days of her _Life_.

BUT notwithstanding how _plain_ and _easy_ soever, I have endeavour’d to make out the above-mention’d METHOD, I would over and above recommend _It_ only to the _judicious_ and _well-qualify’d MIDWIFE_; by no Means to those that are _ignorant_ in the _Parts_ of _GENERATION_, nor to any _stiff clumsy-fisted Person_: And that for the _Two following Reasons_; viz.

I. LEST the STRING (by some _Accident_ or other) should break, and she, missing this _Guide_ to the _SECUNDINE_, should take _One Part_ for _Another_, and consequently _dislodge_ the WOMB instead of the AFTER-BIRTH; which has undoubtedly often happen’d by such blind DOINGS, notwithstanding this very remarkable _Difference_ between _Them_, that the _SECUNDINE_ distinguishes itself from the _Other_, by a great many little _Inequalities_ on the Outside, occasion’d by the ROOTS of the _Umbilical Vessels_. And,