Chapter II: IN the narrower PELVIS, the MIDWIFE needs no ways fear the

above-named _Accident_, and therefore is not to be at so much Pains in _retaining_ the ORIFICE in its proper Place, whatever Trouble she may have in _opening_ it; which would be no easy TASK, was not the OS COCCYGIS to be _thrust back_, (as set forth, _Chap._ IX.) And which I must (for this Reason) recommend once more to all Careful _MIDWIVES_, as the best and most effectual METHOD of performing this happy _Apertion_.

FROM what is said here therefore, we may now conclude, that a great _Variety_ of CAUSES may subject the WOMB to a Diversity of ACCIDENTS, and _those_ of sundry _Degrees_, which may more or less affect its _Motion_ and _Situation_, as already set forth[171].

AND hence it is that we have so many _Degrees_ of _Preternatural BIRTHS_ on _Part_ of the WOMB, _All_ which to enumerate particularly in this Place, would be a WORK as _Superfluous_ as _Tedious_: wherefore, to be brief, I shall here also reduce them to the FOUR following, (as before mentioned, SECT. IV. _Chap._ 13.) viz. _Preternatural BIRTHS_, proceeding from an _oblique Situation_ of the WOMB inclining _Forwards_, or _Backwards_, or to (either _Side_) _Right_ or _Left_: which fourfold _Situation_ of the WOMB may be rightly and properly compar’d to the _Four Cardinal Points_ of the COMPASS, as the rest of its _oblique Positions_ may be analogously adequated to the _Collateral_ and _Middle Points_: For because, as they decline from the _Meridian_, and derive themselves from EAST, WEST, NORTH, and SOUTH, as formerly observ’d[172]; so _those_ are less difficult _BIRTHS_, and branch out from the _Four_ mentioned Extremities: since the WOMB, like a _Magnetick Needle_, may run quite round, and be ill-seated every way, or on every _side_. In all which _Cases_, the _INFANT_ must absolutely be _Turned_; which _Performance_ in any _oblique_ WOMB, requires a competent solid _Knowledge_ and sound _Judgment_, as well as the best adapted and experienced _Hands_. But of _those_, more particularly hereafter; and _First_, accordingly——

CHAP. XIX.
_Of Preternatural BIRTHS, from the WOMB’s inclining Forwards._

IN speaking to this critical _Point_, I shall _first_ give the _Reason_ of such a _BIRTH_, occasion’d by this _Position_; to wit, The _WOMB_ hanging much _forwards_, especially in _Women_ carrying it too _low_ in the ABDOMEN, the _INFANT_ (betwixt the _Pains_) must needs be forced upon the OS SACRUM, or the VERTEBRÆ bending _inwards_; which stops the HEAD that it cannot conveniently or without Obstruction fall into the PELVIS.

HOWEVER, in this _Condition_ we suppose the _INFANT_ to be _well turn’d_, I mean (both _here_ and _elsewhere_) _well turn’d_ in respect of the _WOMB_, with the _Crown_ of the HEAD lying against the _Orifice_; than which nothing can be more _Right_ or _Natural_ in regard of the _WOMB_ itself, nor more _Wrong_ and _Preternatural_ in respect of the _PELVIS_ and _Vagina_ of the _WOMB_, in this _forward Situation_: Because by reason of this _Posture_, the _INFANT_ falls _transverse_ upon the OSSA PELVIS, especially upon the OS SACRUM or _hindmost_ VERTEBRÆ; upon which it commonly offers itself with the FACE _prone_ or _turn’d Downwards_, tho’ it is not brought forth, but with the FACE _Supine_ or _Upwards_. For as it passes, it must be _turn’d round_, partly in a _Circle_, with its HEAD _prone_, and FEET drawn up under it; which happens not in the _WOMB_, but only as it passes the _Orifice_ into the _PELVIS_ or _VAGINA_.

NOW what I mean is more plainly _This_, that as soon as the INFANT comes into the _Turning_ (which it must pass) it necessarily _bends_ and _crooks_ itself, as it finds its PASSAGE _bent_ or _crooked_; by which means the FACE is sometimes _turn’d down_, and sometimes _upwards_: And _This proceeds_ from THAT, in short, as soon as the HEAD begins to enter the _Orifice_, it presently fixes upon (and sticks fast to) the last VERTEBRÆ of the _Loins_ standing _forwards_, or to the OS SACRUM; so that it cannot naturally or possibly go _forwards_, except the HEAD is _bent downwards_, and the _Neck_ and whole _Body_ be accommodated to that BENDING.

HENCE it is, that _THAT_ which just now was _situated prone_ upon its BELLY in the _WOMB_, now passing through the _VAGINA_, is _bent upwards supine_ upon its _BACK_; and from thence it’s evident, that _That Inversion_ is not properly in the _WOMB_, but in the _VAGINA_, or (if you please) in the _Confines_ of BOTH: And, in fine, this _forward Inversion_ (as it happens) occasions a most difficult _Preternatural BIRTH_.

BUT _this_, in short, happens to the _Woman_ with _CHILD_, because her _WOMB hangs forward_, or is _resupin’d_, according to the _Depression_ made on the _WOMB_ by the _Intestines_, forcing it _this_ or _that way_; or to either _Side_, as will by and by more fully appear[173]. But——

SINCE it is most requisite to know presently in the _Beginning_ of _LABOUR_, whether the _WOMB_ be placed _forwards_, in order that the Means of Help may be taken accordingly; I shall in the _second place_ add the _SIGNS_, or _Tokens_, by which the _MIDWIFE_ may know this _Position_ of the _WOMB_, and what _she_ has best to do in such a nice ticklish _STATE_ of Affairs.

FIRST then, _She_ may know it, principally, by the _Hanging forwards_ and _Thickness_ of the BELLY, or perhaps by the good _Woman’s Information_ of the PLACE, where she chiefly feels the _INFANT_ stirring; for it cannot _move_ but where ’tis _placed_.

HOWEVER yet a prudent _MIDWIFE_ will have no great regard to such _Uncertainties_, but betake herself immediately to _that_ which cannot fail her, the TOUCH; which (in this _Case_) affords her the following certain _SIGNS_; viz.

I. THE _Orifice_ of the WOMB is suspended _higher_ than usual; which _she_ cannot _Touch_, by reaching, without a great deal of _Difficulty_.

II. SHE can only _Touch_ the lower Border of the _Orifice_, and that only as the WOMB hangs more or less _forwards_; and by no means the _upper Edge_, except the _Orifice_ has begun to _fall down_.

III. SHE cannot at all, or very hardly, get her _Finger_ into the opening of the _Orifice_, and because of that Difficulty, it must then also be _crooked_ or _bent_.