Chapter II: WE will suppose moreover, that the INFANT is ill-seated, and

presents itself _preternaturally_ with any of the aforementioned _Members first_, in a WOMB hanging _obliquely to either Side_. In this _Case_, I would sincerely advise the _MIDWIFE_, to lose no Time in opening the WOMB, breaking the MEMBRANE, turning the CHILD, and extracting it by the FEET: Because in this _Posture_ of both the _BIRTH_ and the _WOMB_, Experience has taught me that nothing can be safer and less dangerous than this _Method_, when ingeniously and presently perform’d with Dexterity.

IT is true indeed it may be _objected_, that I dissent in _this Matter_, from most (if not from all) _Authors_: To which I _answer_, in short, that _Those_ from whom I do differ, were never acquainted with this _complicated preternatural Condition_, but always supposed the _WOMB_ to continue in its proper Place, never dreaming of its various _Motion_, nor suspecting its _oblique Situation_; erroneously imagining all _preternatural BIRTHS_ to proceed merely from the ill _Version_ of the INFANT: In which _Circumstance_ however, when it happens so, I confess they are so far in the right, that the HEAD is to be _first_ brought into the PASSAGE, and the CHILD excluded by it with all possible Expedition.

BUT that I may farther elucidate the true _State_ of this _Case_, as it becomes me to speak the _Truth_ ingenuously, it is my candid Opinion that, in any _oblique Posture_ of the _WOMB_, it is the safest, quickest, and most convenient _Method_ to extract the INFANT by the FEET, and that presently in the _Beginning_ of the LABOUR, either before or at least presently after FLOODING, as occasion requires. For this very Reason, and to this Purpose, I hope, I may farther justly lay down _one certain Rule_; namely, that all _BIRTHS ill-turn’d_, in a _WOMB ill-seated_, are to be rightly _turn’d_ again, and drawn out by the FEET. Which _Rule_, if duly observed, will, I am positive, save a World of _Women_ and _Children_, that otherwise must inevitably perish; since as for my part, I know no _Situation_ of the INFANT in an _oblique WOMB_, more difficult or dangerous than the HEAD’s _offering itself first_; and _that_ because the _BIRTH_ cannot be then _turned_ without the greatest _Difficulty_ and most extreme _Pains_.

THIS, in short, will be readily granted by All, who do consider or conceive that the _WOMB_ (being fixed by _Ligaments_ on both sides) is always more inclinable to _fall Forwards_ or _Backwards_, than to either _Side_, and first most commonly _bends back_ before it comes to any _lateral Posture_; and that from hence of consequence, the _WOMB_ is _distorted_ as well as _obliquely situated_. By reason of which _Distortion_, if the _CHILD_ comes _Head foremost_, it falls down in the PELVIS _obliquely_; and tho’ a judicious _MIDWIFE_ may bring the HEAD directly into the PELVIS, yet the _Shoulders_ following, must needs fall upon the PELVIS _a-cross_, in its narrower Part; whereby of reasonable Consequence the INFANT must be distorted in the _Passage_.

NOW in this _Case_, no PAINS, how violent soever, can avail to force forwards the _BIRTH_ so fixed upon these _Bones_; wherefore (I say) when the _WOMB_ is thus _seated_, it is most safe in the _Beginning_ of the _LABOUR_, to open its _Orifice_, break the _Membrane_, turn the _CHILD_, and take it out by the _FEET_; since by the HEAD’s coming now _foremost_, both _Lives_ are at Stake and in great Jeopardy.

HOWEVER yet it may be again _objected_, that I have already prescribed another _Method_ in _Chap._ 21; _viz._ of bringing the _Orifice_ together with the HEAD into the PELVIS, and promoting the _BIRTH_ in that Manner: To this I _answer_, that my _Reason_ for so doing, was not only to convince some People, that I know _their Method_ as well as _my own_; but also to whet or assist the _Judgment_ of such good _MIDWIVES_ as cannot forsake their own old _By-Paths_; Not that I ever design’d to recommend _it_ to any, tho’ I must however acknowledge, that sometimes it may effect the desirable _Ends_; but according to the _Rules_ of irrefragable _Truth_, and sound Judgment, we find that, in this _Position_ of the WOMB, let the _BIRTH_ offer itself as it will, the only laudable _Method_ is without Loss of Time to extract the INFANT, and deliver the _Woman_ as above-directed.

III. I observe upon the whole, that as the immediate present _Case_ is applicable to either (_right_ or _left_) _Side_; so what is said of the foregoing _Condition_, with respect to the WOMB’s _inclining forwards_, may be easily apply’d to the _Case_ of its _tending backwards_: Only with this considerable Difference, that the _oblique forward Posture_ of the WOMB, is the most commodious of the _Four_ mentioned _Extremes_, and consequently admits of a more easy _Exclusion_ of the _BIRTH_ by the _Head_, than any of the rest mentioned.

NOT but that either of these grand or complicated _preternatural BIRTHS_ imply and prognosticate imminent Danger to the _MOTHER_, or the _CHILD_, or _Both_; as well as incredible _Labour_ and _Fatigue_ to the faithful _MIDWIFE_; who, in such _Cases_, can less distinctly feel, less commodiously handle, and more difficultly come at the Matter, so as to dispose the _INFANT_’S _Members_ for _Attraction_, than in any other _Condition_ of _BIRTH_: Hence it is, in short, that so many _MIDWIVES_ are liable to the most egregious Mistakes, and unaccountable Deceptions upon these unlucky Occasions. But——

AGAIN farther, I hope I may freely speak my Mind, and openly avow, that the most of these BIRTHS proceed merely from want of seasonable and skilful _Assistance_ in the beginning of the LABOUR: Because the _BIRTH_ (however well seated then) by reason of the _bad Situation_ of the WOMB, cannot possibly pass thro’ the PELVIS of itself; and not being judiciously assisted at that nice Juncture, behold, from a _Natural_, it falls on a sudden also into a _Preternatural Posture_. From hence we have this extreme difficult and most dangerous sort of _Preternatural BIRTHS_, as will more conspicuously appear from a deliberate _Reflection_ upon the preceding _Chapters_. And This much (I hope) may finally suffice any intelligent _Reader_, to conceive the different _Circumstances_ of all _complicated Preternatural BIRTHS_ whatsoever. Whence I go on to the _Fourth_ and last Sort of _Preternatural BIRTHS_ proposed; namely, _Those_ proceeding from intervening _accidental Causes_; which because they are also different, I shall handle briefly and separately in the ensuing Manner; _viz._——

CHAP. XXIV.
_Of Preternatural BIRTHS, proceeding from the NAVEL-STRING’s coming
first, and that either alone, or with some other Member._

AMONG the various unhappy _Accidents_, which may happen in or about the Time of LABOUR, the present _Case_ is none of the most auspicious; in as much as it may, in sundry Respects, occasion a very difficult _Preternatural BIRTH_, according to the Difference of Circumstances: For the NAVEL-STRING having fallen down and come _first_ in the _Passage_, may be variously turn’d, and consequently cause several and sundry _Inconveniences_, as follow, _viz._——

I. WHEN the _Umbilical Vessel_ falls down alone into the PASSAGE, without any other _Part_, the _BIRTH_ is then commonly situated a-cross in the WOMB; and in this _Condition_, _BACK_ or _BELLY_, _HAND_ or _FOOT_, may be probably expected to come _first_: Wherefore the active _MIDWIFE_ ought to discover the _real Posture_ by the TOUCH, and _that_ at least before all the _Waters_ are yet flow’d off and evacuated; and then betimes to fetch away the _CHILD_ by the _FEET_, unless the HEAD be more convenient or pat for the Purpose. But these _Cases_ being already particularly discussed[179], I shall add nothing farther upon them in this Place.