A companion for midwives, child-bearing women, and nurses directing them how to perform their respective offices : together with an essay, endeavouring to shew the influence of moral abuses upon the health of children / by Robert Barret ...

CHAP. VII. Of the different sorts of unnatural Labours, with the best Methods of assisting on such extraordinary oc∣casions.

THere are many Operations full of difficulty and danger, which some forward Midwives are bold enough in undertaking, but for want of Industry, or necessary knowledge, cannot effect; and thus very often leave the poor Wo∣man in a more Tragical condition, than than if they had not meddled with her.

I have met with several Instances of this nature. I was once sent for to a Gentlewoman, that through abuse of her Midwife was reduc'd to a deplorable condition. Her Midwife, it seems, was a topping, fine Woman, with her mi∣nute Watch at her Side; she had so much business forsooth, such and such fine Ladies expected her, and she could not stay: Accordingly she press'd the poor woman to bear down with all her

might: In fine, she was deliver'd in a hurry, some pieces of the Burthen were brought away, and some remain'd behind: But the sage Midwife being a wo∣man of Reputation, and one that made a blustering Figure, perswaded them not to be be troubled at what re∣main'd▪ affirming that it would come a∣way of it self; that nothing more was to be done at that time, and if the woman would but have Patience, all would go well with her. When I was sent for, the woman was oppress'd with a violent Pain in her Head, and perpetually void∣ed black, stinking, corrupted Humours. Immediately I put up my Hand, and brought away the bigness of a Turkey-Egg, of the Burthen, which smelt so ill as to annoy all the women in the Room. When this was taken away, she retriev∣ed apace, and found herself much bene∣fited in a very short time.

I was sent for another time to deliver a woman of an unnatural Birth. It seems the Child presented the Hand first thro' the Birth; and the Midwife resolving to have the honour of the Delivery to her self before I came, would not stay to put up the Arm again, but boldly ven∣tur'd

to twist it off, Then she grop'd for the Head, but could not find it. The poor woman Languishing cry'd out, Help, Help, Help. But the doughty Midwife encourag'd her to be patient, telling her all was well. When I came, I found the woman almost dead, and immediate∣ly Delivered her. VVhen the Child came forth gasping, and its Arm off, I was frightned; but they presently resolv∣ed my doubts, by telling that they had pulled it off three hours before I came.

The Method I use in such cases, which I always find successful, is this I gently introduce my Hand into the Entry of the VVomb, then I turn the Child, and bring it out by the Feet, or as they say, Foot∣ling way, pulling it gently till the Hips are come forth. But in the interim, I wrap the parts in a single Napkin, for the viscous humours that surround 'em, pre∣vent any sure hold of 'em. Then I bring down the Arms along the Child's Body, turning the head to the Share-bone, with the Face downwards. There are some Children that have the Head so big, that when the whole Body is born, yet that stops in the Passage. In that case I en∣deavour gently to disengage it from the Bones in the Passage, with my Fingers.

All the Operation I dispatch as soon as possibly I can, for fear the Child should be suffocated; which would certainly ensue, if it remain'd long in that Po∣sture.

I was sent for to another woman in her Labour, where I met with this unna∣tural Symptom, that the Child's Head thrust the Neck of the Womb forth before it. Women troubled with a bear∣ing down of the Womb before they Con∣ceive, and whose womb is very moist, are very much subject to this Accident, by reason of the previous Relaxation of the Ligaments. In this case, I only lay my Hand on each side of the Head, and for∣bear to pull, or draw hastily, for fear the womb should fall out, as it is very apt to do. I waited patiently till the Child ad∣vanc'd of it self, and the Woman had forc'd it out by her own pressure.

I remember of another Case not very common, which it may be worth your while to take notice of. I was sent for to a woman that had linger'd in her Labour for five or six days. VVhen I came and examin'd her Condition, I found the Child's Head in the Passage presenting towards a regular Birth; but the woman was very little, and 'twas her first Child,

which occasion'd a narrowness in the Pas∣sage. Besides, she was stricken in Years, and her VVomb depriv'd of its youthful Moisture. VVhen I seriously weigh'd all these Indications, I thought it neces∣sary to foment the womb with white-wine and Oyl of Roses, with a Spunge, as often, and as hot as she could bear it. I gave Cordials inwardly, and some sweat∣ing Powders. These things were so effe∣ctual in dilating the womb, that by the blessing of God I drew forth a fine boy, and sav'd the poor Mother.

Another time I was sent for to a wo∣man that was in a very sad Condition. The Midwife had brought the Head of the Child into the VVorld, and the womb closed about the Neck, and hindred the egress of the rest. This Accident may happen through the Laziness of the Mid∣wife in losing Time, and not drawing forth the Child when 'tis upon the move, or not keeping touch with the Mothers Endeavours. Sometimes indeed the Head is small, and disproportionate to the rest of the body; the Shoulders large and broad; so they stick in the passage unless forwarded by help of Art. In this case, I use to put my fingers first under one Arm, then under the other, and so for∣ward

'em by degrees, but withal very gently and cautiously, and observing the Mothers endeavours; all which if right manag'd, will make a quick Birth. But I must again caution you to make as much use as you can of the Woman's own pressure, for if ye discourage or prevent her bearing down, all her pains will van∣ish; and so the Child Perish lock'd up in the Passage.

Sometimes both Hands come forth first together, and leave the rest of the Body in Prison. I remember a remark∣able Instance of such a thing, which I shall give you a Circumstantial Account of. I was call'd for in great haste to at∣tend a Woman in Labour; the Midwife said they ought to have sent for no Body; That she would finish the work her self, having brought part of the Child to the World already, and the rest would quick∣ly follow if they would but have Pati∣ence. She added, that 'twas not a Ser∣geons Province, 'twas hers; that if Dr. Chamberlain came, or any Body else, she would not quit her stool, nor yield her ••••••ce to any Body. I came▪ and was a∣maz'd to see the Midwife so resolute and confident of her own undertakings; I said nothing, but retir'd into the next

Room at the desire of the Gentlewo∣man's Mother and Husband. The Mid∣wife continu'd tugging and sweating, and after all she began to see that all her endeavours were in vain; so she starts up, and drank a good draught of Cinna∣mon Water instead of the Poor Gen∣tlewoman; This gave her a little assur∣ance, so she bluntly cry'd, I care not, He may come, if he will. So I was call'd in, and found the Midwife a little softer in her temper, but the poor Woman almost spent. However, I was willing to satisfy my own Curiosity, and to try if I could do her any service. I examin'd how Cases stood with her, and found that that part which the Midwife cry'd was alrea∣dy come into the World was the two hands, which she had almost lugg'd off. I presently alter'd the Posture of the Wo∣man laying her Hips a little higher than her Head. The Head of the Child lay partly on the sharebone and towards the right Groyn. I caus'd her therefore to lean a little to the opposite side, in order to recover the right Posture. By this means, thro▪ Gods Blessing, I put the two hands back and brought the Head to∣wards the Birth. This gave me some hopes; so I encourag'd the Woman to

forward her pains as much as possible; and gave her as much of the Cinnamon Water as her goodly Midwife had pleas'd to leave, and mix'd it with some drops of the Spirit of Hartshorn. This done, 'twas not long before I brought the Child fairly into the World, but it was Dead, and both Arms and Breast so Prodigiously mortified that all the Women stood in Amazement. But the Mother is still a∣live and Healthy; I have laid her twice since of live Children— In such Cases as this is, I would advise all Women to send for assistance as speedily as they can, because many Women and Children are Murdered after this manner.

Another sort of unnatural Labour is, when both Hands and Feet come toge∣ther. 'Tis altogether impossible the Child should be Born so; therefore some method of recovering the right Posture must be thought of. I ve met with such a Case; when the Midwife has pull'd and lugg'd with all her force and might, but still in vain. At length she bid 'em send for a Man, but withal confidently af∣firm'd that no Man in the World could do more than she did. When I came, I found that her lugging and pulling had so fix'd the Child in the passage that I

was hardly able to put it back. But wi•••• much ado I turn'd it; and gave the Woman a good Spoonful of my Elixir, which immediately brought her pains up∣on her a fresh. I brought the Child out by the Feet, tho' the Midwife had al∣most twisted both a Leg and an Arm off. The Mother and Child came both through.

Sometimes the Knees present to the Birth, with the Legs folded up to the Buttocks; as I perceiv'd once in a Wo∣man by putting up my hand, and finding the part that presented hard and round, and much smaller than the Head. Imme∣diately I turn'd the Child to a right po∣sture 〈◊〉〈◊〉 the Head foremost, and gently bath'd the Womb with a Spunge wet in Oyl of Lillies warm: Thus by Gods help I got the Child into the World alive, and 〈◊〉〈◊〉 mother safe.

Another time I met with the Shoul∣ders and Back presenting first; but con∣tinued in my wonted course of putting the Child back, and turning the Head to∣wards the Birth; and thus brought forth a live Child.

I deliver'd a VVoman once, when the Child advanc'd its breech foremost, tho' it often voided the ordure by its Funda∣ment:

I gently slid up my Hand on each side the Buttocks, and introduc'd 'em by degrees into the Groins, and so by wag∣ging it from side to side, I disengag'd it; and brought it out by the Feet and Legs, and sav'd both its own, and its Mother's Life.

Sometimes the Navel-string comes first; then ye must endeavour to put the Child back, and turn it, till ye get hold of the Feet, and then convey it gently through the Passage.

If the Burthen offer first, or comes quite forth, 'tis a sign that the Child is dead, or near to Death. It is generally accompany'd with great Flooding, which is also a very ill Sign. In this case ye must never venture to thrust it back, but fetch it away the very Moment ye discover it, and then conduct the Child out by the Feet. And take this for a general Rule, that in all Floodings ye ought to be as quick as possible in bringing the Child in∣to the World; for if ye delay, Convulsi∣ons may happen, and then both Mother and Child are in great danger.

I remember to have met with a pretty odd Circumstance, which I think it not im∣proper to insert here. A Gentlewoman going with her first Child, by hearkening

to extravagant Advice, had almost run the Risque of her own, and her Child's Life. She had all over her a great many Child-bearing Spots, brown, rough Tubercles; I have seen such a thing happen to Women with Child upon their Foreheads, Tem∣ples, or Cheeks, many times as large as a Fingers breadth or more; they are so plaguy troublesome, that tho' taken a∣way, they commonly return again. After Delivery, indeed they use to vanish of their own accord. But this Patient was so extreamly afflicted, that I never saw a Woman in the like Condition. I directed her to the following Ointment.

Take one Dram of Sperma Ceti, half an Ounce of Ointment of Roses, two Drams of the Spirit of Vinegar. Melt all over the Fire; and use it Night and Morning after the Skin is well cleansed.