SECT. XXXII. Of delivering of a Woman of a dead Child.
Now if there be any case wherein a Mid∣wife ought to make the greatest reflection and Page 130 use most precaution in her Art it is this, that is to know whether the Infant in the Womb be living or dead; for there have been ma∣ny deplorable examples of Childrens being drawn forth alive, after they have been thought to have been dead, with both Arms or some other limb lopt off, and others mise∣rably kill'd by the use of crotchets which might have been born alive if they had not been mistaken: wherefore before the Mid∣wife resolves on the manner of laying the Woman, to avoid the like misfortune, and the disgrace of being author of such a pitiful spectacle let her do her utmost endeavour not to be so deceiv'd and to be wholly satisfied whether the Child be alive or dead; always remembring in this case that timidity is more pardonable then temerity, that is, it is bet∣ter to be deceived in treating a dead Infant, as if in case it were a live, then a living one as if it were dead.
Now besides what hath been said before concerning knowing whether the Child be alive or not; you must not always put your whole confidence, in the first place, in the Womans telling you that the Child is cer∣tainly alive because it stirs, and though to be the better assur'd the Midwife may lay her hand on the Mothers belly, for there have been Women sometimes delivered whose Page 131 Children had been dead about 4 days, as might be easily judged by their corruption, who notwithstanding have affirmed, though untruly, that they felt them stir but a little before they were delivered; and others a∣gain whose Children were alive, and yet their Mothers never perceived them to stir in three or 4 days before, as they confessed:
Now if the Midwife cannot be assured by the Childs motion that it is alive, she may assoon as the waters are broke, gently put up her hand into the Womb, to feel for the breaking of the Navil-string, the which she will find to be stronger, the nearer she feels it to the Infants belly; or if she meets with in hand she may feel the pulse; but their pulses, you must know are not so strong as their Navil-strings, therefore the best to be known by it; if then also by putting her fin∣ger into the Childs mouth she perceive it to stir its Tongue, as if it would suck; and on the contrary, if no such signs, and the Mother feel a great weight, and great pains in her belly, and it be not supported but tumbles always on the side she lays her self; if she faints and have Convulsion Fits, if the Navil-string or secondine hath been a good while in the World, and if the Midwife by putting her hand into the Womb, finds the Child cold, and feeling she finds that very soft, Page 132 chiefly towards the crown where likewise th• bones are open, and riding one upon the o¦ther at the clefts, or Sutares, because th• brain shrinks, which corrupts more in 2 day• in the Womb, than it doth in 4 after it i• born, which is caused by the heat and moist¦ness of the place, the 2 principals of corrup¦tion; and if there comes a dark and stinking putrid matter from the Womb; all thes• signs together, or most of them demonstrat• to the ingenious Midwife that the Child i• assuredly dead; the which when she is cer¦tain of, she must do her endeavor to fetch i• away as soon as possibly she can, and having placed the Woman conveniently, if th• Child offers its head first, she must gently pu• it back, until she hath liberty to introdu•… her hand wholly into the Womb, and sliding it all along under the belly to find the Feet▪ let her draw it forth by them, being ver• careful to keep the head from being lock'• in the passage, and that it be not separate• from the body, which may easily happe• when the Child being very rotten and putri∣fi'd, she doth not observe the circumstance• that we spake of before, that is, in drawing forth the Child, to keep its breast and face always downwards; And if notwithstanding all these precautions, the head, because of the great putrefaction, should be separated and Page 133 left behind in the Womb; it must be left to be drawn forth by the expert Physitian or Chyrurgion. The same also is to be said when the Head is so far advanced coming first, and engaged among the bones of the passage, that it cannot be put back, then being very sure by all the signs together or most of the chief of them, that the Child is dead cer∣tainly, 'tis better to let the Surgeon draw it so forth, it being a round slippery part, with crotchets, then torment the Woman to put it back. Now if the dead Child (whereof above all there must be good assurance,) comes with its arms up to it shoulders so ex∣treamly swelled that the Woman must suffer too much violence to have it put back, 'tis best then, as was said before, to take it off at the shoulder joint, by twisting it 3 or 4 times about; then afterwards the Midwife will have more room to put up her hand into the Womb, the arm being so separated and no longer possessing the Womb, and so fetch away the Child by the Feet.
For indeed although it be certain that the Child be quite dead in the Womb, and other circumstances that will demonstrate that there is need of a Physitian or Surgeons Art, yet he must not therefore presently use his crotchets; because they are never to be used but when hands are not sufficient, and that Page 134 there is no other remedy to prevent the Wo∣mans danger, or to bring away the Child any other way: for very often, though all hath been done that art directs, some persons pre∣sent that understand not these things will be∣lieve that the Child was kill'd with the crot∣ches although it had been dead 3 days before, and without other reasonings and better un∣derstanding of the matter for his recompence, in saving the life of the Mother, requite him, with an accusation of which he is altogether innocent, and in case the Mother should af∣terwards dye, by misfortune, lay her death also to his charge, and instead of praise and thanks treat him like a Butcher, or Hang∣man; to which divers Midwifes are com∣monly very ready to contribute, and are the first that make the poor Women, that have need of the Men, afraid of them. Insomuch that they are afraid of being blamed by them for having themselves been the cause, (as some of them often are) of the death of In∣fants, and many ill accidents which often be∣fall the poor Women, for not causing them to be helped in due time, and from the very instant that they perceive the difficulty of the labor to pass their understandings. I speak this by way of caution on both sides.
Now therefore for the Physitian or Chi∣rurgion to avoid these calumnies, let him ne∣ver Page 135 use his crotchets, but very rarely when there is no other way; as also to endeavor his utmost, as much as the case will permit, to bring the Child whole into the World al∣though it be dead, and not by bits and peice-meals, to give the ignorant not any pretence of blame; I say as much as the case will per∣mit, that is, with respect to the Woman un∣der his hands; for to save her he had better sometimes to bring forth the Child with In∣struments, then to kill her, by tormenting her with excessive violence to bring it forth whole: for in a word, he must and ought to do, in his conscience, what his Art commands, with∣out taking heed to what may be spoken after∣wards: and every Physitian or Chirurgion that hath a well regulated conscience, will always have a greater regard to his duty, then his reputation, in such a case; in per∣forming of which let him expect his reward from God.
