_Difficulties attending the Contraction, or Ill-site of the_ Inward
Orifice.
In the Fifth Chapter I have told, how the Midwife may judge,
by touching, of an easy Birth; carefully introducing her two
Fore-fingers into the Passage, to find the internal Orifice of
the Womb in the Beginning of Labour; now, in doing this, if the
Orifice, she is in Search for, does not readily occur, she has
great Reason to apprehend Difficulty; and if not well acquainted
with the Parts she handles, by rude Usage, piercing through any
Part of the _Vagina_, which presents to the _Touch_, may do
Mischief. Such an Injury was done to one of Box, where I was
called _Sept._ 21, 1748. This Woman had been in Labour several
Days; the Midwife having, the last Time, been with her eighteen
Hours, the Pole of the Child’s Head lay upon the Share-bone, which
was rectifyed by one Limb of the Extractor and brought into the
Passage; the other Limb being joined, the Infant was soon born; but
what before surprized me, was to find a _Passage_, for my Fingers,
considerably remote from the _internal Orifice_, with great
Complaints of a smarting Pain when I touch’d it; a Suppuration
follow’d, but the Woman soon recover’d, after the frequent Use of
an emollient and discutient Fomentation.
When the _Orifice_ presents rightly, and is easily found, it
is next of Consequence to observe, whether the Pains _relax_,
_open_ and _enlarge_ it; for should it remain _thick_ and
_contracted_, instead of relaxing and growing thinner, if the
Infant comes rightly directed, the Woman’s Pains are not _genuine_
but _spurious_; it will then be proper to give an emollient
and carminative Glyster, and probably the false Pains will be
reliev’d, and the true succeed; or some Time may intervene, before
her true Labour, especially if the full Time of Breeding should not
be expired.
If the Midwife cannot reach the _internal Orifice_, and the Child’s
Head lays _high_, the Orifice may possibly lay _high_, _backwards_
or _forwards_, or more or less so, inclining _Sideways_; the Reason
of which may be apprehended, from the brief Account of the _Womb_,
and the _Pelvis_, in the Second Chapter. In this Case it may be
with great Difficulty, the Assistant can reach the nearest Margin
of the _internal Orifice_, tho’ well instructed and experienced,
and it will often require the Hand of an expert Artist, early in
Labour to rectify it, or turn the Child, when Travil is advanced;
or if too long neglected may occasion the Death of one, or both
Mother and Child.