_Difficulties from other_ ill Positions _of the Infant._
The _Arm_ or _Shoulder_ presenting, is so well known to be attended
with Difficulty, that few Women will attempt such Deliveries,
unless they are so very ignorant, as to imagine they can bring the
Child by _pulling_ at an _Arm_.
As our Miscarriages, or rather Misfortunes, in Practice, may no
less contribute to the Information of others, by Caution, than our
Success, by Example; I shall not scruple to give a candid Relation
of the most fatal Occurrence, which ever fell to my Lot.
The 12th _September_, 1748, I was called to a Woman at TROUBRIDGE,
her _Matrix_ lay _forward_ in a _prominent Abdomen_ hanging very
low, the _Os-uteri Internum_ lay very much _backward_, _both_ Hands
_presented_ to it, this Woman had been very ill the preceeding
Week, and in extreme Misery the last Twenty-four Hours; with a
great deal of Trouble, I got and drew towards me one _Foot_,
with the _Heel turn’d towards the Mother’s Belly_; in drawing
the _Infant_ so far as the _Arm-pits_, I found the _Face_ of the
Child did not _turn_ so readily as I expected towards the Mother’s
_Back_; as soon as I had brought the _Feet_ some Distance without
the _Vagina_, while I endeavour’d to extract the Child by hold of
its _Thighs_, the Midwife, unknown to me, officiously laying hold
of the Infant’s _Feet_, exerted her Strength at the same Time with
mine; I intended to leave the _Arms_ according to DEVENTER, as a
Security to the more safe Transmission of the _Head_; and while
our united Strength was exerted, I found the _Neck_ gave way, with
something of an _audible_ Crack; and with some Surprize, looking
about me, saw the Midwife _labouring_ at the Child’s _Feet_, and
check’d her, as acting very rashly, without my Direction; thus
we had really separated the _Spine_ of the _Neck_, and the _Head_
only adhering to the _Body_ by the _Skin_, was with little or no
Force separated from it: In passing my Hand, after a tye on the
_Navel-string_, I found the _Head_ fell _back_ into the prominent
Part of the _Abdomen_, insomuch that I could only reach the
separated Part of the _Neck_, and I endeavour’d, in vain, to get
hold of the _Head_ by the _Crotchet_: While I was thus employ’d,
a _Flooding_ came on, by the Separation of the _Placenta_, which
quick’ned my Endeavours, from the Apprehensions of her sudden
Death, if she was not immediately deliver’d; but the poor Woman,
much spent with Fatigue and Loss of Blood, begg’d I would desist,
preferring Death to Life; in which being join’d by the People
present, and not a little exhausted of Spirit and Strength myself,
I was, much against my Will, obliged to leave her to her Fate.
Here I would observe, it appear’d the _Body_ was that of a large
Boy, and tho’ I find GIFFARD and others made no Scruple of leaving
the _Arms_ of a small Child, I must join with them in advising
not to bring a _large one_, without first _procuring_ the _Arms_;
tho’ I will not say, whether the Method of delivering on one Side
instead of the _Back_, the lower Part somewhat _raised_ from the
Bed, at the same Time _encouraging_ Labour with Hopes of immediate
Delivery, recommended by DEVENTER, may not occasion the Danger of
leaving the _Arms_.
There are Variety of other wrong _Situations_, and _Cases_ of
Difficulty, which I could illustrate by Examples in my own
Practice, and may be found in the Observations of MAURICEAU
DE-LA-MOTTE, GIFFARD and others, for the Information of such as
practise Midwifry, that have no Relation to the Information of
Midwives, either in their own Practice, or Occasions of Assistance.