Chapter 4. A Guide For Women In Travail...in Labour...delivery

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_ CHAPTER IV

A Guide for Women in Travail, showing what is to be done when they fall in Labour, in order to their Delivery.

The end of all that we have been treating of is, the bringing forth of a child into the world with safety both to the mother and the infant, as the whole time of a woman's pregnancy may be termed a kind of labour; for, from the time of the conception to the time of her delivery, she labours under many difficulties, is subject to many distempers, and in continual danger, from one affection or other, till the time of birth comes; and when that comes, the greatest labour and travail come along with it, insomuch that then all the other labours are forgotten, and that only is called the time of her labours, and to deliver her safely is the principal business of the midwife; and to assist therein, shall be the chief design of this chapter. The time of the child's being ready for its birth, when nature endeavours to cast it forth, is that which is properly the time of a woman's labour; nature then labouring to be eased of its burden. And since many child-bearing women, (especially the first child) are often mistaken in their reckoning and so, when they draw near their time take every pain they meet with for their labour, which often proves prejudicial and troublesome to them, when it is not so, I will in the first section of this chapter, set down some signs, by which a woman may know when the true time of her labour is come.

 

SECTION I.--The Signs of the true Time of a Woman's Labour.

When women with child, especially of their first, perceive any extraordinary pains in the belly, they immediately send for their midwife, as taking it for their labour; and then if the midwife be not a skilful and experienced woman, to know the time of labour, but takes it for granted without further inquiry (for some such there are), and so goes about to put her into labour before nature is prepared for it, she may endanger the life of both mother and child, by breaking the amnios and chorion. These pains, which are often mistaken for labour, are removed by warm clothes laid to the belly, and the application of a clyster or two, by which those pains which precede a true labour, are rather furthered than hindered. There are also other pains incident to a woman in that condition from the flux of the belly, which are easily known by the frequent stools that follow them.

The signs, therefore, of labour, some few days before, are that the woman's belly, which before lay high, sinks down, and hinders her from walking so easily as she used to do; also there flow from the womb slimy humours, which nature has appointed to moisten and smooth the passage that its inward orifice may be the more easily dilated when there is occasion; which beginning to open at this time, suffers that slime to flow away, which proceeds from the Glandules called _prostata_. These are signs preceding the labour; but when she is presently falling into labour, the signs are, great pains about the region of the reins and loins, which coming and retreating by intervals, are answered in the bottom of the belly by congruous throes, and sometimes the face is red and inflamed, the blood being much heated by the endeavours a woman makes to bring forth her child; and likewise, because during these strong throes her respiration is intercepted, which causes the blood to have recourse to her face; also her privy parts are swelled by the infant's head lying in the birth, which, by often thrusting, causes those parts to descend outwards. She is much subject to vomiting, which is a good sign of good labour and speedy delivery, though by ignorant people thought otherwise; for good pains are thereby excited and redoubled; which vomiting is excited by the sympathy there is between the womb and the stomach. Also, when the birth is near, women are troubled with a trembling in the thighs and legs, not with cold, like the beginning of an ague fit, but with the heat of the whole body, though it must be granted, this does not happen always. Also, if the humours which then flow from the womb are discoloured with the blood, which the midwives call _shows_, it is an infallible mark of the birth being near. And if then the midwife puts up her fingers into the neck of the womb, she will find the inner orifice dilated; at the opening of which the membranes of the infant, containing the waters, present themselves and are strongly forced down with each pain she hath; at which time one may perceive them sometimes to resist, and then again press forward the finger, being more or less hard and extended, according as the pains are stronger or weaker. These membranes, with the waters in them, when they are before the head of the child, midwives call _the gathering of the waters_, resemble to the touch of the fingers those eggs which have no shell, but are covered only with a simple membrane. After this, the pains still redoubling the membranes are broken by a strong impulsation of these waters, which flow away, and then the head of the infant is presently felt naked, and presents itself at the inward orifice of the womb. When these waters come thus away, then the midwife may be assured the birth is very near, this being the most certain sign that can be; for the _amnios alantois_, which contained these waters, being broken by the pressing forward of the birth, the child is no better able to subsist long in the womb afterwards than a naked man in a heap of snow. Now, these waters, if the child comes presently after them, facilitate the labour by making the passage slippery; and therefore, let no midwife (as some have foolishly done) endeavour to force away the water, for nature knows best when the true time of birth is, and therefore retains the waters till that time. But if by accident the water breaks away too long before the birth, then such things as will hasten it, may be safely administered, and what these are, I will show in another section.

 

SECT. II.--How a Woman ought to be ordered when the time of her labour is come.

When it is known that the true time of her labour is come by the signs laid down in the foregoing, of which those most to be relied upon are pains and strong throes in the belly, forcing downwards towards the womb, and a dilation of the inward orifice, which may be perceived by touching it with the finger, and the gathering of the waters before the head of the child, and thrusting down the membranes which contain them; through which, between the pains, one may in some manner with the finger discover the part which presents itself (as we have said before), especially if it be the head of the child, by its roundness and hardness; I say, if these things concur and are evident, the midwife may be sure it is the time of the woman's labour, and care must be taken to get all those things that are necessary to comfort her at that time. And the better to help her, be sure to see that she is not tightly laced; you must also give her one strong clyster or more, if there be occasion, provided it be done at the beginning, and before the child be too forward, for it will be difficult for her to receive them afterwards. The benefit accruing therefrom will be, that they excite the gut to discharge itself of its excrements, so that the rectum being emptied there may be the more space for the dilation of the passage; likewise to cause the pains to bear the more downward, through the endeavours she makes when she is at stool, and in the meantime, all other necessary things for her labour should be put in order, both for the mother and the child. To this end, some get a midwife's; but a pallet bed, girded, is much the best way, placed near the fire, if the season so require, which pallet ought to be so placed, that there may be easy access to it on every side, that the woman may be the more easily assisted, as there is occasion.

If the woman abounds with blood, to bleed her a little more may not be improper, for thereby she will both breathe the better, and have her breasts more at liberty, and likewise more strength to bear down her pains; and this may be done without danger because the child being about ready to be born, has no more need of the mother's blood for its nourishment; besides, this evacuation does many times prevent her having a fever after delivery. Also, before her delivery, if her strength will permit, let her walk up and down her chamber; and that she may have strength so to do, it will be necessary to give her good strengthening things, such as jelly, broth, new laid eggs, or some spoonfuls of burnt wine; and let her by all means hold out her pains, bearing them down as much as she can, at the time when they take her; and let the midwife from time to time touch the inward orifice with her finger, to know whether the waters are ready to break and whether the birth will follow soon after. Let her also anoint the woman's privities with emollient oil, hog's grease, and fresh butter, if she find they are hard to be dilated. Let the midwife, likewise, all the time be near the labouring woman, and diligently observe her gestures, complaints, and pains, for by this she may guess pretty well how far her labour advanceth, because when she changeth her ordinary groans into loud cries, it is a sign that the child is near the birth; for at the time her pains are greater and more frequent. Let the woman likewise, by intervals, rest herself upon the bed to regain her strength, but not too long, especially if she be little, short and thick, for such women have always worse labour if they lie long on their beds in their travail. It is better, therefore, that she walk about her chamber as long as she can, the woman supporting her under the arms, if it be necessary; for by this means, the weight of the child causes the inward orifices of the womb to dilate the sooner than in bed, and if her pains be stronger and more frequent, her labour will not be near so long. Let not the labouring woman be concerned at those qualms and vomitings which, perhaps, she may find come upon her, for they will be much for her advantage in the issue, however uneasy she may be for a time, as they further her pains and throes by provoking downward.

When the waters of the child are ready and gathered (which may be perceived through the membranes presenting themselves to the orifice) to the bigness of the whole dilatation, the midwife ought to let them break of themselves, and not, like some hasty midwives, who being impatient of the woman's long labour, break them, intending thereby to hasten their business, when instead thereof, they retard it; for by the too hasty breaking of these waters (which nature designed to make the child slip more easy), the passage remains dry by which means the pains and throes of the labouring woman are less efficacious to bring forth the infant than they would otherwise have been. It is, therefore, much the better way to let the waters break of themselves; after which the midwife may with ease feel the child by that part which first presents, and thereby discern whether it comes right, that is, with the head foremost, for that is the proper and most natural way of the birth. If the head comes right, she will find it big, round, hard and equal; but if it be any other part, she will find it rugged, unequal, soft and hard, according to the nature of the part it is. And this being the true time when a woman ought to be delivered, if nature be not wanting to perform its office, therefore, when the midwife finds the birth thus coming forward let her hasten to assist and deliver it, for it ordinarily happens soon after, if it be natural.

But if it happens, as it sometimes may, that the waters break away too long before the birth, in such a case, those things which hasten nature may safely be administered. For which purpose make use of pennyroyal, dittany, juniper berries, red coral, betony and feverfew, boiled in white wine, and give a drachm of it, or it would be much better to take the juice of it when it is in its prime, which is in May, and having clarified it, make it into a syrup with double its weight of sugar, and keep it all the year, to use when occasion calls for it; mugwort used in the same manner is also good in this case; also a drachm of cinnamon powder given inwardly profits much in this case; and so does tansey broiled and applied to the privities; or an oil of it, so, made and used, as you were taught before. The stone _aetites_ held to the privities, is of extraordinary virtue, and instantly draws away, both child and after-burden; but great care must be taken to remove it presently, or it will draw forth womb and all; for such is the magnetic virtue of this stone that both child and womb follow it as readily as iron doth the load-stone or the load-stone the north star.

There are many things that physicians affirm are good in this case; among which are an ass's or horse's hoof, hung near the privities; a piece of red coral hung near the said place. A load-stone helps very much, held in the woman's left hand; or the skin cut off a snake, girt about the middle, next to the skin. These things are mentioned by Mizaldus, but setting those things aside, as not so certain, notwithstanding Mizaldus quotes them, the following prescriptions are very good to speedy deliverance to women in travail.

(1) A decoction of white wine made in savory, and drank.

(2) Take wild tansey, or silver weed, bruise it, and apply to the woman's nostrils.

(3) Take date stones, and beat them to powder, and let her take half a drachm of them in white wine at a time.

(4) Take parsley and bruise it and press out the juice, and dip a linen cloth in it, and put it so dipped into the mouth of the womb; it will presently cause the child to come away, though it be dead, and it will bring away the after-burden. Also the juice of the parsley is a thing of so great virtue (especially stone parsley) that being drank by a woman with child, it cleanseth not only the womb, but also the child in the womb, of all gross humours.

(5) A scruple of castorum in powder, in any convenient liquor, is very good to be taken in such a case, and so also is two or three drops of castorum in any convenient liquor; or eight or nine drops of spirits of myrrh given in any convenient liquor, gives speedy deliverance.

(6) Give a woman in such a case another woman's milk to drink; it will cause speedy delivery, and almost without pain.

(7) The juice of leeks, being drunk with warm water, highly operates to cause speedy delivery.

(8) Take peony seeds and beat them into a powder, and mix the powder with oil, with which oil anoint the privities of the woman and child; it will give her deliverance speedily, and with less pain than can be imagined.

(9) Take a swallow's nest and dissolve it in water, strain it, and drink it warm, it gives delivery with great speed and much ease.

Note this also in general, that all that move the terms are good for making the delivery easy, such as myrrh, white amber in white wine, or lily water, two scruples or a drachm; or cassia lignea, dittany, each a drachm; cinnamon, half a drachm, saffron, a scruple; give a drachm, or take borax mineral, a drachm, and give it in sack; or take cassia lignea, a drachm; dittany, amber, of each a drachm; cinnamon, borax, of each a drachm and a half; saffron, a scruple, and give her half a drachm; or give her some drops of oil of hazel in convenient liquor; or two or three drops of oil of cinnamon in vervain water. Some prepare the secundine thus:--Take the navel-string and dry it in an oven, take two drachms of the powder, cinnamon a drachm, saffron half a scruple, with the juice of savin make trochisks; give two drachms; or wash the secundine in wine and bake it in a pot; then wash it in endive water and wine, take half a drachm of it; long pepper, galangal, of each half a drachm; plantain and endive seed, of each half a drachm; lavender seed, four scruples; make a powder, or take laudanum, two drachms; storax, calamite, benzoin, of each half a drachm; musk, ambergris each six grains, make a powder or trochisks for a fume. Or use pessaries to provoke the birth; take galbanum dissolved in vinegar, an ounce; myrrh, two drachms, with oil of oat make a pessary.

 

An Ointment For the Navel.

Take oil of keir, two ounces, juice of savine an ounce, of leeks and mercury, each half an ounce; boil them to the consumption of the juice; add galbanum dissolved in vinegar, half an ounce, myrrh, two drachms, storax liquid a drachm, round bitwort, sowbread, cinnamon, saffron, a drachm, with wax make an ointment and apply it.

If the birth be retarded through the weakness of the mother, refresh her by applying wine and soap to the nose, confect. alkermas. diamarg.

These things may be applied to help nature in her delivery when the child comes to the birth the right way, and yet the birth be retarded; but if she finds the child comes the wrong way, and that she is not able to deliver the woman as she ought to be, by helping nature, and saving both mother and child (for it is not enough to lay a woman if it might be done any other way with more safety and ease, and less hazard to woman and child), then let her send speedily for the better and more able to help; and not as I once knew a midwife do, who, when a woman she was to deliver had hard labour, rather than a man-midwife should be sent for, undertook to deliver the woman herself (though told it was a man's business), and in her attempting it, brought away the child, but left the head in the mother's womb; and had not a man midwife been presently sent for, the mother had lost her life as well as the child; such persons may rather be termed butchers than midwives. But supposing the woman's labour to be natural, I will next show what the midwife ought to do, in order of her delivery. _

Read next: Chapter 5. Of Natural Labour--What The Midwife Is To Do...

Read previous: Chapter 3. Of The Parts Proper To A Child In The Womb...

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