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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.
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.
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.
