CHAPTER X.

_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.