A GUIDE FOR WOMEN IN TRAVAIL, SHOWING WHAT IS TO BE DONE WHEN THEY FALL IN LABOUR, IN ORDER FOR THEIR DELIVERY.
THE end of all that we have been treating of is the bringing forth a child into the world with safety both to the mother and the infant, as the whole time of a woman's pregnancy may very well be termed a kind of labour; for, from the time of her conception to the time of bar delivery, she labours under many difficulties, is subject to many distempers, and in continual danger, from one effect or another, till the time of birth comes, and when that comes the greatest labour and travail comes along with it, insomuch that then all her other labours are forgotten, and that only is called the time of her labour; and to deliver her safely is the principal business of the midwife. And to assist her 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 of their 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.
SECT. 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 their belly, they immediately send for their midwife, as taking it for their labour, and then if the midwife be not a skilful and judicious woman, to know the time of her 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 lives both of mother and child, by breaking the Amnios and Chorion. These pains, which are often mistaken for labour, are removed by warm cloths laid to the belly, and the application of a clyster or two, by which those pains that precede a true labour are rather furthered than hindered. There are also other pains incident to women in that condition from a 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 flows from the womb slimy humours, which nature has appointed to moisten and smooth the passages that its inward orifices may be the more easily dilated when there is occasion; which beginning to open at that time, suffers that slime to flow away, which proceeds from the glandules, called Prostata. These are signs preceding 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 reiterating by intervals, answer to the bottom of the belly by congruous throws, 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 throws 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 pains to descend outwards. She is much subject to vomiting, which is a sign of good labour and speedy delivery, though by ignorant women thought otherwise, for good pains are thereby excited and redoubled; which vomiting is occasioned 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 coloured with blood, it is that which the midwives call Shows, and is an infallible mark of the birth's being near. And if then the midwife puts 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 downwards with each pain she hath; at which time one may perceive them sometimes to resist, and then again press forward the finger, being more 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, which the midwives call the Gathering of the Waters, resemble, to the touch of the finger, 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 impulsion of the waters, which presently flow away, and then the head of the infant is presently felt naked, and presents itself at the inward orifice of her 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 Allantois being broken, which contain those waters, by the pressing forward of the birth, the child is no better able to subsist long in the womb afterward 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 foolishly have done) endeavour to force away the water, for Nature knows best when the true time of the birth is, and therefore retains the water 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 admitted; and what those things are I shall show in another section.
SECT. III. 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 section, of which those that are most to be relied on are pains and strong throws in the belly, forcing downwards towards the womb, and 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 of the membranes which contain them; through which, between the pains, one may in some manner with the finger discover the part which presents (as was 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 her labour; and care must be taken to get all things ready that are necessary to comfort the woman in that time. And the better to help her, be sure to see she is not straight laced; you may also give her a pretty 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 hereby will be, that they excite the gut to discharge itself of its excrements, that so the rectum being emptied, there may be 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 midwife and the child. To this end some will get a midwife's stool; 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 readily assisted as there is occasion.
If the woman abounds with blood, to bleed her a little may not he 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 she may do without danger, because the child being about that time 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 some 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 finds they are hard to be dilated. Let the midwife likewise be all the while near the labouring woman, and diligently observe her gestures, complaints, and pains, for by this she may guess pretty well how her labour advanceth;
because when she changeth her ordinary groans into loud cries, it is a sign the child is very near the birth; for at that time her pains are greater and more frequent. Let the woman likewise by intervals rest herself on the bed to regain her strength, but not too long, especially if she be little, short, and thick; for such women have always worst labours if they lie long on their beds in their travail; it is better therefore that they walk as much as they can about the chamber, the women supporting them under their arms, if it be necessary, for by this means the weight of the child causeth the inward orifice of the womb to dilate 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 the time, as they further her throws and pains provoking downwards. But to proceed:
When the waters of the children are ready and gathered, which may be perceived through the membranes to present themselves to the inward orifices, of the bigness of the whole dilation, 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 cause the infant to slide forth the more easily), the passage remains dry by which means the pains and throws 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 bare by that which first presents, and thereby discern whether it comes right, that is, with the head foremost, for that is the most proper and natural way of its birth; if the head come right, she will find it round, big, hard, and equal; but if it be in any other part, she will find it unequal, rugged, and soft or hard, according to the nature of the part it is. And this being the true time when the woman ought to deliver 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 sometimes it may, that the waters break away too long before the birth, in such a case those things that hasten nature may be safely admitted; to which purpose let her make use of pennyroyal, dittany, juniper berries, red coral, betony, featherfew boiled in white wine, and a draught of it drunk; 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, let them make it into a syrup, with double its weight of sugar, and keep it by them all the year, to use when occasion calls for it. Mugwort, used in the same manner, is also good in this case. Also a dram of cinnamon powder given inwardly profits much in this case; and so does tansy bruised and applied to the privities, or an oil of it so made and used as you were taught before. The Stones Aetites held to the privities are of extraordinary virtue, and instantly draw away both child and after burden; but great care must be taken to remove it presently, or it will draw forth the 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 lode-stone, or as the lode-stone the North star.
There are many other things that physicians affirm are good in this case; among which are an ass's or a horse's hoof hung near the privities; a piece of red coral hung near the said place; a lode-stone helps much, hold in the woman's left hand, or the skin which a snake hath cast off, girt about the middle next 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 give speedy deliverance to women in travail.
1. A decoction of white wine, made in savory and drank.
2. Take wild tansy, or silver-weed, bruise it, and apply it to the woman's nostrils.
3. Take date stones and beat them to powder, and let her take half a dram 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 up so dipped into the mouth of the womb; it will presently cause the child to come away though it be dead, and will bring away the after burden. Also the juice of parsley is a thing of so great virtue (especially stone parsley), that being drunk 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 spirit of Castorum in any convenient liquor; also 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, hath a mighty operation to cause speedy delivery.
8. Take poppy seeds, and beat them into powder, and mix the powder with oil, with which oil anoint the loins and privities of the woman with child; it gives 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 things that move the terms are pod for making the delivery easy; such as myrrh, white amber in white wine, or lily-water, two scruples or a dram; or cassia lignea, dittany, each a dram, cinnamon half a dram, saffron a scruple, give a dram; or take borax mineral as a dram, cassia lignea a scruple, saffron six grains, and give it in sack; or take cassia lignea, a dram; dittany, amber, of each a dram; cinnamon, borax, of each a dram and a half, saffron a scruple, and give her half a dram; 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 drams of the powder, cinnamon a dram, saffron half a scruple, with juice of savin make torches -- give two drams; or wash the Secundine in wine, and bake it in a pot, then wash it in endive water and wine -- take half a dram of it; long pepper, galangal, of each half a dram; plantain and endive seed, of each a dram and a half; lavender seed, four scruples: make a powder; or take laudanum two drams, storax, calamite, benzion, of each half a dram; musk, ambergrease, each six grains; make a powder, or torches for a fume. Or use pessaries to provoke the birth; take galbanum dissolved in vinegar, an ounce: myrrh two drams, saffron a dram; with oil of oats make a pessary.
An Ointment for the Navel
Take oil of keir two ounces, juice of savin an ounce, of leeks and mercury, each half an ounce; boil them to the consumption of the juice; and galbanum dissolved in vinegar, half an ounce, myrrh two drams, storax liquid a dram; round birthwort, sowbread, cinnamon, saffron, a dram; with wax make an ointment, and apply it.
If the birth be retarded through the weakness of the mother, refresh her with applying wine and soap to the nose, Confect, Alkermas, Diamarg.
These things may be applied to help nature in the delivery when the child comes to the birth the right way, and yet the birth is retarded; but if she finds the child comes the wrong way, and 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 by another with more safety and ease, and less hazard both to woman and child), then let her send speedily for better and more able help and not as I once knew a midwife, when a woman she was to deliver had hard labour, rather than a man-midwife should be sent for, would undertake to deliver the woman herself (though told by others that it was a man's business), and in her attempting. it brought away the child, but left the head of the infant 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 to her delivery.