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CHAPTER XV

     Directions for Women when they are taken in Labour, to ensure
     their safe Delivery, and Directions for Midwives.

Having thus given the necessary directions to pregnant women, how to manage their health during their pregnancy, I will now add what is necessary for them to do, in order that they may be safely delivered.

When the time of birth draws near, the woman must be sure to send for a skilful midwife, and that rather too soon than too late.  She must have a pallet bed ready to place it near the fire, so that the midwife and those who are to help her, may be able to pass round it, and give assistance on either side, as may be required.  A change of linen must be in readiness, and a small stool to rest her feet against, as she will have more power when her legs are bent, than when they are straight.

When everything is thus ready, and when the woman feels the pains coming on, if the weather be not cold, she should walk about the room, rest on the bed occasionally, waiting for the breaking of the waters, which is a fluid contained in one of the outward membranes, and which flows out thence, when the membrane is broken by the struggles of the child.  There is no special time for this discharge, though it generally takes place about two hours before the birth.  Movements will also cause the womb to open and dilate, and when lying long in bed will be uncomfortable.  If she be very weak she may take some mild cordial to give her strength, if her pain will permit her; and if the labour be tedious, she may be revived with chicken or mutton broth, or she may take a poached egg; but she must be very careful not to eat to excess.

There are many postures in which women are delivered; some sitting in a chair, supported by others, or resting on the bed; some again upon their knees and resting on their arms; but the safest and most commodious way, is in the bed, and then the midwife ought to observe the following rules:—­Let her lay the woman upon her back, with her head a little raised by means of a pillow, with similar supports for her loins and buttocks, which latter should also be raised, for if she lies low, she cannot be delivered so easily.  Then let her keep her knees and thighs as far apart as she can, her legs bent inward towards each other, and her buttocks, the soles of her feet and her heels being placed upon a small rest, placed for the purpose, so that she may be able to strain the stronger.  In case her back should be very weak, a swathing band should be placed under it, the band being doubled four times and about four inches broad.  This must be held by two persons who must raise her up a little every time her pains come on, with steady hands and in even time, but if they be not exact in their movements, they had better leave her alone.  At the same time two women must hold her shoulders so that she may strain out the foetus more easily; and to facilitate this let one stroke or press the upper part of her stomach gently and by degrees.  The woman herself must not be nervous or downhearted, but courageous, and forcing herself by straining and holding her breath.