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1\1 n Vil
,comion he r.egldted, the child \Vil!' Coon hleee! to ue,th:
)'t:t. ií th~ n ... vc:l-(~ring is cu t or l o re ;¡ rll nJ~r (¡{ {WO or
th ree hand -breaddls from the lJell y, and expofl..'d to lhe
cold \\ithollt any Jig¡\turc, lhe arteri<.s \Viii cont r,tél lhem ·
felvcs, Ca as th,II lu d e or no blooJ Ih ,11 be luf! ; nay,
(ol\l~t 'mCs, ir lhe fur.:s beco ticd and cu t al the d.C–
tanc.:c of t hr~e lingcr-brr:.H..Iths from Ihe chilJ's bcJly , fa
as lh .u it h.llh becn kept (roro bboding (or an hUlIT or
( \VD , al thol1 gh l he ligeltllre be lhen untied, and (he navel–
fl ring ;tncl belly 'Charcd. and (u:lked iR warm wate r, DO
mú e blood wil! be diCcharged,
0l d,·¡ivaing Ihe PLA CEN TA,
F E Y. 21 9
of yonr hand oelow the placenta throligll the os int ernum ;
and h8vin~ ddaten the m.crus, Oíp down you r hano to
eh:: edge 0'- the cake. and bring ii" along: but, ir it ad.
helcs to lhe uterus, puO\ up yOl1r h,\nd íI. , and hJ·
ving, f~parated it cautlo\tny, ,dclil'er it as be ror~ ,
I r infl ead of fimi ing lhe cclge or middle or the pl Acenta
prefc:nung to the os. eX lernum or inlcrnnOl, yO\.1 fcel the
m Otlt h ot lhe womb c10fely contraéted, you mufl take
hold of the navel.llring as . bove di"aed , anJ Oide )'our
OI hcr h and aloog runis ioto the vílgina ; then Clowly
pllfh yOUf' fingcrs and Ihumb, joined in form or a cone,
through Ih e os uleri . íllo n2 the fame cord, to the pl ace
of its ¡nfenion in the placenta: here lel, y?ur hand rell,
T HE funis being fepara ~ed, and Ihe child committed and feel wi lh your fingers lO what part of lhe uterus t.!le
to the nurfe, the next care is to dt:liver the pl<tc~O[a aod cake adhercs : ir it be loor:: at lhe lower edge, try tO
mernhranes, ir they are not 3lre!aJy Co rced down by tbe bring it along; bU I if it ad heres, begin and f~parate it
);.¡b0ur. pain.s, \-VI:! ha \'e: alre(¡dy obfcrved, that ~f tbere Clowly, lhe back of your hand being turned tO lhe uterus,
is no dange r from a fl ooding, the Woman m"y ~e all owed and the: lore. pan pf your fi. ngers toward s the placenu :
to ren a liule, in order to reco\'cr (rom tite f.ltigue (he and for this operation the oails 'ought to . e CUt ilion and
l13s uodcrgone i and that the ut:::rus mí\y, in contra~ingJ fmooth. In feparating, prefs the ends or your fi ngers
",,'etiqle to f<llleeze and Cepa r.tte the pl3cent~ from its moreag~inn the placenta than the uterus ; and if you can.
¡nner furf.ice : cl uring which paufe airo. "bou[ one. [WO not ddlinguifh which is w,hich, becí\ufe both (eel foft
or thrce lca,cups full or bl ood is difdurged through lhe (t hough lhe merus ¡s' firmer than the pl acenta, aod this
funís, from the vc{fels of rhe pl.1ccntíl, which is thus di· 1,,1l: more rolid than c03&ulat e:d blood; ) in this cafe,
minifhed in bulk. fo thal the "'omb mfly be rhe more con· nide down your fingers to its cdge, anO. condufl: them by
tr.l8ed j ílnd this is che reafon fo r appl ying one ligature the feparalt:d pan, preffing it gent1y from the uterus,
only u pon the cord . In a rder to dclivc r lhe placenta, unlil the w hole is difengaged . Somelimeso. when part
take huid of the navef.Hring wi! h !he left· hand, !urni og ot it is fepar.ted, the ren wil! loaren and come along,
il r'ound lhe (ore and middle. Cingers , or wrapping it in a if you pull gently al the detached portian; bur, ir this
clolh, lhat it may not Clip froOl your gr..rp; then pull Is ·not efFeEted \Vilh earc, let lhe whole of ir be fepa.
gentl y from Cide to Cide, ¡nd delire the woman tO affia ratc:d io the mon cal1tious manl1er: fometime9, alfo, by
you r endeavour, by fl raining :u ir Ole were al fiool, blow. grafping the inCide of the placentíl. Wilh you r hand, the
¡ng forcit-Iy into he r hanct, or provoking her(elf to reach whole \Vi II be 100 Cened wi thout furth~r u oublc, As the
by thru(ling her finger.into her !hroat. I f by !heCe mc- pl acenta comes along, Ilide down your hand and take hold
thods rhe plAcenta cannot be breught a\víl.y, introduce or lhe lower cdge:, by which it mur! b~ ex tra~eu, becaufe
your hand Oowly into lhe vagio:], and reel ror lhe edge or it is too bu lky tO be brougllt aWdy alt ogether in a he¡p;
, be cake; wh ich when you ha"e found, pulJ it gr.duall y and le! it be d cJ.vered as whole as pollible, kecping your
¡long; as it comes OUt at the os eXlcrnu m, take hold of lhumb or fingers fi xed upon the nilvel~!lring, by which
it wi th bOlh hands and dc:livcr it, bringing away, ,,( lhe mt:;\ns Ii&Ceralion Is often prcven ted.
fame time, 01.11 lhe mcmbrancs, whi::h. ir lhey adhere, Vv hen the 'Yoma n lies on her back, and lhe placenta
nlufi be pulled along \Vil h lei(l1re 2nd camion, adh~res la the lerl (idear the uterus , it wiJl be moll com-
\Vhen rhe runls l.tkes ies origin towan!s lhe cdge or [he modiolls to fcpar:ne lhe cake wirh the r¡ght h anJ i where·
placenta, which is frcqucntly lhe c:trt'". the c.tke cOllles as l he Jert hand is moll convenient1y uled whcn lhe pla...
eílfier off by pullj nJ~' lhan when the navel {l ring is inf\"'l (. ccnta ,lJhercs 10 lhe right {id!! of lhe \\10mb; bUl whcn it
ed in th e míJJ le, unlt:fs ir be uncnmmonl y r!!f:llncd hy is :t1l3ched 10 Ihe rorepdn, uack, or fundns , eirher hanu
its 3dhefi on to the wOlllh, or by dlt: Ilron~ CO~ tlAftlOn of., Wllt an(wer the purroJe,
the os internu01. IFlhe runís i, dtt.lchcd lO th(: l1IidJ le ~rh,tr nal t or th~ utt:rus to which the pl.acenta aJheres,
or the plJcent~, and lha l pa n pldtnt~ to Ihe os Inlt'fIlUm i~ k<I't Ihll ,ji fl ,;,nrl~d. whde:: all lhe reH ol' it is con lra~l."d .
or eXlt'rnU01, lhe whole m~rs will be lOO uulI..y lO ~ome 'T h\! n('.ln;r lhe adhelion is to the:: os ¡nl('roum. l he
¡along 10 ,h .. t po(jtion : in lh is c,lfe }"ou mufl intrvJuct: (\Va e:dia I!' dl~ pl.Lccnta ft:p¡¡r3l1:d, and t'iu tN rj l; bec;lUfe
f: ngers \Vithin Ihe: o~ I:!xt\:rnuOl, :lOd bring it J own \Vit h ItS it is dilliru lt t i) fI:.\ch up 10 lhe rundus, on 2C~OU nt or lhe!
edge rort:01oH. C(\1H I¡,¡~lio n 01' lhe os internum, anJ lowe r pan o r the
' Vh"n d a.: pJ.lcenta is r,,:piH3t!d by 'the cont l:¡('t;tln or \V'Huh. w!lid, are nOl lIrclchetl "!! lin Wilhoul grc:tt fo rce
the t1terll~. in rOnrt' lllcnce eJf il 5 wcit:ht an~1 l)ld!..:, il is 2ltl'r Tlu:}" h ::.,'c '-(.ln (,oulr,t~llll fur any It.:nJ!th ur lIllll.'.
puflh:..I clown hcfurc lhe mClllllran!!s, and UOI I. :lI'~ l.>l o"1;ht \\'-hcn tht:rt,furc lh:.: I'I.tCtllt-l :t.!hl."re:j to lhe fun",h,$,
au',') in\'t:fl<d. :\11.1 al! the lowl'f r ,ln or lhe.: w~mh í~ fl ron!~ly ..:-led.
\\1 hen p:u 1 Or rhe rl:\celll:l lI.,lh p:tn';d ,lle os int l rnllm . 4 Ilh: h ,Uhl mnn hc.' 101Cl."J U r 111 lOl m or el ('(lile ioto Ih!! ,'a.
:Ind Ihe reH or ir c:arnot be.: t,rou;.;h t ,,11'11;'- by e Ir\' pllllln~. g ll1,l, ;¡ nd tllt" n ~!r.I,IIl.dly dd ...t~ the os il\:Cln~:m AnJ
bec luf.: ( h~ os m eri is d"lc contr,I,(ted JOllnd lhe: mirldlc n~ " P;lI l ur t!H' l¡hTU$. 11" grt";n (CIC\,.' i!' ' lqui'út. eXl' lt
of it, el pirt (.If 11 lltll ~ to ¡he wOlllb, lIidc lhe l1.a il Ilu\dy, rd~~ng u.:t\\'ccn whiks, d iJt ti..: mol)" r.O!
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