娠妊之难产。其因不一。有在一月之前。忽然腹痛大作。如欲产而不产者。谓之试月。
有将
临月时腹痛。或作或止。一二日。或三四日。谓之弄胎。有浆水淋漓来少名。试水虽脐腹痛
。而腰不痛者。俱非当产。若腹痛连腰者。即产。
妇人小腹之下。阴户之上。有骨高起。中有节骱相凑。未产则合。一临产则分开。谓之
交骨
产妇横生。一臂先下。乃儿在母腹转运偏侧。筋斗未翻。内有所碍。而不得遂也。逆产
者。两足先下。必是母腹中脂膜窄狭。儿不得转运而直下。此皆因劳力挫闪。误伤其胎。以致如
儿凑心不下者。其手必捧母心。多致母子俱死。必以药引入心。分解儿手。方可得下也
。盖儿手里捉物最紧。药气一到。儿手自软解开。
子死腹中者。腹必闷痛兼冷。略无动意。面如土色。其舌又黑是也。故试验云。面黑舌
不黑。母死子活。舌黑面不黑。母活子死。此之谓也。
或有未曾受蓐。腹中略痛。而胞水未破。乘势而下。固为大幸。设或胞水漏干。恶露出
尽。其儿不能生。苟无法下之。则母子俱不可保矣。
假如生产胞衣不下者。不可视以为细故而忽之。多有升至心而死者。
有盘肠生者。临产之时。母肠先出。然后儿下。
歌曰。欲产之妇脉离经。沉细而滑也同名。夜半觉痛应分诞。来朝日午定知生。又有大
小不调匀。或如雀啄屋漏应。腰疼腹痛眼生花。产在须臾却非病。
妊娠期间难产的原因各不相同。有的在预产期一个月之前，突然剧烈腹痛，像是要生产却生不下来，这叫做“试月”。有的临近预产期时出现腹痛，疼痛时有时无，持续一两天或三四天，这叫做“弄胎”。有的羊水淋漓流出但量少，称为“试水”，虽然脐部腹痛，但腰部不痛，这些都不是真正的临产。如果腹痛牵连到腰部，那就是要生产了。
在妇人小腹下方、阴户上方，有一块骨头高高隆起，中间有关节连接。未生产时闭合，一旦临产就分开，这叫做“交骨”。
产妇横生，即一只手臂先露出来，这是因为胎儿在母腹中转运时偏向一侧，筋脉翻转未到位，内部有阻碍，导致无法顺利下降。逆产，即双脚先露出来，必定是母腹中的脂膜狭窄，胎儿无法转动而直接下行。这些都是因为劳累用力、挫伤闪失，误伤了胎儿，以致胎儿顶住心脏不下行。此时胎儿的手一定会捧着母亲的心口，多导致母子双亡。必须用药引入心经，分解胎儿的手，才能将胎儿生下。大概是因为胎儿手里抓东西最紧，药气一到，胎儿的手自然松软解开。
胎儿死于腹中的情况，腹部必然闷痛且伴有寒冷感，完全没有胎动迹象，面色如土色，舌苔发黑。所以验尸（或诊断）说：面黑而舌不黑，是母亲死胎儿活；舌黑而面不黑，是母亲活胎儿死。说的就是这个道理。
有的人尚未到临产之时，腹部略微疼痛，而胞衣之水未破，顺势而下，固然是大幸事。但如果胞衣之水漏干，恶露排尽，胎儿就不能出生。如果没有方法将其引出，那么母子都不可保全了。
假如生产后胞衣不下，不可视为小事而忽视。多有胞衣上冲至心脏而导致死亡的案例。
有一种情况叫“盘肠生”，即在临产时，母亲的肠子先脱出，然后胎儿才下来。
歌诀道：将要生产的孕妇，脉象偏离常经（离经脉），沉细而滑的脉象也属于同类（指临产脉）。半夜感到疼痛应该分秒必争准备分娩，来朝天明时分一定知道孩子出生。又有脉搏大小不调匀，或者像雀啄脉、屋漏脉那样急促间歇的，伴随腰痛、腹痛、眼花，这是即将分娩的表现，并非疾病。
The causes of difficult labor during pregnancy are various. In some cases, one month before the expected delivery date, sudden severe abdominal pain occurs, resembling labor but failing to deliver; this is called "Shi Yue" (Trial Month). In other cases, abdominal pain occurs near the due date, intermittent in nature, lasting for one or two days, or three or four days; this is called "Nong Tai" (Playing Fetus). In some instances, amniotic fluid leaks out in small amounts, known as "Shi Shui" (Trial Water); although there is umbilical abdominal pain, there is no lower back pain, and these are not signs of imminent delivery. If abdominal pain radiates to the lower back, it indicates that delivery is imminent.
Below the lower abdomen and above the vaginal opening of a woman, there is a prominent bone structure with joint connections. It remains closed before delivery and separates upon the onset of labor; this is referred to as "Jiao Gu" (Crossing Bone).
In cases of transverse presentation, where an arm emerges first, it is because the fetus has shifted to one side within the maternal womb, and the tendons have not yet turned correctly, causing internal obstruction that prevents smooth descent. In cases of breech presentation, where both feet emerge first, it is necessarily due to a narrow space in the maternal fatty membranes, preventing the fetus from turning and causing it to descend directly. These conditions often result from physical exertion, strain, or injury that damages the fetus, causing the fetus to press against the heart and fail to descend. In such scenarios, the fetal hands will likely clutch the mother's heart area, often leading to the death of both mother and child. Medication must be administered to reach the Heart meridian to relax the fetal hands, allowing for delivery. This is because the fetal grip is strongest when holding objects; once the medicinal qi arrives, the fetal hands naturally soften and release.
When a fetus dies in the womb, the abdomen is typically distended with pain accompanied by coldness, with no fetal movement perceived. The complexion appears sallow like earth, and the tongue turns black. Therefore, diagnostic tests state: if the face is black but the tongue is not, the mother is dead and the fetus is alive; if the tongue is black but the face is not, the mother is alive and the fetus is dead. This refers to the aforementioned principle.
In some cases, before the actual time of confinement, slight abdominal pain may occur while the amniotic sac remains intact, leading to premature expulsion; this is fortunately rare. However, if the amniotic fluid leaks out completely and lochia is exhausted, the fetus cannot be born. If no method is employed to assist delivery, both mother and child cannot be preserved.
If the placenta fails to expel after delivery, it should not be regarded as a minor issue and ignored. There are many cases where the retained placenta ascends to the heart, leading to death.
There is also a condition called "Pan Chang Sheng" (Intestine Protrusion at Birth), where the maternal intestines prolapse first during labor, followed by the birth of the infant.
The verse states: The pulse of a woman about to give birth deviates from the regular pattern (Li Jing Mai / Departed Pulse); a deep, fine, and slippery pulse is also associated with this stage. Pain felt at midnight suggests imminent separation and birth; by noon the next day, birth is certain. Additionally, pulses that are irregular in size or rhythm, resembling the Sparrow Pecking or House Leaking pulses, accompanied by lower back pain, abdominal pain, and visual disturbances, indicate that delivery is imminent and are not pathological conditions.