妊娠欲产之时，但觉腹内转动，即当正身仰卧，待儿转身，向下时作痛，试捏产母手中指中
节，或本节跳动，方与临盆，即产矣。若初觉不仰卧，以待转胞，或未产而水频下，此胞衣
已破，血水先干，必有逆生难产之患。若横生者，儿先露手臂，令母正卧，以手徐推儿臂下
体，令其正直，复以中指摩其肩，勿令脐带攀系即生。逆生者，儿先露足，令母正卧，以手
按推其足，仍推儿转正即生。偏生者，儿头偏在一边，亦照前法，徐正其头即生。或见头后
骨，偏在谷道傍，徐推近上即生。碍产者，儿头虽正，但不能下，盖因胎转，脐带攀肩所致
，用中指按儿两肩，理脱脐带即生。坐产者，儿将欲生，其母疲倦，久坐椅褥，抵其生路，
急用巾带高悬，令母以手攀之，轻轻屈足良久，儿顺即生。盘肠生者，临产母肠先出，此难
于收上，以萆麻子四十九粒，研烂涂产母头顶，待肠收上，急洗去。设或为风吹干不能收者
，以磨刀水少许，温热拭润其肠，再用磁石煎汤服之即收上，磁石须阴阳家用有验者。俗以
水母面，皆惊，而肠亦收之，盖惊则气散，恐反致他症，戒之，若胎衣破而不得分娩者，
用保生无忧散，以固其血，自然生息。如血已耗损，用八珍汤料一斤，益母草半斤，水数碗
，煎熟不时饮之，亦有得生者。凡孕妇只腹痛，未产也，若连腰痛甚者，将产也，盖肾候于
腰胞系于肾故也。华陀治横逆产难，用蛇脱二条，蝉壳二十八个，胎发二丸，各烧灰，每服
二钱，酒调，连进二服，即卧片时，儿即顺生。如无此药，令产母仰面正卧，以小针刺儿手
脚心三五次，用盐涂之，手脚即缩上，待身转顺而生。若以蜀葵子四十九粒，白滑石三钱，
顺流水煎服即顺生。或用好京墨浓磨服之，墨水裹儿即下。 或败笔头一个， 过，以藕节
自然汁，温酒和下。 或紫苏叶、当归各三钱，长流水煎服即下。 凡孕家宜预请稳婆，有
仁心识见者，当施恩惠以结其心，先与说知，倘有生息不顺，只说未产，或遇双胎，只说胎
衣未下，恐惊则气散，愈难生息。余家亲验之，大抵难产多患于郁闷安佚富贵之家。治法虽
云胎前消气，产后补血，不可专执。若脾胃不实，气血不充，宜预调补，不然临产必有患难
。如因难产，或大寒时，急以大油纸捻，徐徐烧断其脐带，虽儿已死，令暖气入腹，多得
复生，切不可用刀断之。
治验
荆妇孟冬分娩艰难，产子已死，元气劳伤，用油纸捻烧断脐带，取其阳气以补之，俄间儿啼
作声，即鹄儿也，若以刀物如常断之，其母亦难保生，此儿嗣后一二岁间，并无伤食作泻之
症，可见前法之功。其稳婆又喜平日常施少惠，得其用心，能安慰母怀，故无虞耳。此稳婆
云∶止有一女，分娩时，适当巡街侍御行牌取我，视其室分娩，女为此惊吓，未产而死，后
见侍御，更以威颜分付，迨视产母胎虽顺，而头偏在一边，若以手入推正，可保顺生，因畏
其威，不敢施手。但回禀云，此是天生天化，非人力所能立，俟其母子俱死。
妊娠临近分娩时，只要感觉腹内胎动转动，就应当端正身体仰卧，等待胎儿转身向下时开始阵痛。此时试捏产妇手中指的中节（中间关节），如果本节跳动，才算是临盆，即将分娩。如果起初不仰卧以等待胎儿转位，或者在分娩前羊水频繁流出，这说明胞衣已经破裂，血水先干，必然会有胎位不正、难产的隐患。
如果是横生（胎儿横位），胎儿的手臂先露出，让母亲端正仰卧，用手轻轻将胎儿的手臂及身体推正，使其体位正直，再用中指按摩其肩部，注意不要让脐带缠绕肩膀，胎儿即可出生。
如果是逆生（足位分娩），胎儿的脚先露出，让母亲端正仰卧，用手按压并推动其脚部，仍将胎儿推转正位即可出生。
如果是偏生（头位偏斜），胎儿的头偏向一边，也按照前面的方法，慢慢将其头部推正即可出生。
如果看到胎儿后脑骨偏向肛门旁边，慢慢将其向上推近即可出生。
如果是碍产（脐带缠肩），胎儿头部虽然端正，但不能下降，这是因为胎位转动导致脐带攀附在肩膀上所致，用中指按压胎儿的两肩，理顺解脱脐带即可出生。
如果是坐产（因疲劳久坐阻碍分娩），胎儿即将出生时，母亲疲倦，长时间坐在椅子或褥垫上，抵住了产道，急需将巾带高悬，让母亲用手攀住，轻轻屈曲双腿保持良久，胎儿顺位即可出生。
如果是盘肠生（直肠脱垂伴随分娩），临产时母亲的肠子先脱出，这很难收回，取蓖麻子四十九粒，研烂涂在产妇头顶，待肠子收回后，立即洗去。假如因为风吹干而不能收回，用少许磨刀水，温热擦拭湿润其肠子，再服用磁石煎汤即可收回，磁石必须选用风水先生验证过有效的。世俗之人用水母面（一种海藻）来治疗，大家都感到惊恐，而肠子也能收回，这是因为惊恐导致气机散乱，反而可能导致其他病症，务必戒除。
如果胎衣破裂但无法分娩，使用保生无忧散，以固摄血液，自然能够顺利分娩。如果血液已经耗损，用八珍汤料一斤，益母草半斤，加水数碗，煎熟后不时饮用，也有能救活的。
凡是孕妇只腹痛，说明还未分娩；如果连腰痛得很厉害，说明快要分娩了，这是因为肾主腰，胞宫系于肾的缘故。
华佗治疗横生和逆生导致的难产，用蛇蜕两条，蝉蜕二十八个，胎发两丸，各烧成灰，每次服用二钱，用酒调服，连续服用两次，然后躺片刻，胎儿即顺位出生。如果没有这些药，让产妇仰面端正仰卧，用小针刺胎儿手脚心三五次，涂上盐，手脚就会缩回，等待身体转正即可出生。或者用好京墨浓磨汁服用，墨水包裹胎儿即可排出。或者用败笔头一个，经过处理，用藕节自然汁，温酒送下。或者用紫苏叶、当归各三钱，长流水煎服即可排出。
凡是孕妇家庭应该预先聘请稳婆（接生婆），要有仁心和见识的人，应当施恩惠以结其心，事先告知她，如果遇到分娩不顺，只说还没到产期，或者遇到双胎，只说胎衣未下，恐怕惊吓会导致气散，更加难以分娩。我家亲自验证过，大抵难产多发生在郁闷安逸的富贵人家。治疗方法虽然说产前消气（理气），产后补血，不可专门执着于此。如果脾胃虚弱不实，气血不充盈，应该预先调理补益，不然临产时必然有患难。
如果因为难产，或者在大寒天气时，紧急用大油纸捻，慢慢烧断脐带，虽然婴儿已经死亡，但能让暖气进入腹部，大多可以复生，切不可用刀切断。
治验案例：
我的妻子孟冬时节分娩艰难，产下的孩子已死，元气劳伤，我用油纸捻烧断脐带，取其阳气来补益母亲，一会儿孩子啼哭出声，就是那个孩子（鹄儿，此处指代该子嗣）。如果用刀具像平常那样切断，母亲也难以保全性命，这个孩子此后一两年间，并没有伤食腹泻的症状，可见前面方法的功劳。那位稳婆又喜欢平时常施小惠，得到她的用心照顾，能安慰母亲的心怀，所以没有危险。
这位稳婆还说：曾经有一个女儿，分娩时，正好赶上巡街御史派人传唤我去，我查看其室分娩情况，女儿因此受到惊吓，未产而死。后来见到御史，更以威严的脸色吩咐，等到我看产母，胎位虽顺，但头偏向一边，如果用手推正，可以保证顺产，但因为畏惧其威严，不敢动手。只是回去禀报说，这是天生天化，非人力所能干预，等待母子俱死罢了。
When pregnancy nears the time of delivery, as soon as there is a sensation of movement within the abdomen, one should lie supine with the body straightened, waiting for the fetus to turn downward and for contractions to begin. At this point, gently pinch the middle phalanx (middle joint) of the parturient's middle finger; if pulsation is felt at this segment, it indicates that labor has commenced and birth is imminent. If one does not lie supine initially to wait for fetal repositioning, or if amniotic fluid flows frequently before delivery, this indicates that the membranes have ruptured prematurely. The blood and fluids may dry up first, leading to inevitable complications such as malpresentation and dystocia.
In cases of transverse presentation (Heng Sheng), where the fetus's arm presents first, instruct the mother to lie supine and straighten her body. Gently push the fetus's arm and body to correct the position. Then, massage the shoulder with the middle finger, ensuring the umbilical cord does not entangle the shoulder, so that the infant can be born.
In cases of breech presentation (Ni Sheng), where the feet present first, instruct the mother to lie supine and straighten her body. Press and push the feet to guide the fetus into a cephalic position, after which birth will proceed smoothly.
In cases of lateral presentation (Pian Sheng), where the fetal head is tilted to one side, follow the previous method: slowly push the head back to the center, and birth will occur.
If the occiput is seen deviating towards the anus, gently push it upward and toward the midline, and birth will occur.
In cases of obstructed labor (Ai Chan), where the head is centered but cannot descend, this is often due to the umbilical cord wrapping around the shoulders during fetal rotation. Use the middle finger to press on both shoulders of the fetus to release the cord from entanglement, allowing birth to proceed.
In cases of "sitting birth" (Zuo Chan), where the mother is exhausted and sits for a long time on chairs or cushions, blocking the birth canal, urgently hang towels or belts high up. Instruct the mother to hold onto them and flex her legs gently for an extended period; once the fetus aligns properly, birth will occur.
In cases of prolapsed rectum accompanying delivery (Pan Chang Sheng), where the intestine protrudes before the baby, it is difficult to retract. Take 49 seeds of Ricinus communis (Bixiazi, Castor Bean Seed), grind them into a paste, and apply to the vertex of the parturient's head. Once the intestine retracts, wash it off immediately. If wind dries the tissue preventing retraction, use a small amount of warm water used for sharpening knives to moisten the intestine, then administer a decoction of Magnetitum (Cishi, Magnetite) orally to facilitate retraction. Ensure the Magnetitum used has been verified by Fengshui practitioners for efficacy. Folk remedies using Sargassum (Shuimu Mian, Sea Grape) cause alarm, which may scatter Qi and lead to other pathologies; thus, this practice should be avoided.
If the membranes rupture but delivery fails to commence, administer Baosheng Wuyou San (Preserve Life and Ensure Safety Powder) to consolidate blood and promote natural delivery. If blood depletion has occurred, use one jin (approx. 500g) of Bazhen Tang (Eight Treasures Decoction) combined with half a jin of Leonurus japonicus (Yimucao, Motherwort Herb). Add several bowls of water, boil until cooked, and drink intermittently; survival is possible.
Generally, abdominal pain alone in pregnant women indicates pre-labor. Severe lower back pain accompanying abdominal pain indicates impending labor, as the Kidneys govern the lower back and the uterus is connected to the Kidneys.
Hua Tuo treated dystocia caused by transverse or breech presentations using two pieces of Ophichthus skin shed (Shetuo, Snake Slough), 28 cicada shells (Chanqiao, Cicada Slough), and two丸 (pills) of fetal hair (Taifa, Fetal Hair). Each was calcined to ash. Two qian (approx. 7.5g) were taken per dose, mixed with wine. After two doses, the patient rested briefly, and the infant was delivered normally. If these herbs are unavailable, instruct the parturient to lie supine and straighten her body. Prick the palms of the hands and soles of the feet of the fetus three to five times with a small needle, apply salt, and the limbs will retract. Wait for the body to rotate into a normal position for delivery. Alternatively, take 49 seeds of Malva verticillata (Shuhui Zi, Musk Mallow Seed) and three qian (approx. 11.25g) of Talcum (Huashi, Talc) with flowing water, decoct, and drink to facilitate normal delivery. Or, consume thickly ground Jingmo (Beijing Ink); the ink coating the fetus aids expulsion. Alternatively, use one old brush tip, processed, and take with natural juice of Nelumbo nucifera petiole (Oujie, Lotus Stem Node) and warm wine. Or, take three qian each of Perilla frutescens leaf (Zisu Ye, Perilla Leaf) and Angelica sinensis root (Danggui, Chinese Angelica Root), decoct with flowing water, and drink to expel the fetus.
Families of pregnant women should pre-engage a midwife (Wopo, Confinement Nurse) who possesses benevolence and insight. Show kindness to win her loyalty. Inform her beforehand: if delivery is difficult, claim labor has not started; if twins are involved, claim the placenta has not yet expelled. This prevents alarm, which scatters Qi and worsens delivery. My family has personally verified that dystocia often occurs in wealthy families who live in depression and ease. Although treatment principles state that Qi should be regulated before birth and Blood nourished after, one must not adhere rigidly to this. If the Spleen and Stomach are weak and Qi and Blood are insufficient, preventive tonification is necessary; otherwise, difficulties will arise during labor.
In cases of dystocia or extreme cold, urgently use a large oil-paper wick to slowly burn through the umbilical cord. Even if the infant is dead, warmth entering the abdomen can often revive the child. Do not cut the cord with a knife.
Case Record:
My wife experienced difficult labor in early winter. The child was stillborn, and her vital Qi was severely damaged. I used an oil-paper wick to burn the umbilical cord, borrowing its Yang Qi to supplement her. Shortly after, the infant cried, reviving him. Had I cut the cord with a knife as usual, my wife might not have survived. This child showed no symptoms of food stagnation or diarrhea in his first one or two years, demonstrating the efficacy of this method. The midwife, pleased by my past small favors, contributed her expertise and comforted the mother, ensuring safety.
The midwife also recounted: A woman gave birth while an Inspector General was passing by and summoned me. Upon examining the room, I found the woman had been frightened by the event and died before delivering. Later, when I reported to the Inspector, he sternly ordered me to act. Upon examination, the fetal position was normal, but the head was tilted. I could have manually corrected it to ensure safe delivery, but fearing his authority, I dared not intervene. I merely reported that this was destiny, beyond human control, and waited for the mother and child to die.