孕妇似产未产须知∶凡胎孕临月，胎忽乱动，而腹痛不甚，或作或止，或一二日或三五
日之后方生，名曰弄胎，不可孟浪坐草，须静以待时。或胎水以来，腰不酸痛而不生者，亦
曰弄胎。所以有沥浆生，其浆流一二日不产，俟流浆渐少方生，倘浆来过多，恐胞干难产，
亦非所宜，须八珍时服，助其血气，可保无虑。又有一月前忽然腹痛，状如即产却不产者，
名曰试月。又有腹虽痛而腰不酸痛，脉未离经而不产者。又有腹虽痛而未下坠，胎虽转而儿
身未正，亦非当产时也。要知腹中痛阵，乃儿破衣转身也。气壮者转身自易，气弱者转身较
难，衣薄则破速，衣浓则破迟，所以有腹痛一二日方生。凡孕妇须当宽心以待其自然之势，
切不可乱用气力强产，以致枉命。至于自然当产之时，必有紧阵，如脐腹痛急，腰酸重痛，
眼中如火、肛门迸急等类齐至，待儿身已正，头到产门，用力一送即下，然亦有腹觉微痛，
或腹竟不痛，止觉腰酸下坠而产者，盖肾候于腰，胞系于肾故也。古人云∶时至自然分娩，
譬如登厕，未急不能催，时急不能止，此理虽俗，知此免患。
转胎调摄须知∶凡孕妇儿身转动，其腹必痛。虽迟日不生，切勿惊怕，且令人扶持在房
中行走、或倚物而立，直其体腹，倘精神稍困，则以补褥壅垫脊背，仰卧少顷，又令行立，
听腹中慢慢转身，虽迟无害，且宜稍宽裙带以便儿在腹中转舒有余地也。若不禁痛苦，或伛
偻屈曲，斜倚侧靠，胎中不免为之拥挤，迷其出路，稳婆不解此理，但见生迟，频频试水，
误伤胎破。或风入产户而成肿胀，或胎未至而胎水先干，分娩愈难矣！遇此者惟令产妇勉强
饮食，调其气息，或用活血滑胎之药佐之（活血滑胎药方，俱见催生门），候子逼门户，方
尽
此产家最要紧处。曾见一妇临产畏痛，曲身坐卧，以致胎元转身不顺，儿出胞时寻到产门，
被母曲身遮闭，因不得出，少顷再转，母又护痛再闭，如此两、三遭，则子无力而不能动，
至于难生。人又见子不动则谓死胎，其实子无力非死也，随令产母正其体腹，不时行动坐立
，心安气和，勉强饮食，俟儿少停气复，再转至产门，果顺易生下。
稳婆宜加选择须知∶凡孕妇临产，当选年高有经识稳婆，及纯谨妇女一二人扶持。倘误
用无知孟浪妇女收生，不审察是正产与转胎，一见腹痛，乱将双手摸孕妇腹上，夹腹两边重
按，欲其直下，以免横生，此第一误人性命者。夫腹初痛，则胞衣未破而欲破之时也。儿将
分娩，心中亦有灵性矣，见腹外揣摩，儿不知为何物，遽生惊恐，则缩不敢动，胞衣又何时
而得破乎∶更有稳婆无知害人，私有手指掐破水衣者，极须防范。夫胞浆乃胞内养儿之水，
儿既折破，自随水而下。若过时不得分娩，是胞元无力，转头较迟，恐致浆尽血来，闭塞道
路，令子无路可通，胎涩不行，用保生无忧散以固其血。如血已耗，八珍汤加益母草浓煎，
时饮之。倘元气困惫，急用上好人参两许，当归二钱煎饮，饮尽再煎服，助其气血，最为得
力，舍此而用催生耗气诸药，总无一效也。或先服八珍补养气血，次煎浓葱汤，令稳婆洗产
户，使气上下通畅，更用酥油、滑石涂产门，次服催生万全汤亦妙。
临产避忌须知∶凡孕妇临产之月，不可洗头濯足，犯者胎多难产。若至临盆之际，凡系
门窗箱笼瓶瓮之属，俱宜松开，以及一切外来亲戚，并孀妇、闺女、丧孝、尼姑与污秽不洁
、或月经适至、或原有体气妇女，皆足以触胎致殃，俱宜防备。避忌俗忌多人知觉。盖多一
人入房则多一时迟延，此虽俗论，却有至理。恐产妇心烦以致难产也。
临产宜肃静须知∶凡妊妇临盆，房中不得喧闹，即有意外紧事，户外不得叫喊，倘令产
母恐惧惊心，则胎滞气结不行而难产。《经》云∶惊则神散，忧则气结，恐则气怯，怯则上
焦闭，闭则气还，还则下焦胀，气乃不行矣。此气结不行，以致难产。更有产母，两尺脉绝
，他脉平和，此乃下焦胀，气闭不行，难产之脉，急用紫苏饮散结行气而产矣！
盘肠产子肠先出者，世人莫不惊畏，然无妨碍。令产母安心仰卧，急将净盆盛温水，冬
则再加稍热，加入香油养润，待儿并胞衣俱下，稳婆香油涂手，徐徐送入，令产母两足夹紧
谷道，肠自收上。有用醋和冷水，令人喷面，一喷一收，以渐收之。又有神应丹贴法。然此
喷贴之法，肠虽可收，予恐误事，不若皂角末吹鼻，嚏作自上。又有肠被外风吹干不收者，
用磨刀水少许，火上温过，以润其肠，后用好磁石煎汤一盏服之，其肠自收。又有儿并胞衣
下后，膀胱（即尿胞）壅出产户者，用前法送入。凡此子肠、膀胱先出，皆平日气虚，因努
脱
服
自然正产。若无力转运，脚踏胞衣、脐肠先出，急令稳婆理清推入，稍俟气平，乘势就其脚
下推转，不可久延，久则脐肠复下，便难收拾矣。
临产双生须知∶凡孕妇临产，一儿已下，又见一儿，此系双胞，惟稳婆自知之，只云取
胞，待生下方言，恐惊母成产患也。
候胞衣生下须知∶凡产母生子出户时，人即以两手抱产母胞前，产母亦自以手紧抱肚腹
，令胎衣下坠，如胎衣来迟，切勿慌忙，用草纸烧烟熏鼻即下。如再迟，则急断脐带洗儿，
仍用软帛物系坠脐带，此带极脆，系时犹宜轻巧牢固，然后截断。若不断脐带，恐血反潮入
胞中，胀而不下，攻心则伤。如稳婆谙事者，能以手指取下甚便，取法见后胞衣不下门。
闷脐生须知∶凡儿产下即啼，此正理也。如儿下地气闷不啼，相传寐生呼父乳名、手拍
儿股即啼者，此理亦未讲明。盖儿粪门有一膜，闷住儿气，故不能出声，拍之则膜破而能叫
哭矣。如拍之犹不破，须令女人中有轻巧者以银簪脚轻轻挑破，甚便。或不能挑，急用棉絮
暖衣将儿紧包抱于怀内，勿令散放，未可遽断脐带，速用热水浸其胞衣，寒天则置炭火中煨
之。仍作大油纸捻点灯，于脐带上往来燎之，盖带连儿脐，久则热气内鼓，其膜自破，膜破
则出声而苏，方可断带洗浴。亦有用蕲艾为捻，香油浸润，熏脐带至焦，使热气内鼓破膜。
又一法，用灯心囱门点爆数下，均治闷脐生法也。
儿生即死须知，凡儿生下即死者，急看儿口中前上 上有泡以手指摘破，用帛试血令净
，若血入喉即死，去血即生。其泡中白米如针嘴尖，亦须刮去，不可令其入喉也。
孕妇临产前的征兆须知：凡是怀孕临近预产期，胎儿突然乱动，但腹痛不明显，时作时止，或者过了一两天甚至三五天之后才分娩，这叫做“弄胎”，不可鲁莽地坐在产床上待产，必须安静等待时机。如果羊水已经流出，腰部不酸痛且未分娩的，也称为“弄胎”。因此有“沥浆生”的情况，即羊水流出后一两天仍不生产，等到流出的羊水逐渐减少时才分娩；倘若羊水流出过多，恐怕会导致胞宫干燥而难产，这也是不利的情况，需要按时服用八珍汤，以助气血，这样可以保证无忧。又有一种情况是产前一个月忽然腹痛，样子像是要分娩却并未分娩，这叫做“试月”。又有虽然腹部疼痛但腰部不酸痛，脉象尚未出现离经之象而未分娩的。又有虽然腹部疼痛但未感到下坠，胎儿虽然转动但胎位不正，也不是正当分娩的时候。要知道腹中阵痛，是胎儿破膜转身的过程。气壮的人转身容易，气弱的人转身较难，胎衣薄则破裂快，胎衣厚则破裂慢，所以有的腹痛一两天后才分娩。凡孕妇应当放宽心态，顺应自然之势，切不可乱用强力药物催产，以致危及生命。至于自然当分娩的时候，必然会有紧缩的阵痛，如脐腹部急痛、腰酸重痛、眼中如火烧感、肛门紧迫等感觉同时出现，等到胎位已正，胎头到达产门，用力一送即可产出。然而也有腹部微痛，或者腹部竟不痛，只感觉腰酸下坠而分娩的，这是因为肾主腰，胞宫系于肾的缘故。古人说：时候到了自然会分娩，就像上厕所一样，没到紧急时候不能催促，时间紧急也不能停止，这个道理虽然通俗，但懂得此理可免除祸患。
转胎调摄须知：凡是孕妇胎儿在腹中转动，腹部必然疼痛。即使过了几天也不分娩，切勿惊慌害怕，并且让人扶持在房中行走，或者靠着物体站立，使身体和腹部正直。如果精神稍感困倦，就用柔软的褥子垫高脊背，仰卧片刻，然后再令其行走站立，听任胎儿在腹中慢慢转身，即使迟缓也无害处，而且应该稍微松开裙带，以便胎儿在腹中有足够的空间转动舒展。如果不忍受痛苦，或者弯腰屈曲，斜倚侧靠，胎中不免会因此拥挤，迷乱了出路。接生婆不懂这个道理，只见分娩迟缓，频繁地试水（检查），误伤胎膜破裂。或者风邪侵入产道导致肿胀，或者胎儿未到而羊水先干，分娩就更加困难了！遇到这种情况，只让产妇勉强进食，调理气息，或者用活血滑胎的药物辅助（活血滑胎药方，都记载在催生门），等到胎儿逼近产门，这才是产家最要紧的地方。曾见过一位产妇临产畏惧疼痛，蜷缩身体坐卧，导致胎元转身不顺，胎儿出胞时寻找到产门，被母亲蜷缩的身体遮挡闭住，因而无法出来，过了一会儿再转，母亲又因护痛再次闭住，如此两三次，胎儿无力而不能动，以至于难产。别人见胎儿不动就认为是死胎，其实胎儿是因为无力而非死亡，随即让产妇端正身体和腹部，不时活动、坐立，心安气和，勉强饮食，等到胎儿稍作停顿，气力恢复，再转至产门，果然顺利容易生下。
稳婆宜加选择须知：凡是孕妇临产，应当选择年长有经验识见的稳婆，以及纯朴谨慎的一两名妇女扶持。如果误用无知鲁莽的妇女接生，不审察是正产还是转胎，一见腹痛，就乱用双手摸孕妇腹部，夹着腹部两边重按，想要使其直下，以免横生，这是第一误人性命的错误。因为腹部刚开始疼痛，是胞衣未破而将要破的时候。胎儿即将分娩，心中也有灵性了，见到腹部外部的抚摸揣测，胎儿不知道是什么东西，就会突然产生惊恐，从而收缩不敢动弹，胞衣又什么时候能破呢？更有稳婆无知害人，私下用手指掐破羊膜囊的，极须防范。胞浆是胞宫内养育胎儿的水，胎儿既然折损（此处指胎位不正或受阻），自然随着水流而下。如果过时不得分娩，是胞元无力，转头较慢，恐怕导致羊水耗尽血液涌来，闭塞道路，令胎儿无路可通，胎涩不行，使用保生无忧散以固摄血液。如果血液已耗损，用八珍汤加益母草浓煎，时时饮用。倘若元气困乏疲惫，急用上好人参一两，当归二钱煎水饮用，饮尽后再煎服，以助其气血，最为得力，除此之外若使用催生耗气的药物，总无一效。或者先服用八珍汤补养气血，其次煎浓葱汤，让稳婆清洗产道，使气上下通畅，再用酥油、滑石涂抹产门，其次服用催生万全汤也很好。
临产避忌须知：凡是孕妇临产之月，不可洗头洗脚，犯者胎儿多难产。如果到了临盆之际，凡是门窗箱笼瓶瓮之类的东西，都宜松开，以及一切外来亲戚，并寡妇、处女、丧孝之人、尼姑与污秽不洁、或者月经刚来、或者原有体味的妇女，都足以触动胎气招致灾殃，都应当防备。避忌的俗规很多人知道。大概多一个人进入房间就多一时迟延，这虽然是世俗言论，却有至理。担心产妇心烦意乱以致难产。
临产宜肃静须知：凡是妊妇临盆，房中不得喧闹，即使有意外紧急事情，户外不得叫喊，如果让产母恐惧惊心，则胎滞气结不行而难产。《内经》说：惊则神散，忧则气结，恐则气怯，怯则上焦闭塞，闭塞则气还，还则下焦胀满，气乃不行矣。这种气结不行，导致难产。更有产母，两尺脉绝，其他脉象平和，这是下焦胀满，气闭不行，是难产的脉象，急用紫苏饮散结行气而分娩！
盘肠产子肠先出者，世人没有不惊惧畏难的，然而并无妨碍。令产母安心仰卧，急将干净的盆盛温水，冬天则再加稍热，加入香油滋养润滑，等到胎儿和胞衣都下来后，稳婆涂香油在手，徐徐送入，令产母两足夹紧肛门，肠自收上。有用醋和冷水，让人喷脸，一喷一收，逐渐收回。又有神应丹贴法。然而这种喷贴的方法，肠虽可收回，我担心误事，不如用皂角末吹入鼻中，打喷嚏后肠自然向上收回。又有肠被外风吹干不收的，用磨刀水少许，火上温过，用来润湿其肠，后用上好磁石煎汤一盏服用，其肠自收。又有胎儿和胞衣下来后，膀胱（即尿胞）壅塞出产道的，用前面的方法送入。凡此子肠、膀胱先出，都是平日气虚，因努责脱出。自然正产。如果无力转运，脚踏胞衣、脐肠先出，急令稳婆理清推入，稍等气平，乘势就其脚下推转，不可久延，久则脐肠复下，便难收拾了。
临产双生须知：凡是孕妇临产，一个胎儿已下来，又见一个胎儿，这是双胎，只有稳婆自己知道，只说是取胞衣，等到生下方言，恐怕惊吓母亲造成产患。
候胞衣生下须知：凡是产母生子出户时，人即以两手抱产母胞前，产母亦自以手紧抱肚腹，令胎衣下坠，如胎衣来得迟，切勿慌忙，用草纸烧烟熏鼻即下。如果再迟，则急断脐带洗儿，仍用软帛物系坠脐带，此带极脆，系时犹宜轻巧牢固，然后截断。若不断脐带，恐血反潮入胞中，胀而不下，攻心则伤。如果稳婆熟练，能以手指取下甚便，取法见后胞衣不下门。
闷脐生须知：凡是儿产下即啼哭，这是正理。如果儿落地气闷不啼哭，相传睡梦中呼唤父亲乳名、手拍儿股即啼哭的，这个道理也未讲明。盖儿粪门有一层膜，闷住了儿的气，故不能出声，拍打则膜破而能叫哭了。如果拍打仍不破，须令女人中有灵巧者以银簪脚轻轻挑破，很方便。或者不能挑，急用棉絮暖衣将儿紧包抱于怀内，勿令散放，未可遽断脐带，速用热水浸其胞衣，寒天则置炭火中煨之。仍作大油纸捻点灯，在脐带上往来燎烤，因为带连儿脐，久了热气内鼓，那层膜自然破，膜破则出声而苏醒，方可断带洗浴。也有用蕲艾为捻，香油浸润，熏脐带至焦，使热气内鼓破膜。又一法，用灯心草在囟门点爆数下，均治闷脐生法也。
儿生即死须知：凡是儿生下即死的，急看儿口中前上腭上有泡，以手指摘破，用帛拭血令净，若血入喉即死，去血即生。其泡中白米如针嘴尖，也必须刮去，不可令其入喉也。
Knowledge regarding the Signs Before Labor: When a pregnancy nears term, if the fetus suddenly moves restlessly but abdominal pain is not severe, or comes and goes intermittently, or delivery occurs after one to two days or even three to five days later, this is called "Nong Tai" (False Labor/Practice Contractions). One must not rashly sit on the birthing bed; instead, one must wait quietly for the proper time. If amniotic fluid has been released but there is no lower back soreness/pain and no delivery, it is also called "Nong Tai". Therefore, there is a condition called "Li Jiang Sheng" (Delivery with Prolonged Fluid Leakage), where fluid flows for one or two days without delivery; delivery occurs only when the flow of fluid gradually decreases. If too much fluid flows out, it may lead to a dry uterus and difficult labor, which is unfavorable. In such cases, one should take Bazhen Tang (Eight-Treasure Decoction) regularly to assist Qi and Blood, ensuring safety without worry. There is another condition where sudden abdominal pain occurs one month before term, resembling imminent delivery but not resulting in birth, called "Shi Yue" (Trial Month). There are also cases where there is abdominal pain but no lower back soreness, and the pulse has not yet shown the characteristics of "Li Jing" (Pulse departing from the meridian pattern indicating imminent birth), so no delivery occurs. There are cases where there is abdominal pain but no sensation of bearing down; although the fetus turns, its position is not correct, indicating it is not the proper time for delivery. It must be understood that paroxysmal abdominal pain is the process of the fetus breaking the membranes and turning. Those with strong Qi find turning easy, while those with weak Qi find it difficult. Thin membranes break quickly, thick membranes break slowly, hence some experience abdominal pain for one to two days before delivery. Pregnant women should keep their minds at ease and follow the natural course; they must absolutely avoid using strong drugs to force labor, which could result in death. When the natural time for delivery arrives, there will inevitably be tight contractions, accompanied by urgent pain in the umbilical region, heavy soreness and pain in the lower back, a burning sensation in the eyes, urgency in the anus, etc. Once the fetal position is correct and the head reaches the birth canal, applying force to push will result in immediate delivery. However, there are also cases of mild abdominal pain, or no abdominal pain at all, with only a sensation of lower back soreness and bearing down leading to delivery; this is because the Kidney governs the waist, and the uterus is connected to the Kidney. The ancients said: "When the time comes, delivery happens naturally." It is like defecating; you cannot force it when not urgent, nor can you stop it when urgent. Although this reasoning seems vulgar, understanding it prevents disaster.
Guidance on Managing Fetal Turning: Whenever a fetus turns in the womb, the abdomen necessarily hurts. Even if several days pass without delivery, do not panic. Have someone support the woman to walk in the room, or stand leaning against an object, keeping her body and abdomen straight. If she feels slightly fatigued, use soft cushions to prop up her back, lie supine for a moment, then have her walk and stand again, allowing the fetus to turn slowly within the abdomen. Delay is harmless. It is advisable to loosen the skirt belt slightly to give the fetus enough space to turn comfortably. If the woman endures pain poorly, bending over or leaning sideways, the fetus will inevitably be crowded, confusing its path. Midwives who do not understand this principle, seeing delayed delivery, frequently test the waters (check for rupture), mistakenly injuring the fetal membranes. Wind may enter the birth canal causing swelling, or the amniotic fluid may dry up before the fetus arrives, making delivery more difficult! In such cases, instruct the parturient to eat as much as possible and regulate her breathing, or use herbs that invigorate blood and facilitate fetal descent (recipes for these are found in the Chapter on Promoting Delivery). Wait until the fetus presses against the cervix; this is the most critical point for the family. I once saw a woman who feared pain during labor, curling her body while sitting or lying, causing the fetal position to turn improperly. When the fetus reached the birth canal, it was blocked by the mother's curled body and could not exit. After a short while, it turned again, but the mother, protecting herself from pain, closed off the passage again. This happened two or three times, leaving the fetus powerless to move, resulting in dystocia. Others saw the motionless fetus and thought it was dead, but it was actually just powerless, not dead. We immediately instructed the mother to straighten her body and abdomen, move periodically, sit and stand, calm her mind and harmonize her Qi, and eat as much as possible. After the fetus paused briefly and regained strength, it turned to the birth canal and was delivered smoothly and easily.
Selection of Midwives: When a pregnant woman approaches labor, select an elderly midwife with experience and knowledge, along with one or two pure and cautious women for support. If ignorant and rash women are mistakenly used for delivery, failing to distinguish between true labor and false labor, and upon seeing abdominal pain, they recklessly feel the pregnant woman's abdomen, pressing heavily on both sides to force the fetus downward to prevent breech presentation, this is the first cause of fatal errors. When abdominal pain first begins, the membranes have not yet ruptured but are about to. The fetus, nearing delivery, possesses a form of sensitivity. Feeling external manipulation, the fetus does not know what is happening and becomes frightened, shrinking and refusing to move; thus, when will the membranes rupture? Furthermore, some ignorant midwives harm people by privately puncturing the amniotic sac with their fingers; this must be strictly guarded against. Amniotic fluid is the water inside the uterus nourishing the fetus. If the fetus is obstructed, it naturally follows the fluid down. If delivery is delayed, it is due to weakness of the uterine power, causing slow turning. There is a risk of fluid depletion followed by bleeding, blocking the path, leaving the fetus with no way through, causing stagnation. Use Baosheng Wuyou San (Guarantee Safe and Worry-Free Powder) to secure the blood. If blood has already been depleted, decoct Bazhen Tang (Eight-Treasure Decoction) with Motherwort (Leonurus japonicus, Yimucao) strongly, and drink it frequently. If Yuan Qi (Primal Qi) is exhausted and fatigued, urgently use high-quality Ren Shen (Ginseng Radix, Renshen) 1 liang and Dang Gui (Angelica Sinensis Radix, Danggui) 2 qian, decoct and drink. Finish the dose, then decoct and drink again to boost Qi and Blood, which is most effective. Using other Qi-depleting drugs to promote delivery would be ineffective. Alternatively, first take Bazhen Tang to tonify Qi and Blood, then decoct a strong Scallion Soup, have the midwife wash the birth canal with it to ensure smooth Qi flow, apply Butter (Su You) and Talcum (Huashi) to the vulva, and subsequently take Cansheng Wanquan Tang (Perfect Delivery Promoting Decoction), which is also excellent.
Taboos During Labor: During the month of impending labor, pregnant women must not wash their hair or feet; doing so often leads to difficult labor. When approaching the time of delivery, all doors, windows, boxes, cabinets, bottles, and jars should be loosened/unfastened. All visiting relatives, widows, unmarried girls, mourners, nuns, unclean persons, women currently menstruating, or women with strong body odor, should be kept away as they can disturb the fetus and bring misfortune. These taboos are widely known. Generally, having one more person in the room causes further delay. Although this is a folk belief, it contains profound truth, fearing that maternal anxiety will lead to difficult labor.
Need for Silence During Labor: During delivery, there must be no noise in the room. Even in case of emergencies outside, shouting is prohibited. If the parturient becomes frightened and startled, fetal stagnation and Qi knotting will occur, leading to difficult labor. The Classics state: "Fright scatters the Spirit, Worry knots the Qi, Fear makes Qi cowardly; Cowardice closes the Upper Jiao; Closure causes Qi to return; Return causes Lower Jiao distension; thus Qi fails to move." This Qi knotting and failure to move leads to difficult labor. There are also cases where the parturient has absent Chi pulses (Kidney pulses) while other pulses are peaceful; this indicates Lower Jiao distension and Qi closure, a pulse sign of difficult labor. Urgently use Zisu Yin (Perilla Decoction) to dissipate knots and move Qi to achieve delivery.
Protrusion of Intestines (Pan Chang Chan): People are often shocked and afraid when intestines protrude before the baby, but it is harmless. Instruct the parturient to lie supine calmly. Quickly prepare a clean basin with warm water; in winter, make it slightly hotter. Add Sesame Oil for lubrication. Wait until the baby and placenta are delivered. The midwife should apply Sesame Oil to hands and gently insert the intestines. Instruct the parturient to clench her buttocks tightly; the intestines will naturally retract. Another method uses vinegar mixed with cold water sprayed on the face; each spray causes retraction, gradually pulling them in. There is also a method using Shenyin Dan (Miraculous Response Pill) applied externally. However, I fear these spray and paste methods may cause errors. It is better to blow Rhizoma Belamcandae Powder (Zao Jiao Mo) into the nose; sneezing will cause the intestines to retract upwards spontaneously. If intestines are dried by wind and do not retract, use a small amount of whetstone water, warmed over fire, to moisten the intestines, then drink a cup of Magnetite Decoction (Ci Shi Tang); the intestines will retract spontaneously. If the bladder (urinary bladder) protrudes after the baby and placenta, use the previous insertion method. All cases of intestine or bladder protruding first are due to chronic Qi deficiency and prolapse from straining. For normal delivery, if there is no power to push, and the placenta or umbilical cord protrudes first, urgently instruct the midwife to tidy and push them back in. Wait for Qi to settle, then顺势 push from below. Do not delay; if delayed, the umbilical cord may protrude again, making it hard to manage.
Twins: When a pregnant woman delivers, if one baby is born and then another appears, this is a twin pregnancy. Only the midwife knows this. She should simply say she is retrieving the placenta and wait until the second birth to announce it, lest the shock cause complications for the mother.
Waiting for Placental Delivery: When the baby exits the birth canal, attendants should hold the mother's lower abdomen with both hands, and the mother should also hold her abdomen tightly to help the placenta descend. If the placenta is slow to come, do not panic. Burn straw paper and smoke the nose; the placenta will descend. If still delayed, urgently cut the umbilical cord and wash the baby. Tie the umbilical cord with soft cloth; this cord is very fragile, so tie it lightly but securely, then cut it. If the cord is not cut, blood may reflux into the uterus, causing distension and failure to descend, attacking the heart and causing injury. If the midwife is skilled, she can remove the placenta manually, which is convenient (method seen in the chapter on Retained Placenta).
Suffocation at Birth: It is normal for a newborn to cry immediately. If the baby is born silent and suffocated, some traditions suggest calling the father's name in sleep or patting the thighs to induce crying, but the mechanism is unclear. There is a membrane covering the infant's anus that blocks the air, preventing sound; patting breaks the membrane, allowing crying. If patting does not work, have a dexterous woman gently pierce it with the tip of a silver hairpin. If piercing is not possible, urgently wrap the baby tightly in warm cotton clothes and hold it close, do not let it loose, and do not cut the umbilical cord yet. Quickly soak the placenta in hot water; in cold weather, warm it near charcoal fire. Make a large oil-paper wick, light it, and wave it over the umbilical cord. Since the cord connects to the baby's navel, prolonged heat will internally鼓 (distend/stimulate), breaking the membrane. Once broken, the baby will cry and revive, then the cord can be cut and washed. Another method uses Qiai (Artemisia argyi, Moxa) twisted into a wick, soaked in sesame oil, smoked onto the umbilical cord until charred, generating internal heat to break the membrane. Another method involves popping the fontanelle with a lit rush pith (Deng Xin) a few times. All treat suffocation at birth.
Baby Born Dead: If a baby is born dead, urgently check the upper palate of the mouth for bubbles. Pop them with a finger, wipe the blood clean with cloth. If blood enters the throat, the baby dies; removing the blood brings life back. The white rice-like substance in the bubble, sharp as a needle tip, must also be scraped off to prevent it entering the throat.