When a woman is pregnant with two children, they rarely present to the
birth together, the one being generally more forward than the other; and
that is the reason that but one is felt, and that many times the midwife
knows not that there are twins until the first is born, and that she is
going to fetch away the afterbirth. In the first chapter, wherein I
treated of natural labour, I have showed how a woman should be delivered
of twins, presenting themselves both right; and before I close the
chapter of unnatural labour, it only remains that I show what ought to
be done when they either both come wrong or one of them only, as for the
most part it happens; the first generally coming right, and the second
with the feet forward, or in some worse posture. In such a case, the
birth of the first must be hastened as much as possible and to make way
for the second, which is best brought away by the feet, without
endeavouring to place it right, because it has been, as well as the
mother, already tired and weakened by the birth of the first, and there
would be greater danger to its death, than likelihood of its coming out
of the womb that way.
But if, when the first is born naturally, the second should likewise
offer its head to the birth, it would then be best to leave nature to
finish what she has so well begun, and if nature should be too slow in
her work, some of those things mentioned in the fourth chapter to
accelerate the birth, may be properly enough applied, and if, after
that, the second birth should be delayed, let a manual operation be
delayed no longer, but the woman being properly placed, as has been
before directed, let the operator direct his hand gently into the womb
to find the feet, and so draw forth the second child, which will be the
more easily effected, because there is a way made sufficiently by the
birth of the first; and if the waters of the second child be not broke,
as it often happens, yet, intending to bring it by its feet, he need not
scruple to break the membranes with his fingers; for though, when the
birth of a child is left to the operation of nature, it is necessary
that the waters should break of themselves, yet when the child is
brought out of the womb by art, there is no danger in breaking them,
nay, on the contrary it becomes necessary; for without the waters are
broken, it will be almost impossible to turn the child.
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