De practyk der vroed'meesters en vroed'vrouwen, Of de wyse van een vrouw' te helpen in haar kindbaren. Be...

the peel; and the afterbirth being loosened in this way, it follows without effort, pulling the cord after it.

One must perform this action quickly, since the womb otherwise closes, making it difficult to insert the hand and, consequently, to extract the afterbirth.

When the afterbirth separates by itself, the master or midwife has nothing else to do but to pull gently on the umbilical cord, which must have been wound around the fingers of the left hand as mentioned.

When it has been extracted, one must well consider whether the membranes, which enclose the child and the water, have come away well with the afterbirth, so that nothing has remained behind, for fear that they might stop the mouths of the vessels of the womb. If, however, some part of it remained, one does not need to be worried, since these remaining membranes flow away with the Kraam post-partum discharge/lochia without causing complications, as one sees this happen daily. One must watch that, when one extracts the afterbirth by the cord, this happens gently and never with force, for if the afterbirth sat very firmly on the bottom of the womb, and one used any force, it could

invert itself, which would be of dangerous consequence. Some women to whom this has happened have died in an instant.

After the child and the afterbirth have been fortunately extracted, if it happens that the woman loses little or no blood, one must consider whether it is clotted or stuck in the womb or its neck, from which very often foul vapors arise, which cause the woman to fall into fainting fits.

In this case, the man-midwife or midwife must without delay gently bring the hand into the bottom of the womb, which they will find open just as when the woman was delivering, to take the clots of blood out of there. No sooner are they removed than the woman recovers from her fainting. If, on the other hand, they remain inside and are not expelled by nature, this can cause the woman's death through the malignant vapors that rise from this retained blood in the womb. One can even bring the hand inside during a great hemorrhage, if it occurs after the delivery, because the womb, being full of clotted and coagulated blood, is still dilated enough. And if one does not take them away, the hemorrhage continues, which stops as soon as they are removed.