AGAIN farther, I hope I may freely speak my Mind, and openly avow, that the most of these BIRTHS proceed merely from want of seasonable and skilful _Assistance_ in the beginning of the LABOUR: Because the _BIRTH_ (however well seated then) by reason of the _bad Situation_ of the WOMB, cannot possibly pass thro’ the PELVIS of itself; and not being judiciously assisted at that nice Juncture, behold, from a _Natural_, it falls on a sudden also into a _Preternatural Posture_. From hence we have this extreme difficult and most dangerous sort of _Preternatural BIRTHS_, as will more conspicuously appear from a deliberate _Reflection_ upon the preceding _Chapters_. And This much (I hope) may finally suffice any intelligent _Reader_, to conceive the different _Circumstances_ of all _complicated Preternatural BIRTHS_ whatsoever. Whence I go on to the _Fourth_ and last Sort of _Preternatural BIRTHS_ proposed; namely, _Those_ proceeding from intervening _accidental Causes_; which because they are also different, I shall handle briefly and separately in the ensuing Manner; _viz._—— [Illustration] [Illustration] CHAP. XXIV. _Of Preternatural BIRTHS, proceeding from the NAVEL-STRING’s coming first, and that either alone, or with some other Member._ AMONG the various unhappy _Accidents_, which may happen in or about the Time of LABOUR, the present _Case_ is none of the most auspicious; in as much as it may, in sundry Respects, occasion a very difficult _Preternatural BIRTH_, according to the Difference of Circumstances: For the NAVEL-STRING having fallen down and come _first_ in the _Passage_, may be variously turn’d, and consequently cause several and sundry _Inconveniences_, as follow, _viz._—— I. WHEN the _Umbilical Vessel_ falls down alone into the PASSAGE, without any other _Part_, the _BIRTH_ is then commonly situated a-cross in the WOMB; and in this _Condition_, _BACK_ or _BELLY_, _HAND_ or _FOOT_, may be probably expected to come _first_: Wherefore the active _MIDWIFE_ ought to discover the _real Posture_ by the TOUCH, and _that_ at least before all the _Waters_ are yet flow’d off and evacuated; and then betimes to fetch away the _CHILD_ by the _FEET_, unless the HEAD be more convenient or pat for the Purpose. But these _Cases_ being already particularly discussed[179], I shall add nothing farther upon them in this Place. II. THE _String_ may fall down _double_, and so swell with _Cold_, as to obstruct the _Passage_, which however is but the smallest Consideration in this _Condition_, because by its hanging down _double_, it may be so shortned, that the _CHILD_ may be detain’d, appending by it in the _Orifice_, until the BLOOD of the _Umbilicals_ coagulating either by _Cold_, or by _Compression_ in the _Passage_, the due _Circulation_ is obstructed, and the INFANT expos’d to the greatest of _Dangers_, if a very speedy _DELIVERY_ does not prevent the fatal Accident.