If in the Progress of Travil, the Midwife perceives any Part of the Head, besides the _Crown_, discoverable by its _Sutures_, presenting, and it appear _broad_, and very _hard_ to the _Touch_: If the _Waters_ may be _felt_ descending in a _long_ Form through the _internal Orifice_, somewhat like a Piece of a Gut distended with Water: These Appearances presage the utmost Difficulty and Danger, commonly owing to the small Distance between the _forward_ and _back_ Bones; an ill Situation of the _internal Orifice_; the _comparative Largeness_ of the Child’s Head; or the _ill_ Site of the _Womb_; whereby the Head may be pressed against the Bones _forward_ or _backward_, or somewhat inclined to _either_ Side, in a wrong Direction for the _Passage_. These Causes, singly or concurring, render the Case much beyond the Skill, and very often the Strength, of a Midwife to redress. When unqualified Midwives observe the Head present to the inward Orifice, they are too apt to promise good Success, and behave with the utmost Confidence, wherein they are often egregiously mistaken; for there cannot be a more difficult Birth, than frequently happens, when any other Part, instead of the Crown, offers; and the Misfortune is, the longer Recourse to proper Assistance is delay’d, the greater the Difficulty becomes every Moment; and the poor Woman may think herself happy, if she escapes with her Life, the Danger of a most _fatiguing_ and _tedious_ Labour, succeeded, perhaps, by such a Relaxation of the _Vagina_ or _Passage_, as will occasion great Uneasiness in going, or being in an _upright_ Posture, without the immediate Help of Medicines, both externally and internally; or wearing a _Pessary_ for its Support, during Life. Whereas ’tis certain, that if the Mother’s Pains, _strongly bearing down_, the Muscles of the Belly contracting and becoming sensibly _hard_ to the _Touch_, don’t manifestly promote the Birth, it must needs be owing to some Obstruction beyond the Midwife’s Skill; who in this Circumstance is apt to complain, the Pains are not sufficiently _strong_, ’till the poor Woman is ready to expire, from the Loss of her Strength, by her long Suffering under them; and told she must patiently wait God’s Time, who in Case he miraculously interpos’d, wants not the Midwife’s Assistance: And what still adds to this deplorable Calamity, ’tis likely she is put upon exerting her utmost Strength, assisted by Cordials; when _encouraging_ her _Labour_ and _provoking_ her _Pains_, ’till the Obstructions in the Way of the _Birth_ are remov’d, contribute still further to the Danger attending.