It requires great Care to prevent the _Protrusion_ of the _Womb_ in some Women of a _large Pelvis_, or _Opening_ between the _Bones_; or if the _After-birth_ remains closely fixed, the _Womb_, in a very _open Pelvis_, may be _thrust_ by the Violence of the Pains; or _drawn_ out of the Body by an _unskilful_ Hand, which is commonly very soon fatal to the poor Woman; and I believe happens much oftner than is apprehended, tho’ industriously conceal’d, by _guilty_ Midwives, under the Colour of the poor Woman’s dying in Child-bed, from some other Cause. DEVENTER says, he saw a sad Spectacle at the HAGUE, the _Head_ of the Child excluded to the _Shoulders_ quite without the _Passage_, when Three-fourth Parts of the _Head_ were conceal’d within the _Womb_, the _Crown_ appearing within its _inward Orifice_†. † See Chir. Op. Part ii. Page 32. A much worse Case happen’d in my Neighbourhood, _Sept._ 23, 1749. I was call’d to a Woman, whose Child, on the 21st came unexpectedly, without the least Assistance, in the Presence of an _old_ Midwife of _large_ Practice; she puzzled an Hour, as I was inform’d, to bring away the _After-birth_, which closely adhered to the _Fund_ of the _Womb_; while the _unfortunate_ Woman lay senseless, saving the Memory of being long expos’d to the Cold, when she came to herself; after which she continued in violent _Labour-like_ Pains; upon Scrutiny, I found a large _Substance_ in the _Pelvis_, of the Size of a Child’s Head, considerably resisting my Touch; I observ’d on Trial, a Part of the Woman’s Body every Way _interposed_ between my Fingers and this _Substance_, by her Sensibility of my _Touch_; therefore contenting myself with giving her some palliative Medicines, and telling the Persons present, a Mole, as I thought, or Child still remain’d to come away, I for that Time, took my Leave: On the 24th, she was said to be much better; on the 29th, I was again call’d to this poor Woman, and inform’d, that upon her first going to Stool, since I had before seen her, which happen’d the same Day, the large _Substance_ before-mention’d, came intirely out of her Body; to which it join’d by a thinner Substance, of some length: I now perceived it was no less than the _Womb_ turned _inside out_, suspended by its _Ligaments_, and joining to the _Vagina_, but very much swell’d by the Obstruction of the circulating Humours; And an old Gentlewoman, who was present when the Child was born, inform’d me, she saw the Midwife draw this _Body_ from the Woman, by the _Navel-string_, and indeed, the Impression of her _Nails_, in separating the _After-birth_, remain’d still visible at the _Bottom_ of the _Womb_, and the Midwife having long expos’d the Patient, put this _inverted Womb_ again into her Body.