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For difficult labor conditions such as transverse presentation and breech presentation, manual manipulation should be employed for treatment. The midwife should be selected from among those who are mature, reliable, and kind-hearted. During the delivery process, she must remain calm and composed, applying skillful techniques. It is also appropriate to speak frankly and give earnest instructions, ensuring that all intentions are explained in detail before proceeding. One must not employ impulsive or reckless individuals whose crudeness and ignorance may endanger lives.

Transverse presentation refers to a situation where the fetus presents with its hand or arm first. The treatment method requires the mother to lie comfortably on her back. The midwife should slowly push the lower part of the fetus upward to straighten it. Gradually inserting a finger, the midwife uses the middle finger to massage the shoulder, pushing it up to correct the position, and then gently guides the hand to grasp the ear to align the head. Once the fetal body is aligned and the birth canal is clear, administer labor-inducing herbs. The mother should ascend the birthing bed calmly, and natural delivery will follow easily.

Breech presentation refers to a situation where the fetus presents with its feet first. The treatment method also involves having the mother lie on her back. She must exert no effort whatsoever and avoid panic. The midwife should slowly push the feet to one side to straighten them, waiting for the fetus to naturally adjust. If there is no improvement after a long time, the midwife should gradually push the fetal head to one side to facilitate downward adjustment. Once the fetal body turns smoothly and the birth canal is properly aligned, use labor-inducing drugs, and delivery will occur immediately.

Oblique presentation refers to a situation where the fetal head is tilted against one side. Although close to the vaginal opening, the vertex (top of the head) is not presenting; only the forehead corner is visible. The treatment method also involves having the mother lie on her back. The midwife should gently push the fetus upward and use her hands to correct the head, ensuring the fetal vertex faces the vaginal opening directly.

In cases where the posterior bone of the fetal head presses obliquely against the anus, warm a piece of cotton clothing by roasting it, wrap it around the hand, and quickly and gently push from the side of the anus, gradually moving upward, before allowing the mother to ascend the birthing bed.

Impeded labor refers to a situation where the fetal head is correctly positioned at the vaginal opening but cannot descend. This may be due to the fetus turning and the umbilical cord wrapping around or catching the shoulder, preventing delivery. The treatment method involves having the mother lie on her back. The midwife should gently push the fetus upward, insert a finger, and use the middle finger to press on both shoulders of the fetus to untangle and free the umbilical cord. Once the fetus is aligned, delivery will proceed.

Sitting labor refers to a situation where the fetus is about to be born, but the mother is exhausted and unable to walk or stand. By sitting for a long time on the chair or bedding, she obstructs the birth canal, preventing the fetus from descending. The treatment method is to hang a towel or silk cloth from a high place, allowing the mother to hold onto it. She should gently bend her legs, and after a while, the fetus will be born smoothly.

There is also a condition known as "intestine-prolapse labor," where the uterus/intestines prolapse before the baby is born, and the baby is delivered subsequently. Folk practice often involves splashing cold water on the mother's face, which causes the prolapsed tissue to retract spontaneously. However, this method must never be used for weak patients, as it may cause illness due to shock and fear, or even lead to sudden death. An old method involves grinding forty-nine castor beans into a paste and applying it to the crown of the head, which naturally causes retraction. Once retracted, wash the castor bean residue off the head with water. In cases where the prolapsed tissue has been dried by wind over a long period and cannot retract, apply a small amount of sharpening water, warmed over fire, to moisten the tissue. Then, prepare a cup of Magnetite Decoction (Cishi Tang) and have the mother drink it; the tissue will naturally retract.

Buzhong Tang (Tonify the Middle Decoction): Nourishes new blood, removes blood stasis, tonifies deficiency, and supports critical conditions. It treats spontaneous abortion occurring within half a month postpartum (or incomplete abortion).

Ingredients:
Ganjiang (Pao) (Prepared Rhizoma Zingiberis), Ejiao (Chopped, stir-fried with donkey-hide gelatin powder), Xiong (Rhizoma Chuanxiong), Wuweizi (Each 1 liang), Baizhu (Atractylodis Macrocephalae Rhizoma), Huangqi (De-radix, honey-fried), Danggui (De-radix, wine-soaked), Chishao Yao (Radix Paeoniae Rubra) (Each 1.5 liang), Renshen (Ginseng Radix), Muxiang (Aucklandiae Radix, not exposed to direct fire), Duzhong (De-bark, chopped, stir-fried), Gancao (Stir-fried with honey).

Preparation: Grind the above ingredients into coarse powder. For each dose, take 4 qian, decoct with 1.5 sheng of water, and take orally. There are no restrictions on the timing of administration.