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[Song on Labor] At the time of labor, do not take it lightly. Suddenly, qi rushes upward causing the eyeballs to roll back. Lips turn cyan, jaw is clenched, and saliva foams; both mother and child enter the gate of death. Tongue color is bright red while lips and face are black; the child survives but the mother dies in a short time. Face is red and tongue is black; the child is hard to save, yet one must still seize the life-saving pill (Duoming Dan). For transverse or inverted presentation causing difficult labor, use Cui Sheng Long Tui San; for slippery fetus or leaking fetus, Huai Tai Gan can rescue. To expel a dead fetus, use Xiong Gui Yin, and mash Wu Ma to apply to the soles of the feet. Blood entering the uterus causes distension and oppression; rushing upward to the heart and stomach makes death easy. Piao Xiao San combined with Hong Hua wine, and Duoming Shen Dan, drive out the blood and bring peace. After delivery, blood reversal causes blood syncope; urgently administer Qing Hun San to restore life. Blood inversion leaves the heart without mastery, eyes dim, spirit confused, and sweat pours like rain. Qi follows blood loss and is hard to save; large doses of Guizhi (Cinnamon Twig), Fuzi (Prepared Aconite Root), and Renshen (Ginseng) are competent. Blood rushing to the chest causes madness; panting with Pul Huang (Polygonatum/Smilax symptoms, contextually likely referring to a specific syndrome treated by Pul Huang) is not trivial. Knowing that "child pillow" pain stems from lochia retention, Dang Gui (Angelica Sinensis) combined with Shixiao San yields extraordinary effects. Suddenly, jaw clenching and speech reversal occur; seeing ghosts is originally not due to wind or cold. Stagnant blood rushing upward depletes heart blood; Miao Xiang San combined with Hei Long Dan treats this.

Women at labor, life and death are reversed in the palm of a hand. Those skilled in treatment can truly revive the dead. Slight failure to rescue urgently often leads to premature death. If rescue methods are incorrect and medicines do not act promptly, life cannot be fully preserved. When about to deliver, excessive effort may cause the fetus to fail to rotate, leading to the fetus dropping into the hip crotch and unable to be born. There are cases of difficult labor due to transverse or inverted fetal positions. There are cases of difficult labor due to obesity and fat accumulation, usually sedentary. There are cases of difficult labor due to a large fetus. There are cases of difficult labor due to advanced maternal age and remarriage, where the pubic symphysis bones do not open. There are cases of difficult labor due to premature rupture of membranes and dryness inside the uterus. There are cases of a dead fetus in the womb that does not descend, verifiable by a cold abdomen and black tongue. There is a condition called "uterine water" (Bao Shui), where amniotic fluid accumulates in the uterus, causing abnormal abdominal enlargement and weak, fine pulse. Contemporary physicians do not recognize this, suspecting twins. At labor, over a dou of water must be expelled before birth. The infant's limbs will inevitably be soft and short, with physiological disabilities, because the water soaked the fetus. If physicians recognize this and use water-draining medicines early, the fetus remains unharmed. There are cases of death immediately after delivery due to excessive blood loss after the baby is born. There are cases of fainting due to blood rushing upward. There are cases where the fetus is delivered but the placenta does not descend. There are cases where stagnant blood fills the uterus. If the placenta does not descend, one must remove the uterine blood, and it will descend naturally. There are cases where midwives, attempting to extract the placenta, accidentally injure the five zang organs, resulting in chronic illness if mild, or death if severe. Be extremely cautious. Generally, women of low status give birth easily because their labor keeps the fetal qi flowing. Families of wealth, nourished richly and living in ease, with robust bodies, often find childbirth difficult.

The Mai Jing states: At labor, six pulses per breath indicate the pulse has left its regular channel. It may be deep, fine, and slippery; if no other ominous signs appear, birth occurs immediately. A floating and large pulse indicates difficult labor; frequent chills and fever require urgent observation, focusing on facial signs. The cheeks, lips, and tongue should not be black or cyan. A red face indicates the mother lives, but the child's fate is doomed. If the fetus remains in the abdomen, mother and child return to normalcy.

At the time of labor, noise must be avoided. Select a skilled midwife or capable maid. Do not allow them to be frantic or panicked, which would frighten the parturient woman. Soft rice and thin porridge are suitable foods. If abdominal pain occurs, let her walk while supported. Pain that comes and goes is called "playing fetus" (Nong Tai). Do not allow the midwife to probe with hands, nor allow her to lie with bent waist.

If lower back pain continuously radiates, and one sees flashes of light before the eyes, this indicates fetal rotation. Support her to walk slowly. If rising is difficult, hold onto something and stand for a moment. Wait until the waist and abdomen pull together and walking/standing becomes difficult, then assume the birthing position. Do not sit too early, lest the fetus in the abdomen cannot rotate. Once the membranes rupture and the birth canal is dry, difficult labor is indicated. If there is heat and oppression in the heart, break one raw egg and swallow it. The person supporting the waist must not tilt, so the fetus descends naturally. If one panics at the last moment and exerts force improperly, difficult labor ensues. After the child is born, do not let them sleep immediately. Have them sit with eyes closed. After a short while, help them to bed, lying supine with knees bent. Do not let them fall into deep sleep; wake them frequently. Do not rejoice excessively at having a son, as joy damages the heart and may cause "red sweat" syndrome. Do not grieve excessively at having a daughter, as sorrow may cause stagnant blood to attack the heart. Smoke vinegar in the room to prevent fainting and blood rising. Beyond several days, do not force oneself out of bed. Beyond one month, do not engage in sexual intercourse. Be cautious.

During pregnancy and labor, if the fetus presses against the heart and does not descend, the fetus's hands must be holding the mother's heart, often leading to the death of both. One must use medicine to guide action to the heart region to "unclasp" the fetus's hands before delivery is possible. Because a fetus grips objects tightly, once the medicinal qi arrives, the hands soften, hence the term "unclasp." Regarding retained placenta after delivery, do not treat it as a minor issue and ignore it. Many cases result in the placenta ascending to the heart causing death. This must be known.