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It is essential to know the timing for labor; if the fetus's position is not yet favorable and progress is delayed. If the mother exerts effort too early, it may force the fetus into an abnormal position, making regret futile later on.

[Note] Regarding labor (Zuocao), timing is most critical, and one should not start too early. If the fetal position is not yet aligned, it is better to wait patiently for a slightly slower progression, keeping a relaxed mind until natural onset. If labor begins prematurely, before the time of normal delivery, and the mother is urged to exert force in vain, it often forces the fetus into an incorrect posture, leading to transverse or inverted positions. Even then, regret would be of no avail!

When the fetal body turns favorable and the vertex presses against the birth canal, with rupture of membranes, abdominal and lumbar pain, protrusion sensation at the anus, and pulsation in the middle finger, this is the time to push during labor to deliver the baby.

[Note] The birth of a fetus has its own appointed time. When the time arrives, the fetal position becomes favorable, the vertex aligns with the birth canal, amniotic fluid flows abundantly, the lower back feels heavy with abdominal pain, there is a sense of protrusion at the anus, and the middle segment or proximal phalanx of the mother's middle finger throbs. Only at this moment of normal delivery should the mother push to facilitate birth, ensuring a smooth delivery!

If the pubic symphysis (Jiaogu) fails to open, careful examination is required; it may be due to Qi and Blood deficiency or being a primipara. Generally, one should use Kaogu San (Bone-Opening Powder) to unblock the Yin Qi. The formula consists of Foshou San (Buddha's Hand Decoction) added with Testudinis Carapax et Plastrum (Tortoise Shell) and ash from the hair of women who have given birth to daughters. If caused by Qi and Blood deficiency, adding Ren Shen (Ginseng Root) is excellent; a single dose can cause the bones to open immediately.

[Note] Failure of the pubic symphysis to open in parturient women may be due to Qi and Blood deficiency or being a first-time mother. Both conditions are suitable for using Kaogu San (Bone-Opening Powder) to unblock the Yin Qi. This formula is Foshou San (Buddha's Hand Decoction) added with Testudinis Carapax et Plastrum (Tortoise Shell) and ash made from the hair of women who have borne children. For those with Qi and Blood deficiency, adding Ren Shen (Ginseng Root) allows the bones to open immediately upon ingestion.

Prolapse of the rectum (Panchang Sheng) refers to the intestine protruding before delivery, or remaining prolapsed after the infant is born. Apply a paste of Ricini Semen (Castor Bean) mashed to the vertex, and internally administer decoctions that lift and tonify. If the intestine is dry, moisten it with butter oil.

[Note] Pregnant women may experience Prolapse of the Rectum (Panchang Sheng), where the intestine drags out prior to delivery, or remains unretracted after the infant is delivered. One must apply mashed Ricini Semen (Castor Bean) to the center of the vertex (Baihui GV20 area implied) and internally administer lifting and tonifying formulas, such as Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) or Bazhen Tang (Eight Treasures Decoction), Shiquan Dabu Tang (Ten Significant Tonification Decoction), etc., added with Shengma (Cimicifugae Rhizoma), to lift and tonify, so that the intestine will naturally retract.

Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction); Shiquan Dabu Tang (Ten Significant Tonification Decoction) [Formulas are found in the first volume].