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Care during labor has been detailed in the excellent prescriptions. Chen Ziming compiled *Furen Liangfang* (Excellent Prescriptions for Women), and Xue Lizhai added supplementary notes to *Yi An* (Medical Records). Here, we examine various works including *Bencao Gangmu* (Compendium of Materia Medica) and *Yitong* (General Treatise on Medicine): Zhang Shiweng authored *Yitong*, Wu Zhiwang compiled *Jiyin Gangmu* (Outline of Gynecology), Zhou authored *Chanbao* (Precious Essentials for Childbirth), and Zhang Jiebin wrote *Jingyue Quanshu* (Complete Works of Jingyue). We extract their key points.

Whenever pregnancy reaches eight or nine months, taking several doses of Dasheng San (Daisheng Powder) facilitates delivery. If near term, the amniotic sac has not ruptured but bleeding occurs first, it may be fetal injury rather than true labor. A large dose of Bao Yuan Tang (Bao-Yuan Decoction) with Dang Gui (Angelicae Sinensis Radix) and E-Jiao (Colla Corii Asini) is appropriate. If fetal qi rebels upward, hot Tong Bian (Child's Urine) should be taken urgently, or Zi Su Yin (Perilla Decoction) used. During true labor, blood and qi are turbulent, and the pulse must be slippery and rapid abnormally. If the pulse remains calm and harmonious, and although there is abdominal pain, it is not tight, it is still "trial pain" (false labor). One must wait until abdominal pain radiates to the waist in increasingly tight paroxysms, as the fetus turns for natural delivery; only then will the sac rupture and water flow out, like a ripe melon falling from the stem. Do not induce birth too early. Instead, nourish blood and descend qi before labor using Hua Tai Jian (Slippery Fetus Decoction). Subsequently, invigorate blood and move qi using Bao Sheng Wu You San (Bao-Sheng Wuyou Powder). In cases where the placenta is unstable or force is applied too early, causing the membranes to rupture prematurely without delivery, fearing that fluid depletion leads to a dry and rough passage making fetal turning difficult, one should administer Bazhen Tang (Eight-Treasure Decoction) or a large dose of Wuwu Tang (Five-Ingredient Decoction) with Dong Kuizi (Malvae Semen) and Zhi Qiao (Aurantii Fructus). This assists blood and qi, making the fetus slip easily into delivery. If endurance fails, use Dushen Tang (Single Ginseng Decoction) to replenish yuan qi; even if delivery takes several days or ten days, it can occur. Male fetuses face inward, female fetuses outward, both with head up and feet down. At labor, they must invert to exit smoothly. One must gently assist walking repeatedly to allow rotation; otherwise, there is risk of transverse presentation. Danxi stated: For induction, only Foshou San (Buddha's Hand Powder) is used, which is safest and effective. Combining it with Jisheng Tang (Jisheng Decoction) is also good. In cases where the fetal head presses against the birth canal but the jiaogu (pubic symphysis) does not open, this indicates deficiency of yin qi. Use Jiawei Xiong Gui Tang (Modified Chuanxiong and Angelica Decoction); if ineffective, add Renshen (Ginseng Radix) and Tong Bian. For difficult sitting birth, use Tubrao Wan (Rabbit Brain Pill), Rusheng San (Rusheng Powder), or Ruyi San (Ruyi Powder). Hand-first presentation is transverse birth; foot-first is breech birth, caused by the mother pushing too early. The mother should lie supine. Rub a little salt on the fetal hands and feet. Use the middle finger to locate the shoulder and guide it straight. Wait until the body is aligned before exerting force. If the fetal head leans toward the left or right leg, it is oblique presentation, caused by maternal forceful pushing. Lie supine, gently push the head back up and align it with hand assistance, then push down. If the head is aligned but cannot deliver immediately because the umbilical cord is caught around the shoulder, it is obstructed birth. Lie supine, push the fetus up, press the shoulder with fingers to release the obstruction. If the fetus has not emerged but the mother's intestine prolapses first, it is called "panchang sheng" (intestine prolapse during childbirth). After the fetus and placenta are fully delivered, apply sesame oil to hands and slowly insert the intestine. Alternatively, spray a mixture of vinegar and water on the mother's face; spray three times with each contraction. The method of applying crushed castor bean paste to the crown to suck the intestine in is ineffective. Then sit semi-recumbent and support with soft cloth. Internally administer Juzhong Decoction. If the fetus dies in the womb, verify if the mother's tongue is blue-black, nails purple-blue, mouth foaming, abdomen cold, and breath foul. Urgently use Pingwei San (Pingwei Powder) plus Xiaomaxiao (Mirabilite). If the dead fetus has dried and adhered to the back for a long time, use Dong Kuizi and E-Jiao to lubricate. For retained placenta, first tie the umbilical cord with soft silk, then cut the infant's cord, preventing blood from entering the placenta. If distended and difficult to expel, internally administer Huisheng Dan (Huisheng Pill) or Niuxi Tang (Achyranthes Decoction) to promote expulsion. If retained for a long time, blood enters the placenta, rushing to chest and heart causing panting, urgency, pain, and distension. Urgently resolve stasis using Niuxi San (Achyranthes Powder) or Shixiao San (Shixiao Powder), mixed with warm wine, so the placenta falls immediately. Jingyue said: The uterus in the abdomen is shaped like a lotus leaf. If tilted upward, blood gathers, causing distension and difficulty in expulsion. The midwife should use fingers to lift the upper rim, allowing lochia to drain, emptying the abdomen so the uterus drops naturally. If qi deficiency causes no abdominal distension or pain, only Wuyou San (Wuyou Powder) is suitable, or stir-fry two heaping measures of black beans thoroughly. Quench a red-hot iron scale weight in wine to make Doulin Jiu (Bean-Dripping Wine), dissolve two pills of Yi Mu Dan (Motherwort Pill) in it. After delivery, if yin qi is deficient, the vaginal opening does not close, or yin fire flows downward causing uterine prolapse, due to blood and qi deficiency failing to hold, use Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction) with Wuweizi (Schisandrae Fructus). Tonify and astringe.

For worry and thought damaging spleen causing heat and pain, use Jiawei Guipi Tang (Modified Guipi Decoction). For swelling and pain, use Xiaoyao San (Xiaoyao Powder) plus Mudan Pi (Moutan Cortex), Zhizi (Gardeniae Fructus), and Jingjie (Schizonepetae Herba). For sudden anger damaging liver stirring fire, use Longdan Xiegan Tang (Gentian Liver-Draining Decoction). For yuan qi deficiency and uterine non-retraction, use Buzhong Yiqi Tang (Buzhong-Yiqi Decoction) plus Guixin (Cinnamomi Ramulus) and Cu Chao Baishao (Vinegar-Processed White Peony Root). Tonify and lift. During labor, qi follows blood loss, suddenly causing dizziness, blackouts, unconsciousness, and locked jaw. There are two syndromes: qi collapse and blood syncope. Qi collapse presents with pale face, closed eyes, open mouth, cold hands, and fine pulse nearly imperceptible. Quickly use 1-2 liang of Renshen, decoct strongly, and drip slowly. Once swallowed, consciousness returns; delay means no rescue. Blood syncope occurs when yuan qi is damaged at labor, and lochia attacks upward through deficiency, causing dizziness, blurred vision, and chest oppression. Quickly use hot Tong Bian, and administer Qinghun San (Qinghun Powder). If heavy bleeding causes syncope, unconsciousness, and restlessness, use Xiong Gui Tang (Chuanxiong and Angelica Decoction) plus 3-5 qian of Renshen and a handful of Zelan Ye (Lycopus Herba), decocted, mixed with half a cup of Tong Bian. Tonify while dispersing. If light bleeding rushes upward to the heart, decoct Shixiao San in Tong Bian, add Yu Jin (Curcumae Radix) juice. For phlegm obstruction and coarse breathing, use Erchen Tang (Erchen Decoction) plus Jiangzhi (Ginger Juice), and simultaneously pour vinegar on a red-hot scale weight for the mother to inhale the fumes to stop syncope. If maniacal and losing mind, it is败血 (decayed blood) attacking the heart, mostly fatal. Use Huarui Shi San (Huarui Stone Powder) or Xueming San (Xuemiao Powder). For vomiting, nausea, and abdominal fullness, it is lochia attacking the stomach; use Pingwei San plus Ginger and Cinnamon. For red face and vomiting, it is blood and qi attacking the lungs; use Renshen Sumu Jian (Ginseng and Sappanwood Decoction). If lochia does not flow, with abdominal pain and tenderness to pressure, use Tao Ren (Prunus Seed), Gui Wei (Angelicae Sinensis Radix Tail), Yanhu (Corydalis Rhizome), and Chi Shao (Red Peony Root) to resolve stasis. If lochia continues excessively with heat, use Baoyin Jian (Baoyin Decoction). If collateral damage, use Guyin Jian (Guyin Decoction). For liver and spleen qi deficiency, use Buzhong Tang. For blood and qi deficiency with pale color, use Shiquan Dabu Tang. For fire anger damaging liver, use Jiawei Siwu Tang (Modified Four-Substance Decoction). For "child pillow" pain, use raw and cooked Hawthorn flesh, decocted with rock sugar. Or use Yanhu San. Abdominal pain radiating to waist, relieved by pressure, indicates deficiency; use Dang Gui, Xiang Fu (Cyperi Rhizoma), Zhi Cao (Prepared Licorice), Duzhong (Eucommia Bark), and Xiao Huixiang (Fennel Fruit). Or use Danggui Jianzhong Tang. These are standard methods for labor, extracted here for reference in flexible application.