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When pregnancy reaches the term near delivery, one should calm the mind and eliminate anxiety, walking frequently. One must avoid excessive sleep, overeating, drinking too much water, consuming alcohol (Jiu), or taking miscellaneous medicines. When labor is imminent, there should be no noise or panic from many people. If amniotic fluid (Yang Shui) appears and severe lower back pain occurs, this indicates that the fetus has detached from its meridian position (Tai Yi Li Jing), at which point medication to induce labor and lying on the birthing bed can be used. One must not take labor-inducing drugs too early nor lie on the birthing bed prematurely. Drinking alcohol is strictly forbidden during labor. Alcohol has a hot nature; if it causes bleeding from the mouth and nose, it is often incurable. Urgently administer Er Si Tang with blood-activating herbs and add child's urine (Tong Bian) for treatment.

Generally, while in the womb, male fetuses carry Yang energy on their backs facing Yin, and female fetuses carry Yin energy on their backs facing Yang, with heads up and feet down. During delivery, they turn sideways to exit smoothly. Difficulties such as transverse or breech presentations occur because the mother endures pain by bending her waist and sleeping curled up, refusing to stretch and move, causing the fetal position to invert and fail to rotate. Lying on the birthing bed should not be done too early; one must continue to walk and move under support to avoid disaster. If action is delayed until Qi and Blood are depleted, it is already too late! If labor suddenly becomes slow and difficult, this can be attributed to deficiency of Qi and Blood.

During labor, one must strictly avoid fright, which causes fear and timidity in the mother, leading to upper blockage and lower distension, stagnation of Qi movement, and reckless exertion before the proper time. This forces the fetus onto the wrong path, causing previous disasters. It is like straining to defecate before the time is right; what good does it do? Urgently use Zi Su Yin to regulate Qi.

If there is abdominal pain during labor but it is not severe, true labor has not yet begun. Do not allow midwives to perform internal examinations. Even if there is umbilical abdominal pain, one should endure it patiently, walking with support, standing leaning against objects. One must wait until lower back and abdominal pain are extreme and unceasing, the anus feels protruding, eyes feel fiery, amniotic fluid has ruptured, and the Chi pulse feels tight and round like beads on a string, before proceeding with natural delivery. Transverse, inverted, or breech births are all due to premature intervention, allowing Wind pathogens to enter the birth canal, causing swelling and making the passage narrow and dry. The umbilical cord is tied to the Mingmen (Gate of Life). When the fetus is ready to be born, its hands move, causing the cord to detach, after which it emerges. How could this not be painful? As the proverb says, "When the melon is ripe, it falls off the vine; when the chestnut is ripe, it drops out naturally." This analogy is excellent. In the height of summer, one should stay in deep houses, store plenty of clean water, and prevent complications like blood syncope and unconsciousness. In severe cold, keep doors and windows closed, generate fire for warmth, and cover the lower body with thick clothing to avoid cold coagulating blood.

If sudden abdominal pain occurs near the term, intermittent, lasting three or four days or more, with amniotic fluid leaking but pain not urgent, it is called "Nong Tai" (Playing Fetus), not true labor, and requires no medication.

If vaginal bleeding occurs before the rupture of amniotic fluid during labor, it indicates fetal injury. If there is no abdominal pain, treat with Ba Wu Tang and An Tai Yin. If the amniotic fluid has ruptured, it indicates impending labor; take Zi Su Yin to nourish Qi and Blood.

If a pregnant woman, even at full term, suddenly experiences abdominal pain resembling labor but nothing happens, it is called "Shi Chan" (Trial Labor), not true labor. Regardless of whether amniotic fluid is present, wait calmly for the proper time and take Zi Su Yin with Zhi Qiao to regulate.

If amniotic fluid is exhausted but the fetus does not descend, use Wu You San with Zi Su. This formula is also suitable for cases where the fetus is large with rebellious Qi, or the mother is thin with scanty Blood.

There are ten types of deliveries described. Rapid delivery of mother and child within moments is normal birth; midwives must be cautious. When the month is full, with lower back pain, anal protrusion, ruptured membranes, and bleeding, using drugs to induce labor is called "Cui Chan".

In severe cold, blood coagulates in the birth canal, preventing the fetus from being born; this is called "Dong Chan" (Frozen Birth). In the heat of summer, steaming heat causes fainting and drunkenness, preventing birth; this is called "Re Chan" (Hot Birth). Birth before the full month is called "Ban Chan" (Half Birth). Abortion due to existing pregnancy is called "Xiao Chan" (Small Birth). Lying on the birthing bed too early, excessive straining, fetal inversion failing to rotate, presenting feet first, is called "Ni Chan" (Reverse Birth). Presenting hands first is called "Heng Chan" (Transverse Birth). Head presenting to one side is called "Pian Chan" (Lateral Birth). Umbilical cord entangling the fetal shoulder is called "Ning Chan" (Coagulated Birth). Prolapse of the uterus/intestine before the baby is called "Pan Chang Chan" (Placenta-like Intestine Birth). Intermittent abdominal pain with dripping fluids is "Shi Chan" (Trial Birth). Sitting on an object blocking the fetal head is called "Zuo Chan" (Sitting Birth). These result from ignorance of reproductive principles and panic during labor. Those who protect childbirth must explain these beforehand.

Easy births among village women occur because they exercise without sparing effort during pregnancy and endure pain persistently during labor.

The *Jin Gui Yao Lue* states: New mothers have three diseases: 1. Spasm (Jing), 2. Depression and Dizziness (Yu Mao), 3. Difficulty with bowel movements. These are due to depletion of Qi and Blood, loss of body fluids, and dryness of the stomach and intestines. The pulse is weak, vomiting prevents eating, stool is hard, and there is sweating only on the head. In such cases, Blood deficiency leads to Jue rebellion upwards, causing dizziness; as dizziness resolves, profuse sweating occurs; due to Blood deficiency causing lower Jue, solitary Yang rises, causing head sweating. Therefore, postpartum women welcome sweating because Yin is lost, Blood is deficient, and Yang is abundant, so sweating is expected; Yang abundance and Yin deficiency lead to hard stool and vomiting.

For difficult labor, treat with Bai Zhi San. Severe cases may require a second dose.

[Bai Zhi San] Bai Cao Shuang (Soot from Kitchen Chimney), Bai Zhi (Angelicae Dahuricae Radix)

Grind into powder. Decoct with child's urine (Tong Bian) and wine (Jiu), and take hot.

For three conditions: non-opening of the pubic symphysis (Jiao Gu Bu Kai), non-closing of the birth canal (Chan Men Bu Bi), and uterine prolapse (Zi Gong Bu Shou), all stem from inherent weakness of Yuan Qi and lack of regulation during pregnancy, leading to failure of Qi and Blood circulation. Non-opening of the pubic symphysis is due to Yin Blood deficiency; treat with Fo Shou San plus Gui Ban (Testudinis Carapax et Plastrum). Non-closing of the birth canal is due to Qi and Blood deficiency; treat with Shi Quan Da Bu Tang plus Wu Wei Zi (Schisandrae Chinensis Fructus) to astringe. Uterine prolapse is treated with Bu Zhong Yi Qi Tang plus Cu Chao Bai Shao (Vinegar-fried Paeoniae Radix Alba) and Wu Wei Zi.

For primiparas with swelling, pain but no closure, use Bu Zhong Tang plus Ban Xia (Pinelliae Rhizoma) and Fu Ling (Poria) to strengthen the Spleen, restoring Yuan Qi so diseases heal themselves. Strictly avoid cold-cooling agents.

It is also said that non-opening of the pubic symphysis is due to Yin Qi deficiency. Turtle (Gui) is of extreme Yin nature, thus resolving the interlocking; therefore, it is used.