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Women's childbirth is the natural law of creation. As the common saying goes, "when the melon is ripe, it falls from the vine," which originally belongs to ordinary and easy matters, requiring no panic or suspicion. However, there are indeed cases of dystocia (difficult labor), all caused by sitting on the birthing mat too early before delivery, knowing only to urgently exert force to induce birth, resulting in various difficult births such as transverse presentation (fetus lying sideways) and breech presentation (fetus presenting feet or buttocks first), harming both mother and child, occurring either within moments or delaying for days. Can one not be cautious? While protection during pregnancy is essential, careful attention during labor is even more critical. The *Da Sheng Pian* (Chapter on Reaching Birth) · Six True Words states: First, sleep; second, endure pain; third, delay entering the birthing room.

When abdominal pain is first felt, one must first steady one's own mind, understanding that this is a necessary process of life and an extremely easy matter, without need for panic. If one observes that after one wave of pain subsides, another begins, continuing for five, six, or seven waves, with pain gradually intensifying and becoming tighter, this indicates that birth is imminent, and only then should one inform others to prepare assistance. If the pain is slow, it is false labor pains (prodromal labor); one should simply sleep and eat peacefully (referring to normal sleep and diet) and avoid moving around. Here, great attention must be paid, as it is the primary point.

At this time, the most important thing is to endure pain while waiting for birth. Whether it is false labor or true labor, endure the pain and continue eating and sleeping as usual. When the pain becomes extremely intense and mature, birth will naturally occur easily. Moreover, distinguishing between false labor and true labor requires observing the duration and tightness of the pain over time; one must absolutely not enter the birthing room or rub the waist and abdomen lightly. This is earnestly urged. When standing, one should stand firmly; when sitting, one should sit upright, avoiding twisting the body left and right. It must be understood that one must take charge here; others cannot do it for you. This concerns your own life and has no interference from others.

Appendix: The article "Sitting on the Birthing Mat" in *Yi Zong Jin Jian* (Golden Mirror of Medicine) states: For any parturient woman sitting on the birthing mat, timing is crucial and should not be too early. If the fetal position is not favorable, it is better to wait patiently with a relaxed mind. If one sits on the mat too early, before the time of true labor, and blindly urges the mother to exert force, it often forces the fetus into an abnormal position, leading to transverse or breech presentations, regretting it later would be useless.

At this stage, nourishing the spirit and conserving strength is paramount. Sleeping peacefully on the bed with eyes closed is best. If unable to sleep, getting up temporarily, walking slowly with support, or standing leaning against a table for a moment is acceptable. If the pain eases slightly, return to bed to sleep. Sleep is always the first wonderful method. However, supine position (lying on the back) is preferred, keeping the abdomen comfortable and allowing the fetus to turn easily. When the mother lies down, the fetus also rests, making turning less strenuous. The mother should conserve strength, and the fetus should also conserve strength, waiting for the final moment. Remember this well.

Appendix: If the pregnant woman prefers sleeping before labor, or has a taste for rich flavors, or suffers from Qi stagnation, slight movement during labor is appropriate.

Addendum: Side sleeping during labor is contraindicated as it hinders the fetus from turning. Regardless of whether labor is early or late, one must not lightly exert force in the birthing room. One must not listen to midwives saying the baby's head is already there, causing premature entry into the birthing room and ruining the situation. This is the natural law of heaven and earth. When the time is right, the baby will naturally emerge; why rush? Perhaps fearing the baby lacks strength, if it expends all effort turning, it may not be able to exit the birth canal. In such cases, a brief exertion of force can help it emerge smoothly. At this moment, like a ripe melon falling, Qi and Blood separate, joints open simultaneously, water flows where the channel exists, without forcing. Even the mother may not know how it happened after birth.

Someone asks: Defecation requires force, why not use force during childbirth? One does not understand that feces are inert matter requiring human force, whereas the fetus turns itself. One must wait for its self-turning. Not only is force unnecessary, but it is strictly forbidden. Because the fetus sits upright in the abdomen, and at birth, lowers its head and turns downward. The abdomen is narrow, and external force is hard to assist. One must let it slowly turn to the birth canal, head down, feet up, emerging upside down. If the fetus has not turned and force is applied, feet may emerge first, surprising people who call it "Lotus Flower Stepping on Feet." If force is applied before turning is settled, the fetus may lie transversely, with one hand emerging first, called "Salt Begging Birth." Even if turning downward, if not straight, and force is applied too early, it may hit the leg bones on the left or right and fail to exit. These problems are all due to using force prematurely when the time has not arrived. I advise everyone never to use force. However, it is not that no force is used at all; force is only needed for the time it takes to drink a cup of tea. The rest of the time, one must not move randomly. Just as defecation cannot happen out of time even with force, how much more so for childbirth!

Someone asks: How do we know when to use force for that cup of tea? I say: This time is different. If the fetus truly reaches the birth canal, the whole body's joints loosen, the chest sinks, the lower abdomen feels extremely heavy and pressing, urgency for urination and defecation arises simultaneously, sparks fly before the eyes, and this is truly the time. One should enter the birthing room now, exert force for one wave, separating mother and child, what difficulty could there be?

Appendix: Every infant's birth has its own time. When the time arrives, the fetal body turns favorably, the crown aligns with the birth canal, amniotic fluid flows heavily, lower back feels heavy and painful, the anus protrudes, and the middle finger's middle or distal joint of the parturient woman throbs. Only then is it the time of true labor, and one can enter the birthing room and exert force to send the baby out smoothly.

Someone says: I still don't fully believe the baby will crawl out. Did the ancients mention this? I say: Ancient words capture the main essence; how can they detail everything? One only needs to comprehend. Observing "when the melon is ripe, it falls," one knows the baby will crawl out. Observing "pulling shoots to help them grow," one sees the error of mistaking false labor for true labor. A chick ready to hatch pecks its way out naturally; are there magical drugs for inducing labor or skilled hands of midwives? Ancients said some babies are born three or four years late; this is because they refuse to crawl out. Since they refuse, who can force them? Since they want to crawl out, who can stop them?

Someone says: Being one hour early is absolutely inadvisable. Is being one hour late okay? I say: It is fine. If it is truly the time, there is no reason it won't come out. However, if occasionally it doesn't come out, it is because the baby has exhausted its strength. Let the mother sleep on the bed, letting the fetus rest in the womb, resting briefly, and it will naturally be born.

Someone says: What if the baby reaches the birth canal while the mother sleeps? Isn't that an obstacle? I say: It is better. When the baby moves downward, if the mother sits or stands, the baby hangs upside down, which cannot last long. Now, if the mother sleeps, the baby also sleeps, what harm is there? Another asks: What if it suffocates? I say...

Appendix: If the baby has not broken the membranes, it will not suffocate. If the membranes have broken, it may suffocate, requiring immediate delivery. If fetal stool appears first at the vaginal opening, or if the midwife touches hair or feet, it indicates the membranes have broken.

Someone asks: Is enduring pain for too long unfavorable? I say: It is best. I have never heard of a woman giving birth privately experiencing dystocia. Some say it is divine protection, but this is incorrect. It is simply because the fetus originates in privacy, fearing discovery, she endures pain intensely. When pain becomes unbearable, it emerges smoothly. The logic is clear; what is there to doubt?

Someone says: I have heard not to use force, but what if I mistakenly used force earlier, leading to transverse or breech presentation? Is there a treatment? I say: Urgently let her sleep, administer a large dose of Jia Wei Xiong Gui Tang (Modified Ligusticum and Angelica Decoction). Gently push the limbs back inside, sleep for another night, and it will naturally be born. Another asks: What if pushing fails? I say: If she sleeps, there is no case of failure. If she is still not allowed to sleep at this time, or moves around wildly, taking random medicines, I can do nothing.

Appendix: Dr. Xue's treatment: For transverse presentation showing an arm first, let the mother lie flat, gently push the arm and body to align them straight, then touch the shoulder with the middle finger, ensuring the umbilical cord does not entangle, and it will be born.

For breech presentation showing feet first, let the mother lie flat, gently push the feet, turning the fetus upright, and it will be born.

For oblique presentation with the head tilted to one side, follow the previous method to gently straighten the head, and it will be born. Or if the occiput is near the anus, gently push it upward, and it will be born.

For obstructed labor where the head is correct but cannot descend, caused by fetal rotation issues or umbilical cord entangling the shoulder, press both shoulders with the middle finger, untangle the cord, and it will be born.

For seated labor, just before birth, if the mother is exhausted and sits long on chairs/cushions blocking the path, urgently hang a towel/belt high, let the mother hold it, gently bend legs, and after a while, the baby will be born smoothly.

For "dripping fluid birth" (also called "draining sac birth"), where fluid leaks for one or two days without birth, or even several days, it is harmless. Simply sleep and wait until fluid flow decreases or stops, and it will self-deliver. Do not panic or use manual methods. If fluid drains completely but Qi mechanism remains blocked, causing dry dystocia, do not leave it to nature. Urgently decoct a large amount of Si Wu Tang (Four Substances Decoction), about 2-3 jin, in a large pot in the room, filling the room with medicinal vapor to be inhaled for nourishment. Take Jia Wei Xiong Gui Tang. If one dose is ineffective, wait a short while and take another, continuously until birth. This refers to dry fetus before membrane rupture. If the baby has already emerged from the sac, it is advisable to have a competent midwife manually assist removal.

Addendum: Doctor Wang Zhu from Choucheng said: There was a midwife named Zheng Xianjie, a skilled practitioner. She claimed: Only transverse presentation must be pushed straight; lateral presentation must absolutely not be twisted. Wait for both feet to descend, then use a method to lift the baby's arms upward, making birth easy. With proper technique, mother and child remain safe. She also said: Umbilical cord entangling the shoulder does not require finger manipulation and does not hinder birth. The cord may wrap around the waist or head. Even if wrapped around the head two or three times and the baby cannot cry, removing it allows crying; keep this view for reference.

Someone asks: What is the cause of "prolapsed intestine birth"? I say: It is due to excessive force. Because the parturient woman usually has Qi deficiency, and upon exerting force during labor, all Qi and Blood rush downward, causing the intestine to follow the baby out. Once this happens, the path becomes familiar, and it happens again next time. If one waits for the natural time ("ripe melon falls"), how could such strangeness occur?

Appendix: In prolapsed intestine birth, the mother's intestine drags out during labor. After the baby is born, if the intestine does not retract, urgently apply sesame oil to prevent wind invasion. Use forty-nine castor seeds, remove shells, crush, and apply to the center of the mother's scalp. Internally take ascending and tonifying agents, such as Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), Shi Quan Da Bu Tang (Ten Significant Tonifying Decoction), or Ba Zhen Tang (Eight Treasures Decoction), doubling the dose of Sheng Ma (Cimicifugae Rhizoma) to ascend and tonify, and the intestine will naturally retract. Once retracted, urgently wash off the castor seed paste from the scalp. If dried by wind and cannot retract, use a little whetstone water, warm it, moisten the intestine, and simultaneously decoct high-quality Magnetitum (Magnetic Hematite) to drink; the intestine will retract. Magnetitum, commonly known as lodestone, is best if verified by Yin-Yang practitioners. Common custom sprays water on the mother's face/back to startle her into retracting the intestine. However, startling scatters Qi, potentially causing harm; beware! After experiencing prolapsed intestine once, during the next pregnancy at five or six months, pre-administer herbs that tonify the middle and ascend, so as to avoid this during labor.

Someone says: There are cases where birth happens immediately after one pain, catching people off guard. Why is this? I say: This is the normal principle; why is it strange! Because fetal Qi is sufficient...

Someone asks: Are midwives unnecessary? I say: Since such people exist, they cannot be entirely unused, but one must employ them, not be employed by them. Rely entirely on oneself, do not obey them. Generally, these people are foolish, lacking understanding. Upon entering, regardless of timing or experience, they order sitting on the mat and exerting force, insisting the head is there, ordering waist/abdomen rubbing, or inserting hands into the birth canal to probe, often causing injury. They seek credit and refuse to stay quiet. Worse are cunning women using this to hoard and profit, bringing unspeakable disasters.

Note: Between Wu and Yue, they are called Wen Po (steady grandmother/midwife); between Jianghuai, Shou Sheng Po (receiving birth grandmother); between Huining, Jie Sheng Po (connecting birth grandmother). The meaning of "receive/connect" implies that due to their age and experience, they are asked to catch the baby landing and place the baby on the bed, not necessarily to perform manual interventions. Often seeing wealthy families keeping midwives at home, if labor is slightly slow, they summon countless midwives through front and back doors, creating chaos. As the saying goes, "The world originally has no trouble; fools create it themselves."

Appendix: Families expecting labor must use a receiving midwife, selecting an experienced, sensible person beforehand. Unless necessary, do not let them perform manual tests like checking water or probing fluid. Just instruct them to wait calmly for birth.

Someone asks: Can experienced drugs be used temporarily? I say: No. Formerly, miraculous formulas included Rat Kidney and Rabbit Brain Pills; currently, Hui Sheng Dan (Revive Life Pill) is prevalent. It is not that they are ineffective, but simply unnecessary. Since no force is used, no manual intervention, and sleep aids, the baby will be born naturally; why use medicine? Even if不顺 (not smooth), sleep is the best strategy.

Appendix: Sleep is indeed the best strategy, but slight activity is also needed.

Someone says: Is taking medicine beneficial without harm? I say: How can it be without harm? Rat and Rabbit pills greatly consume Qi and damage Blood; Hui Sheng Dan greatly breaks Blood... the harm is significant. It opens pores, inviting wind inward, disaster unspeakable. Hui Sheng Dan uses Da Huang (Rhei Radix et Rhizoma) and Hong Hua (Carthami Flos) as chief ingredients, others are mostly draining items. Blood is already consumed and then further broken, often causing postpartum fever and other diseases, endless troubles, all blamed on postpartum maladjustment, who blames the medicine?

Note: These few formulas, called spiritual treasures in ancient and modern times, are thus; others can be imagined. Those sending medicine have good intentions but know only benefits, not harms.

Someone asks: Are there really no usable medicines? I say: Yes. Only Jia Wei Xiong Gui Tang (Modified Ligusticum and Angelica Decoction) and Fo Shou San (Buddha's Hand Powder) are sufficient. During pregnancy, blood must be sufficient; once sufficient, like a boat having water, why worry about not moving? We only fear the mother's blood is scant, or membranes break early, causing dryness. Both formulas use large amounts of Xiong Gui (Ligusticum and Angelica), removing old blood instantly, generating new blood rapidly. Medicinal flavors are easy to obtain everywhere, strengthening the body, preventing postpartum illness, truly beneficial without harm. These are formulated by sages understanding Yin-Yang principles to benefit the world. Alas, people value hearsay over sight, considering them ordinary and unused, seeking strange medicines instead, caring only for strangeness, not benefit or harm. How lamentable!

Appendix: If pregnancy strength is robust and fetus is full, induction is unnecessary. Induction merely assists Qi and Blood to facilitate birth. Thus, Jia Wei Xiong Gui Tang and Fo Shou San are excellent. For Qi deficiency, Du Shen Tang (Single Ginseng Decoction) at term is first choice. At labor, prepare Chen Mi Yin Tang (Aged Rice Drink). If medicines are unavailable, drink this first to calm the stomach and sustain strength.

Someone asks: Based on this, are there no difficult births in the world? I say: Occasionally there are. Due to maternal deficiency, insufficient fetal nourishment, incomplete Qi and Blood; or maternal cold-heat toxin damaging the fetus after Shang Han (Cold Damage disease); or excessive intercourse damaging the fetus with desire fire; daily overconsumption of spicy, fried hot foods damaging the fetus with fire toxin; or falls and injuries, all causing dystocia, often resulting in intrauterine fetal death. Apart from these, there are no dystocias. Also, in severe cold weather, when water freezes, poor households with weak fire heat cause blood cold and freezing, preventing birth. But this is also due to entering labor too early, removing clothes and sitting long. If covered and lying quietly waiting for the time, this hazard would not exist.

For difficult births, or babies born not crying or dead due to cold weather, urgently wrap in clothes, then use sesame oil paper twists (sesame oil is lamp oil, paper twist is rolled straw paper) to slowly burn the umbilical cord (prepare many oil-paper twists, burning consecutively, dozens if needed). Warm air enters the abdomen, gradually making sounds and reviving. If the cord is cut first, the baby dies.

Appendix: Alternatively, sit the baby in warm water, burn the cord with oil-paper twists while massaging shoulders, back, chest, and abdomen with warm water, replacing water when cold, burning frequently until the baby lives. This is another method.

Someone asks: How about diet during labor? I say: At this time, with anxiety, abdominal pain, mental fatigue, and loss of taste, good diet is needed for regulation, but not overly greasy.

First, advise relaxation, quietness, enduring pain, and resting. Avoid大惊小怪 (making a fuss), whispering, sighing in the room, which causes anxiety and confusion, leading to mistakes. The room should be quiet as usual, no praying or cursing aloud.

Only one midwife should enter the room, sitting quietly aside, not causing chaos. Diet should be given frequently in small amounts to aid spirit.