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Women are fundamentally based on blood. Only when the Qi mechanism is smooth can the blood harmonize, the fetus remain secure, and delivery proceed smoothly; why then wait for various other care measures? However, those in wealthy families indulge their desires and act arrogantly, causing essence and blood to coagulate and stagnate within the gestational sac. Moreover, they indulge in comfort and do not exercise at all, resulting in a thickened and dense gestational sac. Or they consume raw, cold, and hard foods, causing Qi and blood to stagnate. Or they experience fright during labor; fear leads to timidity of spirit and sinking of Qi, causing obstruction and blockage in the lower Jiao, preventing circulation. All these lead to difficult labor.

If abdominal pain comes and goes intermittently, it is called "Nong Tai" (Playing Fetus). If amniotic fluid drips out in small amounts, it is called "Shi Shui" (Testing Water). Although both the navel and abdomen hurt, and the fetus has turned, if there is no back pain, one must not panic. One must strictly forbid midwives from palpating the abdomen or inserting hands to probe, as this may cause the membranes to rupture and amniotic fluid to dry up, making fetal movement difficult. One must wait until the time is right, contractions are tight, water breaks with back pain, eyes feel like burning fire, and the fetus presses against the birth canal, before getting into bed to deliver ("Zuo Cao"). Only after the fetal head is aligned correctly should one exert force to push. If the family panics and the midwife acts rashly, causing the mother to get into bed too early and exert excessive force, leading to exhaustion while still unable to deliver, only then should parturition-inducing medicines be used. Yet, one must not lightly use harsh/potent formulas, as this will merely drain the water passages and further complicate delivery.

In midsummer, when Qi scatters and blood boils, a large basin of water should be placed in the delivery room to absorb summer heat toxins, and old lacquerware should be burned occasionally to prevent blood syncope. In severe winter, when Qi and blood stagnate, the delivery room should be warmed by fire, and lower-body clothing and bedding should be thickened to avoid fetal coldness and blood coagulation. These care methods should especially be adapted according to the seasons.

First is "Zheng Chan" (Normal Delivery). After ten months of pregnancy, Yin and Yang Qi are sufficient. Suddenly, paroxysmal pain begins, the fetus reaches the birth canal, membranes rupture, and the placenta descends; the infant is born normally.

Second is "Shang Chan" (Traumatic Delivery). The fetus is not yet full-term but is disturbed/injured, causing sudden abdominal pain. This may result from taking parturition-inducing medicine too early or the mother exerting excessive force, forcing the fetus onto the wrong path, preventing normal birth. Therefore, delivery requires waiting for the fetal body to turn and align with the birth canal, then exerting effort to push once, resulting in natural birth.

Third is "Cui Sheng" (Induced Delivery). When labor begins, if the fetal head has reached the birth canal but delivery remains delayed, medicine should be used to induce it. Or if time has dragged on and the mother is exhausted and unable to sustain herself, medicine should be taken to assist her Qi and Blood, enabling rapid birth.
Note: The phrase "assist her Qi and Blood" is very profound and requires careful contemplation.

Fourth is "Dong Sheng" (Cold-induced Delivery). In cold weather, maternal Qi and Blood stagnate, preventing rapid birth. It is essential to keep the delivery room warm and thicken clothing/bedding so the mother remains warm, avoiding blood coagulation and fetal stagnation.

Fifth is "Re Sheng" (Heat-induced Delivery). In summer, if the mother's heat is severe, she may suffer headache, red face, and fainting. Crowded rooms with stifling air also cause this condition, named "Xue Yun" (Blood Syncope). Placing many basins of water helps absorb heat toxins, preventing hemorrhage and syncope. However, if there is cool wind or rain, one must carefully avoid exposure.

Sixth is "Heng Sheng" (Transverse Delivery). This occurs because the fetus is turning, and the mother forces it, causing the fetal head to be misaligned. The mother should lie quietly on her back. Push the fetal body straight and adjust the head to face the birth canal. During pushing/manipulation, use the middle finger to probe the fetal shoulder to ensure the umbilical cord does not entangle. Then use medicine to induce. Generally, a single strong push results in birth. Use Xiong (Chuanxiong Rhizome), Gui (Angelicae Sinensis Radix), E'jiao (Colla Corii Asini), Kuizi (Abelmoschi Fructus), and Huashi (Talcum) ground into powder, mixed with wine and honey for administration. Ancients used "San Tui San" (Three Retreats Powder) ground into powder, mixed with honey.

Seventh is "Dao Sheng" (Breech/Inverse Delivery). This happens because the fetus has not yet turned, due to the mother's forced efforts. The mother should lie quietly on her back. Let the midwife slowly push the fetal feet back into the abdomen, waiting for the fetal body to naturally align. Do not panic. If birth is delayed for a long time, let the midwife gently push the foot to one side, directly upward to rotate the fetus, letting the fetal head gradually descend on one side, aligning with the birth canal. Then take parturition-inducing medicine and push strongly to deliver.

Eighth is "Pian Sheng" (Oblique Delivery). This occurs because the fetal head has not aligned with the birth path, and the mother's forceful push causes the head to deviate to one side. Although the vertex is visible, it is actually the temporal angle. The mother should lie on her back. Gently use hand to correct the fetal head and face to align with the birth canal; one push will deliver. If the occiput deviates to the anus while the temporal angle appears first, let the midwife wrap hands in heated cotton cloth and gently push from outside the anus; with effort, it will deliver naturally.

Ninth is "Ai Sheng" (Obstructed Delivery). The fetal body is correct, the path is clear, and the head is visible. However, during turning, the umbilical cord entangles the shoulder, causing difficulty. The mother should lie on her back. Gently push the fetus upward, using the middle finger to lift the shoulder to release the cord. Wait for the fetal body to align, then one push delivers.

Tenth is "Zuo Chan" (Sitting Delivery). When the fetus is about to be born, hang a towel securely at a high place. Let the mother hold it, gently bending her legs. After a while, the fetus will be born smoothly.

Eleventh is "Pan Chang Sheng" (Prolapsed Intestine Delivery). During labor, the small intestine protrudes first, followed by the baby. The intestine does not retract, called "Pan Chang". Immediately soak an old cloth in hot water and cover the intestine without bandaging. Externally, spray half a cup of vinegar and half a cup of fresh well-water onto the mother's back. Each spray causes retraction; repeat until fully retracted. Do not panic. Apply "Ru Sheng Gao" (Like-Saint Ointment) to the top of the head; wash off after retraction. Another method: blow Banxia (Pinelliae Rhizoma) powder into the nose to retract. Another method: smoke the nose with paper smoked with sesame oil. Another method: use a little grinding stone water, warmed over fire, to moisten the intestine, then drink a cup of decoction made from Cishi (Magnetitum). Magnetite attracts iron; perhaps the grinding water aids this magnetic attraction. If the intestine has been out too long, dried by wind, and cannot retract, store it in a clean vessel and soak it in Huangqi (Astragali Radix) decoction.

Twelfth is "Jiao Gu Bu Kai, Yin Men Bu Bi" (Pubic Symphysis Diastasis, Vaginal Laxity). Both conditions arise from inherent weakness of Yuan Qi (Original Qi) and lack of proper care during pregnancy, leading to failure of Qi and Blood to circulate. For pubic symphysis diastasis, caused by deficiency of Yin Qi, use Jiawei Xiong Gui Tang (Modified Chuanxiong and Angelica Decoction). For vaginal laxity, caused by deficiency of both Qi and Blood, use Shiquan Dabu Tang (Ten Complete Tonifying Decoction).