临产时最戒用力太早，《脉诀》云∶夜半觉痛应分娩，来朝日午定知生。由此观之
则腹痛半日后恰当产也。但产之难易，人各不同，时亦有异，有素易产，有素难产
者，有先难后易，先易后难者，俱无一定。如临产腹痛不生，非是难生，还是子未出
胎，产母切勿惧怕，即一日二日至三五日无妨，安心定气，任其自然，勉强忍痛，进其
饮食，要坐则坐，要行则行，要睡则睡，保养精神为第一，莫听稳婆逼迫，用力太早，
自己亦勿求速于离身，傍人亦勿多言恐惧，以乱其心，时至自然分娩，譬如登厕，未急
则难，时急自易，此理虽俗，知此免患。盖
稳婆逼迫有二，有不知时候逼迫者，有急完此家复往他家者，极误大事。
一未产前几固时辰，子亦要出产户，转身至手，被母用力一逼，即手先出，转身至
脚，母力一逼，即脚先出，横生倒生，皆因错于用力，其实无手足先出之理，故腹痛数
日而不生者，不宜慌忙。今人见其一日半日不产，即谓难生，老少惊惶，求神许愿，产
妇见之，必生忧恐一有忧恐之心，自然无胆气，无精力，难饮食，不审此非难生，乃是
时候未至，惟宜忍痛候时，若乃悯其痛甚，急欲离身，稳婆傍人强之用力，时候未到，
用力太早，关系母子性命，胡不明理，一至此哉！斯时稳婆以意推度，产妇以意审详，
切不可轻易催迫用力，必俟脐腹痛极，腰间重痛，眼中如火，谷道迸急，胞水或血惧
下，脉见离经，或沉细滑，此时子已出胎，产母方用努力，庶不误事。如数候未见，切
不可性急乱为，以致神气早疲，临产却无精力，不能运送出外，并致产后多虚矣。故将
产，宜浓煎人参汤时饮，补接助之。
一有用力太早，致令水衣先破，被风所吹，因而产户肿胀干湿狭小，最令难产者，
只多几个时辰，从容俟之无妨。又有稳婆无知害人，私以手指掐破水衣者，极要关防。
将产最戒曲身眠卧，虽甚腹痛，宜强为站立，散步房中，或免凡立，切戒挛腰，以助
儿转舒寻路也。盖产母畏痛，不肯直身行动，多爱曲腰眠卧，以致胎元转动不顺，儿
子寻到产门，被母曲腰遮闭，再转又再闭，则子必无力，而不能动，决至难产。人见其
不动，则谓胎死，其实因无力而非死也。此时恁有良方妙药，不能令子有力而动，只要
补接产母元气，更要心安气和，调理精神，胎元胜复，可保无虞。又有胞水已下，子忽
不动，停一二日三五日者有之，调补气血之外，切戒惊恐，忧惧暴性，盖惊则神散，忧
则气结，暴则气不顺，血必妄行，多致昏闷，知此善调，自然无恙。
一将产时，须迸饮食，戒喧闹。盖进饮食，则气充胆壮，免致饥渴虚乏无力，戒喧
闹，则神静自安，切勿烦躁，静则神藏，躁则消亡也。其食宜觅母鸡煮汁作粳米稀粥与
食，不可食鸡及诸肉食，常令稍饥为佳，盖饥则气下，气下则产速，若多食肉食，则碍
于上焦，气不得下，故产难。产后亦令勿食过饱，致生疾病。
一临产腹痛而腰不甚痛，产未急也。须扶起直身而行。若行不得，则倚物而立，
盖产自有时，如果熟香飘，瓜熟蒂落，不可仓皇鲁莽，反致有害也。痛时稍放裙带，以
便儿在腹中，转舒有余地也。
一临产时，凡丧孝秽浊人，尼姑孤寡不洁人，莫令入房，致产不利。惟老成解事，
曾经生长者，二三人足矣。俗忌人知，多亦难产，多一人入房，则多一时迟延，此亦当忌。
一产时以饮食为本，有等妇人临产不能饮食者，则精气不壮，何以用力？须未产
前，预买好人参四五钱，如虚极者，及向有产晕者，一二两任用，待将产时，煎汁一钟
听用，审是儿将来时，以此服之，大助精力，胜于肉食百倍。产后人参不可乱投，若
果系虚症，必兼温暖药用，如黑干姜之类。如一产后，以人参五钱，当归二钱，煎汤，
冲入童便，产下即服，元补诸虚，兼却产后百病。（张）常用于极虚之人，产后犹如未产之健旺。
一产后渐进玉米饮，取糠气能降虚火也。白粥宜极稀，以渐调理为上，三朝内不
可食荤及鸡子，及粘硬之物，六七日上胃强者，可少与母鸡、牛肉、鲫鱼作清羹，少少食之。
一将产救生法。凡手先出名曰横生，足先出名曰倒生，相传手出者曰觅盐生，此亦
有理，人未讲明，盖盐主收敛紧缩。又腌螫肌肉疼痛，儿手得盐，且痛且缩，自然转身
顺下，觅盐之名，本于此也。其治法如手足
先出者，急令产母仰卧，略以盐涂儿手心足心，仍以香油抹之，轻轻送入，即便自转顺
生，不可任其久出，久则手足青而子伤，难以送入，亦不可妄用催生方药，盖手足之
出，非药可治。又切勿误听凶妇，用力断手，一断子必腹中乱搅而伤母矣。屡见死
胎，人不慌忙逼迫，亦迟迟生下，而不伤母。夫死胎亦生者，何也？盖人腹中极热，
食物则入内俱化，其胎虽死，人不忙迫，产母安心饮食，腹内热气熏蒸，胎自柔软腐
化，亦生而不伤母。但所出秽气，令人难闻，可见死胎不必用力，况活胎乎？屡见无
知稳婆，轻令用力，动伤两命，特此谆谆。又见有怪胎，人不惊慌，亦自然生下，但勿
令产母知之。又产母危急时，当看面舌，面以候母，舌以候子，面青母伤，舌青子伤，
面赤舌青，子死母活，面舌俱赤，子母无恙，面舌俱青，口中吐沫者，子母难保。（张
秘授一方，专救难产及死胎，交骨不开，神验。用广猴血钱余，酒化服下，立产。）
一将产救生手法，如门户俱正，儿亦露顶而不下，此必因儿转身肚带攀其肩也，名
曰碍产。治法令母仰卧，轻轻推儿向上，以手中指按儿肩，去其肚带，候儿顺正，用力
送下。又有生路未正，被母用力一逼，令儿偏柱左右腿畔，儿头在产户不下，但云，
儿已露顶，非顶也，乃额角也，名曰偏产。治法亦令产母仰卧，轻轻推儿近上，以手扶
其额顶端正，用力一逼即下。又有头之后骨，偏柱谷道，儿乃露顶，名曰HT 后。治法
以绵衣裹手，急于谷道外傍，轻轻推儿头令正，然后用力一逼即下，或用膝头令产母抵
住亦可。三产之难，皆母曲腰眠卧，用力太早致之。三手之法，非历练有分晓稳婆，不可轻易。
一子出户时，人即以两手抱产母胸前，产母亦自以手紧抱肚腹，令胎衣下坠，如胎
衣来迟，切勿慌忙，以草纸烧烟熏鼻即下。再迟则急断脐带洗儿，仍用软帛物系坠脐
带，系时尤宜轻巧牢固，然后截断。此带极脆，若不便断脐带，恐血反潮入胞中，胀而
不下，攻心则伤。如稳婆诸事者，能以手指取下甚便。有产母胎衣久不下，一方用黑牛
粪，略焙带润，以布裹之，束于腹上即下。
一恚音闷脐生，相传有呼父乳名，手拍儿股者，此理亦未讲明，盖儿粪门有一膜，
闷住儿气，故不能出声，拍之则膜破而能叫哭。如拍之犹不破，须用女人轻巧者，以银
簪脚轻轻挑破甚便。或不能挑急，用暖衣紧包，勿令散放，以热水浸其胞衣，寒天则加
火热之，久则热气内鼓，其膜自破，膜破则出声而苏矣。
一妇人有盘肠生者，未产肠先盘出，其治法急将净盆一温水，冬则热水，入香油养
润，侍儿并胞衣俱下，产母吸气上升，稳婆香油涂手，徐徐送入。有醋水喷面，令产妇
惊寒气提，虽可收肠，常多误事，不可用也。又有儿并胞衣下后，膀胱（即尿胞）
壅出产户者，同前法送入。此皆用力太早，五内动摇之故。送入后宜服安脏调补药。
薛立斋曰∶欲产时，觉腹内转动，即当正身仰卧，待儿转身向下，其时作痛，试捏
产母手中指中节，或本节跳动，方临盆即产。或未产而水频下，此胞衣已破，血水先
干，必有逆生难产之患。若胞衣破，不得分娩，用保生无忧散，以固其血。如血已耗
损，八珍汤加益母草浓煎，时饮之。凡孕妇止腹痛，未产也。连腰痛者，将产也。肾候
于腰，胞系于肾故也。凡孕有生息不顺，宜嘱稳婆，只说未产。或遇双胎，只说胞衣，
恐惊则气散，愈难生息，大抵难产多患郁闷，安佚富贵之家，治法虽云胎前顺气，产
后补血，不可专执。若脾胃不实，气血不充，宜预调补之。
冻产者，冬月天冷，产母经血得冷则凝，致儿不能下，此害最深，故冬月产者，
下部不可脱去绵衣，并不可坐卧寒处，务使满房闱炉，常有暖气，令产母背身向火，脐
下腿膝间常暖，血得热则行，儿易生也。
热产者，盛夏产妇要温凉得所，不可过凉，反增疾病，不可人多，热气逼袭，令产
母心烦，热血沸腾，有郁冒冲晕之患。
临产时最忌讳过早用力。《脉诀》说：“半夜感到疼痛，第二天中午必定分娩。”由此看来，腹痛半天后应当分娩。但是生产的难易，每个人各不相同，时间也有差异，有的素来容易生产，有的素来难产，有先难后易的，有先易后难的，都没有一定之规。如果临产时腹痛但不分娩，并不是难产，而是胎儿尚未产出胎外，产妇千万不要害怕，即使是一两天到三五天也没有妨碍，安心定气，顺其自然，勉强忍受疼痛，进食饮食，想坐就坐，想走就走，想睡就睡，保养精神是第一位的，不要听信接生婆（稳婆）的逼迫而过早用力，自己也不要急于脱离身体之苦，旁人也不要多言制造恐惧，以免扰乱她的心神，时候到了自然分娩，就像上厕所一样，不急着解则困难，时机急了自然容易，这个道理虽然通俗，但懂得此理可免除祸患。
接生婆的逼迫主要有两种情况：一种是不懂时辰而逼迫的，一种是急于结束这一家的事情又去另一家的，这极容易耽误大事。
有一种情况是产前还没到时辰，胎儿也要出产门，转身至手部，被母亲用力一逼，手就先出来；转身至脚部，母亲用力一逼，脚就先出来，横生倒生，都是因为错误地用力造成的，其实并没有手脚先出来的道理，所以腹痛数日而不生的，不宜慌张。现在的人见其一天半天不生，就说难产，老少惊慌，求神许愿，产妇看见这样，必然产生忧恐之心，一旦有了忧恐之心，自然没有胆气和精力，难以进食，不明白这不是难产，而是时候未到，只宜忍痛等待时机。如果怜悯她疼痛剧烈，急于让她生下孩子，接生婆和旁人强迫她用力，时候未到，用力太早，关系到母子性命，为什么不明理至此呢！此时接生婆凭心意推测，产妇凭心意审察，切不可轻易催迫用力，必须等到脐腹疼痛至极，腰部沉重疼痛，眼中如火，肛门紧迫，胞水或血液下坠，脉象出现离经之脉，或沉细滑，这时胎儿已出胎，产妇方才用力，才不会误事。如果几个时辰未见动静，切不可性急乱为，以致神气早疲，临产时却没有精力，不能运送胎儿出来，并导致产后多虚证。所以在将产时，宜浓煎人参汤时时饮用，以补益接续元气。
有一种情况是用力太早，导致胞衣（水衣）先破，被风所吹，因而产户肿胀、干湿狭小，最令难产，只是多花几个时辰，从容等待没有妨碍。又有接生婆无知害人，私自用手指掐破胞衣的，极要防范。
临产最忌讳弯曲身体躺卧，即使非常腹痛，也应勉强站立，在房中散步，或者避免总是站立，切戒弯腰驼背，以助胎儿转动舒展寻找出路。因为产妇畏惧疼痛，不肯直身行动，大多喜爱曲腰躺卧，以致胎元转动不顺，胎儿寻到产门，被母亲曲腰遮蔽关闭，再转又再闭，则胎儿必无力，而不能动，最终导致难产。人们见其不动，就说胎死，其实是因为无力而非死亡。此时纵有良方妙药，也不能让胎儿有力而动，只要补益接续产妇元气，更要心安气和，调理精神，胎元胜复，可保无虞。又有胞水已下，胎儿忽然不动，停一二天或三五天的情况，除了调补气血之外，切戒惊恐、忧惧和暴怒，因为惊则神散，忧则气结，暴怒则气不顺，血必妄行，多导致昏闷，懂得这些善于调理，自然无恙。
将要生产时，必须进食饮食，戒除喧闹。因为进食饮食，则气充胆壮，免致饥渴虚乏无力；戒除喧闹，则神静自安，切勿烦躁，静则神藏，躁则消亡。食物宜找母鸡煮汁做粳米稀粥给产妇吃，不可吃鸡及各类肉食，常令稍饿为佳，因为饥饿则气下，气下则生产迅速，若多吃肉食，则碍于上焦，气不得下，故生产困难。产后也令不要吃得过饱，以致生疾病。
临产腹痛但腰部不很痛，说明生产不急。须扶起直身而行。如果走不了，则倚靠物体站立，因为生产自有定时，如同果实熟透香气飘散，瓜熟蒂落，不可仓皇鲁莽，反致有害。疼痛时稍微松开裙带，以便胎儿在腹中有转动舒展的余地。
临产时，凡是丧孝秽浊之人，尼姑孤寡不洁之人，不要让进入产房，致使生产不利。只有老成懂事、曾经生育过的，两三个人就够了。世俗忌讳别人知道，人多也难产，多一个人进房，就多一时迟延，这也应当忌讳。
生产时以饮食为本，有些妇人临产不能饮食，则精气不壮，何以用力？须在未产前，预先买好人参四五钱，如果虚损极重的，以及向来有产晕情况的，用一两二两随意使用，等到将产时，煎汁一杯备用，审察是胎儿将要来时，以此服用，大助精力，胜过肉食百倍。产后人参不可乱投，如果确实是虚症，必须兼用温暖药物，如黑干姜之类。如一产后，用人参五钱，当归二钱，煎汤，冲入童便，产下即服，元补诸虚，兼治产后百病。（张氏）常用于极虚之人，产后犹如未产时的健旺。
产后渐进玉米饮，取谷壳之气能降虚火。白粥宜极稀，以逐渐调理为上，三日内不可食荤腥及鸡蛋，及粘硬之物，六七日上胃强者，可少量给予母鸡、牛肉、鲫鱼做清羹，少量食用。
将要生产的救生法。凡手先出来的叫横生，足先出来的叫倒生，相传手出来的叫“觅盐生”，这也有道理，人未讲明，因为盐主收敛紧缩。又腌肉使肌肉疼痛，胎儿手得盐，既痛且缩，自然转身顺下，“觅盐”之名，本于此。其治法如手足先出的，急令产妇仰卧，略以盐涂婴儿手心足心，仍以香油抹之，轻轻送入，即便自然转身顺生，不可任其久出，久则手足青紫而伤子，难以送入，也不可妄用催生方药，因为手足之出，非药可治。又切勿误听凶妇之言，用力断手，一断胎儿必在腹中乱搅而伤母矣。屡见死胎，人不慌忙逼迫，亦迟迟生下，而不伤母。死胎也能生下来的原因是什么呢？因为人腹中极热，食物进去都化掉，其胎虽死，人不忙迫，产妇安心饮食，腹内热气熏蒸，胎自柔软腐化，亦生而不伤母。但所出秽气，令人难闻，可见死胎不必用力，何况活胎呢？屡见无知接生婆，轻令用力，动伤两命，特此谆谆告诫。又见有怪胎，人不惊慌，亦自然生下，但勿令产妇知道。又产妇危急时，当看面舌，面部以候产妇，舌头以候胎儿，面青母伤，舌青子伤，面赤舌青，子死母活，面舌俱赤，子母无恙，面舌俱青，口中吐沫者，子母难保。（张氏秘授一方，专救难产及死胎，交骨不开，神验。用广猴血钱余，酒化服下，立产。）
将要生产的救生手法，如门户俱正，胎儿也露顶但不下来，这必因胎儿转身肚带攀其肩也，名叫碍产。治法令母仰卧，轻轻推儿向上，以手中指按儿肩，去掉其肚带，候儿顺正，用力送下。又有生路未正，被母用力一逼，令儿偏柱左右腿畔，儿头在产户不下，只说儿已露顶，不是头顶，乃额角也，名叫偏产。治法亦令产妇仰卧，轻轻推儿近上，以手扶其额顶端正，用力一逼即下。又有头之后骨，偏柱谷道，儿乃露顶，名叫HT后（注：原文此处可能有误，通常指臀位或枕后位等，依文意保留）。治法以绵衣裹手，急于谷道外傍，轻轻推儿头令正，然后用力一逼即下，或用膝头令产妇抵住亦可。这三种生产的困难，都是母亲曲腰眠卧，用力太早导致的。这三种手法，非历练有分晓的接生婆，不可轻易尝试。
胎儿出户时，人即以两手抱产妇胸前，产妇亦自以手紧抱肚腹，令胎衣下坠，如胎衣来迟，切勿慌忙，以草纸烧烟熏鼻即下。再迟则急断脐带洗儿，仍用软帛物系坠脐带，系时尤宜轻巧牢固，然后截断。此带极脆，若不便于断脐带，恐血反潮入胞中，胀而不下，攻心则伤。如接生婆诸事熟练者，能以手指取下甚便。有产妇胎衣久不下，一方用黑牛粪，略焙带润，以布裹之，束于腹上即下。
恚音闷脐生（注：指新生儿窒息），相传有呼父乳名，手拍儿股者，此理亦未讲明，盖儿粪门有一膜，闷住儿气，故不能出声，拍之则膜破而能叫哭。如拍之犹不破，须用女人轻巧者，以银簪脚轻轻挑破甚便。或不能挑急，用暖衣紧包，勿令散放，以热水浸其胞衣，寒天则加火热之，久则热气内鼓，其膜自破，膜破则出声而苏矣。
妇人有盘肠生者，未产肠先盘出，其治法急将净盆一温水，冬则热水，入香油养润，待儿并胞衣俱下，产妇吸气上升，接生婆香油涂手，徐徐送入。有醋水喷面，令产妇惊寒气提，虽可收肠，常多误事，不可用也。又有儿并胞衣下后，膀胱（即尿胞）壅出产户者，同前法送入。此皆用力太早，五内动摇之故。送入后宜服安脏调补药。
薛立斋说：欲产时，觉腹内转动，即当正身仰卧，待儿转身向下，其时作痛，试捏产妇手中指中节，或本节跳动，方临盆即产。或未产而水频下，此胞衣已破，血水先干，必有逆生难产之患。若胞衣破，不得分娩，用保生无忧散，以固其血。如血已损耗，八珍汤加益母草浓煎，时饮之。凡孕妇止腹痛，未产也。连腰痛者，将产也。肾候于腰，胞系于肾故也。凡孕有生息不顺，宜嘱接生婆，只说未产。或遇双胎，只说胞衣，恐惊则气散，愈难生息，大抵难产多患郁闷，安佚富贵之家，治法虽云胎前顺气，产后补血，不可专执。若脾胃不实，气血不充，宜预调补之。
冻产者，冬月天冷，产妇经血得冷则凝，致儿不能下，此害最深，故冬月产者，下部不可脱去绵衣，并不可坐卧寒处，务使满房闱炉，常有暖气，令产妇背身向火，脐下腿膝间常暖，血得热则行，儿易生也。
During labor, it is most taboo to exert force too early. The *Mai Jue* (Pulse Classic) states: "If pain is felt at midnight, delivery will surely occur by noon the next day." From this, it can be seen that delivery should occur half a day after the onset of abdominal pain. However, the difficulty of childbirth varies from person to person and time to time; some are naturally easy to deliver, others difficult; some have difficulty first then ease, others ease first then difficulty; there is no fixed rule. If during labor there is abdominal pain but no delivery, it is not dystocia (difficult childbirth), but rather the fetus has not yet exited the womb. The mother must not be afraid; even if it takes one or two days to three or five days, there is no harm. One should calm the mind and spirit, follow nature's course, endure the pain, eat and drink, sit when desired, walk when desired, sleep when desired, with preserving spiritual energy as the top priority. Do not listen to midwives urging premature exertion of force, do not seek to hasten the separation from the body yourself, and bystanders should not speak fearfully to disturb her mind. When the time comes, delivery will happen naturally. It is like using the toilet: if not urgent, it is difficult; when urgent, it is easy. Though this logic is common, knowing it prevents disaster.
Midwives' pressure generally falls into two categories: those who urge without knowing the proper timing, and those eager to finish one case to go to another, both of which can severely delay matters.
In some cases, before the proper time, the fetus attempts to exit the birth canal. If it turns to the hand and the mother exerts force, the hand may emerge first; if it turns to the foot and the mother exerts force, the foot may emerge first. Breech presentation (Heng Sheng / Dao Sheng) results from incorrect exertion of force. In reality, hands or feet should not emerge first. Therefore, if there is abdominal pain for several days without delivery, one should not panic. Nowadays, people see no delivery after half a day and claim it is dystocia, causing panic among family members who pray and make vows. Seeing this, the mother becomes anxious and fearful. Once anxiety arises, courage and energy diminish, eating becomes difficult. Not understanding that this is not dystocia but merely untimely, one should only endure pain and wait. If pitying her severe pain and wishing for immediate delivery, midwives and others forcing her to push before the time is ripe risks the lives of both mother and child. Why is reason ignored to such an extent? At this time, the midwife should judge by intuition, and the mother should assess carefully. Do not easily urge pushing. Only when umbilical abdominal pain is extreme, lower back heavy pain occurs, eyes feel fiery, anus feels urgent, amniotic fluid or blood descends, pulse shows Li Jing (Departed from Normal) characteristics, or is deep, fine, and slippery, indicating the fetus has exited the womb, should the mother exert effort, so as not to cause error. If several hours pass without progress, do not act rashly out of impatience, lest spiritual energy fatigue prematurely, leaving no strength for delivery and resulting in postpartum deficiency. Thus, near delivery, decoct Ren Shen Tang (Ginseng Decoction) strongly and drink frequently to tonify and support Yuan Qi (Original Qi).
Another issue is premature exertion of force causing the amniotic sac (Shui Yi) to rupture early. Exposure to wind causes the vulva to swell, become dry, narrow, and small, leading to difficult labor. Merely waiting a few more hours calmly is harmless. Also guard against ignorant midwives who maliciously puncture the amniotic sac with fingers.
Near delivery, bending the body while lying down is strictly forbidden. Even with severe pain, one should stand and walk around the room, or avoid standing continuously. Strictly avoid hunching the waist, as this aids the fetus in turning and finding the path. Mothers fearing pain refuse to straighten up, preferring to lie curled. This impedes fetal movement. When the fetus reaches the cervix, the mother's curled waist blocks it. Repeated turning and blocking exhausts the fetus, making it unable to move, leading to dystocia. Observers seeing immobility assume fetal death, but it is actually weakness, not death. At this stage, even good prescriptions cannot give the fetus strength. The key is to tonify the mother's Yuan Qi, calm the mind, harmonize Qi, and regulate spirit. Once fetal vitality recovers, safety is assured. Sometimes amniotic fluid breaks, but the fetus stops moving for one to three days. Besides regulating Qi and Blood, avoid fright, worry, and rage. Fright scatters Shen (Spirit); worry knots Qi; rage disrupts Qi flow, causing erratic Blood movement and fainting. Understanding this allows proper regulation and ensures safety.
Near delivery, eating is essential, and noise must be avoided. Eating fills Qi and strengthens courage, preventing weakness from hunger/thirst. Avoiding noise calms Shen, preventing irritability. Stillness preserves Shen; agitation dissipates it. Food should preferably be rice congee made with hen broth. Chicken meat and other meats should be avoided. Slight hunger is best because hunger directs Qi downward, speeding delivery. Meat obstructs the Upper Jiao, preventing Qi descent, causing difficult labor. Postpartum, overeating should also be avoided to prevent disease.
If labor pains are in the abdomen but not the lower back, delivery is not imminent. Support the mother to walk upright. If she cannot walk, lean on something. Delivery has its own time, like a ripe fruit falling or a melon detaching. Do not rush, or harm may result. Loosen the skirt belt slightly during pain to give the fetus room to turn comfortably in the abdomen.
During labor, individuals involved in mourning, pollution, nuns, widows, or unclean persons must not enter the room, as this hinders delivery. Only experienced, sensible women who have given birth themselves, two or three in number, are sufficient. Superstition suggests fewer people aid delivery; each extra person delays the process. This should also be avoided.
Food is fundamental during labor. Some women cannot eat, leading to weak Jing Qi (Essence Qi) and inability to push. Before labor, purchase 4-5 qian of Ren Shen (Ginseng Radix et Rhizoma). For extreme deficiency or history of syncope during labor, use 1-2 liang. Near delivery, decoct one cup and keep ready. When it is clear the baby is coming, take this to greatly boost energy, far surpassing meat. Postpartum, do not administer Ren Shen indiscriminately. If truly deficient, combine with warming herbs like Hei Gan Jiang (Blackened Ginger Rhizome). A formula for postpartum uses 5 qian Ren Shen and 2 qian Dang Gui (Angelicae Sinensis Radix), decocted, mixed with Tong Bian (Boy's Urine), taken immediately after delivery. It tonifies all deficiencies and treats postpartum ailments. (Zhang) often uses this for extreme deficiency, restoring postpartum vitality to pre-pregnancy levels.
Postpartum, gradually introduce corn silk drink, as husk Qi can descend deficient fire. White rice porridge should be very thin, adjusted gradually. For three days, avoid meat, eggs, and sticky/hard foods. After six or seven days, if stomach strength returns, small amounts of hen, beef, or crucian carp clear soup may be given.
Emergency rescue methods near delivery: Hand-first presentation is called Heng Sheng (Transverse); foot-first is Dao Sheng (Breech). Tradition calls hand-first "Mi Yan Sheng" (Seeking Salt Birth). Salt has astringent properties. Salting meat causes pain and contraction. If the baby's hand contacts salt, pain and contraction cause it to turn and descend naturally. Treatment for hand/foot first: Lay mother supine. Apply salt to baby's palm/plantar surfaces, then sesame oil. Gently push back. The baby usually turns spontaneously. Do not leave limbs exposed long, as they may turn cyanotic and injure the baby, making reinsertion hard. Do not blindly use催产 drugs, as limb presentation is not treatable by medicine alone. Do not listen to wicked advice to amputate limbs; this causes fetal chaos and maternal injury. Dead fetuses often deliver slowly without force, sparing the mother. Why? The womb is hot; food digests internally. Even dead, if the mother is calm and eats, internal heat softens/decomposes the fetus, allowing safe expulsion despite foul odor. Thus, no force needed for dead fetuses, let alone live ones. Ignorant midwives often force delivery, killing both. This is earnestly warned. Abnormal fetuses may also deliver naturally if the mother is not panicked, provided she doesn't know. In critical moments, check face and tongue: Face reflects mother, tongue reflects fetus. Cyan face = mother injured; cyan tongue = fetus injured. Red face/cyan tongue = dead fetus/living mother. Red face/tongue = both safe. Cyan face/tongue with foaming = both endangered. (Zhang secret formula for dystocia/dead fetus/opened pelvis: Guang Hou Xue (Macaca Monkey Blood), approx. 1 qian, dissolved in wine, taken orally, induces immediate delivery.)
Manual rescue techniques: If cervix is open and head is visible but stuck, likely due to cord around shoulder (Ai Chan). Lay mother supine, gently push fetus up, press shoulder with middle finger to free cord, align fetus, then push. If birth canal misaligned due to early pushing, fetus leans against leg sides, head stuck. What appears as a crown is actually the forehead (Pian Chan). Lay supine, push up, align forehead with hand, then push. If occiput presses against anus (HT Hou), wrap hand in cotton, push head from side of anus to align, then push, or use knee to support mother. These difficulties stem from curled posture and early pushing. Only experienced midwives should attempt these maneuvers.
When baby emerges, hold mother's chest with both hands; mother holds abdomen tightly to help placenta descend. If placenta is delayed, do not panic. Smoke dried grass paper near nose to induce expulsion. If further delayed, cut cord quickly, wash baby, tie cord securely with soft cloth, then cut. Cord is brittle; improper cutting risks blood reflux into uterus, causing distension and heart attack. Skilled midwives can manually remove placenta easily. For retained placenta, apply warm black cow dung wrapped in cloth to abdomen to expel it.
For newborn asphyxia (Hui Yin Men Qi Sheng), tradition says calling father's name or patting buttocks helps. Reason: a membrane blocks air passage. Patting breaks it, allowing cry. If ineffective, use a woman with light touch to pierce gently with silver hairpin. Alternatively, wrap warmly, immerse placenta in hot water (add heat in winter). Internal heat buildup breaks membrane, restoring breathing.
For prolapsed intestine (Pan Chang Sheng), where intestine protrudes before delivery: Use clean basin with warm water (hot in winter), add sesame oil for lubrication. Wait for baby and placenta to deliver. Mother inhales upward. Midwife applies oil to hands, gently retracts intestine. Spraying vinegar water to startle/retract is dangerous and should be avoided. Prolapsed bladder (Niao Bao) after delivery treated similarly. Caused by early pushing disturbing internal organs. Take organ-stabilizing tonics after reduction.
Xue Lizhai stated: When feeling uterine movement, lie supine upright. Wait for fetus to turn down. Pain begins. Pinch middle phalanx of middle finger; if pulsation occurs at proximal interphalangeal joint, labor is imminent. Frequent water leakage before labor indicates ruptured membranes, drying blood/fluid, risking malpresentation. If membranes rupture but no delivery, use Bao Sheng Wu You San to secure blood. If blood depleted, Ba Zhen Tang plus Yi Mu Cao (Leonurus Herba) strong decoction, drink frequently. Abdominal pain only = not labor. Lower back pain included = impending labor. Kidney governs waist, uterus connects to kidney. For irregular pregnancy, tell midwife "not yet in labor." For twins, mention "placenta," avoiding shock which scatters Qi. Dystocia often stems from depression. Wealthy/easy-living families need care. While theory says regulate Qi prenatally and tonify Blood postnatally, do not rigidly adhere. If Spleen/Stomach weak, Qi/Blood insufficient, pre-adjustment is needed.
"Dong Chan" (Cold Labor): Winter cold coagulates menstrual blood, hindering descent. Most harmful. In winter, keep lower body warm with wool, avoid cold surfaces. Keep room warm with stoves. Mother faces fire, keeping lower abdomen, legs, knees warm. Heat moves blood, aiding delivery.
"Re Chan" (Hot Labor): Summer mothers need moderate warmth/coolness. Too cold increases illness. Too many people create stifling heat, causing心烦 (Vexation), boiling Blood, leading to Yu Mao (Depression/Fainting) symptoms.