《便产须知》曰∶临月或腹痛，或作或止，或一二日三五日，胎水已来，腹痛无已时，名曰弄胎，非当产
也。又有一月前，忽然腹痛，如欲便生，名曰试胎，非当产也。凡腹痛，胎水来与不来，俱不妨事，但当宽心
候时。若果当生，痛极不已，腰间重胀，谷道挺并，浆水淋下，其儿遂生。盖产自有时，如果熟香飘，瓜熟蒂
落是也。
慎斋按∶以上四条，序临产时有将息调护之法，有预备必用之药。若弄胎试胎一条，亦临产或有之事，不
可怆惶卤莽，反致有害也。
《大全良方》曰∶妇人以血为主，唯气顺则血和，胎安则产顺。今富贵之家，过于安逸，以致气滞而胎不
转。或为交合，使精血聚于胞中，皆致难产也。
许叔微曰∶有产累日不下，服催生药不验，此必坐草太早，心惧而气结不行也。经云，恐则气下，恐则精
怯，怯则上焦闭，闭则气还，还则下焦胀，气乃不行，得紫苏饮
一服便产。
郭稽中曰∶难产者，因儿转身，将儿枕血破碎，与胞中败血壅滞，儿身不能便利，是以难产，急服胜金散，
消其血，则儿易生矣。
陈无择曰∶难产多因儿未转顺，坐草太早，或努力太过，以致胞衣破而血水干，产路滞而儿难下，宜先服催
生如神散，以固其血。
虞天民曰∶或问，丹溪所谓难产之妇，多是八九个月内，不能谨慎，以致气血虚故也。其旨何与？曰∶妇
人有娠，不宜与丈夫同寝。今人未谙此理，至八九月内，犹有房室。夫情欲一动，气血随耗。胎孕全赖气血培养，
气血既亏，则胎息羸弱，日月既足，即欲分娩，拆胞求路而出。胞破之后，胞中浆水沛然下流，胎息强健者，即
翻随浆而下，此为易产。胎息倦弱者，转头迟慢，不能随浆而出，胞浆既干，污血闭塞生路，子无所向，遂致
横生逆产。急服催生药，逐去恶血，道路通达，庶速产也。
慎斋按∶以上五条，序临产时有难产之患也。难产之由，在平时则有安逸气滞，有心恐气结，有房室不谨。
在将产则有败血壅滞，有胎浆干涸。大要不外此数证。
《便产须知》说：临近预产期时，如果出现腹痛，有时发作有时停止，或者持续一两天、三五天，羊水已经流出，但腹痛没有停止，这叫做“弄胎”，并不是真正到了分娩的时候。又有一种情况是在预产期前一个月，突然感到腹痛，好像要生孩子一样，这叫做“试胎”，也不是真正到了分娩的时候。凡是出现腹痛，无论羊水是否流出，都不必惊慌，只要放宽心态等待时机即可。如果确实是到了分娩的时候，疼痛剧烈且不停止，腰部沉重胀满，肛门有下坠感（挺并），羊水流下，胎儿就会随之出生。因为生产自有其时辰，就像果实成熟自然飘香，瓜熟蒂落一样。
慎斋按语：以上四条内容，叙述了临产时调养护理的方法，以及预备必须使用的药物。关于弄胎和试胎这一条，也是临产时可能遇到的情况，不可惊慌失措、鲁莽行事，否则反而会造成危害。
《大全良方》说：妇女以血为本，只有气机顺畅则血液调和，胎元安稳则分娩顺利。如今富贵人家，过于安逸，导致气机阻滞而胎位不转。或者因为房事交合，使精血聚积在胞宫之中，都会导致难产。
许叔微说：有产妇分娩过程持续数日胎儿仍不下，服用催生药无效，这一定是因为坐草（上产床待产）太早，心里恐惧导致气机郁结而不行。医经说，恐惧会使气机下陷，恐惧会导致精气怯弱，精气怯弱则上焦闭塞，上焦闭塞则气机返还，气机返还则下焦胀满，气机因此不能运行。服用紫苏饮，一剂之后即可分娩。
郭稽中说：难产的原因，是因为胎儿转身时，将儿枕（胎盘或瘀血块）的血破碎，与胞宫中的败血壅滞在一起，胎儿身体无法顺利移动，所以导致难产。急需服用胜金散，消除瘀血，胎儿就容易生出来了。
陈无择说：难产多因胎儿未转正，坐草太早，或者用力过猛，导致胞衣破裂而血水干涸，产道阻滞而胎儿难以产出。应当先服用催生如神散，以固护其气血。
虞天民说：有人问，丹溪所说的难产妇女，大多是在怀孕八九个月时不能谨慎，导致气血虚弱，这是什么意思呢？回答说：妇女怀孕后，不适宜与丈夫同寝。现在的人不懂这个道理，直到怀孕八九月内，仍有房事。情欲一动，气血随之耗损。胎孕完全依赖气血的培养，气血既然亏损，则胎息羸弱。当足月想要分娩时，撕裂胞衣寻求出路而出。胞衣破裂后，胞中的浆水充沛地流下，胎息强健的，就随即随着浆水下出，这是容易生产的。胎息疲倦虚弱的，转头迟缓缓慢，不能随着浆水而出，胞浆既已干涸，污血闭塞了生路，胎儿没有方向，于是导致横生逆产。急需服用催生药，驱逐恶血，使产道通达，才能迅速分娩。
慎斋按语：以上五条内容，叙述了临产时发生难产的隐患。难产的原因，在平时则有因安逸导致的气滞，有心怀恐惧导致的气结，有房事不谨慎。在即将分娩时则有败血壅滞，有胎浆干涸。大抵不外乎这几类证候。
*Biandan Xu Zhi* (Necessities for Childbirth) states: Near the due month, if abdominal pain occurs, sometimes appearing and sometimes ceasing, or lasting for one to two days or three to five days, with amniotic fluid already present but abdominal pain unceasing, this is called "Nongtai" (Playing Fetus), which is not the actual time of delivery. There is also a condition occurring one month before the due date, where sudden abdominal pain feels as if birth is imminent; this is called "Shitai" (Testing Fetus), which is also not the actual time of delivery. In cases of abdominal pain, whether amniotic fluid has come or not, it is generally harmless; one should simply relax the mind and wait for the proper time. If it is indeed the time for delivery, the pain will be extreme and unceasing, accompanied by heaviness and distension in the lower back, a sensation of bearing down in the anus (Gongdao Tingbing), and the flow of amniotic fluid, after which the infant will be born. This is because childbirth has its own appointed time, just as ripe fruit naturally emits fragrance and a ripe melon falls from its stem.
Shenzhai commented: The above four points outline methods for care and nursing during the臨產 period, as well as essential medicines to prepare. Regarding "Nongtai" and "Shitai," these are conditions that may occur near term; one must not panic or act rashly, lest harm be caused.
*Daquan Liang Fang* (Great Comprehensive Good Prescriptions) states: Women are primarily governed by Blood. Only when Qi flows smoothly does Blood harmonize, and only when the Fetus is secure is delivery smooth. Nowadays, wealthy families live in excessive comfort, leading to Qi stagnation and failure of the fetus to turn. Alternatively, sexual intercourse causes Essence and Blood to accumulate in the Uterus, both of which can lead to difficult labor.
Xu Shuwei stated: There are cases where delivery is delayed for several days, and催产 herbs fail to work. This is certainly because the woman went to bed too early, and fear caused Qi to knot and cease flowing. The Classics state: Fear causes Qi to sink downward; fear causes Jing (Essence) to become timid. Timidity causes the Upper Jiao to close; closure causes Qi to return; returning Qi causes Lower Jiao distension, and thus Qi fails to move. Administering Zisu Yin (Perilla Decoction) results in delivery after one dose.
Guo Jizhong stated: Difficult labor often occurs because the fetus turns, breaking the blood of the "Erzhen" (Fetal Pillow/Placental remnant), which obstructs with stale blood in the Uterus, preventing the fetus from moving freely, thus causing difficult labor. One must urgently administer Shengjin San (Winning Gold Powder) to resolve the blood stasis, making delivery easier.
Chen Wuyue stated: Difficult labor is mostly due to the fetus not being in a normal position, going to bed too early, or exerting effort excessively, causing the membranes to rupture while blood and fluids dry up, blocking the birth canal and hindering the fetus's descent. One should first administer Cisheng Rushen San (Divine-like Delivery Promoting Powder) to consolidate the Blood and Qi.
Yu Tianmin stated: Someone asked about Danxi’s view that women with difficult labor often failed to be cautious during the eighth and ninth months, leading to deficiency of Qi and Blood. What is the meaning? I replied: Pregnant women should not share a bed with their husbands. People today do not understand this principle and engage in intercourse even in the eighth or ninth month. When desire arises, Qi and Blood are consumed. The fetus relies entirely on Qi and Blood for nourishment. Once Qi and Blood are depleted, the fetal breath becomes weak. When the term is full and delivery begins, tearing through the membranes to find a path out, once the membranes rupture, amniotic fluid flows abundantly. If the fetal breath is strong, the fetus follows the fluid down easily, resulting in smooth delivery. If the fetal breath is weak, turning is slow, and it cannot follow the fluid. With the amniotic fluid dried up and foul blood blocking the birth path, the fetus has no direction, leading to transverse or breech presentation. Urgently administer delivery-promoting herbs to expel evil blood, clear the passage, and facilitate rapid delivery.
Shenzhai commented: The above five points describe the dangers of difficult labor near term. Causes of difficult labor include, prior to labor, Qi stagnation from excessive ease, Qi knotting from fear, and imprudence in sexual activity. Near labor, there is obstruction by stale blood and drying up of amniotic fluid. These essentially cover the main syndromes.