A looseness of the sides of the abdomen and untying of the umbilical cord of the child (from the cardiac cord of its mother) and a perception of the characteristic pain at the waist would indicate the approach of the time of delivery. A constant and severe pain at the waist and the back, constant (involuntary) motions of the bowels and micturition and mucous discharge from the vulva arc the symptoms which are manifest at the time (i.e., a little before) of parturition. 4-5.
Rites of benediction should be performed for the safety of the enciente in her travail and she should be made to pronounce benedictory Mantras surrounded by male babies on all sides. A fruit with a masculine name should be given in her hand. Her body should be anointed with oil and washed with warm water and she should be made to drink largely a gruel (Yavágu) made of articles (which exert a beneficial virtue at the time). Then she should be laid on her back on a soft and sufficiently spacious bed, her head being placed on a pillow and her legs slightly flexed and drawn up. Four elderly ladies with paired finger-nails and skilled in the art of accouchement and with whom she feels no delicacy, should attend and nurse her at the time. 6.
Then after having gently lubricated the mouth of the parturient canal along the natural direction of the pubic hairs (Anuloma) (so as not to create any discomfort in the part) one of them (elderly ladies) should address the enciente as follows: - "O fortunate damsel, try to bear down the child, but do not make such an attempt in the absence of real pain." On experiencing an untying of the umbilical cord of the child, the enciente should gently make such urgings, whenever she will experience pain in the pelvic, pudendal and pubic regions and in the region between the neck of the bladder and the pelvis. Deep urgings should be made on the exit of the foetus out of the uterus, and after that deeper urgings should be made during the passage of the child through the canal until delivery. 7.
An urging (made by the enciente) in the absence of any real pain may lead to deafness, dumbness and deformity of the jaw-bones of the child or subject it to attacks of cough, asthma, consumption, etc., or lead to the diseases of its head, or to the birth of a haunch-backed or deformed child. A case of abnormal presentation (Pratiloma) should be converted into the normal or cephalic one (Anuloma) by version *. 8-9.
In the case of protracted delivery, e.g., an obstruction of the child at the vagina, - the vagina should be fumigated with the fumes of the slough (cast-off skin) of a cobra (snake) or with the fumes of Pinditaka (Madana) or the roots of Hiranyapushpi (Kantakári) should be tied (round the neck or the waist) or Suvar-chala (Atasi) or Vis'alyá (Pátalá) should be tied round the hand (wrist) and leg (ankle) of the parturient woman. 10.
The shreds or membranes lying on the body of the child should be removed immediately after its birth and its mouth should be cleansed with clarified butter and rock-salt. Then a linen pad soaked in clarified butter † should be applied on the head of the new-born baby. Then the umbilical cord, after having been slightly drawn out, should be ligatured with one end of a string at a point eight fingers apart from its navel, the other end of the string being tied round its neck; then the umbilical cord should be severed immediately above the ligature. 11.
* The various forms of (Pratiloma) abnormal presentations have been described under MuJha-Garbha Nidánam (Nidán-Sthána - Chap. IX.) and their treatment is to be found in Chikitsá-Sthána - Chap. XV.
† Brahmadcva recommends Valá-Taila instead of clarified butter.