A birth is termed unnatural, however, when it lacks the conditions mentioned previously. It very frequently happens that an infant arrives for delivery feet-first, with the hands drawn down toward the thighs; this is the first type of unnatural birth. The second type occurs when the fetus approaches the exit feet-first, but with the hands stretched out above the head rather than at the sides or thighs, as shown in the accompanying illustrations.

In the first case, a diligent midwife must focus all her efforts on grasping both of the infant's arms to prevent them from being drawn back, ensuring the birth proceeds as it must. However, a careful midwife should never attempt to deliver a child in the other described position unless the infant is particularly slender and the opening of the womb is sufficiently dilated to allow for an easy exit without harm to either mother or child.

Otherwise, it is safer to push the fetus back into the womb so that it can be turned into the correct, natural position for birth.