RobH_en_tn/gen/38/28.md

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It came about as she was giving birth

This phrase "It came about" marks an important event in the story. If your language has a way for doing this, you could consider using it here.

one put out a hand

"one of the babies put out his hand"

midwife

This is a person who helps a woman when she is giving birth to a child. See how you translated this in Genesis 35:17.

scarlet thread

"bright red thread"

on his hand

"around his wrist"