The manuscript records the midwifery cases seen by Mr Richard Hardy, a surgeon in Whalley, Lancashire. A note has been made in the front by Radford which reads, 'The following Registry of Midwifery Cases of Mr Richd Hardy Surgeon was presented to Dr Thomas Radford by his son Dr Robt Hardy. A case of caesarean section in manuscript in which twins (girls) were saved was presented to Dr T Radford by a brother of Dr Robt Hardy and a son of Mr Richard Hardy who was concerned in the case. It is furnished with some remarks in Dr Radford's Observations on the Caesarean Section- Case 32.'
The cases are listed chronologically from 7 January 1794 to 13 June 1832, during which time Hardy was based at Whalley, Lancashire and attended women in the surrounding area. Each page is headed with the year with the date of each case running down the left hand side of each page and indication of whether the child was male or female running down the right hand side with a running tally. The details of the case are given in the centre of the page and are usually listed under the father's name with the exception of single women. Some, presumably uneventful, cases have little detail other than the father's name, town, time, and the sex of the child, whereas others go into much greater detail about the nature of the birth, the actions taken by Hardy, and the physical condition of both the mother and the child. He occasionally refers to how much he has charged for the service.
There is a table at the back of the volume detailing how many children he delivered each year and the number of boys and girls. From 1808 onwards other initials appear alongside certain entries, which seem to refer to other doctors who are attending some of the births, possibly Hardy's apprentices. Only one, Mark Earnshaw, has their full name given.
In the very rear of the volume an exercise has been introduced into the binding which offers a thorough account of a caesarean section performed in 1825 in which twin girls were delivered alive (although it should be noted that the mother did not survive). It is not clear who has written the account but they refer calling both Dr Hardy and Dr Martland of Blackburn to attend the birth/operation also. A note in Radford's hand dated 28 September 1841 is adhered to the front cover in which he introduces the case and makes the claim that "there cannot be found a similar instance on record".