Midwife's Baby Bump

by Susanne Hampton

  Flick suddenly choked on the tears that she’d thought she had under control. Just hearing the words from Sophia’s mouth made it seem real again. She was pregnant. And now she knew she would be facing it alone.

  Sophia’s expression fell. Her eyes met the look of fear in Flick’s face.

  ‘Oh, my God, that’s it.’

  Flick nodded, too upset to say anything.

  ‘Oh, Flick, I should have known,’ she said. ‘You’ve had all the tell-tale signs, and I noticed that you were drinking water instead of your usual white wine socially. I was so embarrassed that I’d mentioned pregnancy before but assumed you probably did just have a bug.’

  ‘I’d only just found out,’ she managed to say between tears. ‘I’m sorry, I wasn’t up to talking about it.’

  ‘There’s nothing to be sorry about, but I want you to know, Flick, I’m here for you. As a friend and mentor, you can trust and confide in me, particularly with something like this.’

  ‘I … I was confused and shocked and I … didn’t know what to do.’ Flick dropped her head in her hands as she sobbed. She cried for allowing it to have happened in the first place, for the way Tristan had reacted, for stupidly thinking he might care, and for the uncertain future she faced. It all rushed at her and she couldn’t suppress it any longer.

  Sophia moved closer and wrapped her arm around Flick’s shoulder and didn’t try to stop her tears. ‘Let it out, you’ve been bottling this up inside and it’s bad for you and your baby,’ she told her, as she brought the tissue box closer too. ‘I’m in no hurry. When you’re ready, we can talk about everything.’

  Sophia left the room for a moment to fetch a glass of water. After a little while, Flick finally felt ready to talk. The words were interspersed with tears but they were coherent as she told Sophia that the blood tests with her GP had confirmed she was pregnant and according to her calculations she was already twelve weeks along.

  ‘You didn’t suspect earlier than now? Didn’t you worry when your period was late?’

  Flick shook her head. ‘No, I’ve always been irregular so it was nothing out of the ordinary. Sometimes when I get stressed, like close to exams, I know my period will be late or I’ll just skip one completely. I was tested three years ago for polycystic ovary syndrome but it was negative. I didn’t have any cysts interfering with regular ovulation and they looked at my thyroid but that was fine too. Sometimes I will be like clockwork and then for no known reason I will be all over the place and miss one or more periods.’

  ‘It’s not surprising that you had no idea you were pregnant.’

  ‘Finding out was a huge shock,’ Flick returned with a desolate expression.

  ‘And the father, does he know? Is he being supportive?’

  Flick felt herself stiffen on hearing the question. She was angry and hurt and disappointed. She couldn’t believe that a man who had built his career around saving newborn babies’ lives wasn’t interested in his own child. It didn’t make sense to her.

  ‘He’s aware but I don’t think he wants to have a place in my baby’s life. I have informed him but from his reaction I don’t think he wants anything to do with me or the baby.’

  ‘That’s sad, for him and your baby,’ Sophia said as she handed another tissue to Flick. The tears had subsided slightly but her eyes were still watery. ‘Maybe he’ll change his mind in time. It’s a huge shock for both of you and he might just need time to adjust. Let’s hope so and if not, your baby will have such an amazing mother and an army of midwife aunties that it won’t matter.’

  Flick shrugged. ‘I’m not giving him too much thought or planning on him changing his mind now. I guess it wasn’t meant to be.’

  ‘Flick, you can tell me to stay out of it but … he’s not married, is he?’

  ‘Not to a woman,’ Flick began. ‘To his work apparently.’

  Sophia shook her head. ‘That is one of the worst excuses from a man trying to avoid responsibility. And I’ve heard it before. No doubt it’s designed to let him walk away as if he had something to blame his lack of commitment on other than his own selfishness. He’s too busy saving the world in a convenient self-serving manner. I dislike the man immensely without knowing him and you don’t need someone like that in your life.’

  The two women stayed in the privacy of the small office until Sophia was convinced that Flick was up to heading out on a home visit. Sophia had tried to convince Flick to go home but she’d refused.

  ‘I’ve thrown up and cried in the last hour,’ she told her. ‘So I should be good for a while.’ Flick was trying to be brave. She didn’t see any other choice.

  Sophia’s mouth curved to a half-smile with Flick’s attempt at humour.

  ‘I have three prenatal home visits scheduled if you’re sure that you’re up to it.’

  Flick smiled. ‘I’d really like to accompany you. I need to. It will do me good to get out and stop thinking about my own problems. Some things in life can’t be changed and this is one of them.’

  Sophia nodded and, sensing the inner strength of Flick, continued. ‘It does seem as if death, taxes and dating the wrong men just can’t be avoided.’

  They both nodded and rolled their eyes as they headed out into the bustle of MMU.

  ‘I’m the primary midwife for a home birth due any day now,’ Sophia added, as she picked up the keys to her car. ‘But I checked in yesterday and my mother-to-be, Sandy, is fine and showing no signs of having an early delivery. Due date’s next Wednesday.’

  Flick’s face lit up a little. ‘I hope she delivers on one of my shifts.’

  ‘How many births have you attended now?’

  ‘Forty, and I’ve caught eleven babies,’ Flick told her with pride.

  ‘It might be forty-one by this time next week,’ Sophia said as they made their way outside and off to the first home visit. They chatted on the way about how Flick was feeling and her antenatal care, and then about other things. Sophia did not bring up the father of the child again and Flick was grateful. In her mind that was a closed book. She needed to keep her focus broader to get through what lay ahead.

  The appointment was straightforward. The young woman, Giselle, was thirty-two weeks pregnant, low risk and it was her second child. Sophia went through the standard but thorough health assessment procedure, and after she and Flick had taken the mother’s observations and checked the baby was progressing well, they sat and answered a few questions the mother-to-be had about the impending birth. Sophia’s approach, like that of all the midwives of MMU, was holistic and ensured that the emotional as well as physical needs of the mother were met, and Flick was learning a lot from her.

  It was just as they left that the call came through. The home-birth mother, Sandy, had gone into labour a few days early. Flick was going to raise her count to forty-one births in a few hours’ time.

  Sandy had already been in labour for five hours when Sophia and Flick arrived at her home. It was her second child so she was relaxed and hadn’t rushed to call them. Instead, she had rugged up and gone for a walk to the local park with her husband and their three-year-old son, enjoying the last of the sun before winter set in. She’d returned when her contractions had grown closer.

  ‘Sandy, Jerry, this is Flick.’ Sophia began the introductions. ‘She’s a final-year midwife student on clinical placement. Flick’s been present at forty natural births and she will be assisting us to deliver your beautiful baby daughter.’

  Sandy and her husband greeted Flick just as a contraction arrived. It was a short, breathless greeting from Sandy. Flick smiled and let Sandy concentrate on the waves of the contraction, which passed quickly. She smiled a silent acknowledgement to Jerry.

  ‘You’ve been the epitome of good health throughout your pregnancy, so the birth should be straightforward,’ Sophia told her. Then she looked at Sandy’s son, who was sitting on the floor, playing happily with building blocks with one hand while eating a sandwich with the other. She continued, ‘Is someone abl
e to supervise your little one towards the end? It can be overwhelming for a child and you’ll need your husband’s complete support.’

  ‘My mother’s on her way. She’s taking him out for the afternoon and will bring him home after our daughter is born,’ Sandy replied. ‘She knows I’m committed to having my second baby at home and she supports me in it. She had all four of us in a hospital but that was the done thing back then. And if she’d tried to have a home birth, my father would have thought she was crazy.’

  Sophia smiled, knowing that Sandy was in her early thirties, and agreed that home births had not been generally accepted when Sandy and her siblings had been born. ‘You managed very well with your first natural birth in MMU. No epidural, episiotomy, or any of the other interventions that are routinely applied in hospitals.’

  ‘I know, and I loved having the baby at the Melbourne Maternity Unit, but I really feel comfortable at home and it will be wonderful to know that our baby was born here. We can tell her when she grows up that she came into the world right here.’

  Sophia nodded. ‘I’m just going to perform an internal check to see how baby is progressing.’ Sandy’s cervix had dilated to three and a half inches so Flick knew that the birth was close. Suddenly Sandy’s waters broke and while they all assumed that the baby would arrive quickly, it didn’t happen. Her labour did a backslide and the baby moved back up the birth canal and her cervix retracted.

  ‘Your cervix dilatation has unfortunately returned to just under three inches,’ Sophia informed her. ‘It’s not unusual, it just means we’ll be waiting a little while longer for the baby.’

  Flick could see that Sandy was growing in discomfort and without prompting, began to massage her back, just as Sandy’s mother turned up and took her grandson to her house for the afternoon. She wasn’t far away and told the midwives that they would both be back when it was appropriate.

  Sandy then suggested to Jerry that they could walk around their garden. They all agreed the park wasn’t a good idea at this stage as labour could progress quickly without warning. They hoped that gravity and movement from walking would help the baby get back into position. Flick accompanied them while Sophia prepared the inflatable birth tub that the couple had purchased. They asked for it to be set up in the lounge room, which Sophia did, filling it with warm water to ease the pain of strong contractions. When the mother-to-be returned from her short walk she undressed and climbed into the tub and crouched on her hands and knees. Her husband, now stripped down to his swimsuit, climbed in with her and began massaging her back.

  ‘I’ll pour this warm water over your back as well, Sandy. It should give you comfort during the contractions.’ Flick knelt beside the pool and gently poured bowl after bowl of warm water over Sandy’s tense body as Sophia’s gloved hand attempted to rotate the baby’s head and initiate movement down the birth canal.

  ‘It didn’t hurt this much last time,’ Sandy complained between clearly painful contractions.

  ‘Labour is a little different this time,’ Sophia replied. ‘But hopefully it won’t be much longer. I can give you something for the pain if you’d like.’

  ‘I’ll try and hold out a little longer.’

  Sophia listened to the baby’s heartbeat with a hand-held monitor. ‘One hundred and twenty beats per minute. You daughter is doing well.’

  Flick continued to pour the soothing water as her husband massaged her back but Sandy’s discomfort was growing and Sophia suggested moving to the bed, which had been covered in clean sheeting. While it was cold outside, the home was heated by ducted air-conditioning and it allowed them to move easily from one room to the other as needed.

  ‘It will be easier if you are on your hands and knees,’ Sophia instructed her. ‘Flick, I’d like you to manipulate Sandy’s cervix to encourage the baby into the birth canal.’

  Flick slipped on a latex glove and gently moved the baby as Sandy pushed, but the baby seemed determined to stay tucked inside her mother’s uterus.

  The midwives were aware the labour was slow and were becoming concerned that the baby could be in a posterior presentation with her head resting against Sandy’s spine, which would explain the extreme pain she was experiencing, or too large to deliver naturally. It had been almost two hours of pushing and Sandy was tired.

  ‘We can move you to MMU, if you would like,’ Sophia offered.

  ‘No, I want to have my baby here,’ Sandy argued, as she caught her breath between contractions.

  ‘I understand, and you know I support your wishes, but I’m a little concerned the slow labour may be because the baby is too large for your pelvis. That’s not a good situation and we may be looking at C-section.’

  ‘Let’s leave it a little longer.’

  Sophia nodded. ‘I will leave it another twenty minutes and then I’ll need to call and have you transferred. I’m not taking that risk.’

  ‘What about a walk again, or I could take a shower? Maybe the hot water and the standing will move things along.’

  ‘Warm water,’ Sophia instructed. ‘Hot water can speed up your baby’s heart rate and I don’t want that to happen.’

  ‘I’ll run the shower and check the temperature,’ Flick said, as she opened the en suite bathroom door and turned on the light.

  ‘I’d like something to take the pain away, before I get in the shower.’

  Sophia prepared the narcotic shot as Flick put a non-slip mat in the shower alcove.

  ‘Should we just go to MMU now and not risk anything going wrong?’ her husband asked, as he grimaced at the sound of her cry from another painful contraction.

  ‘No,’ Sandy spat back. ‘I’ve come this far and the pain relief should kick in soon. I’m having this baby at home.’

  He bit his lip and continued massaging in silence. He knew better than to argue with a woman in labour.

  ‘The shower is ready when you are,’ Flick called to them from the bathroom.

  Sandy sensed she had reacted badly and reached for her husband’s hand affectionately. ‘Let’s see if this shower can start it all again. If not, then call the ambulance and I will have the baby in hospital, I promise. Just give me ten more minutes.’

  Jerry supported Sandy under the shower, where they both stood in the running tepid water for fifteen minutes. Finally they emerged and Flick patted Sandy dry as she walked to the bed. Sophia checked her cervix again and it was finally fully dilated.

  She smiled at the mother-to-be. ‘Looks as if you were right. You’re having your baby at home. It’s time to really push.’

  Suddenly Flick could see a glimpse of the baby’s head. ‘Your little girl is arriving and she has a mop of dark hair!’

  ‘Just like her daddy,’ Sandy muttered, before she put her effort back into pushing.

  To prevent any tearing of Sandy’s perineum, Sophia applied warm compresses and swabs of olive oil. Finally, after more than twelve hours of labour, Sandy pushed her baby daughter into Flick’s hands. Overcome with the joy, Flick’s face lit up as she gently transferred the baby girl to her mother’s bare stomach. ‘She’s beautiful.’

  ‘Her name is Alida—it means the little winged one,’ Sandy said as she looked lovingly at her newborn.

  Sophia clamped the umbilical cord and handed Jerry a sterile surgical knife.

  ‘Would you like to cut Alida’s cord?’

  Jerry nervously cut the cord and then leant over and kissed his wife and new baby daughter.

  ‘Is there anything in the world more special than this?’ Flick asked of no one in particular, and everyone in the room smiled in agreement.

  Sophia delivered the afterbirth and ensured that Sandy was fine before she undertook a standard neonatal baby exam, just as if Alida had been born in MMU. She measured her head and chest, took her temperature and pulse, listened to her heart and lungs, then checked her genitalia and examined her mouth for a cleft palate. Alida scored nine out of ten on the Apgar rating.

  Mother and baby were doing very well. A
nd father was relieved. And she and Flick would be back the next day to check on all of them.

  ‘That went well, all things considered,’ Sophia told Flick as they climbed into the car to go home. It had been a long day and it was now after eight at night. ‘I must admit, if Alida had not arrived when she did I was going to insist on transferring Sandy to MMU. I won’t take unnecessary risks.’

  ‘I think she would have fought you on that,’ Flick replied as she buckled her seat belt, acutely aware that she was safely strapping in two lives as she did it.

  ‘You’ll learn, Flick, that while the mother’s voice is important and we support their decisions, it can only be up to a point. If the life of the mother or baby is at risk in any way, we will insist on a hospital birth. And you need to always remember, no matter what the mother’s or father’s wishes, home births cannot be considered for multiple births, premmies or breech deliveries.’

  ‘That makes perfect sense,’ Flick agreed, pulling herself back to the conversation. She was determined to stay focused, despite the weight of her personal issues. ‘No one wants to risk either the mother’s or baby’s survival. I learnt the cardinal rule of a midwife early in my studies. Always have a back-up plan.’

  Sophia smiled at Flick. ‘You did a wonderful job in there, assisting Sandy, despite what a terrible few weeks you’ve had.’

  ‘I can’t fall in a heap. I almost did, and I’m sorry that I let you down.’

  ‘You didn’t let me down, but I worried that you were letting yourself down. You will be such a wonderful midwife but you need to qualify and it’s so close, Flick.’

  ‘I appreciate your belief in me.’ She paused and looked out of the window into the cold evening sky. ‘I will do it, even though it will be a close call.’

  ‘And after you graduate, there’s some additional training I would like you to consider.’

  ‘What training’s that?’

  ‘The Advanced Life Support in Obstetrics course,’ Sophia replied. ‘It’s helpful in cases like Sandy’s and if you ever work in more isolated units, such as standalone maternity services or public home-birth services. There’s a lot of theory along with the practical but it will help you to better understand and manage emergencies that might arise in maternity care. It’s another string to your bow and will place you in high regard as a midwife.’