Two pupil midwives accompanied Sister Kelly and the trio began to serve up the luncheon with some ceremony. While one nurse held out each white porcelain plate, the other used an industrial-sized spoon to dollop a generous helping of boiled potatoes then a mound of steaming cabbage onto it. Meanwhile, at the head of the trolley, Sister Kelly brandished a giant fork, which she used to skewer thin slices of meat laid out on a stainless steel platter, before depositing them portion by portion alongside the bland potatoes and soggy cabbage.
Once the ladies each had a plateful in front of them, one of the midwives circled the dining table with a heavy jug and poured thick, lumpy puddles of gravy on every meal in precise rotation, never once asking if anybody actually wanted it.
‘Enjoy your meal now, ladies!’ Sister Kelly instructed merrily before thumping back down the ward, retrieving her underwear from between her buttocks as she did so. Nobody seemed to notice or, if they did, her habits didn’t appear to offend or surprise them.
‘Who was it said she was a farmer’s daughter?’ Lottie whispered loudly once Sister Kelly was out of earshot.
‘I can’t remember who said it, but it’s as plain as the nose on your face, isn’t it?’ Bessie replied jovially. ‘The way she wields that serving fork, you can just imagine her pitching it into a bale of hay and tossing it into the back of a tractor!’
‘How do you get your deliveries?’ I asked Margaret when we went for a tea break later. I was still wondering how I would manage to clock up forty in ten months.
‘Oh, it’s a doddle,’ she said. ‘There’s a bell in each delivery room, and every time there’s a birth imminent the midwife will ring it, and any pupil midwives working on the maternity wards needing to clock up a birth can run in. Even catching the baby at the last minute counts towards your forty deliveries.’
‘What about the complicated ones, the forceps, breech and Caesareans?’
‘You only have to witness those, of course, as the doctors are in charge,’ Margaret said. ‘Sometimes you’ll just get lucky. We have no way of telling in advance whether a normal delivery is going to turn into something more complicated. I’ve delivered twins to several women who thought they were only having one baby. We palpate the abdomen and use the Pinard ear trumpet in antenatal clinic to feel and listen for more than one heartbeat, but it certainly isn’t a foolproof way of knowing for sure how many babies are in there, as you’ll no doubt find out. In my experience one twin has a habit of coming out bottom first, and that’s how I got to witness all of my breech births.’
When I think back to that conversation I can scarcely believe how we managed without the routine ultrasound scans we rely on today. Now, it is practically unheard of not to detect multiple babies in advance, and in the vast majority of cases the woman is booked in for a Caesarean to limit the risk of complications during delivery.
‘For forceps and Caesarean births, you’d need a crystal ball to predict them,’ Margaret went on. ‘Sometimes the smoothest of births suddenly becomes an emergency and, before you know it, it’s theatre gowns and general anaesthetic at the double, or the consultant is wielding the Kielland forceps. Needless to say, nobody comes in here planning a Caesarean section or a forceps delivery. Even with multiple births and breech babies, we encourage all the women to have as natural a delivery as possible.’
‘Don’t women who know they are having twins or a breech ever ask if they can have a Caesarean?’ I asked, wide-eyed.
‘No!’ Margaret smiled. ‘The women never ask anything. We tell them what’s what and they never question us. I swear, if a midwife told a pregnant woman to jump, her reply would be “How high?” every time.’
Margaret laughed and I joined in.
‘Hey,’ she asked, still giggling and with a mischievous glint in her eye. ‘I see you’re married, Linda. Tell me, at your interview, did Mrs Sefton ask you what sort of contraception you used?’
‘No!’ I stammered. ‘Why would she?’
‘She must have liked the look of you. She usually gives pupil midwives the third degree. Poor Dorothy was asked that question outright and was so taken aback she just answered, saying she was taking the Pill. She told me she would never even discuss such a thing with her own mother! Apparently Miss Sefton looked over her reading glasses and said, “I’m very glad to hear it. I like my nurses to be responsible.” Poor Dorothy came out of the office with her face as red as a tomato!’
I liked Margaret a lot. I felt I could ask her anything, and I had a feeling I would be picking her brains many more times in the months to come. As we walked back to the ward I described to her how I’d taken a wrong turning earlier and overheard Dr Franklin shouting at a young girl.
‘I couldn’t believe my ears,’ I said. ‘I’ve never heard a doctor speak to a patient like that before.’
‘You’d better get used to it,’ she sighed. ‘He’s well known for having the most dreadful bedside manner. The thing about maternity is that the patients are not actually ill; they are simply pregnant. As I’m sure you know, consultants can be bullish at the best of times. The fact they are not dealing with the sick seems to make them think they can get away with absolute murder. Don’t worry too much about Dr Franklin, though; he’s got a soft heart underneath all the bluster.’
As we approached Ward 16 after our tea break I saw a queue of men standing obediently outside the double doors. Each was holding either a pink or blue teddy bear, a bag of grapes or a bunch of flowers in one hand, and a cigarette in the other. As the clock struck two, Sister Kelly opened the doors and welcomed them inside with the words: ‘Come in, the lot of youse, but don’t be lighting up any more o’ them there cigarettes when those are finished. I don’t want my ward contaminated.’
We followed the visitors, breathing in a lungful of smoke each. Margaret leaned into me and said conspiratorially, ‘This bit is always touch and go.’
I had no idea what she meant until I caught sight of Sister Kelly throwing her arms up in the air. ‘Oh, I’m sorry, I’ve done it again, haven’t I?’ she said as she pulled a stunned-looking young man back out through the curtains of bed thirteen. ‘I do apologise, Mrs Charlesworth, so I do. Now then, Mr Clayton, your wife is just over here in the bed opposite. If you’ll follow me …’
‘She does that all the time,’ Margaret sniggered. ‘Most of the women aren’t bothered, but I don’t suppose poor Mrs Charlesworth is very amused. She’s suffering from engorged breasts and is strapped up with a couple of cot sheets holding up her bosom. No wonder Mr Clayton’s eyes nearly popped out of his head!’
I clutched my sides laughing. It was fun as well as informative working on this ward, and I could tell I was going to enjoy my time here very much. It was very different to working at the MRI. For one thing it was less strict, but best of all the patients were well, and they were celebrating new life.
Chapter Ten
‘Feeling the warmth of a baby’s head in your hands, that new life, I’d honestly never experienced anything like it’
‘Do you need a delivery, Linda?’ Sister Houghton called.
‘Oh yes, please!’ I beamed, my heart giving a little skip.
‘Follow me and scrub up quickly,’ she instructed.
It was early March now and my official training as a pupil midwife had got off to a very busy start. I’d only been on Ward 19, the labour ward, for a matter of days, but I’d already been fortunate enough to step into the delivery rooms and witness a total of ten births. As Sister Houghton well knew, once a pupil midwife had witnessed ten births it was time for her to take part in a delivery herself, and to start ticking off her forty required deliveries.
By this time I’d also spent many hours attending lectures with three other pupil midwives, where we sweated over our Textbook for Midwives by Margaret F. Myles and fretted over how we would translate the hefty tome into reality when our big moment came and we actually got to take part in a delivery, instead of being mere observers. It was tantalisingly close. As we sat i
n those lectures we knew it would probably be just days before a new life would actually emerge into our very own hands, and now my moment was imminent.
The ten routine births I’d witnessed so far were very much like Mrs Hollingworth’s, the first-ever delivery I’d seen at St Mary’s. I was grateful I’d had that valuable experience; it gave me a head start, I thought. I was also pleased that I already knew all about enemas and shaves, procedures with which I’d assisted on the female surgical ward at the MRI, as they were very much on the agenda here.
‘The enema is performed to prevent a compacted bowel impeding the baby’s journey down the birth canal,’ Miss Greeves, one of our clinical instructors, explained during a lecture one day, ‘while shaving is carried out to help reduce the risk of infection.’
Even though I knew this already I still looked on with interest as Miss Greeves stirred a mixture of soap and water in a jug and prepared a tube and funnel to demonstrate the process. In another lesson, much to my amazement, she instructed us in the art of making the perfect cup of tea, and I had learned to sit politely and always pay attention, regardless of how much I already knew about the subject.
‘You must give an enema even if the patient has recently emptied her bowels, or even had diarrhoea,’ Miss Greeves cautioned. ‘It’s a case of making sure the mixture is warm, inserting the tube up the lady’s rectum and pouring the liquid through the tube, which is held high. This procedure is best done by two nurses working together.’
‘Does anyone refuse?’ a bold fellow student asked.
‘No,’ Miss Greeves replied, sounding rather surprised by the question. ‘Not in my experience. Having an enema prior to delivery is always expected and accepted. The same goes for shaving.’
With that she sent us off to watch a friendly midwife called Barbara Lees shave a patient on the delivery ward. I looked on in alarm at the glinting blade on the razor Barbara was wielding, as it looked sharper than any I had encountered at the MRI.
‘Don’t look so afraid,’ Barbara smiled. ‘You’ll be able to do this in your sleep before long. Sometimes we’re shaving the woman in a mad panic just before the birth. You’ll soon get used to it.’
I nodded uncertainly and felt glad the patient had her head turned away from us, as I’m sure I was wincing.
‘So you’re confident at giving enemas now?’ Barbara asked, nodding towards Miss Greeves.
‘Yes, I think so,’ I replied, not wanting to distract Barbara from the job in hand.
‘I don’t suppose Miss Greeves told you this, but when it comes to enemas, all you need to remember is “high, hot and a hell of a lot!” That’s what we always say here.’
Barbara laughed before lathering up some soap, applying it with cotton wool and setting to work with the razor. The unimpressed patient had lifted her nightgown under the raised sheets and now closed her eyes resignedly.
‘One sister had me shaving a woman once who was literally pushing the baby out,’ Barbara whispered. ‘I was in such a panic, trying to holding the head in, that I cut the poor woman and actually made her bleed. I was terrified I’d left her vulnerable to infections instead of trying to prevent them!’
I enjoyed learning the ropes on the delivery ward, but what I really loved was watching babies being born.
I was absolutely thrilled each time I was called in to witness a birth with Sister Houghton, knowing I was getting closer to the moment when I would step forward and be a part of the magical process myself.
I’d seen Sister Houghton deliver three babies so far and it was a real education watching her work: hearing how she soothed and encouraged each woman as she waited for the baby’s head to emerge and rotate, and seeing how she gently pulled the newborn down towards the bed. First the anterior shoulder appeared, then the posterior shoulder, before Sister Houghton hooked the baby under its armpits, heralding its thrilling arrival into the world.
During one of these deliveries, I hovered at the foot of the bed as Sister Houghton explained that this particular lady had started out breathing in gas and air from the large cylinder beside the bed to help her cope with the pain.
‘When the gas and air didn’t seem to help any more, I encouraged her to shout out,’ Sister Houghton whispered. ‘It often helps, but this lady started shouting out for more drugs. She’s had an injection of the painkiller Pethilorfan, but of course that’s nothing out of the ordinary.’ Giving me a little wink, Sister Houghton added: ‘You usually sense it’s time to give it when they either start begging or swearing. Sometimes the women kick and bite too, I kid you not.’
I lapped up everything she said and did, feeling exhilarated at the spectacle of birth and wondering how incredible it would be to step into her shoes and actually help bring a baby into the world with my very own hands.
Now my moment had finally arrived. Had Sister Houghton really just said the words, ‘Do you need a delivery, Linda?’? Yes, she had! I wasn’t dreaming and the reality of the situation suddenly put me on red alert. Excited notions about the joy of being part of the miracle of birth started to slip away. Instead, I was overwhelmed with practical thoughts as words from my Textbook for Midwives began to scramble through my head. ‘Good wholesome cleanliness is the first prerequisite in midwifery …’ it stated.
I followed Sister Houghton as she rushed into the delivery room. As quickly as possible, I attached a cloth mask over my nose and scrubbed my hands and arms up to my elbows using the soft brush on the sink. Next I put on a clean gown.
‘Come on, Linda. Get your gloves on as fast as you can,’ Sister Houghton urged. Her eyes flashed at me between her cap and mask. I couldn’t see her lips but I could tell she was smiling. My heart was pounding as I pulled on my sterile gloves and joined Sister Houghton at the side of the bed.
‘Look, we can already see baby’s head,’ she pointed.
I turned and saw that she was actually holding the slippery crown of the baby’s head. In fact, she almost looked as though she was trying to push it back so the baby wasn’t born before I got there. Excitement made my brain buzz, but something else was happening to me too. Little glass vials were being crunched up inside me, spilling cold liquid into my guts, making them contract. That’s exactly what it felt like, and it was a feeling I hadn’t experienced before in a delivery room. Responsibility was what filled those vials, I realised afterwards. I wasn’t just a witness any more. I was dealing with the lives of two other human beings, and I could feel the weight of that responsibility pushing inside me as I reached out and let Sister Houghton replace her hands with mine.
‘That’s right,’ she said softly as I touched the baby’s head.
Adrenaline had taken over, flooding me, confusing me. Was I ecstatic or petrified? I wasn’t sure if Sister Houghton was speaking to me or to the panting mother. For a split second, I was somewhere else. Touching the baby’s head made everything fantastically real. Feeling the warmth of a baby’s head in your hands, that new life, I’d honestly never experienced anything like it.
My hands were visibly shaking now and I could feel my gloves moving nervously over the baby’s warm scalp. ‘Now guard the perineum,’ Sister Houghton said in a clear whisper. As she did so she placed her hands on top of mine, which immediately helped to still my trembling. She steered my right hand beneath the baby’s head, so as to protect the mother’s straining skin beneath and prevent it from tearing. I desperately didn’t want the skin to tear. So far there had been no need for an episiotomy cut to help with this delivery and I didn’t want anything at all to go wrong. I wanted this baby to be born absolutely perfectly.
‘Now keep your fingers on the head … steady, steady …’ Sister Houghton instructed quietly. In a louder voice she said efficiently: ‘OK, just a little push please, Mrs Carmichael … baby’s head is nicely delivered.’
The crisp whisper was back in my ear a moment later. ‘Check the cord isn’t around the neck and wait for the external rotation of the head … there we have it, baby’s nicely on its
side.’ To the mother, she said loudly, ‘Have you got another contraction for us?’
Mrs Carmichael did.
‘OK now, Linda, you know what to do … pull baby’s head down and deliver the anterior shoulder … lovely, lovely … now sweep the posterior shoulder up and …’
The baby plopped out beautifully onto the bed and my heart somersaulted. I was relieved and delighted to see it was a perfect little girl. With shaking hands, I lifted her carefully and looked at her in awe as she emitted her first little cry. I was the first person in the whole world to hold her. I felt so privileged, so delighted with myself. I’d taken on a huge responsibility and I’d carried it off. I’d delivered a baby!
I glanced at Mrs Carmichael’s face. She was gazing at her baby and looked exhausted but blissfully content. I caught her eye for a moment and she gave me a wonderful, appreciative smile that made me glow even more.
I was so excited I could have turned a cartwheel across the delivery room floor, but I somehow managed to swallow my adrenaline rush and follow Sister Houghton’s continual stream of steady, calm guidance.
As I clamped the cord and the little girl cried out once more, I wanted to cry too, but I kept myself in check. Once the placenta was successfully delivered a few minutes later, and as Sister Houghton cleaned and dressed and weighed the very beautiful black-haired baby, I had the honour of officially recording her birth in the hospital notes. I also had the pleasure of noting the details of the delivery in my own pupil midwife record book.
Using the fine fountain pen in my pocket, I wrote the mother’s name, the sex of the baby, her seven pounds weight and the date and time of delivery as neatly as I possibly could, although my hands were still shaking with the thrill of it all. Sister Houghton signed the entry in my record book too, and I looked at it again and again, not quite believing what I was seeing and what I had done.
‘I can deliver babies!’ I thought. ‘I’ve done it!’ I was filled with an incredible feeling of achievement. Spontaneously, I gave Mrs Carmichael a hug and a kiss on the cheek.
The Midwife's Here!: The Enchanting True Story of One of Britain's Longest Serving Midwives Page 16
