Graham just held me tight, which is exactly what I wanted. ‘Tomorrow’s another day, love,’ he said. ‘I know it’s hard, but it’s a part of your job. I know you can do it. Tomorrow will be better, you’ll see.’
I slept very badly, and each time I closed my eyes I saw the poor dead baby’s peaceful, motionless face. Eventually, I sat bolt upright in bed. A shard of early morning sunlight dazzled me through a knife-thin gap in the bedroom curtains. I blinked my eyes tight shut and everything went blood red, which terrified me for a moment. Then I realised, to my great relief, that this was simply my own blood I could see inside my sunlit eyelids. Silly Linda. Silly, silly Linda. Everything is OK. Get up now, Linda, you’ve got work to do.
Once I was fully awake and putting on my uniform, I reasoned with myself. It was perfectly natural to be upset about that poor little soul, of course it was. I wouldn’t be human if I didn’t get upset. Dealing with tragedies like that was part of life, and part of my job. If you are going to work at the sharp end of bringing new life into the world, you have to be strong enough to cope when things go wrong. ‘I can do it,’ I told myself. ‘Sometimes it’s going to be tough, Linda, but Graham is right. You are in the right job. You must be the best midwife you possibly can be.’
Despite my reasoning, I knew the feelings of devastation at losing that baby would never fully leave me, and I was right. Even to this day, every last detail of that birth is etched on my memory, and I can still feel the pain of the loss.
My heart sank when the delivery bell rang out on the ward later that morning. Normally I sprang to attention, running to sister to ask if I could attend, clutching my record book expectantly, hoping I would be able to tick off another one of my forty deliveries.
Today was different, though. Despite Graham’s support, and the pep talk I’d given myself that morning, I couldn’t get away from the fact I was still very upset about Mrs Wainwright. Devastated, in fact. Her delivery pushed me closer to completing my target of six Caesarean sections, but I hadn’t felt a jot of triumph when Sister Houghton signed the relevant page in my record book.
Reluctantly, I entered the delivery room after Sister Houghton had come to find me and chivvy me along.
‘It’s a first baby, all routine,’ she said with a sunny smile. ‘Come along, chop, chop! Baby won’t wait for you, Linda!’
I tried to be positive and think about my wonderful first delivery with Mrs Carmichael, and I prayed to God this next one would run as smoothly as hers.
I felt a whoosh of hot air fill my mask as I stepped up close to the bed. I’d been so tense I’d been holding my breath, but I hadn’t realised it until that moment. An experienced midwife called Val was telling the sweating mother to pant and not to push, even if she felt the urge. I could just see the top of the baby’s scalp.
‘I’m going to do an episiotomy,’ Val announced, and I watched as she injected local anaesthetic swiftly into the perineum, in between contractions. The labouring mother did not appear to have been consulted about this procedure, though she did not object. From the midwife’s point of view it was a disgrace to have a tear. It was deemed far better to have a clean surgical cut than risk a ragged laceration, and women having their first baby seemed willing to accept that the midwife might make this cut routinely to ‘widen the vulval orifice’, as the textbook described it.
‘I’m just going to make a little cut to help baby on its way,’ Val explained to this mother in a matter-of-fact tone. She waited until the next contraction came so the skin was taut and stretched before making one precise incision just over an inch long in the woman’s flesh. With a swift wipe of a gauze swab, the bleeding was gone and another inch of the baby’s scalp was revealed.
Val let me take over as soon as the episiotomy was completed, and it turned out to be another perfect birth. There was only one difference from Mrs Carmichael’s delivery. I still got an unbelievable rush of excitement when I felt the new life in my hands, but this time my hands weren’t trembling quite as much as they had the first time. I think I’d been too intrigued by the spectacle of the episiotomy to think about my nerves, and I astonished myself by talking calmly to the labouring mother as I copied Sister Houghton’s soothing phrases before announcing confidently and triumphantly: ‘Well done! It’s a girl!’
That’s how I got my second delivery, and it raised my spirits no end. I was buzzing all over again, and I couldn’t wait to deliver my next thirty-eight babies, and more! In fact, in that moment I wanted to deliver hundreds and hundreds of babies, if not thousands! That was my youthful dream and, as ambitious as it seemed, I really wished it would come true.
Chapter Eleven
‘Knickers and tights off, ladies!’
‘Linda, forceps delivery!’ Barbara Lees bellowed above the sound of the trilling bell that announced a delivery was imminent. ‘Put those bunnies down and come quick!’
‘Bunnies’ was the name we gave to the big thick sanitary towels dished out to the women after they gave birth. They were useful for all sorts of other things, and I’d often seen midwives soothing a patient’s brow with a bunny that had been soaked in cold water, or using one as a sponge to mop up a spillage.
I had been about to neatly re-stock the store cupboard and was fondly remembering the time one very posh lady had complained to a colleague: ‘Nurse! I do hope you are not wiping my brow with a sanitary towel!’
When the midwife admitted that she was in fact using a bunny as a facecloth the well-spoken lady suddenly decided that it felt so refreshing on her warm forehead that she didn’t mind after all, which made us all smile.
Barbara’s urgent cry snapped me out of my daydream and I threw the bunnies in a haphazard heap before chasing after her. Dr Franklin had given a detailed lecture about forceps deliveries, and I was intrigued to see how his vivid descriptions and explanations would come to life in the delivery room.
To tell the truth, I was a little fearful too, as the collection of forceps he had displayed in the school room looked more like instruments of torture than surgical instruments. The Kielland forceps were frighteningly big, while Neville-Barnes and Simpson’s forceps were smaller yet, I imagined, could be just as brutal.
‘Kielland forceps are only to be used by the very skilled consultant or registrar,’ Dr Franklin had cautioned solemnly. ‘It is not within the midwife’s province to decide when forceps should be applied, but she must be aware of the various indications for their use.’
He went on to list a multitude of complications that may necessitate a forceps delivery, including maternal or foetal distress or high blood pressure. ‘When it’s not appropriate to perform a Caesarean section, forceps should be called for,’ he explained. Suction using a ventouse vacuum extractor attached to the scalp was another option at this junction, Dr Franklin added, but this was not as commonly used.
The type of forceps chosen depended on the problem encountered. Before the use of forceps, the mother would always require an episiotomy and a ‘pudendal nerve block’, which was an injection delivered into the perineum to anaesthetise the nerves supplying the pelvic floor, vagina and vulva. Her legs would be put in lithotomy, meaning her feet would be raised above hip level and placed in stirrups, to give the doctor the best possible access to the baby.
As if this wasn’t alarming enough, Dr Franklin had not finished yet. ‘The aim is to put the forceps around the baby’s ears and pull at the same time as the labouring mother is pushing. Sometimes the baby is born with large red marks on its face, and sometimes a baby delivered this way may be a little irritable, or can be shocked. It is not uncommon for the baby to have a high-pitched cry, which is a result of the traumatic nature of the birth. A difficult forceps delivery can leave a baby severely traumatised, though this is, of course, extremely uncommon.’
I had come to respect Dr Franklin, despite his reputation for being rude and insulting to young girls who fell pregnant by accident. There weren’t many of those, thank goodness. I had only heard ta
les of two or three teenage pregnancies in my first four months here, and had not actually encountered one myself. The last outburst I’d overheard from Dr Franklin, however, had been just days earlier, when I heard him berating an overweight young girl.
‘Just look at you!’ he scoffed angrily. ‘What a big fat thing you are! Not only do you need to stop having intercourse out of wedlock, you need to stop being such a greedy girl!’
He was outrageous, but from what I overheard the girl took it on the chin and spluttered that she was really sorry.
Despite his faults, I enjoyed having lectures with Dr Franklin. He was surprisingly patient with us pupil midwives and always endeavoured to answer our questions at length. He would discuss deliveries we’d been a part of in minute detail and share his knowledge generously, albeit sometimes very graphically. This meant that when I eventually did see my first forceps birth, I felt very well prepared and imagined I knew it all.
However, I stopped in my tracks as I entered the delivery room hot on Barbara’s heels that day. The mother was screaming relentlessly. I’d never heard such an ear-splitting wail. If I didn’t know better, I’d have thought she was being brutally attacked. My heart went out to her, and I watched and listened in stunned, horrified silence.
Dr Franklin was shouting at the midwife, telling her brusquely to ‘Get the patient pushing, will you?’ while he wielded the dreaded Kielland forceps, grunting and heaving and sweating as he struggled to pull the baby out.
‘Aaaarrrghhh!’ the woman screeched. ‘It’s killing me! Make it stop!’
‘Push now!’ the midwife implored. I could see the woman’s red sore heels grinding into the stirrups as she raged against her pain. The gas and air she had been given, and the Pethidine, were clearly not helping enough. It was as if she were rigged up to a medieval torture bed, as her legs were strapped firmly down and her hands were desperately clawing the air.
The traumatic din and strenuous pushing and pulling persisted for a full ten minutes before the red-faced baby was literally dragged out into the world. He let out an incredibly high-pitched cry, which I realised was about the only thing about the procedure I’d been prepared for after all.
I watched anxiously, sweat pricking my brow, as Dr Franklin delivered the placenta before suturing the perineum. The process took quite some time because the patient needed a great deal of stitches. I winced in sympathy each time the needle went in, but when I stole a look at the mother’s face, to my surprise and relief she was smiling radiantly.
‘I’m going to call him Henry,’ she said sweetly, gazing at her baby adoringly as he was cleaned and weighed and put in a nappy. ‘After Henry Cooper,’ she chuckled. ‘Little bruiser!’
A few weeks later I sat in the ward kitchen eating a ginger biscuit, drinking a cup of tea and giving my throbbing feet a well-earned rest after a round of temperature and blood pressure checks. It was May now, and I was well on the way to completing Part One.
At the end of June, Graham and I were heading off to Torquay for our week in the sun with his parents before I would begin Part Two in July, spending four months out in the district with community midwife Mrs Tattersall.
I flicked through my record book and felt very satisfied to see that I had managed to fulfil my obligation to witness six Caesareans, six forceps deliveries (of which the subsequent five were markedly less dramatic than the first), and five out of my six required breech births. I had not expected it to be so easy to tick these complicated births off my list in a matter of a few weeks, but the hospital was so busy I could easily have witnessed many more.
There was an old copy of the Manchester Evening News lying on the counter top, and I snatched a few moments to read a report about The Beatles’ break-up. Tragically, Paul McCartney had announced that they were to disband on the day he released his first solo album, and I was dismayed to read about fall-outs between the Fab Four, and how the others had asked Paul to wait until the last Beatles album, Let It Be, came out, before releasing his own. I loved every record The Beatles had released, and I hummed one of my favourites, ‘Love Me Do’, as I read the latest news, feeling heartbroken.
‘Nurse Buckley, what are you doing?’
I was startled to see none other than Miss Sefton looming in the kitchen doorway, hands on hips.
I opened my mouth to speak but she answered the question herself with the words: ‘I know you! Eating ginger biscuits no less! I can smell them on your breath!’
‘I’m very sorry …’ I stuttered, knowing that she hated to see any of her staff eating on duty, even in the privacy of the ward kitchen. Simply sipping a cup of tea during a shift was unacceptable in her book, and she expected her staff only to take refreshments during official break times, which this was not.
‘Apology accepted,’ she sighed, sounding calmer, ‘but don’t let this happen again. Now then, Nurse Buckley, how are you getting on with your deliveries?’
Peering at my open record book, Miss Sefton’s eyes fell on my tally of five breech births – the only section that had not been signed off as completed in my Part One.
‘I see you have another breech to witness,’ she said, raising her eyebrows. ‘I know it is not always the easiest target to reach, and of course we would not wish for more breech births, ordinarily.’
Usually it was possible to tell if the baby was breech by palpating the abdomen, but, with only the aid of their hands to feel the shape of the baby, midwives and doctors occasionally got it wrong. Either way, it didn’t affect the delivery plans. Women expecting to have a breech birth generally had to battle bravely on with a vaginal delivery. Back then everyone knew you only got a Caesarean if a vaginal birth was absolutely out of the question, and the mother’s or the baby’s life was in danger. The prospect of heightened anxiety and trauma during a breech delivery was not a good enough reason to go under the knife in those days, not by a long way.
I’d found each breech birth nerve-racking to watch, seeing a little foot or bottom appear first instead of the top of the head. The women sometimes suffered from dreadful stress, and during each birth the tension in the delivery room ran so high it was practically tangible.
‘It may have been fortunate for you that I caught you here today,’ Miss Sefton announced. ‘If I am not mistaken, I believe Dr Franklin has a breech birth imminent. You may be wise to put away the ginger biscuits and seek him out.’
I did as I was told with mixed feelings. I desperately wanted to tick off my sixth and final observation of a breech delivery, but I felt quite sick with nerves that day. The atmosphere in the delivery room would be highly charged, and I knew I would spend the entire birth feeling desperately sorry for the labouring mother, and fearing for the life of the baby as it made its clumsy entrance into the world.
In the early stages the mother would be crying and shouting for more drugs, complaining that the pain-relieving gas and air or injection of Pethilorfan were no use at all, and the midwife would be trying to keep her as calm as possible.
I found Dr Franklin in Room 4. The staff midwife, Val, informed me that the delivery was going quite well and the baby was already halfway out. I knew that a calm atmosphere was of paramount importance at this stage, but an almost unnatural quiet filled the entire delivery room. I would have preferred hollering and cursing to this eerie silence, and I felt instantly afraid for the safety of the baby.
Dr Franklin acknowledged my presence with a brief nod as I tiptoed up beside him. He was seated at the foot of the bed, between the woman’s legs. I could see this was a ‘footling’ breech delivery, also known as an ‘extended breech’ delivery, meaning the baby was arriving legs first rather than bottom first.
To my surprise I recognised the mother as a customer from my parents’ bakery. Her name was Philippa Frodsham and I had served her occasionally when I helped out behind the counter as a teenager. She seemed terribly snobbish and was ‘partial to parkin’, I recalled, which was one of my father’s speciality cakes. Her husband was either a d
entist or a chiropodist, I couldn’t remember which.
I was accustomed to seeing Philippa buttoned into expensive, richly coloured smock coats with matching hats, twittering on about meeting the ladies for lunch or discussing private schooling with other well-heeled customers. Now, the only clue to her social status was the glamorous red satin Alice band still clamped firmly across her neatly bobbed blonde hair.
I caught her eye and smiled, and she gave me a soft smile back. I had no idea whether she recognised me or was just grateful to see another friendly female face in the room. That said, it always amazed me that ladies like Philippa, who were normally refined and even prudish, were never coy about having a man deliver their baby.
Husbands were banished to the corridors during internal examinations, let alone births, but it was perfectly acceptable for a male doctor to be at the ‘business end’ of a delivery. Male doctors were revered, in fact, and were especially glorified if they were consultants. Time and time again I saw patients looking up to the senior male doctors almost as if they were gods. I had to admit that there were times when their skills earned them that privilege, however, and this was certainly one of those occasions.
I saw that one little foot and leg were already dangling, and Dr Franklin was in the process of gently teasing the second leg down, his hand inside the vagina as he unfolded the limb and hooked it free, ever so slowly and carefully. With two legs cleanly delivered, Val fetched a sterile blanket and Dr Franklin wrapped the little boy’s legs together to keep them warm, and so he could get a better grip on the baby.
The Midwife's Here!: The Enchanting True Story of One of Britain's Longest Serving Midwives Page 18
