The Accidental Midwife
The other Side of a Birth Before Arrival
By Mark Powell
As I cycled through Charlton I checked my watch. I’d left work later than planned and the journey home had been slow due to the wind. It was well past six which meant Laura will have had to do bath time alone - normally not an issue but as she was now 39 weeks pregnant, the physical aspects made it a lot harder, not to mention the fact that she’d be tired by the combination of pregnancy and looking after an excitable 18 month old.
As the road bent round past the car boot sale field on the left, I remembered that it was also the first day of my London Marathon training plan and I was due to run six miles that evening. Although I’d rather have not gone out, I knew that I couldn’t skip the first training run. Arriving home to a tired wife later than planned, and then going out for a run leaving her to cook dinner isn’t top of the good husband guide so I started rehearsing my apologetic lines in my head.
As I came in the door a resigned voice called from upstairs: “Mark…”, “I know, I’m sorry I’m lat….”, “It’s alright, come up here.” I go upstairs to the living room (we lived in a three floor house) to see Laura. “My waters have broken” (Having checked my phone records while writing this I have missed calls at 18.06, 18,07, 18.08 and 18.09, I think it’s fair to say that her waters broke at 6.05pm).
That’s the run out of the window then. Action stations. Think. Does Laura need anything? Who do I need to call? Hospital/midwives and my parents to look after our eldest. Where are the bags, what do I need to pack? No, all already done, midwives are on their way shortly (we were planning a home birth) and Granny was coming over to get William. All the bags have been packed for a while and Laura has already re-checked them. Nothing to do then, guess I’ll play with William and read him a book (Pirate Pete’s a New Big Brother seems like an appropriate choice but he’s more interested in Spot the Dog).
By half eight the midwife has been and gone and William is fast asleep on his way to Granny and Grandad’s. Laura was showing no signs of contractions and passed all the checks so the midwife left after giving some basic instructions (call back when the contractions are regularly 3 in 10 minutes, otherwise we’ll see you early tomorrow morning) and checking we had the right kit (towels, plastic sheeting, bin bags). I made myself some dinner and Laura had a shower.
Settling In For The Night
Laura was visibly having contractions about every 10-12 minutes but (and realising only a man could say this) not in any real discomfort. At this point it’s worth a few words on the birth of our first son. The first sign of that labour came on Saturday evening with a show and mild contractions every 20 minutes through Sunday. We think her water’s broke at midnight on Sunday but not much then happened and we spend Monday walking along the Thames to encourage him out. Late Monday evening regular contractions were coming and after some intermediate trips to and from St Peter’s were admitted midday on Tuesday. William finally arrived, with some assistance, just after 7pm. So suffice to say that visible contractions didn’t really mean much second time round - we had two days of that last time.
Contractions got stronger as the evening progressed but, by 10, it was still only at most 2 in 10 minutes, sometimes less. Laura had decided against going to bed and instead tried to watch a film. I was busy with the contraction timer app on my phone and at about 10.45pm commented that the last few contractions had been regularly 4 minutes apart, so I did some (fairly pointless) re-organising of supplies and asked Laura whether I should call the midwife yet. Very firmly and in control, “No, not until they are 3 in 10 minutes”. At 11.03 I said there were 3 in the last 10 minutes, we should call. A little less in control this time, Laura said no again, let’s wait another 10 minutes to check.
Again a bit of context here. With William’s birth our third trip to St Peter’s (midnight to 2am on Tuesday) Laura was having contractions that were 1 minute long and 1 minute apart but was 2cm dilated and was sent home. When we were finally admitted they were the same but at 10cm dilated. However, not long after being admitted contractions eased up - Laura remains convinced it was from being in hospital and being watched. I think two nights of not sleeping and not drinking as much as I should have made her on one of the hottest days of the year might have had something to do with it. The point of which is, Laura was still expecting the labour to continue for some hours and didn’t want to have a midwife just twiddling her thumbs and watching.
The Rapid Progress of Labour
Contractions then sped up a bit. By 11.07 Laura’s attitude had changed and she was telling me she didn’t remember this with William. I got agreement to call St Peter’s. Calm and slow-paced standard questions were asked (reference numbers, any complications etc), which I read off the notes. Then they asked to speak to Laura - this wasn’t too successful in terms of words but told them quite a lot quickly! The phone came back to me, and some more questions, including if Laura needed to push. I started to answer but just then Laura shouted “I need to push” for the first time. Cue an abrupt change at the other end of the phone. One simple, scary sentence: “Hang up and dial 999”.
The next 15 minutes are simultaneously a blur and 15 minutes I will never forget.
I was guided through the next quarter of an hour by a very helpful emergency services operator. There were various questions and commands, interspersed on her part by repeatedly telling me: “It’s OK, the ambulance is on its way” and “Whatever you do, don’t let her go to the toilet”. On my part it was interspersed with running about trying to gather the various towels and sheets we’d got ready, and a combination of trying to do the reassuring of Laura that is the standard role of partners in birth and the tasks I was given by the operator that are normally performed by a midwife.
quarter of an Hour in the LIfe of a Midwife
When you are in this situation you discover that the professional support is a combination of “it will all be fine, the ambulance is only a few minutes away” and the completely conflicting “it’s very straight-forward, exactly as you’ve seen in the movies”. Very little sense of worry comes over the phone apart from the implicit concern by the number of status checks they request. The final admission that YOU are delivering this baby comes after for the 8th time in five minutes you confirm that you can’t see the head, and swiftly change to shouting “I can see the head!”
The thing they don’t tell you in the movies is that after the head first appears, it disappears again between contractions to begin with. Not being aware of this, there is a temptation to panic. Once over that, the real commands begin, essentially giving instructions about how to catch in a very matter of fact way, rather like training a new England wicket-keeper. The next bit really is a blur, and I think was probably only about 30 seconds long but I was soon knelt down holding a VERY fresh baby, blubbering that it’s a boy to an operator who is trying to run through various checks with me (location of the cord etc) and tell me the ambulance is outside.
Cue banging on the door. This is where I realised my first mistake: if you call an ambulance while your wife is in labour, go and put the door on the latch. I needed to go downstairs and let them in pretty quick, but I was holding my son, the towels were out of reach and he was still attached to Laura by the umbilical cord. Somehow, I managed to get a towel, wrap him up and pass him back to Laura - I don’t think this involved placing a 30 second old baby unceremoniously on the floor but I’m not sure how else I did it so maybe that was it - sorry Toby!
The After Birth
I ran downstairs and let the paramedics in, who came upstairs carrying half the ambulance with them. They started their checks and observations immediately (writing the notes on one of their hands). About a minute later one of our midwives arrived, so I ran back down to let her in as well, confirming to her that she had arrived too late (although only just, which suggests she drove fairly fast to get there). Another ten minutes and our second midwife arrived so our sitting room had become pretty crowded - having delivered Toby on our won the aftercare involved a dedicated team of four medical professionals! The fifth person had by this point quietly hung up on her end of the phone, her job complete. I don’t know what she was called and didn’t get a chance to thank her but she helped us successfully bring our son into the world. She was also good enough to record the time of birth (I didn’t think to look at a clock). Thank you for your help.
The next hour was a bit calmer. General chit-chat with the paramedics while we waited for the placenta - apparently one of them (female) loves being called to births, the other (male) really doesn’t. When they got the call he was banking on it being a “grab and run” and, as the updates came through, his heart first sank as he realised that wasn’t going to happen and then rose again as it became clear that they were going to be too late! There was a lot of note taking, which the midwives later admitted was great because paramedics make really detailed notes.
We ended up going to hospital a couple of hours later. The midwives were concerned about how bad Laura’s tear was and couldn’t properly tell in the dim light of our living room. This upset Laura again, who thought she had avoided hospital, but was probably for the best. We stayed in a bit longer than we might have done as they were concerned that Toby was a bit cold (that would be putting him on the floor with no towel shortly after birth…) but were home again before lunch, ready to introduce William to his brand new baby brother when he got back from Granny’s.