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Author : Depth Trust Press
Genre : Biography & Autobiography
Summary : The buzzer goes at 2:47am. It is not the soft chime of a woman pressing for gas and air. It is the flat, furious brrrrrr of the red button in Delivery Suite Four. The one you never press unless the room is coming apart. I am seventeen minutes into a cold cup of tea in the break room. My legs are still aching from the forceps delivery two hours ago – a big baby, a brave mother, a registrar with elbows like coat hooks. I have just peeled off my second pair of scrubs of the shift. My hair is doing that thing where it sticks to the back of my neck like wet string. Then the buzzer. You learn the difference in sound before your first year is out. The call bell for a fresh pad is a polite suggestion. The one for pain relief is a whine. The emergency buzzer has no manners. It does not ask. It commands. I am running before I know I have stood up. The corridor of the labour ward at 2:47am is a strange purgatory. The lights are dimmed for night mode, but the floor reflects the red flash from Delivery Four like a river of blood. A healthcare assistant is backing out of the sluice with a linen skip. She sees my face and steps flat against the wall. No words. We all know. Through the double doors. First thing I see: a student midwife, pale as the sheet she is holding, pressed into the corner like she is trying to become wallpaper. Second thing: the consultant obstetrician, Dr. Parmar, who was on call from home and is somehow already here in her coat over pyjamas, her grey plait undone. Third thing: the bed. She is on her knees. The mother. A woman I will call Leah, because that is not her real name, and because she deserves to have her true self kept safe from this page. Leah is on the bed on her hands and knees, and her baby is halfway out – head delivered, body stuck. Shoulder dystocia. The anterior shoulder caught behind her pubic bone like a key that has turned the wrong way. The baby's face is visible. A small, perfect, purple face. It is not crying. It should be crying. "Get me the McRoberts," Dr. Parmar says, and someone slaps the yellow card into her hand – not a trademarked device, just a reminder of the manoeuvre: thighs flexed back, suprapubic pressure, no pulling on that tiny neck. I have done this drill a hundred times in simulation. Mannequin babies with nylon limbs. A plastic pelvis that clicks when you get it right. But a mannequin does not turn from purple to blue. A mannequin does not have a father standing behind the curtain, whispering please please please into his own hands. "Push up," Dr. Parmar says to me. Not push down – that would be a disaster. Push up on the baby's back, from the sacrum, to release that shoulder. I place my hand on that tiny, warm, too-still body. I can feel the baby's ribs. I can feel the life still thrumming through the cord, but for how long? Every second is a calculation. Four minutes to brain injury. Five to death. I have no idea how long we have already lost. I push up. Nothing. "Roll her," Dr. Parmar says. "All fours to all fours – go." We turn Leah like a ship in a storm. She is screaming now, but not in pain from the contraction – that has passed. She is screaming because she knows. Mothers always know. You can tell them everything is fine until you are blue in the face, but a mother reads the room. She saw the registrar's face drop. She saw me run. She knows. "On the next contraction – push," Dr. Parmar says to Leah. "Push like your life depends on it, because your baby's does." Leah pushes. I push up on the posterior shoulder again. The registrar – a young man whose name I have already forgotten, which is terrible, but that is what emergencies do, they erase names – applies suprapubic pressure from above. Three forces on one small body. And then, with a sensation like a cork coming out of a bottle that is also a prayer, the anterior shoulder slips. The baby slides into my hands. A boy. A small, blue, silent boy. The cord is wrapped twice around his neck. Loose, but there. I slip it over his head like taking off a necklace. Then the clock starts again. The resuscitation trolley is already there – it lives at the end of every bed on the labour ward, the elephant in every room. I don't even remember pulling it over. My hands are on his chest. One, two, three. Stimulate. Dry him. The towel is rough against his perfect skin. "Come on," I say. Not professionally. Just me, just a woman with a blue baby in her hands. "Come on, mate." The father has emerged from behind the curtain. His face is the colour of old milk. He is holding Leah's hand but looking at me. "Talk to him," I say. Because sound travels. Because a father's voice is lower than any monitor. "Tell him his name." "Samuel," the father says. "Samuel, please." And Samuel, the boy who was not meant to breathe, opens his mouth and cries. It is not a lusty yell. It is a thin, reedy, furious little wail – the sound of a kitten who has been stepped on and disagrees with the premise. But it is a cry. It is air. It is life. I wrap him in a dry towel and place him on Leah's chest. Her arms come up like they were always meant to. She is sobbing. The father is sobbing. Even Dr. Parmar wipes her eyes with the back of her hand before she reaches down to deliver the placenta. And me? I step back. My hands are shaking. My tea will be stone cold by now. There is blood on my scrubs – not much, but enough. I lean against the wall and breathe. This is the labour ward. Not the one you see on television, where every birth is a struggle followed by a perfect pink baby and a round of applause. Not the one from the leaflets, where women float on birthing balls in candlelight. Those things happen too. But this – this is the other side. The side where the buzzer goes at 2:47am and you run. I have been a midwife for eleven years. I have delivered something like eight hundred babies. I have held women who were birthing their first and their fifth and their first after a loss. I have cut cords, mended tears, told lies that felt like kindness and truths that felt like cruelty. I have gone home and washed blood out of my hair and sat in my car for twenty minutes before I could turn the key. And I have learned one thing that no textbook will ever teach you: Every birth is a near-death experience. Sometimes for the baby. Sometimes for the mother. Sometimes for the midwife's own soul. The shift does not end with Samuel. There will be a woman with a prolapsed cord at 4am, a grandmother who collapses in the waiting room at 5am, and a straightforward, lovely, boring delivery at 6:15am of a baby girl who slides out like she is late for a party. By the time I hand over at 7:30, my handover sheet will have three red stickers – one for each emergency. A quiet night, by some standards. But Samuel stays with me. He always will. Because in the moment between his head emerging and his cry, I did not think about protocols or guidelines or evidence-based practice. I thought: please not tonight. And then I thought: if he dies, I will have to tell his mother. If he dies, I will have to walk into the room where she is bleeding and look her in the eye and say the words that no one should ever have to say. He didn't die. But some do. This book is about the ones who do, and the ones who don't, and the ones who live in between – the midwives who run toward the buzzer every single time, knowing that one day it will be a sound they cannot outrun.