It’s a boy!
When I did my training to become an ambulanceman, the maternity module was basic, to say the least. It consisted of a plastic pelvis and a woolen doll, with a placenta and umbilical cord (also in wool) attached. A short session of passing this through the pelvis at different angles was followed by an instructional film. This seemed to have been made in the late 1950’s, judging by the vehicles, and the clothing worn by the small cast. Using a willing female ‘star’ of a certain age, a real delivery in the back of an ambulance was filmed in glorious technicolour. It all went off well, with no complications, and ended with smiles all round.
There was some talk about breech births, cords around baby’s neck, and infant resuscitation, as well as pregnancy complications, like Pre-eclampsia, and placenta previa. This was added as information, as we were not expected to encounter these in any great numbers.
The reality is somewhat different. During the many years that I served in the LAS, I delivered just 14 babies, far less than one a year. I should add that the term ‘delivered’ is misleading. You don’t really deliver a baby in those situations, except in exceptional circumstances. What you actually do is catch it as it comes out, and try to keep both baby and mum alive until you get them to hospital, or a midwife arrives to take over. When you work in emergency ambulances, most of the time, you can do no harm. You try your best to help in any given situation, applying your training and skills as well as you can. You soon learn to accept that it is not always enough, and that you will lose people, or fail to save them, depending on how you look at it. What happened to these people is not your fault, and you cannot be blamed for doing your best to attempt to minimise their pain, or trying to save their life.
When it comes to maternity cases, that is all turned on its head. Everything you do, and every action you take, can have a bearing on the outcome for the baby and the delivering mother. For me, the sense of responsibility in these cases was always overwhelming, no matter how many times I was faced with it. Most ambulance people have their don’t likes, jobs that they would prefer not to do. For me, it was eyes, and babies. Perhaps it was because I have never had children, or simply because it is generally so messy, and often a rather disgusting process. I never really worked it out. Luckily, most women who deliver unexpectedly early at home, or in an ambulance, have already had at least two children before, so they can be relied upon to help more than is usual with a patient. Unlike the portrayal in films, I have never seen anyone boiling endless kettles of water, or men pacing outside, waiting to hand out cigars, as soon as they hear the infant wail.
I can vividly recall the first baby that I actually ‘delivered’ at the home address. I had been working in the job for about eighteen months, and was called to a flat off Ladbroke Grove, to a maternity call, on a warm summer day, in the early afternoon. I should state, for your information, that almost all calls given as a maternity, are straightforward ‘taxi’ jobs. You are met by the pregnant female, who is sometimes in labour, sometimes not. You make her comfortable, take notes of her details, and convey her to the maternity department of the hospital that she is booked into. On arrival, you put her in a wheelchair, take her up to the ward, wish her good luck, and move on to the next job. You do not expect her to be having the baby, and not on the floor of her kitchen, wedged between the cooker and the sink.
When the mother tells you that the baby is coming, you rarely believe her, as experience has shown you that this is almost never the case. If they are insistent, you have no option but to ‘have a look’. Pregnant women are far from shy, and are happy for you to inspect their private parts without ceremony. On this occasion, I was shocked to see what was undeniably the top of a baby’s head, protruding from her grossly distended vagina. She told me that it was her second baby, and was one week overdue. I could feel the colour drain from my face as I tried to exude an air of calm professionalism, at least to any onlookers. My colleague left to retrieve the ‘maternity pack’ from the ambulance. This contained a sterile blanket, scissors, a small device for aspirating fluid from the baby’s airway, and a foil space blanket, to keep the newborn warm. We also had oxygen, and a pain relieving gas called entonox. At this time, there was no infusion routinely practiced by ambulance crews, so fluid replacement was not an option.
I helped the mother to get into as comfortable a position as was possible, given the location of a kitchen floor. Blankets were piled on to keep her warm, despite the weather; I put on sterile gloves, squatted between her legs, and assumed the ‘catching position’. Her waters had already broken, so I was kneeling in that small lake of viscous fluid, smiling encouragingly, and hoping that nothing would arrive to complicate matters. Every bit of training that I had ever had was completely gone from my head, and I can only imagine what this poor lady thought, as she looked upon my manic grin, and outstretched hands. After much blowing and pushing that seemed to last a lifetime but was actually only a couple of minutes, the baby’s head appeared into the light, and it opened its eyes. The mother was of mixed race, and the father, who was looking on from the doorway, was a Jamaican Rastafarian; yet the baby, like every other one I have seen in that situation since, was a reddish-blue colour, and covered in a congealed, white slime, called vernix caseosa, that you will never see anywhere else. I cradled the head, and another small push delivered the rest of the baby, with a gush of blood, and other unpleasant fluids. It was as slippery as an eel, and I did well to hold onto it.
I wiped it off as best as I could, and wrapped it in the foil, and sterile blanket. I heard it gurgle, with massive relief. Even though there was no classic cry, it was breathing, and doing well. With the cord still attached inside the mother, I handed it to her, uttering the time-honoured phrase, “Its a boy”. Everyone was both relieved and happy, and I received profuse thanks from the parents, for what I still do not know. The midwife arrived, and sorted out the cord and placenta, and we took them both off to hospital for post-delivery checks. I had busted my maternity cherry, and actually delivered a baby. To be truthful, I felt like a complete fraud. I am sure that any good cricket wicket-keeper could have done the job just as well.
And, despite telling her my name at least three times, she never did name it after me.