Read Farewell to the East End Online
Authors: Jennifer Worth
Farewell to the East End (35 page)
‘I’m going to push you around a bit, Kirsty. Hook your knees over the edge of the bed, and hold on, so that you don’t slip backwards with the pressure.’
Chummy slipped her gloved hand into the vagina. There was no perineal resistance, something she knew she could be thankful for. She felt the partly dilated cervix again, the forewaters protruding and the pulsation of the cord within. With her forefingers she felt around the baby’s head – there must be no pressure on the fontanelle, she thought, because that could kill the baby at once. Her fingers were placed ready to push when the ship moved, causing them to slip. She had to find the correct position a second time. When she thought her fingers were rightly placed she pushed hard, but the head did not move. She felt the sweat running down her face and neck. ‘It’s got to,’ she thought, ‘it’s got to go back.’ So she pushed again. This time the head retreated slightly but not enough for the cord to be replaced behind it.
After the second unsuccessful attempt Chummy paused, trembling.
‘Pressure, that is the only thing I’ve got to help me, massive pressure, and God be with me that I do no harm.’
Shaking all over, she leaned her head on the soft cushion of Kirsty’s enormous thigh, trying to think clearly. The wind groaned outside, and the ship moved in sympathy. Her fingers slipped, and she withdrew her hand. If the amniotic sac broke, that would be the end: nothing could save the baby. Only the fact that the cord was still floating freely in the amniotic fluid made replacement a possibility.
Another contraction came. ‘Five or six minutes can’t have passed,’ she thought. ‘I can’t have spent all that time achieving nothing.’ She looked at her watch – it had been five minutes. Contractions were getting closer, and time was rapidly running out.
She saw the uterus heave with the muscular pressure of the contraction, and a plan formed in her mind. Looking at the uterus, her instinct told her that, if she applied reverse pressure externally, and internal pressure on the baby’s head, she might be able to move it sufficiently to replace the cord. It was not a procedure that had been taught in the classroom, but something told her that it might work. With only five minutes, perhaps four, before the next contraction, she had to be successful, or the baby would surely die. The ship lurched as a great gust of wind hit the side, and Chummy prayed for calm during the next few minutes.
When the contraction passed Chummy said, ‘Kirsty, I want you to listen carefully. Grip your knees over the edge of the bed again, and hold on. Just concentrate on holding your body still, because I am going to push hard, and you must
not
allow me to push you downwards.’
not
allow me to push you downwards.’
‘I’ll do my best, nurse. I have to be strong in my job. I don’t suppose you can push any harder than a fifteen-stone first mate. I’ll be all right.’
Chummy took her at her word. She inverted her left hand over the upturned uterus, just above the pubic bone. Being able to insert her whole hand into the vagina was a huge advantage. She cupped the palm of her right hand over the baby’s head, stood up and took a deep breath.
‘Hold on, Kirsty, don’t let yourself slip. I’m going to push – now.’
Chummy was tall and strong. She exerted massive downward pressure internally and externally. The baby shifted two or three inches from her internal hand, but still she kept up the external pressure on the uterus. When she felt it was enough, she relaxed.
‘That was hard! I don’t know if I’ve had it harder than that. But I didn’t move, did I?’ said Kirsty.
Chummy did not reply. Her job was not done. She still had to replace the cord into the uterus. She felt for the cord, but it was not there. She stretched her finger inside the os and ran it around the rim, but could feel only the smooth, round surface of the baby’s head. The cord had disappeared. Internal fluid suction, caused by shifting the baby, must have withdrawn the slippery cord without any further action being required from the midwife.
Chummy felt giddy with relief and leaned her head on Kirsty’s capacious thigh. She giggled weakly.
‘It’s done, it’s done, thanks be to God! And thanks to you, Kirsty. You didn’t move. I couldn’t have done it without you.’
‘All in a day’s work,’ observed Kirsty casually.
The whole operation had taken only about thirty seconds. But Chummy sat trembling with relief for another two or three minutes, until her more practical side took over. Now that the baby was safe, how was it to be delivered? All sorts of questions tumbled into her mind. Kirsty looked quite comfortable, but could a baby be delivered in an upside-down position? She wondered what the midwifery tutors would say about that! On the other hand, moving this massive female might be a problem. Kirsty had rolled down the slope of the bed, but would she be able to roll up? The third stage of labour, the delivery of the placenta, was vitally important, and Chummy was not confident about the mother expelling a placenta upside-down. Kirsty would have to be moved. Then the cord came into her mind. Reverse pressure had made it withdraw into the uterus, but if Kirsty stood up, as she would have to, would the downward pressure displace the cord and make it slip forward again? Chummy could not be sure, but it might. The risk was too great. Kirsty would have to remain in her present position.
Chummy sat beside the labouring woman, listening to the wind and feeling the ship move beneath her. She was not really surprised by the extraordinary situation in which she found herself; after all she was going to be a missionary and she would have to be prepared for anything. She was a thoughtful, prayerful girl, and she thanked God she was being tested in this way.
She pondered the ugly situation in which Kirsty had been placed. First abused, probably raped, when she was fourteen by her father, and then confined to a ship for the pleasure of all the men, including her father. Yet, Chummy reflected, she seemed happy and content. Perhaps, as she had known no other life, it all seemed quite natural to her. The men were obviously fond of her – their concern as she struggled down the gangway was evident – and she was not ill-treated. Common prostitutes, pushed onto the streets by pimps and beaten up if they protested, had a much worse life, she thought.
Another contraction came, and the waters broke. Thank God I was able to replace the cord, she thought; it was only just in time. Labour was progressing fast, and Kirsty was wonderful. She had had no sedation but had barely murmured at the pain. Chummy could feel the head well down on the pelvic floor. ‘It won’t be long now,’ she said aloud.
Kirsty groaned and pushed. When the contraction had passed she said, ‘I’ve been thinking about this baby. I’m so glad now. I never thought I’d have one, because Dad always gave me the boxes of rubbers and said the boys must always wear them. So they did. But now I’m having a baby. And I’m glad.’
‘I’m sure you are. A woman may not want a baby, but she’s always happy when it comes,’ said Chummy.
‘I hope it’s a little girl. I’d like a little girl. I have enough men. But I don’t want her to have my life. It wouldn’t be right for a young girl. I think Dad will understand if I talk to him. What’s your name, nurse?’
‘Camilla,’ said Chummy.
‘Oh, what a beautiful name. I want to give her your name, nurse, may I?’
‘Of course. I should be honoured.’
‘Baby Camilla. That’s a lovely name.’
Another contraction came, only two minutes after the last, fiercer and longer. Kirsty had no vaginal or perineal resistance, so the head was able to descend quickly and easily. She gripped her hands until the knuckles showed white and pushed hard, forcing the weight of her buttocks against the end of the bed. In protest, the bed trembled and collapsed with a crash onto the floor.
The problem of an upside-down delivery had been solved! Mother and midwife were now on the floor, Kirsty floundering and pushing, Chummy desperately trying to control the situation.
Poor Kirsty was bewildered. ‘What happened?’ she kept asking. Chummy, who had narrowly missed having her hands crushed, tried to calm her.
‘The bed broke, but the baby is all right, and if you are not hurt, no harm has been done. In fact it’s a good thing, because delivery of your baby will be easier.’
Chummy’s concern now was that the baby’s head might be born too quickly. The slow and steady delivery of the head is what every midwife hopes for, but with no perineal resistance, this baby could well shoot out with the next contraction.
Another contraction came, and Kirsty raised her knees and braced herself to push, but Chummy stopped her. ‘Don’t push, Kirsty, don’t push. I know you want to and feel you must, but don’t. Your baby’s head will be born with this contraction, but I want it to come slowly. The slower the better. Concentrate on
not
pushing. Take little breaths, in-out, in-out, think about breathing, think about relaxing, but don’t push.’ All the time she was saying these words Chummy was holding the head, trying to prevent it from bursting out of the mother at speed. The contraction was waning, Chummy eased the slack perineum around the presenting crown, and the head was born.
not
pushing. Take little breaths, in-out, in-out, think about breathing, think about relaxing, but don’t push.’ All the time she was saying these words Chummy was holding the head, trying to prevent it from bursting out of the mother at speed. The contraction was waning, Chummy eased the slack perineum around the presenting crown, and the head was born.
Chummy breathed a sigh of relief. She had been concentrating so hard that she had not noticed the cramp in her legs as she squatted on the deck of the cabin; had not noticed the poor light cast by the hurricane lamp as it swung from a beam; had not noticed the movement of the ship, nor the occasional lurch as the wind hit it. All that she knew was that the miracle of a baby’s birth would shortly take place, that the safe delivery was in her hands, and that the head had been born. Chummy kept her hand under the baby’s face in order to lift it away from the hard floor and waited. Another contraction was coming. Chummy felt the face she was holding move.
‘It’s coming, Kirsty. You can push now. Hard.’
Kirsty drew her legs upwards and pushed. Chummy eased the shoulder out and downwards. The other shoulder and arm quickly followed, and the whole body slid out effortlessly.
‘You have a little girl, Kirsty.’
Emotion flooded over Kirsty with such intensity that she could not speak. Tears took the place of words. ‘Let me have her. Can I see her?’ she spluttered, still floundering with her head on the deck, unable to lift her shoulders. Chummy said ‘I am going to lay her on your tummy while I cut the cord, then you can hold her in your arms.’
The baby sank into the soft cushion of her mother’s stomach. She was slightly blue around the mouth and extremities, but otherwise she seemed to have suffered no harm from the drama of labour. Chummy severed the cord and then held the baby upside down by the heels. Kirsty gasped and held up her hands protectively.
‘Don’t worry, I’m not going to drop her,’ said the midwife, ‘this is done in order to drain the mucus out of the throat, and to help breathing.’
Then she gave a short, sharp pat to the back of the baby, who at once gave a shrill yell. ‘That’s what I like to hear, let’s have another one.’ The baby obliged, crying lustily, and from outside the door a chorus of men’s voices were heard cheering, shouting, whooping and whistling. They started to sing, in a united and raucous male voice. Kirsty called out to them in Swedish, but they were making so much noise they could not hear her. The captain’s daughter was obviously very popular, and the men responded in their own way. ‘I expect they will all get drunk now,’ she said dryly.
Chummy wrapped the baby in a towel and placed her in the arms of her mother, who was weeping with joy. ‘Are you all right on the floor like that?’ Chummy enquired with concern.
‘I’ve never been better in my life,’ answered Kirsty. ‘I would like to stay here for ever, cuddling my baby.’ She gave a sigh of contentment.
Chummy now had to deal with the third stage of labour. In retrospect she would say that it was not the most comfortable third stage she had conducted, sprawled as she was across the floor, but at least it was uneventful.
Chummy washed Kirsty and cleared up the mess as best she could under the circumstances. The problem of how to get Kirsty up off the floor was her next concern. The mother obviously couldn’t care less. She was cuddling, and cooing, and whispering sweet nothings to her baby. Calling the captain was Chummy’s only option, but Kirsty was stark naked. Chummy’s modesty shrank from the thought of exposing her patient, naked, to a crowd of men, until she remembered Kirsty’s profession. She explained to Kirsty that help was needed and opened the door.
A dozen or more bearded faces appeared at the door, all peering in. At once they started cheering and clapping again. Chummy beckoned to the captain, who strode in, shutting the door behind him. She indicated what was necessary, and he nodded. She took the baby from her mother and retired to a stool in the corner.
The captain was a big man, and strong, but for sheer body weight his daughter could easily have doubled him. He took both of her hands and pulled – the bulk shifted a few inches. He stood astride her body and pulled again; no result. He went to the door, shouted, ‘Olaf, Bjorg!’ and two massive men entered. He explained, and they nodded. He took her hands again, and one man stood behind each shoulder. As the captain pulled each man heaved until Kirsty was sitting upright. They gave a cheer. This is obscene, Chummy thought, I can’t bear to look at that poor woman sitting there with her huge breasts swinging on the floor, and these men cheering. They were obviously debating how to get Kirsty onto a chair. The debate was long and contentious; each man had his own ideas. A chair was solemnly brought forward and placed behind the woman. The three men grabbed her torso and heaved once more. ‘That’s not the way to do it,’ thought Chummy, who had been taught how to lift a heavy patient, ‘you’ll never get her up like that.’ They didn’t. After another debate, they tried again, the two men locking their arms under Kirsty’s armpits, and the captain ready with the chair. ‘That’s more like it,’ thought Chummy.
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