“You are my midwife. You are second next to God to me.”
She spoke through an interpreter in Arabic, her second language. Her first language was of her tribe in the Sudan. She had been in Tasmania two and a half months.
She turned up at the antenatal clinic without an appointment and the clerk was trying to work out what it was she wanted when the woman lowered herself to the ground and squatted. The young clerk came looking for a wheelchair, found me and asked me to come.
Together we lifted her gently into the chair. I wondered if she was in labour.
She had a young boy with her, about 5 years old. As I helped her onto a bed in the Pregnancy Assessment Centre another midwife walked in. She wanted the wheelchair for a woman on the ward who had delivered a premature baby the night before by caesarian section and wanted to visit her baby in the neonatal intensive care unit. (No wheelchairs on the ward, one was sighted going past the grand chancellor with ‘MAT’ clearly printed on it’s back the day before.)
I didn’t think, I was in a hurry and she was pressing me. Reluctantly I said yes and it was whisked away. I drew the curtains and the little boy was ushered out to sit on a chair. The woman winced and I felt her tummy harden, there was little time between contractions. I wrapped the CTG straps around her and began monitoring, long enough to see a reactive heart trace from the baby, possibly only a minute and removed them. Covering her up as best I could and drawing the curtains I examined her internally. She was ready to have her baby.wheel
No wheelchair. Two other midwives and myself pushed the bed out of the PAC, down a corridor, around a corner, through double doors, around another corner, down another long corridor, through a doorway and into the Birth Centre birthing room, the only room available on the ward. Another midwife ran ahead, opening the doors, clearing trolleys out of the way and asking the woman with the twin stroller to reverse down the corridor so we could fit through.
She climbed off one bed and onto another. A midwife took her small son to the tearoom where he was given biscuits and warm Milo.
After supplying me with paperwork, a jug of water and a delivery pack, my colleagues left. She removed her jacket and her long skirt, her half-slip and t-shirt remained. Her dense black skin stood out in brilliant contrast to the hospital white sheets. She spoke no English other than “thankyou”. I busied myself in the room, switched on the overhead heater at the baby resuscitation table, got sponges, forceps, scissors, cord-clamp ready. And waited.
Her husband arrived. A tall, dark smiling Sudanese, he spoke a little more English. He shook my hand and told me his name. He went to his wife.
I looked at her file. She was 24 years old, the same age as my daughter. This was her fourth pregnancy. She had 3 children, all born in Africa. Her first child died at 12 months old. No explanation as to how in the notes. She tells her husband to leave.
A female interpreter arrives, they converse in Arabic.
I look at her tight black tummy
I look at her tight black tummy, she is straining, I am standing over her, she tells me through the interpreter, “sit down, sit down. I will tell you when the baby is coming.”
I can’t help it, I laugh. A labouring woman telling me, in Arabic, through an interpreter, to take it easy, I laugh, she laughs, we all laugh.
Her tee-shirt is off and the petticoat has risen up over her buttocks. She is cold, with only a sheet covering her. I get a blanket from the warming cupboard, she pulls it up over her shoulders. I offer her water, she wants a cup of tea. I make her one. I am standing over her. She tells me, “sit down, sit down. Your legs will get tired. I will tell you when the baby is coming.”
Her husband comes in, she talks to him and he strokes her belly with both hands, starting at her breasts and softly sliding his hands down over her abdomen and into her pubic hair. He does this three or four times. I ask him why? He says in broken sentences, “In Africa when the baby is taking a long time, this is how the husband helps the baby come”.
He leaves. It is almost an hour since she arrived in the room. She says she wants to go to the toilet. I help her up and straighten the bed while she’s in the bathroom. As she climbs back on the bed her and I both notices the long streak of bloody mucus she leaves on the sheet.
Now, now. the baby is coming
I am standing over her, watching her once more. She tells me to sit down, she will tell me when the baby is coming and finally I am convinced that yes, she will tell me when the baby is coming and sit down.
I look down at my notes and start to write the necessary, mundane details required when she says with urgency in her voice, “Now, now. The baby is coming!”
I jump up, gloves and apron on, and lift the sheets. Her legs are straight and barely apart. I resist the temptation to widen them. They are separated just wide enough for a glistening black-haired head to appear. She is finally pushing. With one tremendous effort her baby is born. I place my hand down over the head to attempt to slow down the baby’s emergence into the world. A slippery, shiny, pearl grey colour, with masses of tightly curled wiry wet hair, I lift him up and onto her tummy. The baby is a boy, her fourth. She shows no interest. The interpreter hands me a warm towel and I rub the cream-coloured, wet vernix from the squirming, squalling child underneath my hands.
Her head drops back onto the pillow, eyes closed, her arms outstretched. Still no recognition, no movement toward her child. The baby is now quiet, lying on a towel by her side. He reaches out with an arm and slowly opening his hand and fingers, he searches for touch, warmth, skin, his mother. He opens one dark eye, then the other.
I ask her if she wants the needle that helps the placenta come out. She says to the interpreter, “the placenta will come out anyway, with or without the needle?”
I say “yes”
She says, “you decide what is best.”
I decide not to give the needle and the placenta comes out, cord clamped and cut, the baby is free of his mother. She reaches for him as I swap a clean, warm towel for the wet one. We swaddle the baby together. I place a fresh blanket over the mother, she cradles the baby and pulls the blanket right up to her neck and the baby disappears once more into the darkness. His mother is smiling.