It happens to all midwives at some point in their career, through circumstance and the force of nature, they find themselves in a position whereby they must talk somebody through the delivery of a baby over the telephone. I had such a close shave just yesterday:
I was working on the assessment unit. The day had been up to that point, most agreeable, jovial one may say. We were sat drinking coffee ( a rarity I promise). The discussion had moved/lowered to sexual relations and the ir/regularity or lack thereof with respective husbands/boyfriends. I was listening patiently, waiting my turn. I knew that this was a competition I would definitely win. (When trying to conceive you find yourself uncharacteristically shagging like rabbits). Just as I was preparing my coup the 'phone rang. I could not avoid answering said 'phone as it was placed surreptitiously in my pocket for fear of any of my junior colleagues inviting a woman to come in unnecessarily.
"Hello" said the very calm, laid back male voice on the other end "My wife is in labour".
"Mmm," thought I rather too smugly, "I'll be the judge of that".
I asked him to explain to me what was happening. Midway through his explanation I heard the familiar sound of a woman in full blown labour and with it my previous smugness was replaced by genuine concern. The deep guttural noise a woman makes when in advanced labour, as they are trying their best to cope with the pain is unmistakeable to the experienced ear. Followed was an exclamation from said woman
"Tell her my waters have just broken."
Physiologically speaking, the membranes and waters that surround the baby should not go until the cervix is fully dilated. This is because when the cervix is fully there is no longer anything to support the heavy bag of fluid and the membranes weaken and break under the pressure. Obviously, many women experience spontaneous rupture of the membranes (SROM) before this point and it can be due to either a malposition of the baby or possible infection. Sometimes there is no explanation. When it happens in a case like this where the woman has laboured spontaneously and is apparantly in advanced labour it generally means delivery of the baby is iminent particularly in multiparous women (women who have more than one child).
"Shit!" I thought. "I think you had better make your way in".
I put the phone down a little unsettled, unsure if she would indeed make it to the hospital.
Less than two minutes later the calm sounding voice called back. "I don't think she's going to make it".
I called an ambulance for her, still unsure if it would arrive on time. I immediately called the calm man back. I could hear the sounds of the woman now making an effort to push. I told him that I would stay on the phone until the paramedic team arrived. I told him to get prepared just in case. Instructing him to have some warm towels at the ready (yes they really are necessary although I am never sure what the hot water is for. Probably to make everyone a nice cup of tea after the birth).
While he went for the towels I spoke to the woman instructing her to just breathe through the contractions rather than pushing. This is like telling the wind not to blow or the tide to go out.
Although my outward demeanour was calm and voice steady, inside my stomach was in knots. All the potential problems running through my brain. Although I am a strong advocate for home births the birth of a baby before arrival of a midwife or trained professional (BBA) is less than ideal. Firstly, the mother is likely to be extremely scared. Secondly, neither mum nor baby have been monitored throughout the labour this makes it difficult to ascertain whether the baby will require any resuscitation following the birth and thirdly, there are risks associated with any birth that are easily dealt with by a trained professional but can be catostrophic if the woman is without aid.
My inner flap was only exacerbated when the woman told me that she was sat on the toilet. I explained very carefully that this was not a good idea and that perhaps she should remove herself from the kazee for fear of the baby dropping out into the toilet. (This does happen).
Calm man came back on the phone (I have to confess that he sounded far calmer than I felt). The woman had now removed herself from the toilet thankfully. I remained on the phone talking him through the contractions and telling him to offer her words of encouragement and emphasising the need to remain calm.
"Well," he said "flapping isn't going to help anyone I suppose". Mmm, good point.
After what seemed like an eternity I could hear the paramedics had arrived. "Alreet Dahlin'" and then "Don't worry that is just your baby's head coming". Made it in the nick of time they did.
I put the phone down, relieved!
After about half an hour a woman arrived on a stretcher with a beautiful baby girl in arms.Calm man, still calm, shook my hand and said how much he appreciated my help. I secretly didn't think he needed it. I think he was the kind of fella who would have delivered the baby and sat down to watch an episode of Taggart completely unphased.
I have to confess as much as this had set my adrenaline running I did get a bit of a kick out of it. Not least because I love it when nature gets the better of the system. It restores my faith in women and their ability to get on and have babies. All you mothers out there I take my hat off to you. Each and every one! Give yourselves a huge pat on the back (that includes you mother nature).
