Jennifer Worth - Call The Midwife - A True Story Of The East End In The 1950S

Len must have gone over to the dresser. Liz and I had our backs to it, busy with Conchita. We heard a gasp.

“It’s alive!”

“What!” I cried.

“It’s alive, I sez. Ve baby’s alive. It’s movin’.”

I rushed over to the dresser, and looked at the gory mess in the kidney dish. It moved. The blood actually moved. My heart stood still. Then I saw the tiny creature in the pool of blood, and its leg moved.

Oh, dear God, I could have drowned it! I thought.

I lifted the tiny body out with one hand and tilted it upside down. It seemed to weigh nothing. I have held a new born puppy of about the same size. My head raced.

“We must clamp and cut the cord quickly. Then we must get him warm.”

It was a little boy.

I felt desperately guilty. The cord should have been clamped five minutes earlier. If he dies now, it will be all my fault, I thought. I had discarded this tiny living soul to drown in a dish of blood and water. I should have looked more closely. I should have thought.

But wallowing in self-reproach gets us nowhere. I clamped and cut the cord. I felt the fragile rib cage. He was breathing. He was a survivor. Len had warmed a small towel on a hot water bottle, and we wrapped him in the cloth. He moved his head and arms a little. All three of us were stunned by the life in the baby. None of us had seen a human child quite so tiny. A baby that is two months premature usually weighs about four pounds, and seems tiny enough. This baby was about one and a half pounds and looked like a tiny doll. His arms and legs were much smaller than my little finger, yet a miniscule nail completed each digit. His head was smaller than a ping-pong ball, and looked disproportionately large. His rib cage looked like fish-bones. He had tiny ears, and his nostrils were the size of a pin-head. I had never imagined that a baby of around twenty-eight weeks could be so lovely. I felt I ought to suck the mucus from his throat, but was terrified of hurting him. Anyway, when I got the catheter, it was far too large, and would never have gone into his mouth. To force a hosepipe into a normal baby’s mouth would have been just as inappropriate. So I just held him nearly upside down with one hand, and gently rubbed his back with one finger.

I had no experience of caring for a premature baby, and did not know what to do. All my instincts told me that he must be kept warm and quiet, preferably in the dark, and with frequent feeding. No cot was ready. Where could we put him? Just then Conchita, who was lying quietly, spoke.

“ Niño . Mi nino . Donde está mi niño? ” (Baby. My baby. Where is my baby?)

We looked at each other. We had all thought she was semi-conscious or asleep, but obviously she knew exactly what had happened, and wanted to see her baby.

“We’ve gotta give ’im to ’er. Liz, you tell her he’s very little and we’ve gotta be very careful with him.”

Liz spoke to her mother, who smiled slightly and sighed with weariness. Len took the baby from me and sat down beside his wife. He held the baby in one hand so that the child lay within her gaze. Her eyes had been vacant and unfocused for several moments and I don’t think she saw or understood at first; she had expected to take a full term baby into her arms. Liz spoke to her again, and I heard the words.

“ El niño es muy pequeño .” (The baby is very small.)

Conchita struggled to adjust her vision to the minute scrap held in Len’s hand. You could almost see the struggle and the effort it cost her. Gradually she became aware, and with a sharp intake of breath put out a shaking hand to touch the child. She smiled, and murmured “ Mi nino. Mi querido nino ,” (my baby, my darling baby) and drifted off to sleep, her hand resting on Len’s hand and the baby.

Just then, the Flying Squad arrived.

An Obstetric Flying Squad was provided by most big London hospitals, and I believe by all regional hospitals, as an emergency backup for domiciliary midwifery. The service must have saved thousands of lives, because before the 1940s, when no service existed, a midwife could find herself entirely alone with any obstetric emergency - such as a mal-presentation, haemorrhage, cord prolapse, or placenta previa - and all she could do would be to call in the local GP who might or might not be skilled in midwifery.

It was the proud boast of the Flying Squad of the London Hospital that it could reach any obstetric emergency in twenty minutes. But that was reckoning without a London smog. When the policeman contacted the hospital about Conchita no ambulance had been available to bring the Flying Squad. The smog caused acute and deadly respiratory failure in thousands of old people each year, and every doctor and ambulance was out on these cases. When one finally did return to the depot, the driver, who had been working non-stop for sixteen hours, was sent off duty, and another had to be found. Even then, a policeman had to cycle in front of the ambulance to guide it - hence the delay of nearly three hours. However, a registrar, a houseman, and a nurse from the obstetrics department had been sent by the hospital.

Everything happens at once, so they say, and within minutes a GP also arrived on foot. God bless him, I thought. He looked exhausted. He had been working all day and all night, and very likely most of the night before, yet he had the professionalism and the courtesy to apologise for being late.

With so much medical know-how in the house, it was necessary to have a case conference to decide the best course of action for mother and baby. We went down to the kitchen for this, and I asked Len to accompany me. Liz was left with her mother and the baby. The two ambulance men and the policemen joined us too - they couldn’t be asked to sit outside in the cold, and there was nowhere else for them to sit in the house. Sue, one of the older girls, made tea all round.

I gave my case history, and handed over the recorded notes. All doctors were agreed that mother and baby must be transferred to hospital at once. Len was alarmed.

“Does she ’ave to go? She won’t like it. She’s never been away from home before, she hasn’t. She’d be lost an’ frightened. I knows as ’ow she would. We can look after ’er. I’ll stop at home, an’ the girls can muck in an all, till she’s better.”

The doctors looked at one another and sighed. Fear of hospital was commonplace. Among the older generation, it arose mainly from the fact that most of the hospital buildings were converted workhouses, which had been feared more than death itself. The doctors agreed that as Conchita was now safely delivered, if no post-natal complications arose, she probably could be treated at home. A course of antibiotics would clear the infection that was causing fever. The head injury, causing concussion and delirium, would heal with rest and quiet. They tried to point out that she would get more rest in hospital than at home, surrounded by children, but Len would have none of it, so they capitulated.

However, the baby was another matter. He hadn’t been weighed, but my guess of between one and a half and two pounds was accepted. They all said twenty-eight weeks was barely viable, and that a living baby of that gestation must have hospital treatment, with the latest technological equipment, and twenty-four hour expert nursing and medical care. They suggested that he should be transferred at once to Great Ormond Street Hospital for Sick Children. Len looked dubious, but when they told him that without such care the baby would die, he readily agreed.

We all went upstairs to the bedroom. I don’t know what these hospital doctors thought of having to squeeze past all the prams in the hallway and parting the washing flapping around their heads as they climbed the wooden stairs. Nor did I ask. But I smiled to myself.