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

From then on she improved rapidly. No doubt the penicillin helped, but alone it could not have effected the astonishing transformation, within a few hours, from someone close to death who didn’t even know her own husband, to a calm competent woman who knew exactly what she was doing and why.

I have a theory that it was the living baby that cured her, and that the crisis had occurred when she thought that they were going to take him away. In that moment, her powerful maternal instincts had kicked in, and told her that she was the protector, the provider. She didn’t have time to be ill. She couldn’t afford to be woolly minded. His life depended on her.

Had the baby died at birth, or had he been taken away to hospital, I think Conchita would have died also. The animal world is full of such stories. I have heard that a sheep or an elephant will die if the baby dies, and live if the baby lives.

The level of consciousness or unconsciousness is also deeply interesting. Having sat with many dying patients over the years, I am not at all convinced that what we call “unconscious” is anything like the state of unknowingness we think it to be. Unconsciousness can be profoundly knowing, and intuitive. Conchita had seemed quite unconscious, yet her hand tightened over her baby when the paediatrician tried to take him. She could not have seen who was in the room, because her eyes were not focusing, nor known what had been said, because she did not understand the language. Yet somehow she understood that they were planning to take her baby away, and she fought back with every ounce of her strength. This had cured her.

Douglas Bader, the Battle of Britain flying ace, tells a similar story. After an air crash and bi-lateral mid-thigh amputations, he heard a voice say, “Hush, a young airman is dying in that room.” The words focused his mind, and he thought, “Die? Me? I’ll bloody well show you.” The rest is history.

Conchita reached for a saucer at the side of her and began to squeeze her nipples, pressing out a few drops of colostrum, which fell into the saucer. Then she took a fine glass rod which was used by one of her daughters for icing cakes. She held the little baby in her left hand and, having suspended a drop of colostrum on the glass rod, touched his lips with it. I watched, fascinated. His lips were no bigger than a couple of daisy petals. A tiny tongue came out and licked the fluid. She repeated this about six or eight times, then tucked him back between her breasts.

Len said: “She’s bin doin’ this every ’alf ’our since six o’clock. Then they both ’ave a little sleep, an’ she does it agen. She said ’e won’t die, and ’e won’t, yer know. She knows ’ow to look after ’im.”

I checked that she was not bleeding unduly, and left. I had to get back to Nonnatus House to report, and to request a district nurse to monitor the blood transfusion when it arrived. The smog was beginning to lift, and one could just about see across the road. It felt as though the world was filling with new life as the foul smog cleared, and I cycled back with a light heart.

Sister Julienne herself prepared a huge breakfast of double bacon and eggs for me “to keep the wolf from the door”, as she put it, and then took my report in the dining room whilst I was eating. She said, “I have never cared for such a premature baby myself, but a Sister in one of our other Houses has experience. We will consult her. Conchita will have to be watched very carefully for further blood loss.”

She found the whole story astonishing, and said, quietly, “God’s will be done.” She then went away to make arrangements for covering the blood transfusion.

Conchita didn’t lose any more blood. After the transfusion colour returned to her cheeks, and also to Len’s. She was weak, but all danger had passed. The baby lay on her breast, day and night, fed in the manner that I have described about every half hour. All the lay staff and Sisters from Nonnatus House came to see the two of them, it was such a beautiful and unusual sight. On the fourth day I weighed the baby in a handkerchief. He was 1 lb. 10 oz.

After three weeks, Conchita began to get up for short periods. I had thought ahead, and had wondered what would happen to the baby. Obviously Conchita had also been thinking ahead, and knew exactly what was to be done. She had asked Liz to acquire from the dressmakers several lengths of the finest unbleached silk. With the help of her skilled eldest daughter, she fixed a kind of sling or firm blouse around her shoulders and breasts, tight underneath, but loose above. The baby was carried in this for five months, between his mother’s breasts, never leaving her.

Who had taught her this? I have never before or since, in any literature, heard of such a way of caring for a premature baby. Was it purely maternal instinct? I remembered back to the delivery, and to her monumental struggle when they tried to take the baby. I had the impression then that she was trying to think, trying to remember something; and the sudden clarity and conviction with which she said, ” No morir á.”

Had she remembered seeing a peasant or gypsy woman carrying a tiny premature baby like this when she was a child in Southern Spain? Had this fleeting memory of times half forgotten been the cause of her conviction that her baby would not die?

Some years later, when I was night sister at the Elizabeth Garrett Anderson Hospital in Euston, I cared for several premature babies of about the same gestation and weight. They were all nursed in incubators, and I do not remember any fatalities. The hospital staff prided themselves on the excellent modern care which preserved the life of the baby. The hospital way, and Conchita’s way, are poles apart. Incubator babies are alone, day and night, lying flat on a firm surface, usually in strong light. Only hands and clinical equipment touch the baby. Food usually comes as formula cow’s milk. Conchita’s baby was never alone. He had the warmth, the touch, the softness, the smell, the moisture of his mother. He heard her heartbeat and her voice. He had her milk. Above all, he had her love.

Possibly today, her decision to refuse hospitalisation for the baby would have been over-ruled by Court Order, the assumption being that only trained staff and advanced technology can adequately care for a premature child. In the 1950s we were less intrusive into family life, and parental responsibility was respected. I am forced to the conclusion that modern medicine does not know it all.

Admittedly Conchita was lucky. The speed of delivery might have caused brain damage to the baby, but this did not occur. Apart from that, the great danger for a premature baby arises from immature vital organs, especially lungs and liver. The baby did indeed become very jaundiced, more than once, in the first few months, but each time it passed. It was a miracle, after I had heedlessly left the baby in a kidney dish, that his lungs were not wholly, or even partly collapsed from birth. I can take no credit for that. However, the fact is, he breathed. I like to think that by holding him upside down, and tapping his fragile back with a finger, I facilitated his first breath. His mother was advised to do the same after each feed, because, if fluid enters the trachea, a premature baby cannot cough as a full-term baby would. She was also given a very fine suction tube, and shown how to use it.

Apart from that, which was very little, the baby received no medical treatment. The constant temperature of his mother’s skin kept his body temperature stable. Possibly the constant rise and fall of her breathing helped him over the first critical weeks. I am sure that her feeding policy - a few drops of breast milk placed on the lips at frequent intervals - was the right one. She even did this all through the night, I was told. Conchita took no precautions about sterilising her feeding equipment. I doubt if she had ever heard of such a thing. The saucer and the glass rod were simply wiped clean after each use, ready for the next time. The baby survived. Either he is the ultimate survivor, or we put far too much emphasis on technology and techniques, I thought.