Call the Midwife: A True Story of the East End in the 1950S

the whole scene was peaceful.
     
    The baby looked even smaller now that the entire hand of the mother covered it. Only its head was visible. It did not really look as if it were alive, although its colour did not suggest death.
     
    The registrar wanted to examine Conchita. I told him that I had not yet examined the placenta, as I had not had time between delivery and the arrival of the ambulance. We examined it together; it was very ragged. “Not hopeful,” he muttered, “and it all came out at once, you tell me? I must have a look at her.”
     
    He pulled back the bedclothes to examine her abdomen and see the vaginal discharge. Conchita seemed quite unconscious and didn’t move as he palpated the uterus. Some blood rushed out.
     
    “Another pad,” he said, and, to the houseman, “Draw me up 0.5 cc of ergometrine for injection.”
     
    He sank the needle deep into her gluteus muscle, but she didn’t move. He covered her and said to Len: “I think part of the placenta has been left behind. She may have to go to hospital for a D and C. It would only be for a few days but we cannot risk a haemorrhage occurring at home. In her condition it would be very serious.”
     
    I saw Len turn white and he had to grab the back of a chair to prevent himself from falling.
     
    “However,” continued the registrar kindly, “it may not be necessary. The next five minutes will tell if the injection is going to be effective.”
     
    He then took Conchita’s blood pressure.
     
    “I can hear nothing,” he said, and the three doctors exchanged significant glances. Len groaned and had to sit down. His daughter put her hand on his shoulder, and he squeezed it.
     
    We all waited. The registrar said, “There is no point in examining the baby. It is obviously alive, but we are none of us paediatricians. Examination must wait for the experts.”
     
    He asked for the telephone, to ring Great Ormond Street Hospital, but there was no telephone in the house. He cursed silently under his breath and asked where he could find the nearest phone box. It was two hundred yards down the road, on the other side. The long-suffering houseman was dispatched out into the freezing fog and icy roads with a pocket full of pennies gleaned from us all, to ring the hospital and make the necessary arrangements.
     
    We continued waiting. There was no sign of an abdominal contraction. Five minutes slipped by. The houseman returned to say that Great Ormond Street would send a paediatrician and a nurse with an incubator and special equipment to collect the baby at once, although the time of their arrival depended on visibility.
     
    Another five minutes passed. There was steady vaginal bleeding, but no contractions.
     
    “Draw up another 0.5cc,” the registrar said. “We must give it intra-venously. There is something in there that has to come out. If we can’t get it this way,” he said to Len, “we will have to take her back with us for a scrape. And if you value her life, you must agree to this.”
     
    Len groaned, and nodded dumbly.
     
    I clamped the upper arm and endeavoured to pump up a vein for injection, but nothing showed. Her blood pressure was so low that the venous return could not be found. The registrar tried, with a couple of stabs, to locate the vein and on the third attempt blood showed in the syringe. He emptied the 0.5cc into her vein, and I released the arm.
     
    Within a minute Conchita winced in pain and moved her legs. A large quantity of fresh blood spurted from her vagina, and then, mercifully, several large, darker lumps. There was a pause, then a second contraction. The registrar grasped the fundus and pressed the uterus hard, downwards and backwards. More blood and placenta were evacuated.
     
    All this time Conchita was inert, but I thought I saw her hand tighten over her baby.
     
    “That might be it,” said the registrar, “but we must wait a bit longer to see.”
     
    He was more relaxed now and started chatting with anyone who would listen about the excellent golf down at Greenwich and the house he was buying at Dulwich, and his holiday in Scotland.
     
    Over the next ten minutes there was no further blood loss, and no more contractions. Thanks to modern obstetrics, the danger of post-partum haemorrhage had been overcome for Conchita. But she still looked very ill indeed. Her breathing and pulse were rapid, her blood pressure abnormally low, and her temperature high. She did not appear to be conscious,