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

must not be allowed to get cold. Most of her body is now exposed, and if the shock of cold air makes her gasp, she will inhale amniotic fluid, which could be fatal. Secondly, the towel gives me something to grip hold of. The baby is slippery, and I have to turn her another one quarter circle so that the occiput will be under the pubic bone. I will do this as I deliver the shoulders.”
     
    With the next contraction, the left anterior shoulder impinged upon the pelvic floor, and Sister delivered it by hooking a finger under the arm, and at the same time rotating the body a little clockwise. The right shoulder was delivered in the same manner, and both baby’s arms were out. Only the head remained inside the mother.
     
    “You have a little girl,” Sister said to Betty, “but from the size of her limbs I don’t think she is six weeks premature. I think you got your dates wrong. I want you, Betty, to push now with all your strength and really use every contraction for delivery of the baby’s head. Doctor may have to exert some supra-pubic pressure, but I would prefer it if you could push the head out by yourself.”
     
    There had been no contractions for a full three minutes, and I was beginning to feel tense and anxious, but Sister was relaxed. The baby was supported by her hands, and then she let go completely, so that it was hanging quite unsupported. I gasped in horror.
     
    “This is the correct thing to do,” Sister explained. “The weight of the baby’s body will gently pull the head down a little, and will increase the flexion of the head, which is what I want. About thirty seconds like this will be enough. It will not hurt the baby.”
     
    Then she took hold of the baby again. I must say I felt relieved. A contraction came on.
     
    “Now push, Betty, as hard as possible.”
     
    Betty did, but the head did not descend any more. Sister and Dr Turner agreed that with the next contraction he would exert suprapubic pressure, and if that did not prove effective, a low forceps delivery of the head would be necessary.
     
    Sister explained to me, “That is because the cord will be compressed between the head and the sacral bones. The baby is all right at the moment, but if it goes on for too long, that is more than a few minutes, there is a definite risk of asphyxia.”
     
    I clenched my fingers with shock and anxiety, but Sister remained completely calm. Another contraction came, and the doctor placed his hands on Betty’s abdomen just above the pubic bone and pressed down firmly. Betty groaned with pain, but there was a definite movement of the head.
     
    “I am going to use the Mauriceau-Smellie-Veit method of extraction of the head,” Sister explained to me. She was allowing the baby to hang unsupported again, and my heart was in my mouth.
     
    “With the next contraction, all being well, we will have the airways clear, and the baby will be able to breathe. I will want my Sim’s vaginal speculum, so be ready to pass it when I need it.”
     
    I looked to see where the Sim’s was on her delivery tray. My hands were trembling so much that for a ghastly moment I imagined I would knock the whole tray over, or pick up the Sim’s only to drop it on the floor.
     
    Another contraction came on, and the doctor exerted the same pressure on Betty’s abdomen. Sister placed her right hand over the shoulders of the baby and the fingers of her left hand into the vagina. I could see her gently moving her fingers and feeling for something. The baby was resting on her forearm.
     
    “I am trying to hook my index finger into the mouth of the baby, in order to maintain flexion of the head, so that the mouth and nose will be the first part of the head to encounter the air. It is not to exert pressure by pulling. If you ever use this method of delivery, nurse, remember that. If you try pulling, you risk dislocating the jaw.”
     
    I felt sick with fear, and just hoped to God that I would never have to deliver a breech. I could see that she was manipulating the back of the skull with her right hand. She explained, “I am simply pushing upwards on the occipital protuberance of the skull to increase flexion. A little more pressure, please doctor, if you can, and I think I shall have the airways clear. That’s it. The Sim’s now, nurse, please.”
     
    I had to grip my wrist with my other hand to stop it trembling. All I could think was, I mustn’t drop it, I mustn’t drop it. My relief when I handed it over