Farewell To The East End

sheets to protect the mattress, cotton wool for the baby, sanitary towels, that sort of thing. Where are they? Have you got them?’
    ‘No.’
    ‘You should have been given a maternity pack. Who did you book with?’
    ‘I was just told to call you when I went into labour.’
    ‘You’ve told me that. But which clinic did you go to for antenatal care?’
    ‘None.’
    ‘None! You mean you have had no antenatal care?’
    ‘I didn’t tell anyone I was pregnant. Me mam and me grandma, they would have killed me, they would. Never trust a sailor, they always say. And I did, silly me, and now look at me.’
    The girl cheerfully patted her stomach. But then her face changed. ‘It’s coming again …’
    She threw her head back as pain seared her body. Beads of sweat stood out on her forehead, and her whole expression seemed to be turning inwards as her mind and body focused on the tremendous force of the contraction.
    There was no time to lose. Ruth took her stethoscope, gown, gloves and mask from the outer compartment of her delivery pack. She opened the box, and the sterile lid formed a tray on which she placed in readiness her kidney dishes, gallipots, sterile water, antiseptics, scissors, hypodermic syringe, needles, sterile cotton wool and gauze swabs, catheters and blunt forceps. She also carried chloral hydrate, potassium bromide, tincture of opium and pethidine for relief of pain. Cord clamps and cord dressings, powder for the baby and gentian violet or silver nitrate for sterilisation of the cord stump completed her equipment.
    All her training and experience told her that a primigravida 4 who had had no antenatal care should be transferred immediately to hospital. But to arrange this, she would have had to go down the road to a phone box, and birth was imminent. While she was gone the baby would probably be born. She looked at the thin, horsehair mattress on sagging springs. There were no sheets, no waterproofing, no brown paper, no absorbent pads. There was no cot, no baby clothes, nor any apparent provision for a baby. There was no fire, nor heating of any kind, and the room was cold. There was a jug of cold water, but she had no means of heating it. The light was quite inadequate for delivery, and the only means of supplementing it was the bicycle lamp. But her midwife’s training had been strict and uncompromising; whatever the circumstances, she must improvise, and cope.
    The contraction passed, and the girl sighed with relief.
    ‘Oh, that’s better. I feel all right when the pain has gone.’
    ‘I want to listen to your baby’s heartbeat, and then to examine you. I need to know how near you are to delivery. Would you lie down, please?’
    She palpated the girl’s abdomen to determine which way the baby was lying. She listened for the heartbeat and heard it quite clearly. Satisfied that the baby was safe, she prepared to do a vaginal examination, saying as she gowned and gloved: ‘You don’t seem to be prepared for having a baby. There isn’t even a cot or baby clothes here.’
    ‘Well, I haven’t really been here long enough to get anything. I only came over from Ireland yesterday.’
    ‘What! You came on the ferry yesterday!’
    ‘Yes.’
    ‘But you might have gone into labour on the boat.’
    ‘I might have, but I didn’t. The angels must have been looking after me.’
    ‘When you got to Liverpool, how did you get to London?’
    ‘I got a lift with an overnight lorry driver.’
    ‘I can’t believe it! You might have had the baby on the lorry!’
    ‘The angels again.’ The girl shrugged cheerfully.
    ‘When did you arrive?’
    ‘This morning. I had been given this address and the landlord’s name. That was the only good thing my charming sailor-boy did for me.’
    She looked around the room and smiled contentedly.
    ‘Just draw up your knees for me, please, and let your legs fall apart. I want to examine you internally. The waters have broken, and I want to feel how far you are dilated, and in what position the baby is lying.’
    But there was no time for a vaginal examination. Another contraction was coming, and the girl winced in pain, throwing herself around the bed in an effort to escape it. The pain intensified as the uterine contraction became more fierce. Ruth admired the way the girl was coping with labour – she had already had a lot of physical exertion getting to London during the past twenty-four hours. She must have been tired and hungry, and there were no signs