Farewell To The East End

strength in my job, I can tell you. These men will be the death of me. Oooh, no, not again!’ She threw her body back in pain and cursed in Swedish.
    Chummy watched her carefully and made a note that contractions were now coming every seven minutes and lasting for approximately sixty seconds. She could feel the uterus firmly just above the pubic bone, but nothing higher, because abdominal fat occluded it. She longed to be able to hear the foetal heart and reassure herself that the baby was healthy, but it was impossible. She was going to make a vaginal examination. Perhaps that would reveal something. Suddenly she remembered the obligatory enema – that monstrous practice, sacred to midwifery – and abruptly forgot the idea. How absurd on a ship, and surrounded by men! She wrote in her notes: ‘Enema not given’.
    The pain passed, Kirsty relaxed with a sigh, and Chummy gave her a drink of water.
    ‘I’ve got to examine you internally,’ she said. ‘That means I have to put my fingers into your vagina to assess where the baby is lying, and how close to birth it is. Will you allow me to do that?’
    ‘Well, I’m used to that sort of thing, aren’t I? But not for the same reasons!’
    Chummy placed her delivery bag on the captain’s desk and opened it. She scrubbed up and extracted a sterile gown, mask and surgical gloves and put them on. While she was doing so, it occurred to her that Kirsty had probably contracted syphilis during her career. Chummy had no practical experience of venereal disease, but from her classroom work she remembered that syphilis can usually be diagnosed by the hard, rubbery chancre on the vulva, whilst gonorrhoea is manifested by profuse greenish-yellow vaginal discharge. She recalled the midwifery tutor saying that a syphilitic woman very seldom carries to full term, because the foetus usually dies within the first sixteen weeks. She also remembered the next part of the lecture: that in the event of the baby going to full term, it was likely to be stillborn and was frequently macerated. Chummy felt queasy at such an idea. A macerated stillbirth could leave a midwife feeling sick and depressed for days, or even weeks – let alone the effect it had on a mother.
    Chummy quickly put the thought from her. Another contraction was coming. She timed it to be seven minutes since the last one. Full dilation of the cervix was getting closer, and as she had been unable to assess the lie of the baby from external palpation, a vaginal assessment was imperative. When the contraction had passed, she said ‘Now I want you to draw your knees up, put your heels together and then let your legs fall apart.’
    Kirsty did this with great agility. Her lower limbs were surprisingly flexible. Her massive thighs not only flew apart, but her knees touched the bed on either side, revealing a vast, moist purple-red vulva. Chummy was a bit taken aback at the speed and efficiency with which the exercise was undertaken, and Kirsty must have seen her expression because she laughed. ‘You seem to forget I do this all the time,’ she said.
    Chummy examined the external vulva carefully. She could neither see nor feel syphilitic chancre, nor was there any evidence of a foul-smelling and profuse vaginal discharge. Against all the odds, it seemed that Kirsty did not have venereal disease. It must have been her father’s gifts of boxes of 500 rubbers at frequent intervals that had protected her. ‘Bully for the captain!’ thought Chummy.
    Chummy did as every good midwife would do. She prepared to place two fingers gently in the vagina, but without the slightest effort her whole hand slid in. ‘Great Scott! You could get a vegetable marrow in here,’ she thought.
    With easy access she could feel the cervix. It was three-quarters dilated, a head presenting, fairly well down, waters intact. She breathed a sigh of relief that the baby was lying in a good position for a normal delivery.
    Then she felt something very strange. At first she thought it was part of the soft, undulating vaginal wall. She moved it with her fingers. It was not part of the vaginal wall. ‘What on earth is it?’ she wondered. It was attached above, and seemed to be hanging freely beside the baby’s head. She palpated it with her fingers, and it moved a little. Chummy was feeling this strange thing and moving it about with her fingers, when she realized with horror that it was pulsating. She froze, and blind panic overtook her for the