Farewell To The East End

of food in the room. She had had no sedation or analgesic, yet she made no fuss nor complaint. The contraction became even more powerful, and suddenly Kathy spontaneously pulled her legs up, gave a prolonged grunt and pushed with all her strength. Ruth only got there just in time, pressing the palm of her hand firmly over the emerging head of the baby and holding it back to prevent an uncontrolled delivery.
    ‘Kathy, don’t push, not now, do not push. The baby mustn’t be born too quickly. Pant, my dear, quick breaths: in, out, in, out. Don’t push, just pant quickly, in, out, in, out.’
    The girl did exactly as she was told, and Ruth breathed a sigh of relief as the contraction passed.
    ‘With the next contraction your baby will be born. I know you feel as though you want to push, but don’t, not until I tell you. I want the baby’s head to be born slowly. If you push too soon, it will come too fast. Do you understand me Kathy?’
    The girl smiled weakly and nodded.
    ‘Is it possible for you to turn onto your left side to face the wall? It will make it easier for both of us.’
    The girl nodded and turned over, and as she moved another contraction started.
    Ruth was on her knees beside the low bed with its sagging mattress. The light was terrible, but she had no time to get her torch. The girl gave a low scream and buried her pretty face into the filthy pillow in order to stifle the sound. The baby’s head was emerging fast, too fast. Again Ruth held it back.
    ‘Don’t push, Kathy, just pant in and out quickly. Keep panting – like that. Good girl.’
    As the contraction subsided she eased the pressure on the presenting part and allowed the head to slide out a little, until it crowned. The perineum was stretched, but was still holding it back.
    ‘Only one more contraction, and your baby will be born. Try not to push. Your stomach muscles are pushing hard enough. They don’t need any help. The baby will come anyway.’
    Kathy nodded, but was unable to speak because another contraction came almost immediately. Ruth slowly edged the perineum around the broadest part of the baby’s head – ‘Now you can push, Kathy.’ The girl did so, and the head was born.
    ‘That is the hardest part over, my dear. There will be a minute of rest, then another contraction.’
    Ruth watched the head move about ten degrees clockwise as it aligned with the rest of the body. Another contraction came quickly.
    ‘You can push now, Kathy – as hard as you like.’
    Deftly she hooked her forefinger under the presenting shoulder. The baby’s whole body slid out easily, Ruth guiding it upwards between the mother’s legs, and over the pubic bone.
    ‘You can turn over now, Kathy, onto your back, and look at your baby. It’s a little boy.’
    The girl rolled over and raised her head.
    ‘Oh, bless him. A sailor’s son. Isn’t he tiny, nurse?’
    The baby was indeed tiny, smaller than Ruth had expected from her admittedly brief abdominal examination. From appearances, he seemed to weigh no more than four pounds. ‘No doubt due to malnutrition and overwork in the mother during pregnancy,’ she thought bitterly. It was not uncommon. She clamped the cord in two places, and cut between the clamps. The baby was now a separate being.
    But where should she put him? There was no cot, no blankets, he was small, and the room was cold. He must be kept warm.
    She pressed him firmly under his mother’s arm.
    ‘Keep him warm with your body. Haven’t you got anything I can wrap him in?’
    The girl was contentedly cuddling her naked baby and paid no attention to what was being said. Ruth opened the chest of drawers. There was a towel in the top drawer. She opened the second drawer. There were a couple of jumpers in it. She opened the third drawer, which was empty. ‘This will have to do,’ she thought, taking up the towel and jumpers. They were all cold, but thankfully did not feel damp.
    ‘Just lift your head and shoulders a minute, will you, Kathy? I want to put these things under your body to warm them, before I wrap your baby in them.’
    She pulled the dirty grey blankets over the girl and baby to keep them warm and sat on the chair beside the girl to await the third stage of labour. A few minutes passed. She placed her hand on the abdomen to assess progress. ‘Something’s not right here,’ she thought. The uterus felt hard and bulky, and a strong contraction was developing. Kathy grit her teeth and started to bear down.