Farewell To The East End

Ruth leaped into action.
    ‘There’s another baby coming! Don’t push, whatever you do, don’t push – just pant, like you did before.’
    Kathy was tensing all her muscles, and the baby lying under her arm was in danger of being crushed. Ruth grabbed the towel and jumpers and pulled them sharply from under the girl’s body, then took the baby from her. She wrapped him up quickly, and put him in the top drawer of the chest.
    She returned to the bedside, pulled back the blankets and saw the head of the second baby emerging. She was just in time to control a rapid delivery.
    With a twin birth, if the lie of the second baby is in a normal head-down position, if the uterine activity is normal, and especially if the baby is small, the birth can be fairly quick, because the birth canal has stretched, and there will be little resistance. Two or three good strong contractions may be sufficient to complete the birth. Kathy’s second delivery was swift and easy, and within a few minutes the baby was lying on his mother’s abdomen. She stretched out a hand to touch him. Her voice sounded incredulous. ‘Another baby! It can’t be true.’
    ‘It is true, Kathy. You have another little boy.’
    Kathy stroked his head. ‘Another little boy,’ she repeated vaguely. Her blue eyes were wide and dreamy, and her body was limp after the exertion. Her voice sounded far away.
    ‘Another little sailor boy. Oh, you poor wet little thing. And where’s your daddy, little sailor, where’s your daddy? He sailed away on the deep blue sea. Sailed far away.’
    Ruth took Kathy’s pulse and blood pressure, which were slightly lowered, but not too much. She knew that she had been lucky in having no complications for which medical assistance, or at least another midwife, would have been necessary.
    ‘You are a healthy girl,’ she said aloud. “How did you get yourself into this pickle?’
    Kathy smiled dreamily. “Oh, that sailor boy. His curling hair, his night-black eyes, and oh, his saucy smile! Somehow I knew he wouldn’t be true. Never trust a sailor, they said, and silly me, I did. Now I’ve got two little sailor boys. What’s me mammy going to say? And me grandma? She’s the one I’m frightened of. A real terror, she is. If you knew her, you’d be frightened too, nurse.’
    Kathy sighed sleepily, and closed her eyes. ‘I feel so tired now,’ she murmured, and fell fast asleep.
    Ruth had many practical duties to attend to, not least of which was to separate the baby from his mother – and she had only one set of cord clamps in her bag, which she had used for the first baby. So she cut a gauze swab in half, tied each piece firmly to the cord, and cut between the knots. ‘Always improvise, ’ her midwifery tutor had taught.
    The baby was small, but looked perfectly formed and healthy. Ruth picked him up, and he whimpered. She held him upside down, and he cried lustily. ‘That’s what I like to hear,’ she thought, ‘cry some more, little baby. Your lungs are only small, and this is the best way of inflating them.’ The baby obliged by screaming. She nodded in satisfaction and laid him with his mother to keep him warm.
    Then she began wondering what to do with him. Ideally both he and his brother should have been bathed, examined thoroughly, weighed and measured, and put into a clean cot near to a fire. But she had no hot water, no soap, no clean towels, and the room temperature was far too cold to expose his naked body. To wrap him up warm was the immediate challenge. She looked around the room for something – anything she might use. She saw a cupboard in the corner and opened it, hopefully, but all she found was a lot of broken mechanical equipment. Then she saw the clothes that Kathy had taken off – a skirt, a jumper and a thin, cheap jacket. ‘That will do,’ she thought, ‘better than nothing, anyway.’ The garments were still quite warm, so she wrapped the baby up in them, and tucked him into the second drawer. ‘Phew!’ she thought, ‘this has been a night. What next?’
    What happened next was more than she, or anyone else for that matter, could have imagined in their wildest dreams.

    Ruth sat down once more on the chair beside the mother, to await the third stage of labour. She had time to reflect on the situation. After a twin birth the uterine muscles are stretched and tired and can take up to half an hour to contract again for the expulsion of the placenta. Kathy lay sleeping, her fragile