Farewell To The East End

it as taut as possible. With sharp episiotomy scissors he then cut the perineum diagonally. Mavis let out a piercing scream, and Meg rushed into the room. Seeing Mavis in a lithotomy position surrounded by blood she yelled, ‘Murder!’ and rushed over to the bed. She attempted to fight the doctor, but Sister pulled her back by the shoulders. Meg turned on her like a tigress and slapped her face so hard that the poor Sister fell against the wall. But she stood up again quickly, her face burning.
    ‘If you interfere, Mavis will die. There is no alternative. You may not believe it, but we know what we are doing. And we are doing it to save the life of mother and baby.’ She repeated more emphatically: ‘If you interfere, your sister will die.’
    Meg stared at her blankly. The shock of Sister’s words reduced her to silence.
    ‘Now, if you want to help, and I am sure you do, you will hold this gas and air mask over your sister’s face … keep it firm over her nose and mouth … turn the knob up to maximum and talk to Mavis quietly, try to keep her calm. This is going to hurt, but you can help a great deal if you do as I say. Mavis needs you. Her life depends on it.’
    Meg calmed down. She administered the gas and air. Giving her something to do was the best thing that Sister could have suggested.
    Sister Bernadette listened to the foetal heartbeat. It had dropped to sixty beats per minute, and was weak and irregular. The doctor inserted the first blade of the forceps into the vagina, muttering to Trixie, ‘Whatever you do keep her legs in that position. Don’t let her move.’ Trixie, who was trembling and felt sick, put all her weight on the two legs.
    ‘Sister, the os is still fully dilated, thank God, but the head is above the rim. Can you apply steady pressure on the fundus to try to force the baby down an inch or two? There’s not a moment to lose.’
    Sister grasped the fundus with both hands and pressed down as hard as she could. There was a massive spurt of blood and meconium from the vagina, splattering the doctor all over. He hardly noticed it.
    ‘Quickly. The head is down a little. But more.’
    Sister applied more pressure, and a contraction developed.
    ‘That’s better. It’s coming. Now I can get hold of it.’
    The doctor inserted the second blade of the forceps around the head of the baby. Muffled screams were heard from Mavis, behind the gas and air mask, and Meg was looking grim, but held the mask in place.
    Slowly, steadily, the doctor pulled the forceps, with Sister applying pressure from above.
    ‘Keep those legs still,’ muttered Sister to Trixie. ‘She must not move at this stage.’ It took all of Trixie’s strength to prevent Mavis from throwing herself off the bed.
    Within half a minute the head was born. The baby’s face had no colour. Sister immediately left the bedside, took a couple of swabs and a fine catheter, and tried to clean the airways, but the baby did not move or attempt to breathe.
    The doctor hooked a finger under the presenting shoulder and with one swift movement pulled the baby upwards towards the mother’s abdomen. It was another little girl, completely white and limp. She looked dead.
    A mere ninety seconds had elapsed between the first haemorrhage and the birth of the baby, yet Trixie told us later that it had seemed like ninety minutes. Time had stretched unnaturally. Even the steady tick, tick, tick of the clock seemed to slow down, as if time itself were suspended.
    The baby was separated from the mother. She was like a rag doll and seemed to be quite dead. Sister carried her near to the fire. The doctor stretched out his hand and touched a tiny arm that swung lifelessly. He looked at Sister.
    ‘Do what you can,’ he said sadly, ‘we might have to …’
    But there was no time to speculate. There was another spurt of fresh blood, and the cord, which was protruding from the vagina, lengthened.
    ‘The placenta is coming. Quick, nurse, fetch a kidney dish,’ he said.
    Trixie tried to get one, but her legs were shaking and she could not move. The placenta slid out onto the floor.
    ‘We will examine it later,’ said the doctor, pushing it aside with his foot. ‘First, I must control the haemorrhage.’
    Blood continued to seep out, then another spurt of fresh blood. The prognosis for Mavis was not looking good. She was no longer in pain, but was extremely weak and sweating from shock. Meg’s know-all arrogance had burst like a bubble. The