Farewell To The East End

speed and drama of events had shaken her. She sat quietly at Mave’s head, stroking her hair, whispering words of love and comfort.
    The doctor massaged the uterus vigorously and squeezed out clots by further kneading and fundal pressure. Mavis groaned and weakly moved a leg.
    ‘I think that is all the residual blood clots. I need to administer intravenous Ergometrine, but I want you, nurse, to exert external bi-manual compression of the uterus while I am preparing the injection. Have you ever done it before?’
    Trixie shook her head.
    ‘This is what you do, then. It will be only for a minute or two, but we cannot allow the uterus to relax. If it does we might get another haemorrhage.’
    ‘Right, then, stand here … press the left hand into the abdomen just above the umbilicus, like this. Now, clench your right hand into a fist and press down as far as possible behind the symphysis pubis … that’s it … now push the ball of the uterus upwards and compress it between the two hands as hard as you can … harder … that’s it. Keep it there.’
    The doctor went over to his medical kit to draw up the injection. He returned to the bedside and bound the upper arm tightly in order to inject into a vein at the bend of the elbow. But he could not find a vein. Mavis had lost so much blood that her veins were flat and slippery. He made several attempts with no success. He swore under his breath.
    ‘Keep that compression going, nurse. Another haemorrhage could be fatal. I must get an intramuscular injection. They take longer to work, but if I can’t get a vein it will have to be an IM.’
    Trixie continued exerting bi-manual compression of the uterus. She was feeling sick and faint, but the sight of Mavis looking so ill and the thought of another haemorrhage and its consequences kept her strength up.
    The doctor returned and swiftly plunged the needle into Mavis’s thigh. ‘That’ll do the trick.’ Then, to Trixie: ‘I’ll take over now. I want you to go and ring the hospital.’
    Meg interrupted. ‘No. I won’ let ’em take ’er.’
    The doctor turned on her savagely.
    ‘Will you be quiet, woman, and stop interfering. If Mavis had gone into hospital, as I advised in the first place six months ago, all this might never have happened.’
    Meg held her peace.
    Sister Bernadette had carried the baby closer to the fire and had wrapped a roll of soft cotton wool around her. She cleared the airways with a fine mucus catheter. Blood, mucus and meconium were sucked out of the nose, mouth and throat. She held the tongue forwards with fine baby forceps, because if the tongue is without muscle tone and flaccid, it can fall backwards into the throat, blocking the airways. She held the baby completely upside down for a few seconds, and then sucked out the airways again. She turned the baby face downwards and massaged the back from base of spine upwards, then cleared the airways once more. Next she undertook a procedure known as Eve’s Rocking – that is, alternately raising the head and feet of the baby by about forty-five degrees. The baby did not respond. Sister administered mouth to mouth resuscitation by filling her cheeks with air and puffing three puffs into the tiny white lips, then twenty seconds of Eve’s Rocking again, then three more puffs. After about two minutes of this procedure she listened to the baby’s heartbeat.
    Her face became radiant. ‘I can hear a faint heartbeat – around eighty per minute. Praise the Lord.’ And she continued her efforts. Suddenly the baby gave a short, convulsive gasp, sucking air into its lungs and then lay quite still again, making no further attempt to breathe. But a baby can take shallow breaths that are almost imperceptible to the observer. Sister could still hear a faint heartbeat, so she continued. A couple of minutes later the baby gave another convulsive gasp, repeated thirty seconds later, and this pattern continued for nearly half an hour, during which time the heartbeat increased to a healthy 120 per minute.
    Sister Bernadette had no drugs, no oxygen, no incubator or modern equipment for resuscitating an infant with asphyxia pallida. She had only the methods described above, and the baby did not die.

    The intramuscular injection of Ergometrine given to Mave by the doctor worked within five minutes. The uterus contracted into a firm hard ball, and all fears of further haemorrhage were removed. Mavis looked terribly ill, however. Her skin was white, cold