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Liz will be glad of your support after she has had her baby too. That’s when the real work begins. As vital as it is, this is still just one day.”
She smiled at him and thanked him for the sandwich before heading for the stairs.
“It’s my first home birth too,” Gemma confided to him. She stood up to follow Rachel, “So I know how
you feel. Thanks for the sandwich.”
On the stairs they could hear Liz’s laboured breathing. Rachel looked in on Liz and Maggie to make sure they were okay and asked Gemma to listen to the baby’s heartbeat. Then she went to the bedroom, where everything was laid out ready for the birth.
There she rechecked the syntometrine injection, just in case it was needed, and made a final check of her equipment. Gemma came into the room.
“Its okay,” she said, “One hundred and thirty beats per minute, with a brief acceleration to one fifty.”
“Good,” Rachel replied. “Liz has asked for a physiological third stage of labour,” she explained to Gemma. Gemma knew this meant no injection of syntometrine immediately after the birth of the baby’s shoulders; that syntometrine, when given, would facilitate a quick delivery of the placenta, usually after about ten minutes. The injection of syntometrine was given routinely in hospital, to help prevent haemorrhage after the birth, which it did, but it did cause some women to vomit. Liz did not want this, Rachel explained. Without the injection it might take up to an hour for the placenta to deliver. Liz knew this and was prepared to wait, but they would keep the injection nearby, just in case it was needed.
Back in the bathroom Liz gave an involuntary grunt with her next contraction and complained that she wanted to go to the toilet.
“Just wee in the bath,” Maggie said - to save getting in and out of the water.”
“It’s not a wee I want mum,” she insisted.
“That’s wonderful, you are progressing; and that is a definite sign,” Maggie said,
“Remember what we talked about, this may be the second stage now.”
It was then that Maggie saw the small red show of blood in the water. She called Rachel.
Rachel observed Liz for the duration of another contraction, then put a glove on and briefly examined her internally. “Your baby’s head is just sitting there,” she said smiling down at Liz.
“Is it?” Liz exclaimed with relief. “You mean I’m fully dilated?”
“And I’m fully delighted,” Maggie added with a smile.
“What time is it, Maggie?”
“It’s five twenty.”
“We need to get you out of the bath, Liz,” Rachel explained. “It’s not suitable for having a water birth. It’s not deep enough.”
Liz nodded, and breathed a long “Okay” with her out breath. Her contractions had changed. She didn’t like that feeling of wanting to have a poo, and she had a sudden fear of soiling herself. This, in turn, was inhibiting her reaction to the overwhelming urge to push. So much so that she realised that she was resisting.
“Can I go to the toilet?”
“To wee?” Rachel asked.
“No.”
“We are not having this baby born into the toilet, Liz, so I think it is not a good idea. Please try your hardest not to worry about your bowels. The baby’s head is so low now that it is pressing against the nerve endings on your back passage. The same nerve endings that let you know when you need to open your bowels. Try to ignore that thought, so that when you start pushing you are not wasting all that effort because you’re afraid of a little bit of poo. It’s your baby’s head you can feel. Now let’s help you out of the bath before the next contraction.”
It was awkward, climbing out of the bath, and no sooner was the soft white bath-sheet wrapped around her than Liz had another very strong contraction. This time the urge to push was more powerful and she could feel her baby’s head moving downwards. The pain in her lower back was unbearable.
“You’re doing really well, Liz,” Maggie said, her voice quivering slightly despite her efforts to hide her own feelings. Seeing her daughter like this made her feel so proud and yet fearful. It was far from being over, and Liz was now entering another crucial part of her labour. She would have gladly changed places with Liz and taken all of her pain.
“If you can manage to walk to the bedroom,
between your contractions, you could try the gas and air. This bathroom is so small we couldn’t swing a cat.” Maggie and Rachel coaxed and encouraged Liz along to her bedroom where she grounded herself on the covered futon mattress they had prepared on the floor. There she stayed on all fours. Rachel brought her the gas and air.
“Start breathing it in the moment you feel the beginning of the contraction, that way it will be in your system and working by the time the contraction reaches a peak,” she explained.
Liz couldn’t hold the mask and lean forward and rock at the same time, so Maggie helped her. “Mum, my sacrum, can you press on it?” Maggie tried, but it was difficult to manage the massage and the mask.
Gemma swapped the mask for a small mouthpiece, like a pipe, which would enable Liz to breathe the gas in. She held it for Liz. In one of the spaces between contractions Rachel asked Liz if she would mind if Gemma helped with the delivery. Liz said no, not at all.
“How many deliveries have you had?” Maggie asked her.
“Fifteen, but none at home so far,” Gemma replied. She looked slightly nervous, but Maggie reassured her.
“I’m sure Rachel will look after you.” Rachel was opening the delivery pack. She tried to listen in to the baby’s heartbeat between the contractions, but
sometimes this was difficult to find, “Your baby’s head is so low now,” she explained, “It is often difficult to find the heartbeat at this stage.
When she did find the heartbeat, it was good. Rachel and Maggie exchanged a brief smile.
The gas and air made Liz’s head swim. She didn’t like the feeling at first, but was encouraged to "get used to it", which she did. Then later, when the time came to concentrate on pushing her baby out and Rachel asked her to put it down, she didn’t want to part with it.
With each contraction Liz could feel her baby’s head moving very slightly forward. When her effort stopped, at the end of the contraction, she could feel the head slip back a little.
“It’s like two steps forward, one step back,” Rachel explained, “but that’s how it is and you’re making progress, Liz.”
Maggie applied direct pressure down onto her daughter's sacrum each time a contraction started. This helped to ease the pain and Liz wouldn’t let her stop.
“I can see some dark hair,” Rachel said, “You are doing really well Liz, it won’t be long now.”
“How much longer?” Liz managed to ask, between contractions that seemed to be so close together now there was no time in-between to rest.
Then it came to her that the deep-throated
shouts she kept hearing were her own. Now, each time a contraction came it took the whole of her, enveloping her in an ecstasy of pain. The urge to push her baby out was completely overwhelming. The energy of her voice matched the expulsive energy of her whole being. She had not imagined the power of it, and she had not expected the sensuality of the pain. When Rachel poured warm water over her genitals it was almost pleasurable; then immediately the pain of the next contraction claimed her.
Downstairs in the kitchen Leo fed the goldfish – possibly enough to kill them - and Harry turned the volume up on the television, and poured himself a whiskey. Elizabeth was his baby girl, he knew what was happening up there, and he couldn’t bear it.
Liz felt burning. Her perineum stung. This is the ‘ring of fire’ they talked about in class. Her baby’s head was crowning.
“Fucking hell,” she said, because at that moment that is how it felt. Then: “Sorry mum.”
Maggie smiled, “I’ve heard worse.”
“I want you to listen to me carefully now, Liz,” she heard Rachel’s voice, from somewhere. “Pant now, just little pushes, no more big ones, let’s have your baby’s head out nice and gently. Would you like to feel your baby’s head?”
Someone took Liz’s hand and helped her to reach down to feel the crown of her baby’s head, warm, wet and motionless between her legs. Another
contraction started.
“Pant, a little push, pant,” this time it was Gemma’s voice. She was helping deliver Liz’s baby. Liz felt like she was about to split in two. Then there was amazing relief. Her baby’s head was out. Liz was kneeling, holding on to the end of the bed. She looked down and could see the back of her baby’s head moving, turning to face her right leg, until the wet dark hair rested against her left leg and a dainty, perfect ear was uppermost framed by Liz’s pubic hair.
And there they waited for the next contraction, for a minute, maybe two; five people were held suspended by a thread of time.
The contraction came and a wet, blue-tinged infant was swept up in front of Liz’s stomach and into her arms where she was cradled for the first time by Liz, her mother.
Rachel gave the towel to Maggie who dried the baby while Liz held her, resting back on her heels. The infant took her first breath and roared into life with a cry from the bottom of her newborn lungs. Liz cried tears of joy and relief. Maggie’s eyes were full of the same joy, and Gemma, who would later tell the tale of her home birth experience to her envious classmates, was stunned by the miraculous simplicity of it.
“A baby girl,” Liz proclaimed, “I’ve had a baby girl.”
Rachel was relieved and happy. It was six twenty in the evening. She glanced towards the door. “There are two men outside the bedroom door.
They heard everything and now they want to see.”
“Give us a few minutes,” Maggie called.
“Let me put my dressing gown on, and then they can come in for one minute, I’m not finished yet, am I?” Liz asked.
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