Birth in Suburbia, Carol Falaki [electronic reader .TXT] 📗

suddenly, since I came to the hospital.”
“That happens to a lot of women,” Ed explained, for Gemma’s ears as much as for Debbie's.
“It’s the change of environment. It affects the hormonal balance of your labour. Arriving at hospital causes your adrenalin levels to rise and as a consequence the endorphins, which were helping you to cope, lose some of their effect. It may take half an
hour or so for you to achieve that sense of equilibrium again; so try to bear with it if you can. We will sort you out with some pain relief as soon as we get you to your room. What did you have in mind?”
Debbie had imagined that she would have been desperate for an epidural by now, but she surprised herself. Although the pain was worse than she had expected, now she was in it, she felt she could manage for a while longer, but she didn’t want to rule it out. An epidural was her ‘insurance policy’, there if she needed it.
“How far on do I need to be before it is too late for an epidural?”
“I think if you get to fully dilated, well, by then you might as well get on with it. Up to then, with a first baby, there is usually enough time, provided the anaesthetist is not in theatre or busy working through a queue of epidurals. Do you want one, Debbie?”
“What about the injection, pethidine, can I still have an epidural if I have that?”
“Yes you can, and the gas and air.”
“Okay, I’ll go for the injection for now, and see how well it works.”
The examination necessitated Debbie lying on her back for the abdominal palpation. Ed needed to confirm the position of her baby. This was difficult, not least because this was the least comfortable position for Debbie.
The abdominal examination consisted of the
same routine as the antenatal examination Debbie was used to. Ed endeavoured to make this brief, and worked between Debbie’s contractions which were coming every 2 to 3 minutes.
Then came the vaginal examination, and once again Ed worked between the contractions.
Sean held Debbie’s hand. Debbie did her best to relax while she was examined. This helped to reduce her discomfort. When at last it was over Debbie held her breath for the verdict.
“Well, you are seven centimetres Debbie. That’s great. You have done really well. You have a bulging bag of waters there, so I am not able to define the position of your baby, but the baby’s head is very low, and all of this is good news. Do you mind if Gemma examines you briefly?” Debbie shook her head.
“Now take care, Gemma, not to rupture her membranes. Debbie and her baby are doing just fine with them still intact. I just want you to feel them, and the edge of Debbie’s cervix, to assess the dilatation.” Ed smiled at Debbie
“What time do you go off duty?” Debbie asked.
“Seven-thirty.”
“Do you think you will deliver my baby, Ed?”
“Well that would be nice. What time is it now? Four fifty. You never know. I really hope so. Come on, let's get you to your room”
Debbie attempted to walk slowly round to her room, supported by Sean, but she only managed halfway before it was decided that a wheelchair would
be easier. Once in her room Debbie gladly knelt with her upper body over the birth ball and with her knees on the mattress on the floor, while Sean continued to rub her back. Ed went for her injection.
Ed reached the door. She called Gemma to her and said quietly. “I want you to stay with Debbie and talk her through each contraction, keep her as calm as you can by reassuring her, she is doing very well, isn’t she?” Gemma nodded.
“Make sure she knows it, and Gemma, see if you can listen in to the baby for a full minute after the next contraction, without making Debbie lie on her back.”
“Okay,” Gemma turned and surveyed the room. This was a very different set-up from what she had experienced in this hospital up to now. Most of the ladies she had attended in labour here had been semi-recumbent on the bed in the middle of the room. The lights had almost always been on full, and the sound of the baby’s heartbeat had dominated the room with a gentle rhythmic pop, pop, pop emitting monotonously from an electronic monitor. This new experience was strange but exciting, and reminded her a little of the home birth she had attended for Liz only the day before.
Sean had given Gemma a CD to play, and quietly, the crystal clear voice of Enya singing Harry’s Game, permeated every part of the darkened room, so that even the air seemed to close in and focus with calm intent on the woman kneeling on the floor.
Debbie, in the ordinary sense of being present, was no longer with them. She was in a world of her own. Her whole being, every part of her, was focused on the birth of her unseen infant.
Gemma could see there were similarities in the way that Debbie moved. Rocking her pelvis, just as Liz had done at the home birth, changing position between contractions. Both women demonstrated a freedom of movement that Gemma realised was impossible to achieve on a small hospital bed. She picked up the sonic aid. A Pinard's stethoscope would be no use at all with Debbie in that position.
Her contractions had become so intense that Debbie had not been aware of Ed’s return to the room. The gas and air made her feel dizzy, she was not sure she liked the feeling, but it gave her something to focus on at the beginning of each contraction; something to think about other than how bad is this one going to get? This was excruciating, all consuming; everything she had heard was true.
“Here’s your injection Debbie.” Was she in a dream? Did someone speak?
“I’ve put an anti-emetic in it, to help stop you from being sick.” Debbie gave a small nod and said then to Sean, to anybody: “Don’t stop. Rub my back, lower, there, yes harder.”
Another contraction. “God help me. I can’t do this.” Then woozy, spaced out: “Yeah, sleep, so tired, so very, very tired”
For a short while, after her injection Debbie dozed,
aware of the contractions. They still hurt but seemed displaced, distanced somehow, and then gradually, like a ship at anchor being drawn beneath the mounting waves by the chain binding it to the sea-bed, Debbie felt a mounting urgency to act, to surface and to survive. She knew what she had to do, but she was afraid.
A powerful contraction, urgent and fiercely intense, came to her like a pouncing tiger propelling her thoughts with its deep roar, so that for a moment, Debbie saw herself, there on the black mattress on the floor. There was her beloved Sean, one hand on her back, the other on her shoulder and when she looked up to the corner of the room the light was so bright.
There was someone standing in the light. “Mummy, mummy it’s you, you’re here.” She’s smiling at me, Debbie thought, I must be all right, why else would she smile? And the woman standing with her, she’s smiling too.
“Debbie, you have work to do.”
“Yes, Mum, I know.” Then they were gone.
“Get on with it Debbie,” she told herself. “You have some work to do. Just do it.” Then out loud: “I want to push.”
Ed smiled at Gemma,
“It looks like we might catch this baby before we go off duty, Gemma,” she whispered.
“Is this good? Are we nearly there?” Sean asked. He felt a small wrench in his gut, and a huge desire to
be away, out of there, with Debbie and their baby, somewhere else, home, with everything okay.
“I hope so, Sean, let’s wait and see.” Ed said.
Gemma listened in to the baby’s heartbeat again. Sean gave Debbie sips of iced water between contractions.
“For some women the second stage of labour is the hardest part, they become afraid, the sensations are so powerful,” Ed explained to Gemma. “For others, the second stage is the best part, because they know they are near the end of their labour. They can feel their baby moving down. It all depends. Knowing that your efforts are worthwhile, that you are making some progress, is the important thing; the knowledge the contractions are having an effect, that it will come to an end, which of course it always does, and importantly, knowing that your baby is all right.”
There followed a lull, a period of calm. Debbie had a ‘rest and be thankful phase’ of around fifteen minutes, during which her contractions, apart from one or two niggles, stopped.
Gemma looked anxiously at Ed, with visions of a syntocinon infusion and other interventions looming through her thoughts, things she had watched happen for other women when their contractions ‘went off'.
“Just be patient, everything is fine,” Ed reassured her.
At 6.30am the contractions started again, powerful, expulsive and noisy. Debbie found her voice,
and with a gush of clear fluid her waters had gone.
“Sorry about the shouting,” Debbie said to Ed, between pushes. She had returned to the all fours position and was demanding pressure on her sacrum for the duration of each contraction. Gemma had become quite good at this. Meanwhile Sean bathed Debbie’s forehead with a wet cloth.
This pain felt like it had purpose to Debbie. She could feel her baby moving. Vocalising the pain seemed to help, but it was hard. She was pushing for almost an hour. The contractions were relentless with not much more than a minute between the end of one and the start of another. She was worn out to the point of exhaustion. At times Debbie was oblivious to her companions, yet when she was aware of them, she was reassured by their presence.
In desperation she found the energy to ask: “How much longer, I’m so tired?”
Someone knocked on the door and a displaced voice intruded into their space. “Are you all right in there?”
“We’re fine,” Ed called and under her breath whispered: “Go away," then, “I can see dark hair Debbie, plenty of dark hair.”
Sean raised his head, he wanted to see the dark hair of his baby, but could not leave Debbie’s top end. She would not let him. Debbie didn’t want him looking. There was still that fear, in the back of her mind, that she would soil herself, even