All thoughts of Campbell fled when Shirley doubled over and clutched her husband’s arm.
‘What’s up, Shirley?’ asked Claire, remaining calm. She guided her client into one of the birthing suites, motioning to Campbell to stay where he was.
‘I don’t know,’ she said, straightening. ‘I’ve been having a lot of false labour pains over the past couple of days and some nagging backache. But just now, in the car park, I think I had a couple of contractions.’
‘OK,’ said Claire. ‘Are you all right to lie down while I feel the baby’s position?’
‘It’s still breech. It hasn’t turned,’ said Shirley as her husband helped her onto the bed.
Claire gently palpated her client’s very pregnant abdomen. ‘Hmm. You’re right. You’re, what … thirty-seven weeks now?’
‘Yes.’
Claire paused, removing her hands as Shirley had another contraction. She gripped Claire’s hand hard as Claire watched the clock to time the contraction. Ninety seconds.
‘They’re bad, aren’t they?’
‘Yes.’ Shirley grimaced.
‘Right. Well, I think we need to get you up to Labour Ward straight away. I’m sorry but, as I already explained, we can’t do a breech birth here.’
‘I know. It’s all right. Frankly, I just want this baby out. I don’t care how or where you do it.’
‘OK,’ Claire laughed. ‘We can do an internal when we get there.’ Claire popped her head out the door.
‘What’s happening?’ Campbell asked.
‘Still breech but definitely in labour. Grab the wheelchair from the storeroom, will you? You can accompany us up to Labour Ward.’
‘Oh, so I do have my uses,’ he teased.
‘Just get the wheelchair.’
Campbell did as he was asked and entered the room shortly afterwards, pushing the chair just as Claire was helping Shirley off the bed. ‘Your chariot, madam,’ he said with a flourish, and bowed.
Shirley and her husband laughed. As she turned to sit in the chair, she cried out and her membranes ruptured. Amniotic fluid flooded over the chair and floor.
‘Oh, God. I’m sorry,’ Shirley apologised.
‘It’s fine, don’t worry,’ Claire assured her, grabbing some hospital-issue towels and throwing them onto the puddle on the floor.
Shirley clutched her stomach and her eyes grew wide in alarm.
‘What?’ asked Campbell.
‘It’s coming. The baby’s coming now!’
Campbell and Claire exchanged the briefest look and sprang into action. They knew that a woman who had been through this three times already could give birth quickly. They also knew that often, when a mother made such an alarming statement, she was spot on.
‘Right, Shirley,’ said Campbell, his voice calm and confident. ‘We’re going to need to have a look at what’s happening.
I know this may be difficult right now, but the most important thing to remember is not to push. OK? You can pant but don’t push. Are you comfortable standing? It really is the best position to deliver the baby. It’s better to have gravity on our side.’
‘This is fine,’ Shirley agreed.
‘If your husband …?’
‘Graham,’ Claire supplied.
‘Graham could support under your arms and you lean back into him … That’s great,’ he complimented them as Graham supported his wife perfectly.
Campbell pushed the wheelchair out of the way and got down on his hands and knees on the towels. Claire followed suit.
Shirley was absolutely right. The baby was coming. In fact, as Claire removed Shirley’s underthings it was evident that it was already there. Adrenaline accelerated her heartbeat as they looked at the baby’s bottom and scrotum bulging from the birth canal.
‘Delivered any breeches before?’ Campbell asked quietly.
‘A few, when I worked out west. You?’
‘I studied for six months under a French obstetrician who specialised in breech deliveries. I delivered plenty while I was there. So we can do this, OK? Remember the cardinal rule? Hands off the breech.’
‘Let’s do it.’ She smiled and he squeezed her hand.
His confidence buoyed her. The potential for complications increased with a breech presentation. It was good to have an experienced obstetrician by her side.
Claire got up and pulled a trolley close. Campbell grabbed some gloves and pulled them on.
‘OK, Shirley, your little boy is going to be here soon.’
‘B-boy?’
‘Yes, the evidence is hanging free for all to see. I’m just going to have a feel and see where the legs are, OK?’
‘Sure,’ she panted.
Campbell inserted two fingers and shut his eyes, concentration puckering his brow. ‘It’s a frank,’ he said, removing his hand. A breech in a frank position meant that the legs were jackknifed onto the abdomen—the commonest form of breech.
‘You’re doing so well, Shirley. At the next contraction, feel free to push with it, OK? We’ll see if the legs will come out without any help.’
‘Oh, boy, another one—now,’ she said, starting to breathe heavily.
‘Go with it, Shirley. Big push for me.’
Shirley bellowed loudly as she bore down. The legs slipped out in textbook style and the baby was now visible up to his belly button.
‘This baby sure wants out, Shirley,’ Campbell joked. ‘He’s doing all the right things. He’s practically delivering himself.’
Campbell pulled a loop of umbilical cord down to give them some slack for when the rest of the body made its appearance. The baby started cycling his legs, slowly inching himself out, obviously determined to be born. The arms and shoulders came out next. The baby was almost completely out now. Only the head remained.
‘Wonderful, Shirley,’ Claire soothed. ‘You’re doing really well. The head will be out soon.’
‘I’ll hold you to that.’ A flushed and sweaty-faced Shirley attempted humour.
Campbell was supporting the baby’s weight, cupping his bottom. His other hand spanned the tiny chest to slow the delivery while they waited for the next contraction to deliver the head.
Both Claire and Campbell knew that delivering the head was the crucial time and the one most fraught with potential complications. With a normal delivery the head was the first part out, having fully dilated the cervix and vaginal opening to accommodate it. With a breech, the head was the last part to come out, so if full dilatation hadn’t occurred, and particularly if the head was large, the baby could get stuck.
Shirley moaned as another pain contracted her uterus. Graham comforted and encouraged her as he took her weight. Campbell continued to support the baby as the back of the head cleared the birth canal. They could see the nape of the neck now. Shirley cried out as her birth outlet slowly stretched to allow the passage of her baby’s head.
Campbell supported the baby as it slipped out. He stood and placed the newborn in his mother’s arms. Jubilation reigned supreme as the baby wailed lustily. Claire