Episode 1 The Country Midwives

-Midwives...

-Hello!

BABY CRIES

They have to be there when they're needed.

My baby!

Being mother to the mothers...

You're waters haven't gone, have they?

..support to the fathers....

Yeah, yeah, fine.

..and trusted colleagues to each other.

All dressed, ready to go.

But, in this part of the world, their journey is never easy.

Oh, 'eck!

It's full of great ups and difficult downs...

It's through gates, over fences...

..of twists and turns...

Most bizarre places... Up a tree house, actually.

..of never quite knowing what's round the corner.

A total bag of emotions.

Welcome to the world of safe hands...

You've got a lovely belly.

My office is my car, you know.

..all-seeing eyes...

Absolutely perfect.

..and big, big smiles.

Very au naturel.

I think a lot of the women are quite strong characters.

Welcome to the real-life drama of The Country Midwives.

Carmarthenshire is one of Wales' most rural counties,

whose expectant mums are looked after by the Hywel Dda

University Health Board's midwives.

To the north - in the Teifi Valley - is the village of Glangwili

and its neighbouring farming communities.

It's very beautiful in summer.

Winter is something different, as community midwife Anwen Evans

knows only too well.

It's fun and games.

Because I live on a farm, Friday morning I got up at quarter past six

to take my works car to the bottom of the lane so I wouldn't be stuck.

I'm on call tonight, so if I get called out,

I'll have to get Sean out of bed to take me down to my car -

in the 4x4. He'll be impressed.

Anwen tackles over a thousand miles a month of Carmarthenshire's

maze of country roads and farm tracks.

She's calling on farm wife Bethan, who's 30 weeks pregnant.

It's her first time. And it's twins!

For midwives, a first-time pregnancy means extra care.

A first time and twins means extra, extra care.

We do try to see Bethan once a week.

Whether it be us in the community or the ante-natal clinic.

We check her blood pressure to make sure everything's OK.

We check her urine to make sure there's no infections.

We check the positions of the baby

and we listen to the babies' heartbeats - both of them.

WHOOSHING

Perfect.

Both happy.

Husband Dylan is in the middle of lambing -

a time for great care, as sheep and lambs carry

a parasitic disease, dangerous for both mother and child.

Be careful, don't go into the lambing shed because of the disease, toxoplasmosis,

which could have an effect on your pregnancy, and Dylan needs to

wash his own clothes and stuff, when he comes in from the farm.

Anwen learnt the dos and don'ts of being a farm wife

and mum-to-be from her own, personal, experience.

Because I live on a farm, I couldn't go out to the lambing shed,

and then in my clothes go and see a woman.

I would have to be careful to get changed.

Or just avoid the lambing shed. It's a good excuse, really.

In her garden, near Carmarthen, mother and midwife Sian Maynard

is not only concerned with feeding the birds.

As team leader to Anwen and colleagues, she has to ensure

that all expectant mums are attended to, whatever the weather.

Hello, could you put me through to the community office, please?

Is it busy on the ward now?

You got into work OK, then?

Are you going to keep me till later this afternoon to come in?

I've written up what I think should be in the report.

OK, see you soon. Ta-ra.

I'll recheck the annual leave today.

Unfortunately, I only live two miles from the hospital so there's a little

sort of handful of us that live within walking distance, so when the weather is like this,

we are the ones that are on stand-by.

Because our area is so rural, there are pockets that are

going to be really bad. If anybody does have problems,

we get the ambulance out to them.

We just come across that at the time.

Last resort, helicopter.

A comfy hop in a handy helicopter

would be very welcome for Sian herself this morning.

The reality, unfortunately, is a bit different.

Blinking 'eck, it's cold.

I think my ears are going to drop off at any moment.

Hopefully, she needn't go further today than her Glangwili

hospital base at nearby Carmarthen.

Carmarthenshire's eastern edge -

particularly around Llandeilo - is also very rural.

It's served by enough B and C roads to confuse the best sat-nav.

Area midwife Nan Duncan isn't fazed by the weather.

But what of the hours?

17 hours yesterday, so I was in bed about 2:30ish and eventually

went to sleep and woke up at eight o'clock this morning.

Got up and at it, so I'm here.

This is a knitted breast. We show people how to express breast milk.

So would you like a demonstration?

You pull back and you squeeze -

that's how you get some milk.

Excellent, actually, it works.

Hiya, how you doing?

Helping at the time of birth is only a small part of a midwife's work.

Their responsibility starts at around the tenth week of pregnancy

and will continue until at least ten days after birth.

-Famous question - have you pooed?

-We saved you a nappy.

SHE LAUGHS

I like it, I like it.

-Can I have a look at it?

-Yeah.

Aw. Isn't that the best?!

Hang on, hang on. You've got to see this.

This is best breastfeeding poo.

I'm so proud. Yeah. So proud.

It takes time to get breastfeeding going,

but when you get lots of poo-y and wee-y nappies, it's just champion.

When they are born they've got brown fat which keeps them going

while the breastfeeding gets initiated.

So there's a natural fall-off of weight.

Then as the breastfeeding gets established, there is

a gain in weight, so Helen has worked really hard

because it is tiring, to say the least.

Becoming a parent is awful, it's hard work.

So I'm really chuffed -

-are you chuffed?

-Yeah, getting there. Just tired.

-You've got to be tired.

Yes, indeed, as Zac's mum and dad are finding out,

becoming a parent is a tiring business.

With the snow - for the time being, anyway - melting away,

Sian Maynard has hit the road.

But the way it's hitting back is not all that good

for her blood pressure.

God. There's a dip there, hold on.

Oh!

This is the bit that people don't see,

my stress now is 10 out of 10.

Give me a baby to deliver any day.

This is her first get-to-know visit to farming wife Mari Phillips.

But even at this early stage,

there's one problem which she must draw attention to - toxoplasmosis.

It's usually an infection which is carried with stillborn lambs or

contact with placentas. But it is general hygiene.

He wears overalls, they all come off, he washes and changes them

before he comes anywhere near me.

-That's it.

-He does his own washing. Yeah.

-That's even better.

-He does really good washing, actually.

We've invented this, actually, it's not really true!

Oh, gosh!

Sian and her team are happy for Mari -

because of her age and good health - to have a homebirth.

But it's the challenge of getting there that's on her mind at the moment.

We just need to be mindful that we record that it takes 15 minutes

if you're coming in the middle of the night and it's a midwife from

another team, just so they have some idea in their head how long the track is.

From the remoteness of Mari's farm near Cynwil Elfed, Sian's next

call takes her to the metropolis of Newcastle Emlyn, a town which is

a good 35 minutes from the maternity unit at Glangwili, Carmarthen.

Hello, Kelly, how are you?

Like Mari, 29 weeks pregnant Kelly Walters

and husband Darren also want a homebirth.

As this will be Kelly's fourth child,

Sian doesn't expect complications.

Even so, things might not go as planned.

We view each pregnancy as being full-term from

-when you are 37 weeks pregnant onwards.

-Right.

So if you happen to go into labour before that,

then we would advise that you go into hospital to have the baby.

-Just because the baby will be premature.

-Yep.

-The pregnancy so far has been perfectly normal.

-Yes.

So unless anything dramatic happens

or changes, then we are aiming for a homebirth.

One baby in every 25 in Carmarthenshire is born at home,

a figure well above the Welsh average.

In the 1970s and 1980s

the Health Service tended to discourage homebirths.

But attitudes have changed and they're now on the rise again.

Darren is a songwriter.

His latest number is a celebration of the baby-to-be.

HE SINGS

I'm actually hoping to sing it for my wife when she is in labour.

Cheer her up a bit and see how it goes.

I'm writing it for my baby, so it makes sense, really.

SINGING CONTINUES

It's very sweet, quite flattering,

it will be nice to listen to him singing.

The new baby is due in the heart of winter.

So there's just one thing troubling Darren.

If it snows and you can't get here?

First of all, ring us,

but you must make sure you've got lots of warm towels.

If your waters go and you think Baby is coming,

as the head is being delivered,

really, just be hands off, baby will actually turn.

It'll go perhaps from looking at the floor

-to turning to the left or right.

-Yeah.

Gently put your hands by the side of the baby's head

and just pull down gently, and with the pushing as well,

baby will fall out.

-That bit, is that with towels in hand or is that just bare hands?

-Up to you.

The important thing is when a baby is delivered,

you dry the baby quickly.

-Really dry them off well and put a warm dry towel around the baby.

-OK.

-I hope this doesn't happen.

-It won't happen.

Before all this, I should have said, put your guitar down!

It'll be your fault...

Near Llandyfri,

a midwife is on her way to a scheduled call on a new mother.

But there was nothing scheduled about the last time Nan Duncan called here.

Right... We are going to see a little girl

who had an emergency Caesarean section,

week before last.

She is due for a general check-over to see how things are going.

But it was a hairy moment, I can tell you.

The "hairy moment" came when Lisa's placenta broke away from her womb.

Suffering terrible stomach pains and losing a lot of blood,

something had to be done -

quickly.

The first person who came into my head was Nan,

because I knew who Nan was,

she knew me, she knew my previous pregnancies.

Nan said, "I'm coming round straightaway.

"Ring the ambulance," and that was it.

It was like, "No, we can't stop and collect this that or anything,

"we've got to go now."

That is why we are here. They know us and we're the first person they call.

It's our job to make sure that the problem gets sorted.

I remember the surgeon speaking to me and saying,

"Well, the baby only had minutes, you would've had, like, half an hour

"to an hour if things were left, and we could've lost you as well."

One, you were bleeding

and, two, he was early. We could've lost the two of you.

-Thank goodness we don't get them every day!

-I know.

I should be a couple of stone lighter if there was.

Jayden was born eight weeks prematurely.

He's still in Glangwili Hospital's Special Care Unit.

Slowly, he's gaining.

But he's still too small and too weak to be allowed home -

a day that won't come soon enough for Lisa.

We're just waiting to get his feeding established.

As soon as that's established, sometime in May, he can come home.

Glangwili Hospital is HQ for the 40 community midwives that

care for mums in the Carmarthenshire team.

And on its maternity ward,

the big day has arrived for first-time mother Bethan.

This will be a Caesarean delivery,

and, as it's twins, both Anwen and Sian will be present -

if Anwen can get over her little phobia, that is.

I don't like doing this because it's oxygen,

and it just shoots out sometimes and I'm scared it'll hit my face.

Oh!

Not too bad.

All dressed, ready to go. Right.

This is obviously Bethan's first pregnancy.

And she's having twins, which is huge,

so she is obviously very nervous about the whole process,

so it would be nice to just get on with it and see the little babies and

make sure everything is fine, and Bethan's OK after it as well.

In 2013, over a quarter of all births in Wales

were by Caesarean section.

Commonplace it may be, but the surgery involved is major.

Complications can still happen. But, hopefully, not today.

45 minutes later, Anwen has the all-important news.

We've got a boy and a girl. Fantastic! I can weigh them now.

Now that it's all over, the atmosphere is truly relaxed.

Whilst Bethan recovers,

the arms that are used to cradling lambs are now holding babies.

Look at you! Old hand!

Easy, wasn't it?

Easy?! THEY LAUGH

The little boy came first. Cian David.

And then, Elliw, followed after, the little girl.

Now the work begins.

Oh, yes!

As the double birth brings double joy to the parents,

the midwives face the challenge of double the paperwork.

Sian's getting confused.

-Sian can't count.

-Very confused.

For midwives, working days often become working nights.

The end of the shift has come and gone.

And so - as often happens - it's now phone-a-friend time.

I'm lucky that my friend Cheryl has managed to get hold of her

mother-in-law and she's picked up my children for me from school.

And hopefully take them back to her house

till I get back and pick them up.

Finally, the moment that's been a long time coming.

Following an emergency Caesarean and 12 days of very special care,

Lisa and little Jayden are homeward bound.

Together, at last.

Jayden has been let out today.

We'll be going home.

Can't wait.

Taking a baby home brings excitement,

but also worries.

This is why, today, Nan is on her way to see Lisa.

She's had no trouble breastfeeding her previous children.

But, a day after getting Jayden home, Lisa isn't happy.

I got a breast pump.

I used it yesterday

and I used it this morning

and I've only got, like, 20ml on each one...

Not that much at all.

Breastfeeding may be natural.

But it's something that has to be worked on,

and mothers often need extra support.

With all her years of experience, Nan just knows what's wrong

and what to do about it.

It's instinctive, really, it's like being a detective, the midwife knows

the parameters of normality and who to call and how to make the outcome safe.

He needs to have the quality and quantity of feed

because we don't want his weight to dip down.

That's when his energy levels are sapping and we'll have a big problem.

So you've got to show him how to get onto that breast properly.

Behind the tips, you have got a reservoir...

Nan shares her knowledge so that little Jayden may get

the sustenance that he so badly needs from his mother's breast.

You want some winding as well to go with it...

To parents with their doubts and anxieties, the calm reassurance

and good-natured advice of the experienced midwife is invaluable.

So I need you to eat loads.

-Is that very important, to eat?

-Huge amount, huge.

-Oh, is it?

Huge!

Show me now how you'd feed him.

Right, that's it.

When his mouth is open wide, you can whack him on.

You want to develop my whack.

The all-seeing eyes watch carefully as Lisa manages to satisfy

little Jayden's need.

Home at last.

The twins are also home and, with the help of student

midwife Natalie, Anwen is paying her final home visit to Bethan

and Dylan before passing care on to the health visitor.

-So, eating OK, both of them?

-Yeah, both of them.

We check the eyes, we check that the mouth is nice

and clear to make sure there are no signs of thrush or anything.

We check the colour of the babies, make sure they're nice and pink,

no jaundice.

We then check the umbilical cord to make sure that's OK.

We always check if there's wet and dirty nappies so that we know

the babies are feeding fine,

their urine and their bowel movements are all fine.

Anwen's journey with this family is coming to an end.

Today will mean breaking the umbilical cord of care

and friendship between her and Bethan and the babies.

You do get attached to the babies - how can you not?

They are absolutely beautiful.

But with Bethan and Dylan, they are up a lot in the night -

at least I get to sleep at night.

THEY LAUGH

It's a lot of hard work, but between the two of us,

we get round it in the end, I think.

I am going to miss Anwen, it is really nice to have somebody here.

She's been a lot of help and support to me over the last few months.

It can be really emotional

because you get to know the mothers during the pregnancy.

You do build up a relationship with them.

It is going to be strange after today, not to have them around.

Both absolutely healthy, perfectly healthy twins.

-Ta-ra!

-Ta-ra!

-Ta-ra!

Oh, 'eck! Oh, dear.

Erm...have you got a jack?

The tyre's flat, but Dylan is buoyant as he enjoys this

opportunity to show his gratitude.

Aw, thank you, Dylan.

And away they go, but not to the nearest garage.

It's on to the next new mother and the next new baby.

Midwives enjoy their work.

But even the most dedicated of midwives such as Nan Duncan

have to have time to themselves.

Come on, then! Come on!

My husband's hobby, nothing to do with me, I just put up with him.

I just pay for him!

I wish.

It's a beautiful place to live and completely different to my work.

-I can completely unwind here.

-Come on.

Over 33 years as a midwife, Nan's built up a wealth of knowledge

and expertise.

But it's only recently that's she come to question, at what cost?

Three children, a farm, a business.

Yes, they have lost out a lot.

It's taken me until this age, really,

to realise that the important things in life is your family.

My grandchild now, I've got far more time with him

because I realise what I'd lost with my own children.

This is my husband, Wayne. Sometimes known as Ginge.

But he's turning white now so I ought to call him Whitey now, I suppose.

With rural midwives often on-call day and night,

should Wayne perhaps be called a "mid-husband"?

He's good, very good, actually.

Although I don't give him credit to his face,

-he is extremely good.

-I can't see me

part-exchanging her for a nice 18-year-old,

but that was the idea in the past,

but I think we've gone past that now.

It's all good fun and good stuff -

it is what makes marriage and a happy life, isn't it?

In the heart of the Teifi valley, midwives Anwen and Sian

are not hanging about, as they head for Newcastle Emlyn.

Darren has had to put down his guitar and pick up the phone.

Things are beginning to move.

Darren rang to say Kelly had started having contractions.

-I could hear her. It was the end of one contraction, wasn't it, Darren?

-Yeah.

I thought, she is cracking on, so it was...running out into the car park.

Darren and Kelly already have three boys.

Knowing that the imminent birth will give them a baby girl

is making it difficult for Darren to contain his excitement.

Kelly will tell you, I am terrible at waiting.

We were expecting, through previous births, for her to be early,

but she is on her due date so exciting times.

Feeling quite good at the minute, relaxed...

So the contractions are coming quite regularly now.

We now monitor how often Kelly is having the contractions.

We see how long they are lasting.

We listen in to baby's heartbeat

to make sure the baby is coping well with

the contractions as well.

It's Kelly's fourth baby

and she's had others no problem, so no concerns or anything with Kelly.

Just go with it now and hopefully have a lovely baby pretty soon,

for Kelly's sake, isn't it?

For midwives,

"pretty soon" can in fact mean quite a few hours, as the stages of birth

progress according to the mother's and the baby's very own timetable.

Go with your body now, OK?

Nice, slow breathing.

Watching carefully is an important part of Anwen

and Sian's work throughout the whole pregnancy.

Despite the relaxed atmosphere that they are purposefully

maintaining, it's in these last critical hours

that their watchfulness becomes hyper-sensitive.

DEEP BREATHING

Well done.

GROANING

That's right.

You're doing brilliantly. Wash the pain away.

SHE INHALES AND GROANS

That's the way.

Even though this is Kelly's fourth birth, it's no easier...

and the painful, contraction-after-contraction

process of giving birth

draws mother, father and midwives closer and closer together.

Slowly now...

-I've got cramp in my blinking leg!

-Which one...?

-Left.

-Yours!

I see her now, she's on her way. All signs looking good.

Despite Kelly's obvious discomfort, everything is looking good.

The miraculous moment of birth is imminent.

A little hand coming there as well.

A really big push now.

-Well done.

-Here she is!

BABY CRIES

Ohhhhh!

There we are! Fantastic!

And so it happens.

Zoe Jane is born.

Safe and sound.

She's fine.

-Is she a girl?

-She's definitely a girl. She's gorgeous.

SHE SOBS

Yep...there we are.

It's relief and joy all round, of course.

But, although the hardest work is done,

the placenta - the afterbirth - has still to be delivered.

A nice and healthy one.

Saving and serving it up for its health benefits is a growing trend amongst parents,

although few, perhaps, are as enthusiastic as Darren.

I've managed to get one of my chef friends to agree to cook it.

So, it should go in the freezer, and be ready to be eaten.

-Hello.

-Another good day's work, Anwen?

A perfect day's work.

-Lovely, and I've got two days off now so I'll be on a high now.

-Yeah.

It's very painful...

and, er, I'm glad she's here now.

Finally, whilst Anwen and Sian

get to grips with all the boxes that need to be ticked,

Darren greets his newborn daughter with a newborn song.

# Sunshine of my life The twinkle in my eye

# You're everything to me... #

You just look at them there now and just think,

this is what it's all about.

# It's plain for all to see

# Why you are everything to me. #

Another hard day's night draws to a happy close.

I know you're not allowed to drink, so I have got some apple juice

-and lemonade.

-Thank you.

-Congratulations!

Well done, Kelly, this is to you and our beautiful little girl, Zoe Jane.

-Yeah.

-Well done.

-Congratulations.

Next time on The Country Midwives...

Anwen's friendly call becomes a call for concern...

Sian hears about the strangest of cravings...

Flannels. Just sucking flannels.

And carnival star Lynne delivers a show-stopping home-birth.

Hello!