Episode 2 The Country Midwives

Midwives.

Hello!

They have to be there when they're needed...

My baby!

..being mother to the mothers...

Your waters are not gone, are they?

..support to the fathers...

-All right, Sam?

-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.

Ooh, heck!

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

It's through gates, it's over fences.

..of twists and turns...

The most bizarre place is up a treehouse, 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's most rural counties,

whose expectant mums are looked after

by the Hywel Dda University Health Board's midwives.

South of the M4 lies the former coal mining valley of Cwm Gwendraeth

and, at its head, Burry Port.

Today is carnival day.

Everybody's dressed up, including midwife Lyn Smith.

Burry Port's a good community spirit

and everybody comes together on carnival day.

It's always a good turnout and everybody comes to enjoy.

Being a local girl, familiar faces are everywhere,

including many she's helped bring into the world.

Oh, there must be about 10. I think there's five in our crowd now.

There's one of them.

Someone who's renewed her acquaintance with Lyn

over the last nine months or so is Jenny, along with partner Sam.

Just come down to see everybody,

because I'm from the area anyway, and we came to see Lyn

and to see her dress up, because I knew it would be quite funny.

Jenny's booked in for a home delivery that could happen

any day soon.

What if it's today?

I am on call for a home delivery so I'm hoping... My bra...

No, my phone was in my bra but it's not now, it's in here.

But I've just seen her and she said she's not having pain,

so hopefully I'll have time to change, then.

Maybe if I get a movement now, she'll have to come up like that!

Well, if the phone goes I'll just have to go like this, as I am,

and I'm sure she'll be happy to see me.

The midwives' northern patch stretches to Lampeter.

Occasionally they cross the border into Ceredigion itself,

as today has Anwen Evans.

She's calling in the home of Lois Puw,

whose journey of discovery is only just beginning.

The two are life-long friends,

but because Lois lives outside the Carmarthenshire area

Anwen's had to gain special permission to be her midwife.

Within such a close relationship,

that role will carry added responsibility.

You worry about somebody's pregnancy anyway, but, you know,

you're more involved with it and it's more personal, and it's...

I think it's nicer in a way as well.

The process begins today with the first home visit - the booking-in.

-Right, loads of paperwork, Lois, OK?

-OK.

-Little bedtime reading for you.

-Lovely, thank you.

This is a book that explains everything about pregnancy,

any little questions that you've got, it'll answer them in there.

We do recommend that you have the flu jab in pregnancy.

Despite knowing each other so well, all the questions have to be asked,

even though some of them are... well, quite personal.

-Is Martin the baby's father?

-Well, I hope so!

-Good.

-Yes.

-And you're not addicted at all, are you?

-No!

-Lovely.

At last, questioning over.

With the help of the "magic wheel" comes...the exciting bit.

So we're going to make your baby due on 20 August,

-by our little wheel, but we'll always go by scan.

-Right, OK.

After going through your medical history,

you do class in the category that we can offer you a home birth.

We'd come to you and there'd be two midwives present

and we'd look after you at home throughout your labour.

-Have you thought?

-I haven't, but I'll think about it.

The form-filling done, it's time for the real health checks to begin.

All expertly executed - apart from one "sticky" problem.

This is what you have to do to pass the test to be a midwife!

Wahey!

Lyn's carnival is over.

But Jenny's big event is getting really close.

All the family's getting excited.

And they all know Lyn so well.

Lyn was my midwife with my first pregnancy

and when Adam was born on Christmas Day

she was there, she delivered him.

And she still hasn't forgiven me 10 years later

for spending her Christmas Eve in hospital with me.

-So you've felt more pressure now, have you?

-Yeah.

-What, down below?

Yeah. I get shooting pains all the time as well.

That's normal now at this stage, OK?

By now, Jenny and Lyn are a well-rehearsed double act.

But this will be Sam's first child.

Opting for a homebirth seemed perfectly normal for Jenny,

but came as quite a surprise to Sam.

It was just something that came out of left field to me,

and I was like, "What? You what?"

You know, I was really surprised by it.

He said, "Babies are not born at home, they're born in hospitals,"

and that it's his baby as well and he should get a say in it.

And why did I get to make the choice?

That's so inconsiderate, isn't it?

148 beats, that's brilliant.

But, you know, Lyn reassured me

that probably at home Jenny would be the most relaxed she could be

and her every need is going to be catered for.

The things that can go wrong at home

-can go wrong in hospital anyway, so...

-Exactly, yeah.

At the end of the day it's where she feels comfortable, is the most important thing.

Midwives in the east of the county serve the market town of Llandovery

and the furthest reaches of the Towy Valley.

Looking after expectant mothers here -

from traditional farming wives to New Age tent dwellers -

is community midwife Nan Duncan.

I'm very fortunate to have a lovely job.

Not often I think, oh, my word!

Mostly it's, yes, up and at it.

It's lovely to see the little ones growing up

and then before you know it they're into school,

and then they have more children!

So, yes, we're in their lives for quite a substantial time

but, you know, I'm always Nan, I'm always around.

Today she's on her way to the mums-to-be clinic.

As fertility rates in Wales are steadily rising,

it's going to be another busy day.

-Have you still got itchy hands?

-Yeah.

-Are they?

-And all over now.

The ten or more women Nan will see today

will all have different issues...

You've got a lovely belly.

..from swollen feet

to Lindsay, set for a homebirth but who's had an accident.

Yeah, wrote off my car and I seem to have stretched my ligaments

and done some sort of damage to my lower back as a consequence.

So where... You know your pain, where is your pain predominantly?

The pain is, well, in this lower back region...

Nan is all for homebirths, but not, sadly, in this case.

Were things to go wrong and a late move to hospital necessary,

she sees too much of a risk of making things worse.

Well, I'd rather you be in place

where we can actually do something for you.

The moving of you, in labour, with an exacerbated problem,

it's not good for you.

That is the major reason why I'm thinking...

Nan's hair may turn grey with worry, but Lindsay persists.

There is only so much hair dye available. No.

Last in today is Tina Muller.

Happily for her, there are no complications, as yet.

-All happy for the homebirth?

-Yes. I'm all happy you're coming.

-You are coming, are you?

-Yes, we're coming.

-OK.

That's what I wonder sometimes!

In the Teifi valley,

midwives hold regular clinics in the market town of Llanybydder.

Lois Puw is about to have her 16-week check-up

with lifelong friend Anwen.

Good, your iron levels are fine.

We check your urine every clinic appointment, OK?

At this stage it's to make sure

there are no signs of infection or anything.

These are still early and anxious days.

As many as one in eight women suffer an early miscarriage

within the first three months - as Lois did last year.

Hearing her baby's heartbeat today will be so important.

-Whoo!

-Sorry, cold hand!

Should have pre-warned you!

-Get used to my cold hands.

-It's quite exciting.

It usually takes 12 weeks for the uterus to get out of the pelvis

so up until 12 weeks we can't really hear anything.

And now it's only small, and, you know, they can move and dodge

the sonic aid so it's hard to try and find them and pick them up.

Ooh!

THEY SPEAK WELSH

That's lovely.

I think it's because, erm...

-Because I lost last year, I think it's more...

-Yeah.

It's nice and exciting.

With any woman, you constantly make sure that everything is OK,

but I think when you're caring for a friend

you question everything just a little bit more

because you're the only midwife that sees them through their pregnancy.

But I'm just keeping my fingers crossed now that

everything will be OK for the rest of Lois's pregnancy

and that she has a wonderful birth at the end.

From Carmarthen to Drefach Felindre is only some 20 miles.

But ahead of Sian Maynard are 20 very twisting and confusing miles.

Not surprisingly, her first morning chat is with her trusted friend,

the sat-nav.

I'm looking for Drefach Felindre. I get a little bit confused sometimes.

I remember, years ago, I went to the wrong Drefach -

or Hebron, I think it was -

and I ended up going about 30 miles out of my area.

Oh, it's market day in Llanybydder, today.

I got lost loads of times.

The first year I was out in this area, I had a little A4 map.

A year into it, they decided to give me a sat-nav, which is brilliant.

In such a rural area, Sian's hands spend as much time at the wheel

as they do on expectant bellies.

Perhaps we'll have 30 miles between one visit and another,

so we might only do three or four visits in a day

and we could do 120 miles

whereas when I worked in...in Carmarthen, Carmarthen town,

if I did ten miles, that was a lot of mileage in one day.

This is a familiar road for Sian.

Three weeks ago, she took charge of a homebirth at this farmhouse.

Today's, she's back to hear any views Lottie may have on her

and her fellow midwife's work.

Hello?

Lottie was hypnobirthing,

a technique used by some mothers during childbirth

as a way of controlling their pain.

It demands great concentration on the mother's part -

an effort not appreciated, in Lottie's view,

by everyone present.

If there's chit-chatting,

which I was joining in with early on -

-we were having a good laugh, weren't we?

-Yeah.

But then it gets to a point where you're like,

"OK, we can't do this any more.

-"I've got to think about delivering the baby."

-Yeah.

During the first stage of labour,

Lottie was quite chatty, and as it progressed,

then, you know, perhaps... we could have, sort of,

lowered our voices a little bit.

So I expected more sensitivity,

thinking, "Ooh, we might be a bit loud, here."

-It's knowing that cut-off point, isn't it?

-Yeah.

'It's good to have that feedback,

'because we'll certainly be more aware of it.'

You learn every day -

every single day, you learn something.

No time to ponder - it's straight on to Lottie's sister-in-law, Ellie,

who lives close by.

Despite having seven weeks to go, Ellie's bump is big...very big.

So what have they said in the hospital now?

Um...last week, they said that I've got an extra-large baby.

All right, OK!

'The scans and measurements that have been taken recently'

suggest that the baby that Ellie is carrying now

is about the size of her sister-in-law's baby,

which is about three weeks old.

So that is freaking her out a little bit.

Yeah - long legs, big head, big waist.

-Yeah - no, the head's normal size.

-It was just at the top.

-OK.

-So he's got a big belly.

-Big belly.

That's probably the amount of cake I'm eating.

'Lots of women will have very large babies'

no problem at all -

it just means we need to monitor the progression of the labour.

Pregnancy has been full of surprises for Ellie -

none more so than her cravings.

Flannels - just sucking flannels. I don't know what it is.

-Fish, as well, I'm eating fish.

-Did you eat it before?

No - I'm vegetarian.

-All right, that's a problem, then!

-Yeah.

Sian will keep a watchful eye on Ellie's big belly

over the coming weeks.

Back in the town of Burry Port, near Llanelli,

it was Lyn's day off...

..until the call came from Jenny.

From her two past experiences,

she's pretty certain that things have really started to happen now.

Contractions were ten minutes apart, then eight. The last one was seven.

To know it's coming closer is really, really exciting.

Lyn, she just phoned me now, she's going to come and have a check.

Knew it'd go today, on her day off. Just typical.

The difficulty I have, my husband works away.

With a home delivery, obviously I make arrangements.

I've always got friends. My family are really helpful.

So they'd always step in.

I could phone one sister, she'd come at 4.30 in the morning,

She'd be over here straight, you know?

All right? Said you were having a baby!

Feeling OK? Good movements?

Yeah. In-between the contractions as well,

the baby's moving and it's going really tight.

Got a contraction timer -

it's been downloaded quickly

so we knew where we were, sort of thing.

-Let's hope today's the day, then.

-I hope so.

It's just so uncertain in midwifery -

if we could tell when these girls were going to deliver,

it would be so much easier.

It's not the posh ones in the hospital...

So it's time to run all the checks.

And, yes, Jenny's right.

It really does look as if today is the day.

I've just encouraged her now to walk around,

go into the garden for a little walk and see how things go.

So when contractions pick up, in the next few hours,

I'm sure we'll be well on our way, you know?

Whilst Lyn waits for nature to take its course,

Sian's on her way to a home

where nature has recently changed the course of life dramatically.

She's calling on quite a special young mother,

20-year-old Non Williams and Jack, her two-week-old baby boy.

-Hello!

-Hello.

-How are you then?

-Hey, how much weight has he put on?

-He's 8lbs 14oz.

-Fantastic.

-Yeah, weighed on Monday.

Imagining how things will change

is part and parcel of being an expectant mum.

But Non was given little time for such thoughts.

Well, I went to the GP, had a bit of pain in my stomach.

And my belly had swollen up a little bit

so I went in and I said,

"Well, obviously I've got something growing

"or I've got something wrong with me."

And then we done a pregnancy test and it showed it was positive.

But a greater shock was to come.

Not only was she pregnant,

her baby was to arrive in four weeks' time.

-So you didn't feel the baby move at all.

-No, nothing.

-Funny, isn't it?!

-It's strange.

-Yeah.

It was a very, big shock.

But no, it's been a nice shock.

Now then, have you had any thoughts on contraception?

-Were you using anything before?

-I was on the pill.

Right, so the pill doesn't suit you?

-No.

-We know that.

-Yeah.

It was just a mistake, wasn't it?

A very good mistake!

Oh, Non's doing great. She's like a duck to water.

She's as happy as Larry there, no problems.

No two births, no two pregnancies... it's never the same.

Every one is totally different.

And that's what makes the job really interesting.

Near Lampeter, midwife Anwen Evans

is giving Lisa and Steffan their start for the day.

Husband Sion is used to the unpredictability of Anwen's days,

even if, like today, it's her day off.

It's a juggling act.

Midwifery and taking the kids here, there and everywhere.

And if she's not on... If she's at home, then we're lucky.

If she's not, she's always prepared something for me and the kids.

Yeah, it just takes one phone call to completely change your day.

You can plan it out to a T in the morning

but it can change in a matter of seconds.

And it's quite difficult thinking,

"Oh, gosh, where are the kids tonight?"

"Where's Sion?"

"How am I going to get them looked after?"

And obviously, concentrating with my work as well.

Anwen likes to keep work life and home life apart.

But sometimes, it's just not possible.

It's a challenging position, really.

Obviously it's life and death.

And unfortunately when the bad things do happen...yeah,

we do have a chat about it but not that I can do much.

But I can listen, make a cup of tea and hopefully things will get better.

Lois is Anwen's best friend.

Her due-date has passed.

Like brides, first babies tend to be late.

On her day off, Anwen has called on her friend

to give her some moral support.

-How are you feeling?

-Oh, I'm OK. A bit of backache.

Lois is now seven days overdue so I'm on pins,

waiting for the phone call.

-You're waiting on that phone call!

-I am! I am.

I'm scared if I leave my phone anywhere for long.

I think, "Oh, my God, where is it?!"

Anwen is used to postponing things at the last moment.

But not tomorrow, please!

Hubby is home today, hoping to finish

so we can go for a day out tomorrow

for our wedding anniversary.

Unless Lois has the baby!

If Lois has the baby, I'll be there...

..celebrating my 10th wedding anniversary with Lois and Martin!

I'm sure the hospital won't mind if Sion comes in for a couple of hours.

Before leaving, Anwen transforms from friend to midwife,

just to be sure that all's well.

BABY'S HEARTBEAT RACES

But, as you can hear, all is not well.

The baby's heart is racing.

With time, it might well calm itself down.

On the other hand...

No, it's still high.

Anwen's taking no chances.

That of course means hospital.

-I'll book for you to go in for a monitoring.

-Oh, right.

Cos it was 160-175.

Oh, was it?

It could be that just the baby's been active and moving around a lot

and by the time she gets down there, it could have settled down.

But we need to rule out,

just in case there is anything...

that the baby's heart rate is getting higher for some reason.

We need to know.

-Oh, yeah, I can feel it.

-Yeah.

If the baby's heartbeat is still high,

they might think about inducing Lois sooner rather than later,

because she is term plus seven now.

So we'll just wait and see.

In Burry Port, the contractions are coming stronger and faster.

Jenny's discomfort is clear to see.

Sam isn't looking too good either.

Now that the process of pain has begun,

Lyn has a pretty good idea of what's going to happen, when.

I've just examined Jennifer now

and the cervix is almost fully effaced, 3cm.

So another hour or two and I'm sure we'll be cooking on gas, then.

Time allowing, two midwives are present at every homebirth.

Just arrived and helping Lyn with the equipment

is team member Amelia.

We're making sure that everything is to hand and again,

it's important that you do choose wisely

when you're saying yes to a home delivery, you know?

That we're looking at the low risk women.

Because Jenny is young and healthy

and has already had two trouble-free births,

Lyn is confident that she's made the right call.

An hour later, the hard work of labour has begun.

The morning's excitement

has turned into the nervous quiet of the waiting game.

She's doing really, really well.

The contractions are getting a lot stronger now.

Whereas before, downstairs, Jen was really chatty,

now she's gone quiet and this is all normal, you know,

in labour, how you change. Cos they're working so hard.

And you can see her grimacing now, with the pain.

But I believe she's still smiling along with it!

THEY GIGGLE

For Jenny, being at home helps her smile, even now.

And Lyn and Amelia's expertise is a source of real reassurance.

Lois was already overdue when Anwen called for a chat,

heard the baby's racing heartbeat

and sent her best-friend quickly off to hospital.

Thankfully, little Osian was well.

So well, in fact, that he was in no hurry at all

to leave the snugness of his mother's womb.

Hello, Osian!

We had a hot curry, just to try and get things moving,

and the following morning, on the Saturday,

my waters broke about 4.45am.

Sunday morning, they thought they'll start to induce me now

because it'd been 24 hours after the waters had broken.

On the drip for six hours

and only 2cm dilated, doing that for two hours!

So because of no progress, really,

they said it would need to be an emergency Caesarean.

So at 9.51 on Sunday night,

Osian was born.

-And are you having some sleep at night?

-I am.

Lois knows that she is very lucky indeed

to have Anwen as her midwife as well as friend.

With Anwen, I can call her on her personal phone, which is lovely!

Oh, hello, beautiful!

-Oh, look!

-LOIS EXCLAIMS

Ah, what a life!

Oh, that's the best way to be, Osian.

Bringing a new life into the world is a wondrous occurrence,

especially if past experiences have ended in disappointment.

It's overwhelming sometimes.

You look at him and you're thinking, "My gosh!"

Because of the loss last year,

it means so much more that there's a new life there.

And it's fantastic, it's really nice.

Absolutely perfect.

Hello, beautiful!

Being midwife to a lifelong friend

has been a quite an experience for Anwen, too.

Perfect, absolutely perfect.

It's nice.

It makes my day.

We took some photos after coming out of the theatre,

of Anwen with Osian

and with us and everything.

And it's lovely, I think. That bond is there then, I think.

It's a lovely start for their relationship, as well.

I think that's what's nice being a community midwife,

is that you see a nice closure to everything.

You've seen them through the whole procedure

and it's just perfect, absolutely lovely.

In Jenny's bedroom,

gas and air help ease the pain as the hour of childbirth approaches.

JENNY: Is it out?

No!

I feel like I've just gone this way.

No, no, you're OK, you're doing really well.

-LAUGHING:

-Is it out!

Just go with it now, don't be frightened,

just go with what your body's telling you now, right?

With 18 years' experience behind her,

Lyn's cool-hand approach is of immeasurable importance to Jenny.

-You all right, Sam?

-Yeah, fine.

Pushing down, just go with it now, you're doing a fab job,

just go with it.

Well done, Jenny, keep going, babe.

Brilliant, well done.

Good girl, well done.

Nice and slow for me know, nice and slow.

Good girl.

Keep it coming, that's fantastic.

-Well done.

-Well done.

-You're coming out in one fair scoop, are you?

-Oh!

And this is your daddy.

-Whoa-ho!

-Yeah!

Oh!

-Hello!

-Well done.

-Hello.

Well done, babe.

The pain and the pushing over, the age-old miracle is complete

as the newborn baby boy fills the room with emotion.

Not a dry eye in the house, now!

Well done.

Another successful homebirth for which Lyn has just one word...

Fab.

You've done amazing, you've done so well.

-Look how small he is.

-You going to give him a kiss?

For first-time dad Sam, it's been quite a day.

I knew it would be the best moment of my life

and it's even better than I could have ever thought. Amazing.

And, even after her years of experience,

it's been quite a day for Lyn, too.

I think the day I stop getting emotional is the day I give up.

This is the bit I love now, watching them

all together after the baby, it's lovely.

Makes it all worthwhile, you know?

Next time on The Country Midwives...

a mum-to-be's visit to the loo gives the midwives the runs.

Big, big push in your bum. That's it, fantastic.

What happens when morning sickness lasts all day, every day.

She vomited 16 times overnight.

And how midwives deal with sorrow, as well as joy.

I've just got to be strong and try and help her

to come through the tears.