0:00:00 > 0:00:04Midwives.
0:00:04 > 0:00:08- They have to be there when they're needed...- Oh, my baby!
0:00:08 > 0:00:13- ..being mother to the mothers... - Your waters are not gone, are they?
0:00:13 > 0:00:15..support to the fathers...
0:00:15 > 0:00:17- Right, Sam?- Yeah, fine.
0:00:17 > 0:00:19..and trusted colleagues to each other.
0:00:19 > 0:00:21All dressed, ready to go.
0:00:21 > 0:00:24But in this part of the world, their journey is never easy.
0:00:24 > 0:00:26Oh, 'eck!
0:00:26 > 0:00:29It's full of great ups and difficult downs...
0:00:29 > 0:00:31It's through gates, it's over fences.
0:00:31 > 0:00:35- ..of twists and turns...- The most bizarre place is up a treehouse.
0:00:35 > 0:00:38..of never quite knowing what's round the corner.
0:00:38 > 0:00:40A total bag of emotions.
0:00:40 > 0:00:44- Welcome to the world of safe hands...- You've got a lovely belly!
0:00:44 > 0:00:47My office is my car, you know?
0:00:47 > 0:00:49- ..all seeing eyes... - Absolutely perfect.
0:00:49 > 0:00:53- ..and big, big smiles. - Very au naturale!
0:00:53 > 0:00:56I think a lot of the women are quite strong characters.
0:00:56 > 0:00:59Welcome to the real life drama of the Country Midwives.
0:01:03 > 0:01:07Carmarthenshire is one of Wales' largest counties.
0:01:07 > 0:01:11Here, expectant mums are looked after by a team of midwives,
0:01:11 > 0:01:15travelling and working in these rural communities.
0:01:16 > 0:01:19The county's northern team serve most of the Teifi Valley,
0:01:19 > 0:01:23including the small town of Llanybydder.
0:01:23 > 0:01:27Team leader Sian Maynard normally enjoys driving in this
0:01:27 > 0:01:31beautiful countryside, but the extra call of duty of the last few days
0:01:31 > 0:01:34means that today, she's struggling a bit.
0:01:34 > 0:01:37I was OK last night. The night before, I was on call.
0:01:37 > 0:01:41I ended up getting called in at about 2:30am to help on the ward
0:01:41 > 0:01:45and I finished about 2:00pm yesterday.
0:01:45 > 0:01:48I was a bit tired then and it's hard to get to sleep,
0:01:48 > 0:01:51to know how much to sleep, so you can still sleep in the night.
0:01:51 > 0:01:54So your body clock is round the right way.
0:01:54 > 0:01:58So, yeah, today will be hard going, probably,
0:01:58 > 0:02:00to keep awake.
0:02:01 > 0:02:05Her first call today is on Meinir Thomas
0:02:05 > 0:02:07and her two-week-old son Tomos.
0:02:07 > 0:02:08- Nice to be home?- Yes, lovely.
0:02:08 > 0:02:12Some three-quarters of women in Wales start breastfeeding,
0:02:12 > 0:02:15but within six weeks, the number's down to less than half.
0:02:15 > 0:02:19Meinir has tried, before deciding that the bottle is best for her
0:02:19 > 0:02:20and Tomos bach.
0:02:20 > 0:02:23For the first few days, it was fine,
0:02:23 > 0:02:29but we had two nights that were quite sleepless, so I tried him on
0:02:29 > 0:02:32the bottle and he was more content, so you could get on and do
0:02:32 > 0:02:36something else then instead of feeding all the time, to be honest.
0:02:36 > 0:02:39- You just felt that you were tied. - When did he have his last feed?
0:02:39 > 0:02:43- About half past nine. - 'I'd seen her on the postnatal ward,
0:02:43 > 0:02:45'I'd helped her with the breastfeeding,'
0:02:45 > 0:02:49so I already had a little bit of an idea when it came today as to
0:02:49 > 0:02:52whether she would be continuing to breastfeed or bottle feed.
0:02:52 > 0:02:55You felt a bit guilty then that you'd gone to the bottle,
0:02:55 > 0:02:59but as far as I'm concerned, the baby's got a better
0:02:59 > 0:03:03quality of life cos at the moment, he just feeds and sleeps.
0:03:03 > 0:03:06Now you're not feeding, hands off the boobs,
0:03:06 > 0:03:09hike them up with your bra now, under your chin!
0:03:09 > 0:03:13Don't keep doing that, you'll keep producing milk!
0:03:13 > 0:03:15You'll be feeding the whole of Llanybydder!
0:03:15 > 0:03:19'You can't make people feel guilty cos it's their choice'
0:03:19 > 0:03:21and at the end of the day,
0:03:21 > 0:03:24Tomos has had almost a week of breast milk,
0:03:24 > 0:03:27he's had all the colostrum, and that's fantastic,
0:03:27 > 0:03:30that's what she wanted to do and she's as happy as Larry there.
0:03:30 > 0:03:34Sian's particularly familiar with Meinir because of her history
0:03:34 > 0:03:38of high blood pressure, which meant she needed extra attention.
0:03:38 > 0:03:41They used to come and visit me at work and everything,
0:03:41 > 0:03:45to check the blood pressure, so it's quite nice to get close to them.
0:03:45 > 0:03:48You feel as if you're getting to know them
0:03:48 > 0:03:51as a friend type of thing, you know? No, it's nice.
0:03:54 > 0:03:58On top of that, a blood test taken around the 17th week of pregnancy
0:03:58 > 0:04:02showed that Meinir's baby carried a high risk of having a birth defect.
0:04:04 > 0:04:05- 130/78.- Oh, my God!
0:04:05 > 0:04:09'We've monitored her closely. She was referred then, she's had'
0:04:09 > 0:04:11an amnio and that amnio showed
0:04:11 > 0:04:15that the baby was fine, and as you can see, Tomos is absolutely lovely.
0:04:15 > 0:04:20Both Tomos' weight and vocal cords confirm his healthy progress.
0:04:20 > 0:04:23TOMOS CRIES
0:04:23 > 0:04:25Now, what could possibly quieten him?
0:04:25 > 0:04:28There we are.
0:04:28 > 0:04:29Instant!
0:04:29 > 0:04:31Duw!
0:04:31 > 0:04:33- I wish teenagers were like that! - I know!
0:04:35 > 0:04:40Despite the risks they faced, Meinir and Tomos are a success story,
0:04:40 > 0:04:43thanks, in no small part, to the care
0:04:43 > 0:04:45and attention of our community midwives.
0:04:45 > 0:04:48- Take care now. Give us a ring, any problems.- OK.
0:04:48 > 0:04:50- Ta-ra.- Bye.
0:04:50 > 0:04:53'It's really nice to have a case like that cos it'
0:04:53 > 0:04:56restores your sort of faith in what the human body can do, really.
0:05:00 > 0:05:04Community midwives are at the front line of maternity care,
0:05:04 > 0:05:07but they're just part of a larger system of care within
0:05:07 > 0:05:09the local health board.
0:05:09 > 0:05:12Meinir's blood samples were analysed in the
0:05:12 > 0:05:16blood sciences department at Glangwili Hospital, Carmarthen.
0:05:16 > 0:05:20Here, a backroom staff of 40 check up to 1,500 blood samples a day.
0:05:28 > 0:05:32Dwynwen Davies' blood would also have been tested in Glangwili.
0:05:32 > 0:05:37She lives near Llanybydder with daughter Delyn Mair.
0:05:37 > 0:05:42Dwynwen is 30 weeks into her pregnancy. She's carrying twins.
0:05:42 > 0:05:4611 weeks pregnant when I found out. Jumping for joy.
0:05:46 > 0:05:50And then to find out that I was pregnant with twins was
0:05:50 > 0:05:53unbelievable and the joy, you know?
0:05:56 > 0:06:01I own a day nursery and work obviously very closely with children
0:06:01 > 0:06:07and I've picked up the parvovirus, which is linked to slapped-cheek.
0:06:07 > 0:06:10Children with slapped-cheek syndrome,
0:06:10 > 0:06:12that shows as a red rash on the face,
0:06:12 > 0:06:16usually recover from the cold-like symptoms in a few days,
0:06:16 > 0:06:19but what's quite harmless for children can be very serious
0:06:19 > 0:06:21indeed for unborn babies.
0:06:25 > 0:06:28At its worst, the virus can make the baby swell up with fluid,
0:06:28 > 0:06:31with the potential of death by drowning.
0:06:31 > 0:06:34At 17 weeks, on the weekly scan,
0:06:34 > 0:06:39they'd seen fluid in one of the babies' bellies.
0:06:39 > 0:06:41After three weeks, the fluid had gone
0:06:41 > 0:06:44and the unborn baby was well again.
0:06:44 > 0:06:49However, a month later, at 24 weeks, the virus struck again.
0:06:51 > 0:06:56They said it had come back with such a vengeance that they didn't
0:06:56 > 0:06:59think that the baby would survive.
0:06:59 > 0:07:04For that month, I felt it was the longest time in my life because
0:07:04 > 0:07:09I knew the baby was deteriorating but there was nothing I could do.
0:07:09 > 0:07:10The baby was in my belly
0:07:10 > 0:07:13and there was nothing I could do to help that baby,
0:07:13 > 0:07:18so in effect, it was waiting for the baby to fill up with fluid,
0:07:18 > 0:07:21drown if you like, and day in day out, there was nothing
0:07:21 > 0:07:26I could do and I was 28 weeks pregnant when her heart stopped.
0:07:31 > 0:07:33It's really hard.
0:07:33 > 0:07:37You feel quite like you've failed, in a way,
0:07:37 > 0:07:42because there was nothing you could do to stop it happening.
0:07:48 > 0:07:50After careful consideration,
0:07:50 > 0:07:54the medical team decided that removing the baby that had died
0:07:54 > 0:07:58was not possible without risking the wellbeing of its remaining twin.
0:07:58 > 0:08:01Dwynwen will have to carry both babies through to the
0:08:01 > 0:08:03pregnancy's full term.
0:08:03 > 0:08:06I'm going down every week to have scans,
0:08:06 > 0:08:10just to check that there's no fluid in the healthy baby.
0:08:10 > 0:08:13But they can't rule out that it won't come back,
0:08:13 > 0:08:16so it's quite an anxious time
0:08:16 > 0:08:19and you don't know at the end of it what will be the outcome.
0:08:22 > 0:08:26The team working in the west of the county serve from
0:08:26 > 0:08:31Carmarthen Town itself to Whitland and the border with Pembrokeshire.
0:08:31 > 0:08:34Caren Thomas has just joined the team in this area.
0:08:34 > 0:08:37For 13 years, she was a hospital midwife,
0:08:37 > 0:08:41but six weeks ago, Caren swapped the familiarity of the ward
0:08:41 > 0:08:46for the diversity and unpredictability of the community.
0:08:46 > 0:08:51It is very different to my hospital work, but it's fantastic,
0:08:51 > 0:08:55especially on a day like today when the sun is shining.
0:08:55 > 0:08:59Out in the community, you've got more time to be with women
0:08:59 > 0:09:02and to listen to their problems and people are pleased to see you
0:09:02 > 0:09:07and it just seems...less stressful, I suppose, in a way.
0:09:07 > 0:09:10Caren's been called to see an expectant mum who is suffering
0:09:10 > 0:09:15from hyperemesis, a morning sickness that doesn't know when to stop.
0:09:15 > 0:09:20She's been actually in hospital twice already to be rehydrated, then.
0:09:20 > 0:09:24Bless her. It's not nice. Not nice at all.
0:09:24 > 0:09:28They really suffer, these girls, with hyperemesis.
0:09:28 > 0:09:29It's horrible.
0:09:31 > 0:09:34Mary Pascal has the unfortunate experience of being amongst
0:09:34 > 0:09:38the 1% of women who suffer from hyperemesis.
0:09:38 > 0:09:40And how is the sickness now today?
0:09:40 > 0:09:44- You were very sick overnight, were you?- Yeah. Last night, I had 16.
0:09:44 > 0:09:46And then today, six.
0:09:46 > 0:09:49'She vomited 16 times overnight,'
0:09:49 > 0:09:51six times already this morning,
0:09:51 > 0:09:55unable to tolerate any fluids or any food.
0:09:55 > 0:09:59So the oral tablets aren't working as well then.
0:09:59 > 0:10:01Probably cos you're vomiting, you see?
0:10:01 > 0:10:03You're sicking the tablets up then, you know?
0:10:03 > 0:10:06What I was wanting to do was to just test your wee today.
0:10:06 > 0:10:09- Are you able to do me a wee sample. - Yeah, have you got a pot?
0:10:09 > 0:10:11'She's 13 weeks now,'
0:10:11 > 0:10:14we should be expecting the sickness to ease a bit, but unfortunately,
0:10:14 > 0:10:18some women do get it a lot longer and all the way through their pregnancy.
0:10:18 > 0:10:22Yeah, I can see straightaway that there's quite a lot of ketones
0:10:22 > 0:10:26in this, which is a sign the body's quite dehydrated now.
0:10:26 > 0:10:32I think probably our best bet would be to send you in again, Mary,
0:10:32 > 0:10:38and get some IV fluids into you and get you feeling a bit better again.
0:10:38 > 0:10:40What do you think?
0:10:40 > 0:10:41I think that's all right,
0:10:41 > 0:10:44but I'm more worried about the medication, if it's not working.
0:10:44 > 0:10:48If it's not working. That's something they'll be able to sort out.
0:10:48 > 0:10:50It's tough going for Mary
0:10:50 > 0:10:54- and husband Joseph is naturally concerned.- It's quite worrying.
0:10:54 > 0:10:57They tell me the baby's going to be OK.
0:10:57 > 0:11:00It's just I'm worried for Mary as well.
0:11:00 > 0:11:02I mean, it's normal to be sick in pregnancy,
0:11:02 > 0:11:05but this is extreme sickness.
0:11:05 > 0:11:07I'm with a patient who is 13 weeks...
0:11:07 > 0:11:10Caren arranges a short hospital stay for Mary.
0:11:10 > 0:11:13Dehydration is not a matter to be treated lightly.
0:11:13 > 0:11:16OK, give me a ring if I can do anything else for you.
0:11:16 > 0:11:19'The best thing for Mary now is to get into hospital and get treated.'
0:11:19 > 0:11:21So no, it's not always rosy.
0:11:21 > 0:11:23But there we are. She'll be better soon.
0:11:25 > 0:11:28Glangwili Hospital in the county town of Carmarthen is
0:11:28 > 0:11:33- the midwives' operating base.- Hello.
0:11:33 > 0:11:36Women who are diabetic carry a higher level of risk
0:11:36 > 0:11:38to their health when they become pregnant.
0:11:38 > 0:11:42Whilst modern advances have made such risks more manageable,
0:11:42 > 0:11:44modern living is presenting mothers, doctors
0:11:44 > 0:11:47and midwives with new challenges.
0:11:47 > 0:11:50Hannah Roberts, expecting her second child,
0:11:50 > 0:11:53is amongst the growing number being seen by Dr Lisa Forrest,
0:11:53 > 0:11:57who've been diagnosed with gestational diabetes.
0:11:57 > 0:12:01Gestational diabetes is a form of diabetes that tends to be
0:12:01 > 0:12:06diagnosed during pregnancy and often disappears at the end of pregnancy.
0:12:06 > 0:12:10- Still managing to check the blood sugars?- Yeah.
0:12:10 > 0:12:13'I've never had diabetes or any problems like that, but I did'
0:12:13 > 0:12:17have gestational diabetes when I was pregnant with my daughter.
0:12:17 > 0:12:21There's a lot of hormonal changes during pregnancy
0:12:21 > 0:12:25and you screen women with certain risk factors,
0:12:25 > 0:12:28women who are overweight at the start of pregnancy,
0:12:28 > 0:12:31women who've got family history of diabetes, women who've had a
0:12:31 > 0:12:35previous large baby or have previously had diabetes
0:12:35 > 0:12:36in a pregnancy.
0:12:38 > 0:12:41I have to monitor my blood sugars four times a day.
0:12:41 > 0:12:46So many things contain sugar that you wouldn't even think of.
0:12:46 > 0:12:48I have to avoid white bread,
0:12:48 > 0:12:51I have to be careful what time I eat certain things.
0:12:51 > 0:12:56Gestational diabetes is becoming more common and that's partly
0:12:56 > 0:13:00because of the sort of increasing rise in overweight
0:13:00 > 0:13:03and obesity in sort of young women.
0:13:03 > 0:13:06And it's also because of the increasing maternal age,
0:13:06 > 0:13:09becoming pregnant in their sort of 40s.
0:13:09 > 0:13:12We estimate in Carmarthenshire around about sort of four in ever 100
0:13:12 > 0:13:15pregnancies are complicated by diabetes.
0:13:15 > 0:13:18We'll see you back here either clinic,
0:13:18 > 0:13:20Hannah, in about two weeks' time.
0:13:20 > 0:13:24Unchecked, the condition can cause abnormally big babies,
0:13:24 > 0:13:26leading to a more difficult birth for the mother,
0:13:26 > 0:13:29as well as long-term risks to her health.
0:13:29 > 0:13:33I'm seeing the doctor every two weeks in clinic,
0:13:33 > 0:13:37just to make sure all my blood sugars are OK,
0:13:37 > 0:13:39that I don't have any problems with my tablets.
0:13:39 > 0:13:42And that hopefully the baby's not too big.
0:13:46 > 0:13:51It's a 20 mile journey from Carmarthen to the town of Llanybydder.
0:13:51 > 0:13:54Dwynwen Davies lives nearby.
0:13:54 > 0:13:58She has five weeks to go before the time will be right for her to
0:13:58 > 0:14:01give birth to twins, one alive and one that has died.
0:14:03 > 0:14:08For the sake of the surviving baby, her pregnancy must run its course,
0:14:08 > 0:14:11which means she's having to travel regularly to Cardiff,
0:14:11 > 0:14:15where specialist equipment checks for any sign that the deadly
0:14:15 > 0:14:19parvovirus is back, threatening the healthy baby.
0:14:19 > 0:14:20Hi. How are you?
0:14:20 > 0:14:25From the start, Dwynwen has been under Anwen's care and guidance.
0:14:25 > 0:14:28Giving birth to twins means that two midwives will be there,
0:14:28 > 0:14:32so today, Sian is accompanying Anwen to start to get to know her.
0:14:32 > 0:14:35- This is Sian, our team leader. - So how... Ooh!
0:14:35 > 0:14:39- LAUGHTER - Yeah, nearly landed up on the floor!
0:14:42 > 0:14:45The number of stillbirths in Wales is now very low indeed,
0:14:45 > 0:14:49less than one in every 250.
0:14:49 > 0:14:52Part of Anwen and Sian's work here today is to prepare
0:14:52 > 0:14:56Dwynwen in any way they can for what lies ahead.
0:14:56 > 0:15:00Obviously, we can dress the baby, whatever you want us to do,
0:15:00 > 0:15:04or we can leave the baby just as it is for you to look at
0:15:04 > 0:15:06and have some time with.
0:15:06 > 0:15:11It's so nice to have the midwives that you've dealt with
0:15:11 > 0:15:14for the last seven months,
0:15:14 > 0:15:18that they're going to actually be there, that's really nice.
0:15:18 > 0:15:22'Today's been a lovely opportunity to come round to see her.'
0:15:22 > 0:15:25We're just trying to make a few plans as to who is going to
0:15:25 > 0:15:28be with her because it would be really nice for her to have
0:15:28 > 0:15:32a bit of continuity and a little bit of extra support from ourselves,
0:15:32 > 0:15:35seeing as we'll be looking after her afterwards.
0:15:35 > 0:15:37I need to start...
0:15:37 > 0:15:40I know where the baby will be buried and things,
0:15:40 > 0:15:44- but it's just not knowing what undertakers and bits.- Yeah.
0:15:44 > 0:15:49- We can look into that for you.- Yes. - Don't worry about that.
0:15:49 > 0:15:53And little things like if you want something special to
0:15:53 > 0:15:56go in with the baby, a blanket or...
0:15:56 > 0:16:00- I've got them. - You've got them already. Yeah.
0:16:00 > 0:16:02'Things do happen.
0:16:02 > 0:16:06'We don't always have the happy stories, as midwives, unfortunately.'
0:16:06 > 0:16:09And in a case like this, it's so difficult because it's twins
0:16:09 > 0:16:12and one is alive, one is dead,
0:16:12 > 0:16:15the emotions that she's going through are just horrific.
0:16:15 > 0:16:20You can't begin to imagine what she's going through.
0:16:20 > 0:16:24West of Carmarthen lies the village of Bancyfelin.
0:16:24 > 0:16:28- Midwife Caren is calling on Hannah Roberts.- Are you all right?- Yes.
0:16:28 > 0:16:32- Good, thank you. Come on in.- Thank you. There's me coming in anyway!
0:16:32 > 0:16:34SHE LAUGHS
0:16:34 > 0:16:36As in a growing number of women,
0:16:36 > 0:16:39Hannah's pregnancy has brought on gestational diabetes.
0:16:39 > 0:16:42For the baby's sake and her own,
0:16:42 > 0:16:45she has to be very careful of what she eats.
0:16:45 > 0:16:49- Good. And are you good with your diet?- I am now.
0:16:49 > 0:16:51Yeah. I wasn't at all.
0:16:51 > 0:16:54It's quite amazing, the difference, you know,
0:16:54 > 0:16:58that you have to go through and you realise actually how much rubbish
0:16:58 > 0:17:01you do put in your mouth when you're not actually thinking about it.
0:17:01 > 0:17:04When you've got to actually think about everything that goes in.
0:17:04 > 0:17:07I'm very good now.
0:17:07 > 0:17:09My carb intake is huge.
0:17:09 > 0:17:13Cake, biscuits, anything, you can grab on the go.
0:17:13 > 0:17:17Amongst other matters, it is the size of the baby and the
0:17:17 > 0:17:21resulting birthing problems that midwives are most concerned with.
0:17:21 > 0:17:25- Can you tell whereabouts...? - Yeah, I can feel a head down there.
0:17:25 > 0:17:27A big fat bum there.
0:17:27 > 0:17:31'Diabetes is becoming more common now.'
0:17:31 > 0:17:35As midwives, we have to be a bit more on the ball about what it means
0:17:35 > 0:17:40and what it means for them and their pregnancy and that it's more at risk.
0:17:40 > 0:17:45The careful monitoring of Hannah's condition means that all is well.
0:17:45 > 0:17:48- BABY'S HEARTBEAT - Aw!- Perfect.
0:17:50 > 0:17:52That's lovely.
0:17:52 > 0:17:56Although she's obviously doing her best to keep to the strict
0:17:56 > 0:17:57dietary guidelines,
0:17:57 > 0:18:01there's something worrying her that she needs to get off her chest.
0:18:01 > 0:18:06Say, I may have had two mouthfuls of cheesecake at work...
0:18:06 > 0:18:10But say for example I did, is it really going to affect things badly?
0:18:10 > 0:18:13Has that happened? Have you had two mouthfuls of cheesecake?
0:18:13 > 0:18:17- Is this a confession? Did somebody bring it in to work?- Yeah.
0:18:17 > 0:18:20- And do they know you're diabetic? - They do now.
0:18:20 > 0:18:23LAUGHTER 'That was brilliant though.'
0:18:23 > 0:18:26I didn't know what she was going to come out with when she said,
0:18:26 > 0:18:29"I do have something to ask you." She seemed quite serious. Bless her.
0:18:29 > 0:18:33- You've confessed all now and all is well.- I feel better.
0:18:33 > 0:18:36I feel cleansed!
0:18:36 > 0:18:40'Mums will tell us everything. You become close friends'
0:18:40 > 0:18:42with lots of your clients
0:18:42 > 0:18:44and they do tell you lost of things then.
0:18:44 > 0:18:47She feels better now that she's confessed to Caren
0:18:47 > 0:18:50the priest/midwife.
0:18:50 > 0:18:53Back at Glangwili Hospital, Carmarthen,
0:18:53 > 0:18:57fluid could be threatening Dwynwen's healthy baby.
0:18:57 > 0:18:59Her pregnancy isn't quite full term,
0:18:59 > 0:19:04but doctors have decided the day of birth and stillbirth has arrived.
0:19:04 > 0:19:09'It's hard because as a human being, my emotions are everywhere as well.'
0:19:09 > 0:19:12It would be easy for me to cry with Dwynwen,
0:19:12 > 0:19:14as to be expected with the situation.
0:19:14 > 0:19:18But I've just got to be strong with Dwynwen,
0:19:18 > 0:19:21try and help her to come through the tears.
0:19:24 > 0:19:26But, yeah...
0:19:26 > 0:19:30It's nice to have a familiar face, you know. That's a lot of help.
0:19:32 > 0:19:37The lost baby will have been dead for over seven weeks now.
0:19:37 > 0:19:42What affect that will have on its appearance no-one can tell.
0:19:42 > 0:19:45I've got the little crib to one side,
0:19:45 > 0:19:48all dressed ready to put the baby in for her.
0:19:48 > 0:19:50And I know Dwynwen has got some little clothes.
0:19:50 > 0:19:54So we will be able to put them on and dress the baby afterwards.
0:19:54 > 0:19:57Dwynwen's been so brave.
0:19:57 > 0:20:02Now it's actually the moment, that's when it really hits you
0:20:02 > 0:20:05and it's good that we're there to support one another as well.
0:20:07 > 0:20:11Dwynwen's Caesarean section is scheduled for 2:00pm.
0:20:11 > 0:20:14Can you get me the registrar...
0:20:14 > 0:20:17Babies, however, have little regard for ward timetables.
0:20:17 > 0:20:21Another mother, visiting the loo starts giving birth.
0:20:21 > 0:20:23- Which means but one thing... - Fantastic.
0:20:23 > 0:20:25..all hands on deck.
0:20:26 > 0:20:29There we are. Argh!
0:20:30 > 0:20:33All of the hands on deck of course are experienced hands.
0:20:33 > 0:20:37Well used to the "anything can happen-ness" of the maternity ward.
0:20:37 > 0:20:40A lady had to be delivered quite quickly, but everything's fine
0:20:40 > 0:20:42that's just being on the labour ward...it's normal.
0:20:44 > 0:20:47Blinkin' heck, we were just going to have a cup of tea!
0:20:50 > 0:20:52Dwynwen's time has come.
0:20:56 > 0:20:58Her mother is by her side.
0:21:02 > 0:21:08Nevertheless, her walk down to the theatre cannot be anything but lonely.
0:21:08 > 0:21:11Dwynwen is going to be grieving and also...
0:21:11 > 0:21:16Joyful that the other baby is fine and relieved at the same time, so it's...
0:21:17 > 0:21:22It's just...a total bag of emotions, you just don't know what she's going through.
0:21:32 > 0:21:36Not all that far from the town of Carmarthen, Caren's next call takes
0:21:36 > 0:21:40her not to a street or a cul-de-sac, but to the top of a field.
0:21:42 > 0:21:44I'm not sure how er...
0:21:44 > 0:21:49how muddy it's going to be at Michelle's now, because we do have to walk across a field.
0:21:49 > 0:21:50I'll have to put my wellies on.
0:21:50 > 0:21:53It's less than two months since Caren swapped
0:21:53 > 0:21:57the life of a hospital midwife for that of the open road.
0:21:57 > 0:22:00I've seen more of West Wales in the last six weeks
0:22:00 > 0:22:02than I think I have done in my whole life time.
0:22:04 > 0:22:06This is why I haven't got a posh car, you see.
0:22:06 > 0:22:10Because this is what the community is all about, potholes, mud...
0:22:11 > 0:22:12Rough terrain.
0:22:15 > 0:22:17DOGS BARKING
0:22:18 > 0:22:22Eventually, Caren makes it to an alternative community that's
0:22:22 > 0:22:26a far cry from the enclosed maternity ward she worked in for 13 years.
0:22:26 > 0:22:28Hi, Michelle, how are you?
0:22:31 > 0:22:35Michelle gave birth to a little Aria just 15 days ago.
0:22:35 > 0:22:37How much does she weigh now?
0:22:37 > 0:22:39- She is 8.8 now.- What was she born?
0:22:39 > 0:22:41She was 8.4, but she went down to 8.
0:22:41 > 0:22:44That's right and she's back up to 8.8.
0:22:44 > 0:22:48See, you've got double cream in those boobs. That's excellent feeding.
0:22:48 > 0:22:54So that's your sort of reassurance things are all going well with
0:22:54 > 0:22:57- the feeding. So in yourself, you're feeling OK?- Yeah.
0:22:57 > 0:23:00It must be wearing you out a little bit? Tired.
0:23:00 > 0:23:02I think we're getting the hang of it now,
0:23:02 > 0:23:05it's just she's not really sleeping through the night very well.
0:23:05 > 0:23:08She looks lovely, she doesn't look unwell or anything, does she?
0:23:08 > 0:23:09So I'm not worried about her.
0:23:11 > 0:23:15A healthy blood pressure means this will be Caren's last call on Michelle.
0:23:15 > 0:23:17It's absolutely normal.
0:23:17 > 0:23:20Looking after her pregnancy has been a central part of Caren's work
0:23:20 > 0:23:23since she hit the community road.
0:23:23 > 0:23:26And as often happens, they've become good friends.
0:23:26 > 0:23:28Do you think it would be all right if I can quickly use your loo?
0:23:28 > 0:23:31Of course, you do have to venture outside.
0:23:31 > 0:23:34- Venture outside to go to the loo? - Yeah.
0:23:34 > 0:23:37An outside toilet may be nothing new to some, but how about this?
0:23:37 > 0:23:40- Can you see the yellow bucket? - That's fantastic.
0:23:40 > 0:23:45- Until recently, this was Michelle's shower.- I was out here in the snow.
0:23:45 > 0:23:48Oh, my word you are far braver than I am.
0:23:48 > 0:23:51So yes, this one is like luxury now.
0:23:51 > 0:23:53- Oh!- That's our shower now.
0:23:53 > 0:23:56That's like an normal bathroom, it's fantastic.
0:23:56 > 0:24:00And now it's here in a very snug bathroom.
0:24:00 > 0:24:02I'll just leave you to it.
0:24:04 > 0:24:06- Is it OK to wear my wellies in here? - Yeah.- OK.
0:24:17 > 0:24:20Outside the hospital theatre where Dwynwen's C-section
0:24:20 > 0:24:23is taking place, it's an anxious time for her mother.
0:24:27 > 0:24:29NEWBORN BABY CRIES
0:24:29 > 0:24:34But finally, she hears the sound that announces to the world that all has gone well.
0:24:34 > 0:24:37The healthy baby has been delivered safely.
0:24:37 > 0:24:38BABY CRIES
0:24:43 > 0:24:48But also delivered is the baby that died of the parvovirus seven weeks ago.
0:24:56 > 0:25:01It is Sian's responsibility to clean and clothe the lost child.
0:25:01 > 0:25:04It will be treated with the same respect as the healthy baby
0:25:04 > 0:25:06being looked after now by Anwen.
0:25:10 > 0:25:12It's fantastic the relationship that I and Sian have got.
0:25:12 > 0:25:15Because we've got a faith in your colleague knowing, OK,
0:25:15 > 0:25:20she's doing that, you don't have to think about that bit, then.
0:25:21 > 0:25:25By the time Dwynwen is returned to her room, her newborn little
0:25:25 > 0:25:30girl, Cadi Aur, is ready to be cradled and cwtshed for the first time.
0:00:00 > 0:00:00Aw...
0:25:34 > 0:25:37Dwynwen has always said that she'd want to take
0:25:37 > 0:25:40the stillborn baby also in her arms.
0:25:40 > 0:25:44The loss of Martha Aur may seem tempered by the joy of Cadi Aur.
0:25:45 > 0:25:50Actually it's no less a loss. Grieving is a necessary process.
0:25:50 > 0:25:52She's not going to look like her sister, OK?
0:25:54 > 0:25:59Now, you can't see her face, OK. But you can see her now.
0:26:02 > 0:26:04Can you see her little hands there?
0:26:04 > 0:26:07You can never prepare yourself for it and I think it's just...
0:26:08 > 0:26:10You just feel a bit...
0:26:10 > 0:26:12Pants, really. Yeah.
0:26:13 > 0:26:17If you look closely, you can see her little fingernails.
0:26:17 > 0:26:20It's just about supporting Dwynwen now through this
0:26:20 > 0:26:22and making sure that she's stable
0:26:22 > 0:26:26and that we've got facilities over on the ward for her now.
0:26:28 > 0:26:29OK?
0:26:29 > 0:26:31It's bittersweet.
0:26:32 > 0:26:36You can't help but think, well, it's not how things should have been.
0:26:38 > 0:26:40But, erm...
0:26:40 > 0:26:42You know, it's just one of those things, isn't it?
0:26:44 > 0:26:48Dwynwen will stay here now for as long as it takes for us to do the paperwork.
0:26:48 > 0:26:51It'll take us a good couple of hours.
0:26:52 > 0:26:54Probably three to four hours,
0:26:54 > 0:26:58so nice, strong coffee now and get through that paperwork.
0:26:59 > 0:27:03After such a day, everybody's quite drained.
0:27:03 > 0:27:07But Dwynwen has one important and uplifting moment to come.
0:27:07 > 0:27:11My daughter's going to be chuffed to bits. She wanted a girl
0:27:11 > 0:27:14So...she's going to be chuffed to bits.
0:27:16 > 0:27:17Hello!
0:27:19 > 0:27:23Aw, Delyn, Wow!
0:27:26 > 0:27:29Whilst Delyn Mair gets to know her little sister,
0:27:29 > 0:27:34Anwen and Sian work through the awaiting forest of paperwork.
0:27:35 > 0:27:37It's a part of the job,
0:27:37 > 0:27:40but you know it doesn't happen this late every day, it's just...
0:27:41 > 0:27:44And families understand as well you know,
0:27:44 > 0:27:46they get used to it don't they?
0:27:46 > 0:27:49I'll probably see Sean, but Stefan will be in bed.
0:27:49 > 0:27:52Lisa's in Italy, so won't get to see her.
0:27:52 > 0:27:58They started work over 12 hours ago. It's been a long day.
0:27:58 > 0:28:01We were both supposed to clock off at five.
0:28:01 > 0:28:03- So this is just a labour of love. - Yeah.
0:28:11 > 0:28:14Next time on the Country Midwives...
0:28:14 > 0:28:18a midwife's home visit becomes a tepee visit.
0:28:18 > 0:28:21Do you know what, I think I've got a tickle coming here. I think I've got a tickle here.
0:28:21 > 0:28:24A pill that may be hard for some mothers to swallow.
0:28:24 > 0:28:28I don't think it's anything unnatural about it.
0:28:28 > 0:28:31And midwife, Caren, takes charge of her first homebirth.
0:28:34 > 0:28:38I waited weeks for that. It's exactly what I wanted.