Delivering Under Pressure The Midwives

DOOR KNOCKS

Hi, it's the midwife.

-That's it, that's it, you're doing it, you're doing it.

-Little pushes,

little pushes.

Oh my gosh!

When we're at our most vulnerable,

we all need someone who ISN'T afraid.

I'm your midwife and I'm going to be looking after you.

Midwives are responsible for bringing our children

safely into the world.

-Hello world!

-You have to make a very, very

intimate relationship with somebody you've never met in your life.

I apologise.

You've not done anything wrong.

You're having a baby, you've not killed someone!

But now, they are facing the highest birth-rate in 40 years.

BABY CRIES

Too many women having babies. That's the problem.

Oooh!

-Parents are more demanding.

-I don't feel that she's getting any answers.

-And pregnancy is more complicated.

-We're worried.

Do you know we're worried?

When you see a baby come out like he did,

you just think, "Oh no".

Yeah yeah, I'm fine. I just delivered my first baby.

That's the best feeling in the world!

This is what it's really like to be a midwife in Britain today.

SHE SCREAMS

Good, keep breathing,

keep breathing. Well done.

It's Sunday night on the delivery unit of St Mary's Hospital in Manchester.

-We just need to do what is best for baby, all right?

-OK.

One of the busiest labour wards in the country.

So, what do you think is going to happen tonight, then?

Oh, I don't know. That's the joy of triage.

The unexpected. We don't know.

So, we just, sort of, watch him.

He's a really small baby and probably doesn't have a good outcome, if she delivers.

Last week, they delivered 136 babies.

This week, it could be anything up to 170.

A gorgeous girl. All done. Made my Mother's Day.

With every expectant mother,

the midwives have to work out how best to look after her and her baby.

But they also have to juggle the resources of a busy hospital.

-Hello everybody.

-Hiya.

If you could do a urine sample for us, please. Not you, sir,

and not the child, but you please.

Some births will be straightforward. Others will not.

You never know what you're going to get.

Like a box of chocolates.

INTERCOM SOUNDS

Midwife Gill Barras has worked at St Mary's for 26 years.

Too much pain, OK, Jade, love. Let me have a look at you.

Tonight, she's manning the triage desk.

Yeah, room one, I think, Pam.

The first port of call for everyone who comes into the hospital.

As an midwife on the labour ward,

you have to very, very quickly

make a very, very intimate relationship

with somebody you've never met before in your life.

-Don't you?

-You do.

-Isn't that a challenge? A massive challenge.

That is the challenge.

INTERCOM SOUNDS

-What's the name?

-It's Lindsay Hall.

-Hey. We were giving up on you.

With delivery beds filling up

and a constant stream of women coming through the door,

it's up to Gill to work out who to admit

-and who to send home.

-Into this room, darling, OK?

-What do you think then, Gill?

-No.

I don't think she's in labour.

Lindsay's fifth child is due today and she's convinced she's in labour.

You look too relaxed for me!

But I think you've had four babies before?

-Plenty of practice.

-Yes,

and practice means calmness, I think.

I'm just going to examine you very briefly.

-You're not in labour yet, you know.

-You're joking, this is killing me.

No, I'm not joking, mate. I know you're not.

Your cervix isn't properly dilated.

It's slightly open, I'm not saying it will not dilate,

but at the moment, no, you're not in labour at the moment.

I would rather you went home.

-Could you cope at home?

-No.

-It's really hurting. That's why I came in.

I know she's in pain. Of that there is no doubt.

-Yep.

-But, she needs to have some more pain, really,

before proper labour starts.

If you could, when she's ready to come out she can come out.

We cannot risk the dangerous practice

of filling the delivery unit up with people that are not in labour

when people might well come in that are very much in labour

or having various complications and they might well need to have a bed.

That's difficult.

She doesn't want to go home until the baby comes out.

Gill doesn't want to admit Lindsay too soon

but technically she can't send her home against her will.

-It's really hurting now.

-You what?

It's really hurting.

You keep walking about, try and keep mobile, sweetheart.

I think go to the dining room

or every time you see me, have a contraction.

-It's never hurt like this before.

-Oh, yes it has.

-Not this early on.

What do you mean, this early on?

Like without doing anything.

It's not hurt this much.

Well you won't feel great cos it's the end of your pregnancy.

Get a drink of water in there and take two paracetamol.

I promise you, as soon as you go into labour you can have the gas.

My life.

Just by the fact that I've got five beds,

that means I'm not bed-blocked,

so my only issue at the minute appears to be staffing.

It's not just beds that are a problem.

-A midwife's called in sick.

-Morning.

I can't grab you, then? I can't steal you?

There are now only 13 midwives on duty.

I could do with grabbing you for an extra pair of hands.

I've got this lady from upstairs who I can't leave.

-They've only got three up there.

-Threes on the wards as well.

I can't pull from MLU. I've pulled Glenys from management already.

-OK.

-Hello, my dear.

There might only be one midwife on induction of labour bay.

Well if she's actually here she needs to stay here.

I've not even checked over there yet.

Certainly when I've done the ward round I'll need to be letting

the deputy head lead midwife know what's going on,

just in case we get in a position where we can't provide care.

You soon realise when you look into midwifery

that it's about being with women.

Babies are a part of that, but midwife means "with woman".

That's what it means and that's what we're here for.

And the baby's the end result.

I would say it's more difficult to be with the women now,

than it used to be.

Obviously we give women as much time as they need,

but in the back of your head

sometimes you're thinking, "I've got a hundred other things to do."

And that's just your issue, you just have to deal with that,

cos that woman is the most important thing

and you have to give her the time she needs.

You have to make it your problem and not the lady's problem.

Are you all right there?

-Room one. Just through that door, first on the left.

-Thank you.

Hello, Triage. Can I help you?

With her first baby, you have a lot of work to do.

It's five o'clock on Monday morning.

After an hour, Lindsay is still refusing to go home.

She needs to brave it out a little more at home.

Home is where you go into labour, hospital is where you have the baby.

All right darling, goodbye. Not in labour.

Oh, now this is a good one!

-What do you want me to do?

-Make it stop.

Do you want me to put you on the induction bay and induce labour?

Do whatever you want to make this pain stop.

Make it stop? The only way to stop them is to have the baby.

-Make it bearable.

-Make it bearable how?

Gas and air works but you won't give me that.

I will but you need to be sat in a room and I can't keep you in.

-Why not?

-Cos you're not in labour.

But I'm going into labour.

-You're going into labour.

-I know I'm going into labour.

Right. OK. I know you can't cope. Neither can I.

And you know I can't. Don't you?

SHE LAUGHS

OK. I'll just find your notes.

OK. That's Thursday.

You've won.

Let's take you upstairs.

After two hours of pleading, Gill finally gives in and admits Lindsay.

I'll go and sort the baby out now.

Farhana Faruque and her student midwife have just finished

delivering their second baby of the night.

They're ready to look after Lindsay.

Her pains to me didn't seem to be labour as such.

But I can't not believe what they're telling me.

So I've got to act upon what I hear,

even if I may be thinking entirely differently.

Hello, Lindsay. I'm Farhana, I'm one of the midwives.

You've got me for an hour and a half,

so that's how long you've got to deliver this baby!

-OK. Do you want some gas and air? Is that what you want?

-Yes, please.

SHE GROANS

INHALES GAS AND AIR

SHE MOANS

OK, that's fine. You're about nine. OK? So we know it's labour.

Lindsay's made surprising progress.

It just goes to show how mums know best.

She says she has quick deliveries when they do kick in

and she's gone and laboured really quickly.

Fancy standing up?

On your knees? On the ball?

No, cos it hurts.

She's like a little foetus herself, isn't she, like that?

No.

Just take a little, just take some breaths.

That's baby coming round the bend there.

GROANING

OK.

Lindsay , hold your breath. Hold it in and push. Right into your bottom.

You're doing really well. Come on.

Let's give the baby some room. Come on.

Is that one gone?

It's gone. Off the gas.

No, I don't think we'll manage that.

You're very easy going in labour, aren't you?

Just sometimes you say no to everything.

Let's give the baby some room.

Focus on your pushing.

-SHE MOANS

-Is it stinging? That's baby's head!

-Tiny push.

-Bit of room.

-Just breathe for me.

-Breathe.

-Just breathe.

Baby's there. That's baby's head!

Baby's head. Look. Have a feel. Be careful. There.

Just let us deliver the baby.

SHE MOANS

-There she comes.

-That's it. Well done!

And a good cry for us straight away.

-Exactly half past seven.

-Oh!

-Look at all that vernix on her!

-Wow!

Hello, Eloise.

-Here we go.

-There we go.

-BABY CRIES

-So that's for you.

-Thank you.

Just in between. Just in there.

OK, fab.

Didn't we ask for a baby by half past? Delivered right on time.

I know! Spot on!

It was very, very normal.

Just the way mother nature intended it to happen.

I think I tried to bully her a little bit but it didn't work.

No. She knew what she wanted.

-PRODUCER: How many is that tonight?

-Three. Hat-trick.

-Hat-trick.

-Very good, hat-trick.

-Yeah.

-PRODUCER: So what next?

-Home!

-Bed!

-Bed!

Obviously, for mums, it's very special and, you know,

it's very exciting and sometimes very frightening for them.

But for a midwife, obviously, we'll know there'll be another one

right behind her and another one behind her

and another lady coming through.

OK, and how often are the pains coming? How long are they lasting?

And this one's 34 weeks but with tightening so they both need a CTG.

-Yeah, and whatever.

-Yeah, three and four.

Right. Is...

-I couldn't see that name, then. Leonie Crawley? Yeah?

-Right.

Are you on any medication at the minute, Carren?

If you put Miss Simpson in four then I'll know where I'm up to.

Just bear with me a moment and I'll find out.

-Come on, sweetheart.

-Do you want to make your way in?

And we'll check you over and see what you're doing.

-Where's the midwife from triage gone?

-She may be in with...

I thought she'd gone back.

It's Tuesday morning.

The number of women in labour is steadily increasing.

They pull a midwife off the triage desk,

leaving Ann Stapleton to look after four women at once.

We'll talk to you in a minute. Is that my lady?

BELL SOUNDS

-Yes, honey. All right. Come on.

-PATIENT GROANS

The patients rock up without always telling us

and there's only so many rooms and there's usually,

there's usually three of us on as midwives.

It's like the slowest lift in the world.

Carren has travelled 20 miles to be looked after

by the St Mary's specialist teams.

She hasn't felt her baby move in the last 12 hours.

Am are going... Is this the right place?

-Is this triage?

-It is.

-SCREAMS

I'll go and see. She seems a bit more distressed.

I'll come and see Carren in a minute. Are you OK, honey?

I'll be back shortly. Are you all right?

Thanks for that!

SHE LAUGHS

Well, there's a position! I'm Anne. Hiya.

-I haven't met this one.

-You haven't met this one?

-I haven't met you.

-Sorry.

-They all seem to know you. You either work here or you...

-I live here.

-Oh, does she live here? Oh.

Right. Has anybody looked at you yet? Felt your tum?

Can I have a little look? Have a quick read.

I'll get up while I'm all right.

-So it's your second baby, then.

-Third.

Oh, right. So your due date is the 15th. Lovely.

So tell me what's happened to you today, Carren.

Just gently seeing how baby is.

What did the last babies weigh, Dad?

-What's your name?

-Barry. They weighed...

Just while she's chilling. I thought she was chilling, then.

-Seven pound six.

-Sorry, love. Just relax, Mummy.

-Seven pound five.

-Six.

-No, she was seven pound five.

-Six.

-And eight pound seven.

-Right.

-All normal?

-Normal deliveries.

-Any problems after?

-No. just the cardiac defect with the second one.

Right. Did it need treatment?

-She died.

-Oh, sorry babe. Nobody told me that.

-We usually tell each other before we come in.

-It's all right.

-Don't worry.

-Right. Big breath in.

Take a big breath.

When you're ready. Just seeing how...

All right. You know, it is so busy out there.

I do apologise about that again but we do little things, well,

big things like that for yourselves...

-She was 15 weeks so we had surgery.

-Oh, no, you don't have to tell me!

-No, it's fine.

-But you don't understand.

We usually try and, within the madness of triage,

we usually tell each other if we can.

So I don't ask that question, I could read it.

-SHE GROANS

-I do apologise.

-It's not your fault.

Carren and Barry's second child, Lagan,

was born with a severe heart defect and died just a year ago.

Let's see if we can wake little'un up a bit.

Should he be moving, still?

Well we, we, it's obvious that there's...

-Let's see where your placenta is.

-Where is it? To the back.

-Is it to the front?

-To the back.

-Right.

Cos sometimes if there's placental tissue to the front,

you don't feel it moving so well.

The death of their last child makes the lack of movement an even greater concern.

It could be a sign that baby's distressed for some reason.

So we need to do monitoring on the baby,

and it gives us a good signal of how the baby really is.

It might be that, if we're seriously worried about movements,

she might have to be induced.

Have you had extra scans this time?

I've had one extra scan... two extra scans.

Have you found it all a bit more stressful?

Yeah.

I think however reassuring we are, with every test in the book,

until you see your baby...

Until I've had it scanned I won't be certain.

No, absolutely.

-It's going to the baby unit, that delivery.

-OK.

So she's on the monitor.

She just needs a VE then.

And she'll need a canula if she's going to go to 64 as well. I'll come and do that in a bit.

Worried about dips in the baby's heart rate,

Ann's called in the registrar.

Every now and again, when you're having a contraction,

baby's heartbeat is dipping down.

It's coming back up again but it is becoming a bit of a pattern.

So what I need to do really is pop you back on the monitor,

see if this is still happening, and if it is

I need to talk to my boss, about whether we can break your waters

and maybe bring labour on a bit quicker than it's already happening. Is that OK?

Yeah? I'll be back soon.

You all right?

You sure?

You're going to wet the bed before you get on it.

SHE SOBS

Every baby I've had has been in heart distress

at some point during labour. What is that about?

It's frustrating. It's upsetting.

Because it suddenly puts a lot of pressure on me.

How long has this pain been coming for?

Since about half-past-eight.

SHE GROANS

Joanne and Steve wanted a Caesarean section

after a difficult delivery with their first child,

but Joanne's gone into labour early.

We were booked in for a...

Booked in for a section on Friday

but he's decided to play today by the sounds of it.

Breathe some fresh air now, all right?

I'm going to examine you.

-Is that pain going away?

-No.

SHE GROANS

Ow!

-Ow!

-Come on.

Joanne, you're about seven centimetres.

You're joking!

Your membrane's, I can still feel your waters intact there.

Right.

I'm going to get the doctor to come and talk to you.

Do you still definitely want a section?

-Am I too late for an epidural?

-No.

If I can have an epidural and it works,

-because my last one didn't work, I'll give it a go.

-All right.

If she can get an epidural in, no, she'll go for vaginal.

-14.

-14.

I've not done her obs yet.

JOANNE GROANS

Joanne is rushed to the delivery unit for an epidural.

-Hello! Did we want to have a vaginal delivery?

-No, we didn't!

She was booked for a section on Friday.

Just try and relax for me, take some really big deep breaths.

SHE CRIES OUT

All right, darling, try not to panic.

I'm going to sit you up a tiny bit.

When she's examined, there's a problem.

Because you've done so well and so quickly,

I'm not sure we can put an epidural in,

because by the time we sit you up to get it in, you'll be ready to push.

OK? All right? But that's not it for pain relief.

We've got lots and lots of better stuff.

Joanne, try and calm down for us and breathe.

Just breathe.

It's all a bit of a shock, isn't it?

You got yourself to seven before you got here, so you did well.

I know what's what with a section.

-Please.

-Finish the pain.

-But you've done so well!

-I don't care.

Ultimately it is her decision

but we're looking at the safety of her and her baby.

WOMAN: Do you think women in labour

are the best judges of what they want?

That's a tricky one.

Yes and no.

Yes because their body's telling them

what they want and what they don't want

and what stage of labour they're potentially at.

But then some women do get those premature urges and do get

a little bit out of control and restless,

and I think at that point decisions can be a little bit irrational.

Please let me have a section.

'I try and encourage women to be as open-minded as possible

'cos you're never always going to get exactly what you want.'

I know, I know, but the thing is you're fully dilated and you've been pushing

so if baby's come down we'll be able to give you a hand out from down below instead.

Obviously with better pain relief. All right?

And that's safer for you and baby than it is trying to do

a Caesarean when you're fully dilated and have been pushing.

All right?

Hiya, Joanne. My name's Ann, I'm going to take you to theatre, OK?

-Yeah.

-I'll take good care of you, OK?

-Thank you.

-We'll get this baby out!

Thank you.

With the baby in a tricky position,

the doctor wants to give Joanne a forceps delivery.

If you just go in there

and the midwife will come and speak to you in a minute, OK?

'We had a baby two years ago on Sunday.

'Matthew James.'

And he died in our arms the April 1st at 21-days-old.

Matthew was an IVF baby,

it's taken us five or six years to get him,

and obviously we had him for 21 days,

and then a couple of years of trying now,

we were saving up to have more IVF,

and managed to get caught naturally.

We found out while we were away on holiday.

And then it's just been like a rollercoaster.

Been subject to a lot more scans to make sure this baby's OK,

and touch wood, fingers crossed, everything's OK.

So just need to get him here now.

-No pain at all now the spinal's in, so she's fine.

-Fantastic.

-Take a seat there, sir.

-Certainly.

Hi, Sweetheart. How are you feeling?

A million times better.

Take a little bit of tilt off as well.

-I love you.

-Love you too.

So, next contraction,

I'm going to pull and you're going to push like you've never pushed before.

Take a breath in again.

Right, now, just pant for me, Sweetheart, just pant.

Well done.

And you were worried about this childbirth malarkey!

Pain? What pain?

-Keep on pushing your bum.

-I'm trying! I can't feel anything.

-Yay!

-Oh, my God!

-Look at his face!

He's trying to scream there.

-No sound.

-BABY CRIES

There you go!

-Congratulations.

-Thank you.

Well done, Sweetheart.

You did really well.

I'll try and watch.

Could you have been a bit quicker? Four-and-a-half hours since you started having pain,

and you think you're no good at this bit.

JOANNE LAUGHS

-Nine pound one!

-He's a bruiser!

4.1 kilos.

Nine pound one!

Oh, my goodness.

It would have been his brother's birthday on Sunday, he would have been two.

It's a hard day for us but I'm glad he didn't come on his brother's birthday.

We want both the days to be special for each of them.

Your little brother's up heaven, isn't he?

Isn't he?

For that couple, I think what made it was because their first baby had died.

You think, now they've got a healthy little one they can keep,

and love, it's not got to be rushed off to SCIBU like last time.

I think it's just knowing how happy they are makes you really happy

to give that kind of gift to them in a way.

That really hurts.

Try not to worry. Try not to worry.

Remember, you don't have to press it, you know how to use it?

Self release. You don't have to press it.

You'll get too much, like Delboy.

Midwife Ann is looking after Carren and Barry,

whose baby has not been moving.

Carren Bell is going to room 5 on 64.

Carren's become a major priority

and will be transferred to the delivery unit.

Room 5, Carren Bell.

This lady is a para 2.

She had one neonatal death with the last baby in 2011

and she had multiple congenital heart defects, that baby.

You OK? We're just going round the back way.

Carren's second child, who died,

was born a year ago on this very same unit.

Come on then!

Do you want to stay sat out a little while, Sweetheart?

MAN: Does it feel weird to be back in the same place?

Um...

It feels like we've never left actually, to be honest.

Now I'm in here it's upset me.

It was on the end of the corridor on the other side.

It was about twice the size of this room.

I'm glad it's not the same room because I'd be a bit freaked out.

Baby machine, routine in every room.

They're set up in every one, with a heater and a light, OK?

And a little bit of oxygen.

Cos remember you've got oxygen in your gas and air,

so sometimes babies are startled, born quickly,

need help to come,

so sometimes it's just a little way of giving them a kick-start.

They're all set up, all cleaned, all checked, twice a day.

All right, Darling. Nothing to worry about at all.

-Right, so if we pop you in bed then.

-On the bed?

-We've got to do your waters.

-Oh, no! Right.

-You've never had your waters popped.

-Yeah, I did with Lagan.

Right.

I use my fingers to shield you from that little hook at the end

and protect you and it's there to pop waters.

It's just designed for that, not to touch you. OK?

We appreciate it's not a nice procedure.

There's been no let-up overnight.

Nine more babies have been delivered.

14 beds are now occupied, and the delivery unit is filling up.

Right, all sorted.

I've brought the midwife back to triage now, so they're fine.

Sorted. OK, see you later.

The lady in room two is a para 1 that's come across. Four centimetres, wanting an epidural.

The challenge is to try and free up beds.

She's going to try and come back into that room.

All right, let's see if we can have a look at that board.

With so many women in labour,

the hospital is in real danger of running out of beds.

If there is a problem, cos I can see there's a lady who's going down to Ward 66

because she's developed raised blood pressure and proteinuria,

which we need to monitor much more closely.

She'll go down to the high-risk ward.

-Have you got any more discharges? No?

-No.

-OK, thank you!

Thanks very much, toodle-oo.

We've got two more on the induction bay to come across.

But I don't want to bring any over just yet.

In society we're very much, it's our next turn, it's our next turn

and sometimes situations evolve that don't allow us to do it like that.

It's about the safety of the mum and baby.

So, there's lots of decisions that have to be made sometimes

and you try to explain that to the families.

But obviously when it's their baby they're very anxious anyway.

Charlotte is overdue and needs to have her labour induced.

She's been waiting for a bed on the induction bay for the last six hours.

-Hi Charlotte, I'm Jackie.

-Hiya.

-Are you all right?

-Yeah.

Good. I'll be looking after you. I'm going to take you into your bed.

I apologise for the delay in getting your bed.

There's been quite a lot of movement this afternoon.

It's so quiet.

The quiet before the storm!

The midwife needs to do an examination

to decide how best to get Charlotte's labour started.

Just stay nice and relaxed. Are you OK if I examine you now?

Excuse my hand, just shuffle your bottom down a little bit more.

Cold gel, sorry, Darling.

Someone talk to me. Seriously! About anything!

-OK.

-Come on!

Nice and central, baby's head is bobbing away when I examine you there.

You're two centimetres dilated so we probably can break your waters.

OK, so it's time to start moving?

You can have a walk around. The trace is lovely.

We'll get you off the monitor. I won't give you any Propess or anything.

-Get you walking around.

-Can someone get me up?

Yeah, of course.

-All right?

-Yeah.

People are told that when they come in for their induction of labour

that they expect to be done and dusted within a day.

So the expectations... We really have to say, "I'm sorry, but no,

"that's not the process."

Right, I've just come to let you know what's happening now.

Obviously you're two centimetres dilated,

so at this stage we won't do anything else for the rest of the night.

There's not a bed available on the delivery unit.

But there's other ladies who are ahead of you anyway, unfortunately.

There's nowhere for Charlotte to give birth

so the midwife can't break her waters.

She's left to see if her labour starts naturally.

Hello. Hi.

We've got a problem. We need to turn rooms around quickly.

We've got ladies that are going out of them and ladies waiting to come in to them.

And we have got - the domestic is going off now.

Its nine o'clock in the evening.

Liz has come on shift to take over from Ann.

-It's due.

-She'll be all right.

-Feeling more pressure down below?

-Not yet.

-MAN:

-Carren you've always been critical of certain midwives.

-How was Ann?

-Ann's lovely. So far!

-That's Liz. Ann's gone!

-Oh!

Oh, Ann was like what I think a midwife should be. Absolutely 100%.

Spot on.

Excuse me.

Good night.

She's nice because she explained everything, she was calm.

She enjoys the one-to-one.

Just has...an eye for detail with people.

Unfortunately I've got a lot to live up to then, haven't I?

No, I think you've been good cos you've sat with me already.

In Carren's circumstances, she's come in with reduced movements

and she's had a suspicious trace

and also with her history as well, things are quite tense really.

So you are really being quite vigilant

and trying to be calm for Carren really.

Carren, are you all right?

They may have got all these anxieties going on

and you may feel a lot of this anxiety yourself,

but you can't show it.

CARREN GROANS

Am I OK to examine you, Carren? Yeah?

I'm just trying to see whether...

I can't really feel much

I apologise.

You are fully dilated.

Well done.

Oh, I hate this.

Liz has found meconium in Carren's waters.

The baby has opened its bowels, a sign that it may be in distress.

That's it. Excellent. Excellent.

Nearly there. You are so close now.

Can I have a paed as well, please?

-Is he all right?

-Yes, yes, yeah.

You're doing a brilliant job, Carren, brilliant. Well done, well done.

Now just... Brilliant. Very well done.

Nice and slow.

Little pushes.

Blow, blow. No pushing, no pushing no pushing, no pushing, no pushing.

-Wonderful.

-There's baby's head.

There you go. Baby's head is out.

Next contraction.

I've asked the paediatrician to come as well, just because of the meconium.

Yeah?

-Very well done.

-Here he comes, here he comes.

-There we go.

-Hiya, bubba!

Hello.

Oh, you're beautiful. Hello. Breathe again. Please.

-All right.

-Hey, bubba.

We're just going to take him and dry him off.

Four minutes past eleven.

The paed's here.

They'll have a look in his mouth, give him a bit of suction.

He probably will just need a little bit of oxygen.

OK, but they're just going to give a little bit of suction in his mouth.

What's wrong with him?

He just needs a little bit of assistance.

OK?

Neonate.

-What are they doing to him?

-They're going to give him oxygen.

-Can you hear him?

-It's a long time two-and-a-half minutes when you're trying.

Did you just hear him then? He went, "Waaa!"

< He's having a cry under here.

-Is he all right?

-His heart rate's fine.

-His heart rate's good.

It's just doing all this pooing has just affected him, all right?

They've managed to get him breathing,

but they're concerned about his colour.

Very, very pale.

Just thinking with his heart rate

and the oxygen going into him that he would have pinked up a bit more,

so whether there's something else, I really don't know.

It could be another heart problem.

Baby was in a bit of shock when he came out.

His heart beat was always very good. It picked up.

He's needed a fair bit of oxygen

so he's probably going to need to go to the neonatal unit just for a little bit. OK?

Can I get a cuddle now or has he got to go now?

I think what we need to do is let the baby doctor decide, OK?

More baby people, OK?

Oh, God, why do all my babies do this?

Did you know that your baby had a problem last time?

-Mmm. We'd had him scanned and there was always this risk that he might have one.

-Yeah.

-But he's crying and stuff, isn't he? He's not flat, flat.

-No, no.

He is making some respiratory effort,

but he's just not doing enough, shall we say?

Last baby had a known congenital heart defect.

Last baby, last year.

It's unclear what's wrong.

The doctors decide to send the baby to intensive care

for an emergency blood transfusion.

When you see a baby come out like he did,

you just think,

"Oh, no, please..."

I hope everything is OK.

I hope there's nothing that's gone amiss

that I should have picked up on.

I worry all the time, all the time.

You do because there's always the unexpected that happens, like tonight.

We don't know what's wrong with baby,

it's just a waiting game, for all the results of tests.

It's one of the reasons we wanted to come back here,

because we know that, you know, if there is anything that does go wrong,

this is probably the best place to be, isn't it?

-Hi, are you OK? What's your name?

-Charlotte, I'm just trying to find out what's...

Hi Charlotte, I'm Emma, I'll be looking after you tonight.

It's Thursday evening,

Charlotte has been waiting to have her waters broken for 29 hours.

She said that they're going to do an assessment over there

to find out how long it'll be before

the people from here move over there.

-WOMAN:

-How are you feeling about it?

-Pissed off.

-Why are you pissed off?

Because I just don't feel that she's been getting any answers about what's happening.

One's telling us one thing and someone's telling us something else.

Charlotte's getting stressed with me because I'm getting worked up.

But all I want is an answer of when something's going to happen.

I think if you're firm but kind with people, they respond better.

If I have confidence then they have confidence in me.

We are always calm cos we're bred to be that way. That's just how we are.

She's not in there, is she?

-Anyone called Charlotte?

-Me.

-I'm taking you over.

-Never!

-Yes.

-Oh, my God!

-Have you been waiting a little while?

My name is Gill. I'm your midwife, I'm going to be looking after you.

-So, if you get your stuff ready.

-Yeah.

Just get your bags packed and all that jazz.

Go and sort that out now. I'll help you.

-Oh, my God!

-Don't be scared.

You haven't got much, really.

When the waters are broken, does that mean it'll happen tonight?

-It'll happen tonight.

-The baby will happen tonight?

-It will.

That's what I like to hear.

Nothing like positive thinking.

Finally, an answer. A direct answer.

-Yep, OK.

-Good luck, Charlotte.

I'm telling you, you'll deliver tonight.

-I like you.

-I do like that!

-I'm very scared now!

-You'll be fine.

-I like this lady.

-Anyone want to go back nine months and swap places?

-Don't be scared.

Your bed. Do you want to change into a nightie of ours

or have you got something to wear to have your baby in?

-I'll get into that to break the waters.

-OK.

Getting a bit of the daddy butterflies now.

Are you? Don't worry.

-I think it'll be nice and quick.

-I know she's in safe hands with you.

-I think it'll be nice and quick.

-Do you?

-I think so.

How many babies have you brought into the world...

-What's your name again?

-Gill.

-How many babies, Gill?

God, I don't know. Thousands, I think.

Thousands! Wow!

Yep.

Oh, yes.

WATER SPLASHES

Whoa!

SHE WINCES

Wow, you are quick!

She is quick. You've got these socks on, they'll be soaking wet.

That was brilliant.

Now, you're not going to have a pain-free labour.

-I know.

-But you will have, I think, a quick labour.

And a quick labour is better than a slow pain-free labour.

-Are you with me?

-Yeah.

-That's the truth of it.

I don't want to be... It's hurting!

I know it is. You can change to any position you like.

It's my hip!

Get yourself in a position where it's better, then.

Come on, son. Just get out.

Charlotte injured her pelvis seven years ago.

It's making her labour especially painful.

Don't know how I'm doing this with gas and fucking air.

Do you want some more diamorphine?

-Yeah.

-You do? OK.

I'll get you some of that in a minute.

What time is it?

-Not home time yet.

-No.

It's only us.

Charlotte, I've got you the injection.

I'm so tired.

I know.

Baby doesn't think very highly of these contractions.

Charlotte's labour is now progressing quickly.

Can I just check, please, there's no cervix there.

There's been bloody cervix the whole time.

-No, there's no cervix there now.

-Fantastic, baby.

Thank God for that.

-That's all that's slowed her down, hasn't it?

-It is.

OK, now, you're fully dilated, I don't want any panicking.

When you feel the need to push, just push. Baby will come.

OK, are you pushing now?

CHARLOTTE GROANS

Good girl. There he is.

Come on, another, bigger push.

Come on, big, harder shove.

That's it. That's it. That's good.

Arrgggh!

Come on. Big hard push, make it the biggest you've ever done.

If you've got one, I want you to shove it.

No.

Come on, big, big, hard shove.

Bit harder, bit harder. Come on.

Oh, yeah.

In your bottom, right down there.

Open up down there.

-I'm trying.

-I know you are.

Come on, bit more, bit more.

Good, good, good.

Keep pushing, even when you feel it's too much pain, keep on.

Good girl!

Come on, Charlotte. That's it. Get yourself mad with it all.

Oh, that's it.

Would you take my glasses off? They're doing my head in.

Come on.

If you push really hard, the baby might come right out with this one.

-Argh!

-Yeah?

-Get out!

-Get out!

Baby's head is now out. The worst is over.

You'll get another pain

and when you do, I want you to give it a good push.

This is the one, it's only his shoulders.

Oh, hold on, there is cord.

-Is he OK?

-He's all right.

-He's fine.

He's fine.

And up and out.

-Oh, my God.

-Oh, my goodness!

He's out and he's crying, look.

Oh, he's a lovely boy! Here you are.

And that all happened at 46 minutes.

Lovely, lovely.

Oh, no, no! Give me a bit of space.

I still need space for things happening down there.

-Why's he not crying?

-He will.

He's all right, baby, he took a breath. I seen him do it.

-Is he breathing?

-Charlotte, he's fine.

-Are you sure?

-Yeah, he's fine.

But why is he so dark?

It's just because he's been newly born.

I'll take him over to my machine and I'll give him...

He's fine. He's fine, he's fine. Hey!

BABY CRIES

There he is.

He's having a little cry.

He's fine.

Our baby's fine. Charlotte, he's beautiful.

He needs to have a little cry.

Do you need a paed?

Yeah.

He needs to have a bit of a cry.

Oh, no!

He needs to cry a bit more.

He's all right.

He's not! Look at them rushing around him!

They're just making sure baby's OK.

-Hey, honey, are you all right?

-No, he's not OK!

-He is, he's fine.

-He is.

Just recently had diamorphine? Yes.

In the last hour, was it? 40 minutes?

About the last hour.

He's just shocked at being in the outside world.

But he's breathing on his own?

-He's making a few whingey noises.

-Can I have a bit of oxygen, please?

BABY CRIES

There you are.

He's fine, honestly. He is fine.

He was born at 46.

-Spilling his lungs, yeah?

-Oh, he is.

He's fine.

There we go.

I'll just cover him up a little bit.

Hello!

Can you help me try and get him on the mobile?

Right, what I need to do...

-It's been lovely.

-You've been fantastic.

BABY SCREAMS

Nowt wrong with his lungs.

I think I need a cuddle!

It's been lovely.

-Have you got name bands for this baby?

-No, not yet.

Oh!

Obviously, the mum had had diamorphine within an hour of birth.

That does make the baby floppy

so that was why he took a bit of resuscitation.

Even after delivering thousands of babies,

things don't always go to plan for the midwives.

They're always learning.

It was floppier than I thought it would be, that baby,

so it did give me a fright.

Midwifery is a very challenging job.

If somebody told me,

"You're going to go in that room and this is going to happen,"

I wouldn't want to go in the room

but because you're doing it at the time,

before you've had time to think about it,

it's done and you've dealt with it. That's just how it is.

-Right. Shall we go, then?

-Yes, let's go for a walk.

If you need anything, Carren, press the buzzer, someone will come.

It's midnight. An hour after his son was born,

Liz takes Barry to see him in intensive care.

Got baby Bell?

-I shall see you in a bit.

-OK.

As you can see... Oh, sorry!

That's to protect his eyes from the light.

He was quite anaemic when he first got here,

so we're just giving him some blood at the moment

and I think it's making a difference already.

He's a little bit more alert than he was.

They've discovered the baby's lack of movement

was due to a huge haemorrhage.

The baby was bleeding into the mother through the placenta.

I know it's a lot to take in.

Yeah, it is a bit, but...

If you don't feel your baby moving,

you must come in and get checked out.

If Carren had left it any longer,

then the baby may not have survived

and she may have come in with, unfortunately...

..baby have died inside.

'I think she's very lucky.'

So she's gone to 66?

She is, yeah. In a single room, room four.

-OK, see you later.

-See you later.

So where are we going, 66?

A day later, Ann's back on shift.

She wants to find out how Carren and the baby are doing.

You see things that might have been peculiar to your own family history

and it just reminds you, when you get very upset.

We lost our first baby, actually, which is a long time ago now

and I know that gave me...

I wasn't a midwife then, obviously.

That gave me the push, I suppose,

to find out more about what happened to me

and to give some of my experiences back.

None of it was a bad experience, losing the baby was awful,

but I just wanted to be able to look after other women.

'In all the years I've worked, there's only one time'

I've ever shared it with a lady

because it's not about my experience, it's about their experience now.

So most women, I'll have that rapport and compassion and empathy

for what's going on around them

but I've never needed to disclose my own.

OK.

Hello? Hello, Carren.

Hello.

I did ring about half 11.

-So you didn't do too bad in time.

-Didn't do too bad in time?

We did say you might not get another examination!

-Sit down.

-Oh, thank you.

He was put onto Resuscitaire, and vented.

We were scared, if that had happened at home, he wouldn't have survived.

Yeah. No, there's no way, it's the resuscitation, isn't it?

Yeah, he would not have made it.

And we weren't to know that was going to happen.

Yeah, how do you pick that up?

So I'm so glad we were in.

He will get better, that's the good thing.

In the long term, he shouldn't have any lasting effects.

Carren's baby, Lochlyn, is recovering well.

In two days' time, they'll be able to take him home.

Very nice having you.

Thank you for looking after me.

-No, it's a privilege.

-It made a big difference.

Thank you very much.

-I'm going to have a little cry now.

-Ah! Going to cry!

Thank you very much.

-Tarara.

-See you later. Thanks.

-Bye.

Ah, ain't that lovely?

Very nice.

-You almost had a tear in your eye.

-I did.

I will after, I know. I've left a lady, so I feel a bit stressed

because even though she's lovely,

you just are aware of your colleagues looking after your lady.

-The next one.

-Yes, the next one!

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