How the Other Half Push The Midwives

This programme contains some strong language.

-Hi, it's the midwife.

-That's 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 before in your life.

-I apologise.

-You've not done anything wrong.

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

But now they're facing the highest birth-rate in 40 years.

Too many women having babies, that's the problem.

-Parents are more demanding...

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

-..And pregnancies more complicated.

-We're worried.

You know, we're worried.

When you see a baby come out like he did, you just think, "Oh, no".

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

It's the best feeling in the world!

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

This is the Wirral,

a small peninsula between Liverpool and Wales.

It's a place of two worlds, divided by the M53.

On the west are some of the wealthiest postcodes in Britain.

The east is home to some of the most deprived.

But no matter where they live,

the babies and new mums in the Wirral are looked after by the same team of midwives

from Arrowe Park Hospital.

Sometimes on a labour ward,

you have two babies from totally different backgrounds

and you think one baby's going to go back to a mansion

and one baby's not, but whose life's going to be any better?

You don't know, do you?

The midwife's job is very different

depending on which side of the Wirral they work.

Katie works in Birkenhead, on the east side.

In Birkenhead, there are a lot of child protection issues.

I have been in houses where the toilet was broke,

so they were actually going to the toilet in empty milk tins.

A lot of Katie's time is spent tracking down mums

who haven't turned up for their check-ups.

It takes up a huge amount of your time, really,

following people around.

You'd think it would be easier to turn up to a 15 minute appointment.

The midwives have come up with a plan

to deal with women who skip their appointments.

They put midwives on the high street.

A few doors up from Primark is a drop-in centre,

the only one of its kind in the country.

Do you want to feel his little head?

Katie works here regularly.

Today, she's seeing 18-year-old Rachel and her boyfriend, Tom.

Rachel is seven months pregnant,

but hasn't been to her last two midwife appointments.

-How have things been going?

-All right.

-OK.

-So you're 31 weeks?

-Yeah.

-So do you know what you're having?

-No.

-It's a surprise.

-Yeah, I don't want to know.

-Ah.

You're measuring a little bit under. It's 28 centimetres.

I'll just have a little listen in to the baby's heartbeat.

BABY'S HEARTBEAT HEARD VIA ULTRASOUND

It's a little bit faster than normal.

-Could be because I've just drank coffee.

-Might just be the coffee.

But just to be 100% sure, is it all right

if we refer you up to the hospital? I'm going to put you on the monitor,

you see, for them to have a little listen in.

-Is that OK?

-Yeah, when will that be?

-Probably now.

-Is that OK?

-Yeah.

There's a number of reasons why people don't come

and see the midwife.

They don't want to. Sometimes it's like an acknowledgement of the pregnancy.

If you see a midwife, you've got to acknowledge

that "I'm pregnant and this is really happening".

Rachel and Tom are sent to the hospital,

so the baby can be checked.

The midwives want to be sure the baby's heart rate is normal.

They'd only been together a month when Rachel got pregnant.

Her mum asked if we were being careful.

Which we weren't.

She told her mum that I bought condoms that were too big for me.

SHE LAUGHS

So her mum thinks I'm a bit of a...

It was literally just a drunken thing.

We were just messing around,

had one bottle of amaretto too much. So...

How did your mum react when you told her?

I was lying in bed,

and she must have heard me crying and came in.

And she just asked me, "Are you pregnant?" I was like, "Yeah".

Then she just went, "Right.

"Are you sure you want to keep it?"

And I knew abortions and things like that weren't really an option,

because I've seen so many people struggle

to even just become pregnant,

never mind miscarriages and everything like that.

Like, just because of my age and my circumstances,

doesn't mean I can just throw away that life so easily.

It's my own fault for getting in that mess.

If it is a mess, I don't know.

Do you really think it is a mess?

Yeah.

Yeah.

Tom is planning to move in with Rachel and her mum

when the baby arrives.

I don't know, it's quite scary.

It's a really new relationship,

and to be talking about moving in together, it's mental.

-But you see couples like that all the time.

-On Jeremy Kyle!

See, I've just got so many images of myself walking around

with a pram with some screaming toddler,

or, like, years later, on the school run, starting on the hoovering.

That's my idea of hell.

I think you don't see how you want to be as a parent.

But living round here,

you see how you don't want to be and what you don't want to do.

Like, I'd rather it hadn't happened.

But...now that I'm used to it, I'm excited.

Oh.

SHE LAUGHS

Good for you. Well done.

On the other side of the motorway, West Wirral is a different world.

This is where midwife Jan works.

This afternoon, we're going to visit a woman

who is 36 weeks pregnant,

and she wants to have a home birth.

Hi, Sally.

37-year-old Sally is a business development manager

for a multinational company. She's expecting her third child,

and knows just how she wants this birth to be.

So, home birth and a water pool,

-I would like.

-OK.

-The pool would be here?

-Yeah.

-Where's your bathroom?

It's just next door.

Check those taps,

-and check the pressure that the water comes out at.

-OK.

-It'll be lovely.

-Yes.

-As long as that floor's strong enough.

My first birth was in a hospital,

and it was really hard and it went on for a long time

and it was a bit of an emergency in the end, quite scary.

So once maybe you've had not such a good experience,

then you quite like to try and do the opposite.

Although midwives encourage women to consider home birth,

they also have to mention some of the risks.

Potential complications - you know, for somebody like yourself,

it's extremely rare for any of these things to happen.

First one on our list -

foetal hypoxia is where the baby's oxygen level

starts to reduce during the labour.

Shoulder dystocia is where the baby's head delivers,

but the shoulders get stuck.

Then there's placental abruption,

where the placenta abrupts or detaches from the wall of the uterus.

Umbilical cord prolapse.

There's a chance that the cord can come down

in front of the baby's head.

What you need to do is immediately push it back inside, and dial 999.

So can I ask you to sign this to say that

"I've been through all those potential complications",

to say that you want the pool and that

you understand that should these things happen,

we would strongly advise you to transfer in.

But at the same time, you know that they're not likely to happen,

and hopefully, they won't.

There are some people that do think,

how can you put your baby at risk

by choosing to have this birth experience and have this home birth?

Whereas my view is the opposite.

It's that, you know, I think it's the safest way,

and I think things that can escalate in a hospital

and the complications I had the first time...is more risky.

I love home births.

I personally had all my three children at home,

even though I was a labour ward sister at the time.

So I'm very in favour of keeping things as normal as possible.

Back at the hospital, Jan is making arrangements for Sally's home birth.

This is the baby resuscitation equipment, with the oxygen,

enough oxygen for the baby.

She's preparing a pack she'll send to Sally's house.

This is her pool, and these are the pool kits. Delivery pack.

Suture set for stitches, should she need it.

Splash glasses to protect our eyes. This is all just-in-case stuff.

You don't actually need much to deliver a baby

except a pair of gloves,

cord clamp and a pair of scissors.

Jan runs classes for expectant parents in West Wirral.

The classes here are almost always oversubscribed.

Most of us, especially when having our first baby,

realise your tummy's getting quite big,

and the exit route is quite small.

And you start to get a little bit worried about how it's going to fit.

Once you're pregnant,

you do not have control over your physical body, really.

It's happening. It's happening to you.

And some people like to be in total control.

I find highly educated,

well qualified professional women to need a lot of psychological support.

You can dance your way through your labour.

Arms round your partner's neck.

You can be whispering in her ear to keep her calm.

Often, you see them sort of think...

you know, "The baby's in there.

"I don't really want to think about how it's got to get out."

And then pant.

SHE MIMICS PANTING

I encourage all my women to come to a class like this

with their partners.

Visualise your cervix just going...opening.

Remember, it's nothing to be afraid of.

It's not pleasant, but it's got to be done.

Over in the east, Katie is on her way to visit an expectant mum

in one of the most deprived areas of Birkenhead.

There are more health problems here than in the west,

and life expectancy can be as much as 15 years shorter.

Katie is making a home visit,

because the mother didn't turn up for a blood test yesterday.

You all right?

-How are you getting on, Danielle?

-OK.

-Baby moving OK?

-Kicks every day, yeah.

-Ahh.

Have you got any ideas about names?

Yeah, Danielle wants Riley, off Hollyoaks.

Bruce and Danielle's third child is due in two weeks.

Danielle's iron levels have been unusually low during the pregnancy.

Katie's worried that this could lead to complications in labour.

I explained to you yesterday that I've got to do your blood again,

and see if we can find reasons for your blood being a little bit low.

Go over that way with that. I don't want to see it.

-You'll have to turn your head that way.

-I'm watching my telly, thanks.

All right, you sit and watch your telly. I'll do this.

Bruce and Danielle are both unemployed,

and the family rely on benefits.

They haven't had a cooker in their house for almost a year.

Press on there as hard as you can.

So are you eating plenty?

Yeah, I eat sweetcorn in a lot, like.

And green things as well, broccoli and stuff.

-And raisins are good as well. Don't you like raisins?

-No.

How have you got on without a cooker?

Microwave, chip pan, chippy, kebab shops.

Are you a good cook?

-I do home-made lasagne and macaroni cheese.

-Ooh!

Better watch out. I'll be coming round here for some dinner.

I'll see you later. See you next week.

Say bye.

They eat a lot of takeaways and fast food.

So obviously, there's not much iron in a pizza.

So it looks like it's been the diet,

but they are working with the family support worker

and they are working with them to go to cooking classes and things.

Rachel's come back to see Katie at the Birkenhead drop-in.

Last week, there were concerns about her baby's heart rate.

BABY'S HEART BEATS OVER ULTRASOUND

-That's better than last week.

-Yeah.

Are you going to be living at your mum's?

Yeah, I'll be staying with her.

I don't know what I'd do without my mum helping me with the kids.

How's your mood and everything going?

-That's not great.

-Feeling a bit down?

-Mmm.

How come you're feeling a bit down?

Because I don't, like, I don't want it.

So I suppose I'm not excited about it.

Without sounding weird, like,

you're meant to want all these things for your children

and stuff like that.

But...I couldn't give a stuff at the moment.

Like, I have no instinct, maternally,

to look after this thing in my belly at the moment.

But I suppose it'll be different when it's born, hopefully.

Rachel's feelings about her baby

have raised concerns amongst the midwives.

She's been referred to Helen,

a midwife who specialises in mental health.

-How do you feel about this baby now inside you?

-It freaks me out.

You know like when people say "Oh, it's beautiful and natural".

It's like, it might be natural, but it doesn't mean it's beautiful.

So if you don't think it's beautiful,

how else would you describe how you feel about it?

-Do you talk to the baby at all?

-No.

No. Are you looking forward to the baby being born?

-No.

-OK. Do you feel the baby wriggling around?

-Yeah.

-See, I find that annoying. I don't find that sweet.

-OK.

I'm picking up very much

that you are not having any bond, really, with the unborn baby.

She is a concern. She's somebody we need to watch closely.

Mainly, I think, from an emotional point of view,

because obviously, she's got to be able to look after her baby

when she gets home, and that's challenging at the best of times.

Whether or not we're going to be able to make everything smooth for her,

I don't know, but I do hope that with Rachel,

we can turn things around for her so that she can enjoy her baby.

Midwife Cheryl works in east and west Wirral.

She sees how families on both sides cope with their new arrivals.

Today, she's making home visits on the east.

-Have you noticed any lumps, bumps, bruises, rashes?

-No.

Nothing you're worried about?

And underneath, is that OK?

-You didn't need stitches?

-No.

-OK.

You know in the next couple of days, round here, Dolly Parton, yeah?

Or should I say Jordan? Tell him to get his camera out.

You see that a lot in Birkenhead,

where they just get on with it and do it.

It's not like an illness or a massively big thing to them.

It's so easy, in a way, to look after the girls from Birkenhead,

because that's what they do.

They don't want you for anything, really.

It's a big difference between them and the West Wirral women.

A lot of them are career people,

so it's a big shock when they have a baby.

You can be there for two or three hours,

just chatting to reassure them that they're doing everything right,

because this baby's not conforming to the standard they're expecting!

Is the snorting definitely normal? He does it quite a lot. He's like...

SHE SNORTS

-Is that a normal noise?

-Yeah.

It's normal for them to have a bit of dry skin as well.

I'm not really worried,

but it's because I started reading about it, and I was like "Oh".

Every new mum probably gets worried

-that their baby's going to die at some point.

-Everyone worries.

They are really emotional, you know.

I feel like I want to do that with a wand

and make it right for them,

when you know...the sensible part of your brain says you can't do that.

But actually, the caring side of you wants to just do that

and make it all right, you know.

DOG BARKS

-Molly!

-In West Wirral, two midwives will attend Sally's home birth.

There's a chance that she won't have met them before,

so she's hired a doula,

a private birth partner who'll be with her during her labour.

Today, Anne's come round to go through the birth plan

Sally's written for the midwives.

"We'll create our own birthing environment,

"a peaceful and quiet room with dimmed lighting and relaxing music.

"Contractions to be referred to as surges,

"and no references to pain or hurt.

"All decisions to be made by us.

"Questions to be directed to Anthony and you,

"so that I can do the breathing.

"Calm, low tones, free of pushing prompts.

"And breast-feeding as soon as possible". That's great.

On the east side,

midwives deal with ten times more teen pregnancies than in the west.

The Wirral's teenage mums are seen throughout their pregnancy

by midwife Camilla.

-Are you still with Jake?

-No.

-Is he still going to come and see the baby?

-I don't know.

And your family's happy about everything that's going on?

Are you going back to school after the baby?

Yeah, I'm going to stay on in the Hospital School.

Yes, a lot of our young women are from areas on the Wirral

that are known more for deprivation.

The reasons behind that could be a history of exclusion from school.

They might be the daughters of young mums themselves.

There's a level of acceptability. It's what you do next.

Camilla is concerned that Rachel is finding pregnancy

more difficult than most young mums she sees.

Hi, Rachel. How are you?

-I'm OK.

-Are you?

-I suppose.

-Ish.

-Yeah.

Is there something you're scared of?

Labour, delivery, is there an aspect that's stopping you getting excited?

No. You know, I'm not stupid.

I know labour's going to be bloody painful.

But because you're feeling quite ambivalent now,

that doesn't mean that's going to go on for ever,

I promise you that, OK?

You're sort of expecting the worst. I think that's your fear,

that you're going to see this baby and not feel anything for it.

You're not going to bond. You're worried.

I'm expecting to fall in love with it, because it's natural.

It's natural to do that,

so you think it's going to happen, but what if you don't?

Plus, I think it's the fact

that me and my partner are still really new, and I didn't want...

you know, that was a bit embarrassing, to be honest,

to be with someone a month, and you're up the duff.

I think somewhere along the line, you're judging yourself a little bit.

Yeah.

Because I look at other 18-year-old mums, you know what I mean?

-And now I bloody am one.

-Yeah. OK.

So, yeah.

You've not actually done anything wrong.

You've not done anything wrong.

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

So embarrassment and guilt

have just got to come out of the equation here, babes,

because you've got nothing to be embarrassed about.

You've got nothing to be guilty about. OK?

-I'm going to get you some tissues.

-OK.

Bollocks.

-Are you OK?

-Yeah, I think it's just hit home now.

She's hit the nail on the head there.

I am just judging myself.

-Just loosen that for me a bit, Danielle. What's your name?

-Bruce.

Bruce and Danielle have come into hospital. Danielle is in labour.

-Midwife Sue is on duty.

-You're more than five, actually.

I could stretch it to what we wanted! Very stretchy.

I've had everything sorted for the last five weeks.

If it's a girl, then the boys will be excited.

And so will Bruce as well.

I'm done then. I'm not having nine more. I've had enough.

I won't not be looking at the baby when it comes out.

I'll be at the top end. I can't stand blood one bit.

Keep your blood to yourself.

Though her labour is progressing quickly,

Danielle is coping with just gas and air.

Wiggle, wiggle, wiggle.

DANCE MUSIC PLAYS

Bruce, I think, is just particularly excitable at the moment.

He's quite excited. That would drive me nuts if I was in labour.

I don't dislike the music,

but it's perhaps not the most appropriate stuff.

But not everybody's into whale noises either, are they?

I'll put it on the baby, and you'll see the feet kicking.

You've not had any kicks in there at all, have you?

It's being good this time.

Just a sec - Bruce, sorry.

Are you getting a bit of pressure?

Yeah. Oh, well. Moving on a bit.

SHE GROANS

-Oh, it hurts!

-It does. Take another suck on your gas, Danielle.

Nearly there.

Oh, here we are. Baby's out.

Wahey!

Hello!

Do you want to lift the baby up yourself? No?

What's that?

-It's the baby.

-Oh, is it? Sorry.

-There's your baby.

-I'm sorry if I drowned you!

-You haven't!

-Oh, it's a little boy!

-It's a boy.

-It's all right, babe. Don't worry.

-He's fine.

I've got no room for manoeuvre.

Can't believe it's a boy again. I wanted a girl.

He's beautiful.

I'm a bit gutted. I wanted a girl,

but at the end of the day, it's a little boy. But you should be happy.

She was brilliant.

It was just at the end, before she started to push,

she made a bit of noise then.

Otherwise, she was silent, wasn't she?

And the placenta plopped out nice and quick as well.

Four miles away in West Wirral, Sally is now a day overdue.

She's doing everything she can to get things started.

These are my hypnobirthing images,

to help with the visualisation, to help...

I have to imagine the thinning and opening

of the cervix,

which is represented by the picture.

It's just supposed to help bring on labour, really. Come on, cervix.

The midwives have told Sally to keep mobile

if she wants to bring on labour.

I don't want him to stay in there much longer

in case he gets too big,

and it's more difficult to get him out then!

So that's why I'm keen for him to come soon.

I'm not very good with pain either.

Despite the fact that I'm having a home birth

and trying not to have any pain relief,

I'm not the best with pain!

Jan has offered to visit Sally at home

to see if she can hurry things along.

DOORBELL RINGS

I'll examine your inside, see what's happening in there

and see if we can tickle this labour into coming.

-Good. Right, touching the head now.

-Touching the head?

Yeah, just going through the cervix.

This is where the baby has a little head massage.

-There's not a lot of hair on it.

-Isn't there?

OK, are you ready for this?

Take a deep breath in,

and breathe out slowly.

Well done.

Right, we'll do one for the road, and then we'll leave it be.

Big breath in. And breathe out slowly.

OK, well done.

Coming out.

Sally knows that if she's more than two weeks overdue,

it'll no longer be safe to have the home birth she wants.

-See you tomorrow.

-Oh, I hope so.

All right, bye.

Bye-bye.

Had you literally just pulled in at the car park when he popped out?

Back at the hospital, midwife Sue has had an unexpected arrival.

You did deliver? I thought it was just...

Gemma, a young mum from Birkenhead,

has given birth in the back of an ambulance.

While the baby arrived in the ambulance,

the midwives still have to deliver the placenta.

Just pop it out. It's coming on its own. Good girl.

SHE PANTS

The pain started at four o'clock,

and what are we now? Quarter to seven.

That is incredibly fast for a first labour

by anybody's standards, isn't it?

And she's had a lovely, low-risk pregnancy.

The placenta looks lovely and complete and healthy.

And baby is fine.

Younger girls often labour extremely well.

It just goes to show you're in your prime for having babies

when you're sort of late teens, early twenties.

Professional women tend to leave it as late as possible now.

They want to have it all -

the career, the nice car, the holidays.

And by the time they test their fertility,

they unfortunately sometimes find it's too late,

which is sort of what happened to me, actually, but that's another story.

I am making a right bloody mess here, aren't I?

Gemma is taken upstairs to the maternity ward,

to recover with baby Ollie.

I love his little nose.

I'm glad I had him when I had him,

because I'm 22 and Lewis is 24 now,

so I think if we'd left it any longer,

I'd have felt a bit old.

People have babies really young nowadays, don't they?

So I feel quite old at 22, just having my first,

cos all my mates have got two by now.

Come in.

Hello, everyone, I'm Jen, one of the community midwives for Birkenhead.

I'm going to start on the MLU, which is the midwife-led unit,

which is this part.

Rachel and Tom have come on a tour of the delivery suite.

Their baby is due in five weeks' time.

I definitely recommend you all try and go in the pool.

There's a little seat.

Mums can sit on that,

but I recommend that you don't sit on that.

I recommend that you crouch over, like that.

Dads, unfortunately, you can't whip your Speedos on and jump in,

because the pool, as you can see, isn't that big.

Also in these rooms is the gas and air, if you want it.

Years ago, they used to say it was like laughing gas,

but I doubt you'll be laughing when you use it.

Come in. This is baby Riley, born today at 2.28.

And he's lovely. He was only born today, so he is really a newborn.

And he's gorgeous. This will be what yours looks like. Look at his hair!

He's gorgeous, isn't he? And a lovely weight.

So this makes it feel more real for you,

because it won't be too long...

It's scary seeing a newborn baby in front of you,

because you see pictures on Facebook and things like that.

But when you actually see a real newborn baby...

Aaahh...

I'm getting really freaked out.

Three weeks later, Rachel's baby is making its presence felt.

I find it funny when it punches and stuff like that sometimes.

Like, you can see it moving now.

You can just watch feet and hands running over your stomach.

There's something kicking and punching you from the inside.

Other than that, I've got no real feeling towards it.

I've got no real bond.

But I've got no real hatred or anything like that either.

Like, I can still be a great mum, without loving him...maybe.

-But would you want that?

-No.

It's not great, really, is it?

If you don't feel love towards a child,

why would you bother looking after it and stuff like that?

You think that you should get pregnant

and you should feel a sudden urge, this gush of love

and be all maternal about it, and some women aren't like that.

Some women are like that, some really enjoy the pregnancy,

but some women aren't like that.

With some women, it takes time to bond with the baby.

Even after the baby's born, it takes a few weeks to bond with the baby.

The day after Danielle is discharged from hospital,

Katie has come to do her first check-up.

No answer.

Usually, though, on the first day,

they've been up all night, haven't they?

Hi, Bruce, it's Kate, the midwife.

You're on your way home now?

I just need to check Danielle and the baby.

Were you off to Birkenhead, shopping?

You've got to be careful in case she has a bleed or anything.

You'll end up back at the hospital.

Is it all right if we have a little look at him?

-Yeah, I'm just going to take this bit of sick out of his mouth.

-Oh.

Do you want me to take his little coat off?

No, I want to take the other one to school and stuff.

-Take it easy, Danielle, you know.

-Oh, I will do.

-How's your cooker getting on?

-What cooker?

-I thought you got a cooker?

-Got rid.

-Why?

It's too high volume.

It could blow all the leccy. Got to sell it and get a new one.

I was waiting for my macaroni cheese!

I was waiting for my own home-made lasagne.

-You're doing well, but you just need to take it easy, OK?

-Yeah.

"Advised to rest".

Four days after her due date, Sally's waters have broken

and she's gone into labour.

Jan isn't on shift tonight. Lorraine is the midwife on duty.

She'll be working alongside the doula, Anne.

I've never, ever worked with a doula,

and I think they're an extra supportive birthing partner, really.

That's what they are there for. We are the prime care-giver.

Obviously, I don't need to build such an intense relationship

with Sally, because she's got that from the doula.

I think she just likes to have the safety of us in the background.

Blow out through the mouthpiece.

-Oh, it feels so much better being in here.

-Yeah.

Sally has asked her husband, Anthony,

to keep the water in the pool at the right temperature.

-No!

-What?

That bucket, I've been cleaning the floors with,

and it was filthy.

Ugh!

An hour later, a second midwife, Michelle, arrives,

ready for the delivery.

The midwives keep a close eye on Sally,

but because she has a doula looking after her,

she doesn't always want both of them in the room.

You're joking!

Just after five in the morning, there's a noise from upstairs.

That was sneaky!

BABY CRIES

-Oh, fantastic!

-Where's Anthony?

Anthony, we've missed it!

-Oh, my God!

-It was just me and her!

Oh, let me see you!

You're beautiful!

Oh, he looks like his brother and sister, doesn't he?

After six hours in labour, Sally has given birth. It's all gone to plan.

Look at that little face.

She was so in control, you know, it was just great.

She sort of breathed him out more than she'd done anything else.

It was just amazing. Amazing. Good job well done. She was a star.

Eight pounds eight.

I'll just let you know we've delivered.

Yeah, delivery at five o'clock. Placenta's out and everything.

So we'll be heading back probably by around seven o'clock-ish,

something like that.

Whether I feel I supported them or not makes no difference.

It's what she feels.

At the end of the day, this is her delivery, not my delivery.

It's how she feels, and if she felt that we supported her

and she got the delivery she wanted, that's all that matters, really.

On the east side,

Katie is on her way to visit a mum who gave birth two weeks ago.

But she won't be examining the newborn baby.

It has already been taken into care by social services.

It's hard being a midwife in Birkenhead.

I mean, when you first start dealing with it, it's a big shock.

I'm not saying it gets normal. It doesn't get normal.

It doesn't get easier, but it is part of your job.

Katie has been in close contact with the mum throughout her pregnancy.

Hiya, you all right?

The mother of the baby has chosen not to be identified.

-How about your legs, any pain or swelling?

-Er...no.

I've just had a bit of back pain.

This isn't the first time that social services have been involved.

She's had a number of other children removed at birth

because of very serious allegations made against the father.

In the weeks since this birth,

she has been allowed to visit her baby under supervision.

How's the baby doing?

-He's taking his bottles, sleeping through the night now.

-Is he?

-He's doing well, isn't he?

-He was doing it in the hospital.

-Model child.

-All my babies asleep through the night.

-Ah.

It's really sad. It pulls at your heartstrings.

It is the right thing to do for the baby at this moment in time, so...

But I don't think it makes it any easier when you go in there

and there's the empty Moses basket.

And it was brought up in a lot of the meetings

that maybe she should be offered to be sterilised.

But it's her human right, isn't it, to have children.

Whether it's the right or wrong thing to do, I don't know.

But you can't sterilise nobody without their consent.

You know, is she going to come back in ten months' time again

pregnant, and we're going to go through the whole situation again?

The mother has given Katie a thank you card.

"To Kate, happy Christmas and all the best.

"PS - thanks for all the support you have given me

"when I have been pregnant.

"It really means a lot to me and baby."

You just wish there was something more that you could do, don't you?

But...

I think it's the world, isn't it, that we live in?

Which is sometimes lovely and sometimes horrible.

Rachel has come to hospital with her mum and her boyfriend, Tom.

OK. All right, come on in, mister.

Tell me a story. What's been going on?

I've been getting contractions since, like, midnight last night.

-How often are they coming?

-They were every three to four minutes.

Chill out, put your feet up on the bed.

-What names have you got for this baby, then?

-None.

-None?

-Is it a baby girl or boy?

-Don't know.

OK, let me have a feel of your tummy.

The head's lovely.

That's normal. I don't think you're in active labour.

She's three centimetres. OK.

Right, one to ten. That's where you are.

You've got to get to that.

-Wow. That's so cool!

-What, that's cool?

-Yeah!

-Like, your body can do that.

-It's great, isn't it?

You're doing it yourself, so you're doing really well.

I thought I was in labour.

Come on, then, let's go.

Rachel is sent home to wait for her labour to progress.

People keep texting me saying, "Is there any baby news?"

There obviously wouldn't be,

because I'd write something quickly on Facebook.

I'd write something quickly on Twitter, just to let people know.

So I don't understand the point of asking me.

It's just really...especially because nothing's happening.

A day and a half later, Rachel comes back to the delivery ward.

The contractions are getting a lot worse.

Contractions are getting a lot worse.

-What number baby is it, love?

-Huh?

-What number baby?

-One.

-Number one. OK.

A bit cold on your tummy.

BABY'S HEART BEATS VIA ULTRASOUND

Happy little baby.

She's still three centimetres dilated.

RACHEL SIGHS

I know, it can take a long, long time to actually get into labour.

She'll know when she's in labour.

In the early hours of the following morning, Rachel is back again.

So your waters went at 2.45?

-Yeah.

-Just breathe and blow, long and slow.

Fuck.

Oh, what are you doing, man? What's he doing?

Breathe in.

Fabulous.

Going to give your secrets away in a minute on this. Breathe in.

Only joking. Breathe in.

You going woozy yet?

-Do you like it?

-Little bit.

-Right, OK.

-That's a pretty ball.

-That's a birthing ball.

-Do you want to sit on it?

-No. It's pretty, though.

Do you like it? It's all right.

There we go.

SHE CRIES OUT

There's nothing you can do.

You feel like you should help, but you can't.

I want to be, like, with her, but she's also got her mum there

and the midwife, and I've just got to kind of sit back,

because I don't want to overcrowd,

but I don't want to look like I'm not bothered.

How are we doing, love?

-All right.

-All right? You look a bit tired. Bit spaced.

I haven't slept in four nights.

I think she's not that enthusiastic at the moment. It's scary, isn't it?

She's young, it's scary, it's not what she planned.

But she's doing well, she's progressed. She's six centimetres.

Be positive. She's more than halfway there.

I don't know where her pain threshold is.

She's just mentioned an epidural.

I don't think she needs an epidural.

If she wants one, she can have one. It's up to her.

I'm wondering if there's anything...

I was just going to say, do you want some paracetamol?

Yeah. Is there anything, like, you know, like...hardcore?

-Drugs?

-Drugs. Give me your drugs.

< SHE LAUGHS

-Not at the minute.

-Oh.

-Paracetamol are very good, OK?

-Right.

Nice, deep breaths. Come on. Stay nice and calm.

Good girl.

I just want you to really listen to me,

and I'll talk you through every step of it.

-OK. Can I not have an epidural?

-No, you're not having an epidural.

-It's a bit late.

-Oh!

If you want to use your gas, take a nice breath on your gas.

Listen to your body, do what your body's telling you to do.

SHE SCREAMS

Go with it, Rachel. Nice breaths.

Go with it. Well done.

Good girl.

Breathe through for me.

You did fantastic there. You pushed your baby out.

The baby's coming round that little U-bend.

-Can you see the baby yet?

-Not yet.

-OK.

-Almost.

Want you nice and relaxed.

Take another breath.

You can't push if you haven't got breath in your lungs. Go on.

That's it. Good girl.

What's that? I can feel something.

That's the baby's head.

-Stretching everything. Are you all right?

-Yes.

-Are you OK?

-Yeah. Don't worry about me.

-Another big breath in.

-I can't do it!

-Yes, you can.

Another big, big push. Go on.

Oh, shit! Oh!

You're allowed to swear when you're in labour, love.

Go with your body.

Next big push, baby's head will be out.

-The head's not out?

-No.

Big, big push, into your bottom. Big push. Go on.

RACHEL SCREAMS

Rachel, look down.

Rachel, look down. Look down.

There's your baby.

Happy birthday!

Do you want me to tell you, or do you want to have a look?

-I'll have a look.

-You have a look.

You've got a daughter.

BABY CRIES

Hello, baby.

Happy birthday, young lady.

They just do it. They know they've got to do it, and they do it.

Whatever kicks in, I don't know,

but she just controlled herself so well,

and you've seen the result. Beautiful.

We all get it. We all get that little choked bit.

It's a very, very privileged position,

having your hands on that new life.

Room four, delivered. There we go.

Hiya. Congratulations! I heard you were a star.

BABY CRIES

She's got a voice already, hasn't she?

Oh, she's lovely, isn't she?

When you've had a sleep, you wake up and think, "Is that mine?

"What do we do?"

-What have we called her?

-Rose.

-Rose! Like Titanic!

Rachel stays in hospital overnight.

The following day, Camilla, the teen pregnancy midwife,

comes to see how she's coping.

Hello! Hiya.

So how are you feeling, sort of bonding-wise and stuff,

or is it too early to tell?

At the moment, I think I'm just getting to know,

because I'm not confident picking her up or anything yet.

But I feel all right because, like, she's mine.

-Do you feel proud of what you've done?

-Yeah, she's pretty cute.

-She's fantastic!

-She's pretty cute.

-You did make that from an egg.

You had a bit to do with it, young man.

But honestly, you grew her from an egg.

You've got a whole other human being there and you made her,

so you should feel really clever and really proud.

-Breasts are fine?

-Yes.

-Bowels all right?

-Yes.

-You know I can visit for up to 28 days.

-Yes.

But I'm not concerned in any way about you or about Charlie.

-Very best of luck. Look forward to seeing you next time.

-No!

I think three's enough.

So I'll see you in about 18 months, two years, max?

-No!

-I think you said that last time!

-I did, yes.

-Bye-bye, little boy.

Bye, Sally. See you in a couple of years. Bye.

SALLY LAUGHS

You all right to turn the music off?

Turn it off for a bit while I'm here, for my final time.

In Bruce and Danielle's house, the baby isn't the only new arrival.

Let's have a look.

Oh, isn't it great?

You will be a super chef, won't you?

He's lovely, isn't he? Yeah.

Blue eyes.

Contraception - yes, you're on the pill.

But we don't want no more babies. Eh?

Ta-ra, Bruce! See yous again.

Bye!

You're a bit sad to see them go,

because you've looked after them for a while

and been involved in their life for a while.

Rachel and baby Rose have been discharged from hospital,

and are going home for the first time.

-She's really bloody cute. She's really cute. Isn't she cute?

-Yeah.

I just want to...umm!

That's all you need, isn't it, in life?

You know, love, isn't it? Love and support. You don't need money.

You don't need materialistic things.

It'd be nice, but, you know, it's two different worlds, isn't it?

But they all come out the same way, don't they?

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