0:00:01 > 0:00:04Hello, ward four, Midwife speaking.
0:00:05 > 0:00:07Don't panic, it's going to be over soon.
0:00:07 > 0:00:09With the highest birth rate in 40 years...
0:00:09 > 0:00:13Look what you've done!
0:00:13 > 0:00:15You are just amazing, look at him.
0:00:15 > 0:00:18..midwives are under more pressure than ever before.
0:00:18 > 0:00:20You are kidding me,
0:00:20 > 0:00:22we have a lady on the table in theatre waiting to come out.
0:00:22 > 0:00:24We filmed in busy maternity departments
0:00:24 > 0:00:26in Birmingham...
0:00:26 > 0:00:28Manchester and Cardiff.
0:00:28 > 0:00:31Six-eleven, I reckon. He's about six-eleven and a half.
0:00:32 > 0:00:35As the midwives deliver the next generation...
0:00:35 > 0:00:37The scary thing is, you're all going to be midwives.
0:00:39 > 0:00:40..with care...
0:00:40 > 0:00:41Oh, please help me.
0:00:41 > 0:00:44We're here, we're here, we're here. You're all right.
0:00:44 > 0:00:45..and dedication.
0:00:45 > 0:00:48My baby's life is in YOUR guys' hands, that's it now.
0:00:48 > 0:00:51Not good for the stress levels, this job, at all.
0:00:51 > 0:00:54You'll be absolutely fine, I told you I'd be with you, OK?
0:00:54 > 0:00:56It does touch you.
0:00:56 > 0:00:59This is the reason we do what we do. It's OK.
0:00:59 > 0:01:00You smell nice.
0:01:00 > 0:01:02It's more than a job, it's...
0:01:02 > 0:01:05You're part of somebody's life and they never forget you.
0:01:19 > 0:01:24This year, over 8,000 babies will be born at Birmingham Women's Hospital.
0:01:24 > 0:01:27The birth rate's actually doubled,
0:01:27 > 0:01:29or even more than doubled since I started.
0:01:30 > 0:01:32The turnover's faster, much faster.
0:01:32 > 0:01:34How was that one?
0:01:34 > 0:01:37It's one of the busiest delivery units in the country
0:01:37 > 0:01:40and deals with an increasing number of high-risk women.
0:01:40 > 0:01:42Keep going, keep going.
0:01:42 > 0:01:44Over the years, got used to this very fast pace
0:01:44 > 0:01:47and I don't know how to go slower any more.
0:01:47 > 0:01:50It's top gear all the time.
0:01:50 > 0:01:51ALARM SOUNDS
0:01:52 > 0:01:56With only 21 beds, planning for 600 births a month
0:01:56 > 0:01:59is one of the toughest parts of the job for the senior midwives.
0:02:02 > 0:02:04So there's six, they're all waiting for...
0:02:04 > 0:02:06Yeah, and then we've got three.
0:02:06 > 0:02:09So, four - no, three.
0:02:09 > 0:02:12So there's nine women waiting for ARM. Just write these notes.
0:02:12 > 0:02:15We've got quite a lot of ladies
0:02:15 > 0:02:16who've been booked for induction this week
0:02:16 > 0:02:20but we've got more than we would normally expect to see.
0:02:20 > 0:02:22So, we're just going to prioritise now
0:02:22 > 0:02:26on a basis of clinical risk and start to look at
0:02:26 > 0:02:31moving some of these ladies through the system, hopefully later on today.
0:02:31 > 0:02:34Well this lady's due tomorrow...
0:02:34 > 0:02:39and she's a GDM on diet and wanted to go a full two weeks,
0:02:39 > 0:02:41so she could be...
0:02:41 > 0:02:43pushed to Saturday.
0:02:43 > 0:02:47Although we've got a number of women who are booked with us
0:02:47 > 0:02:50for this month, you don't know then how many of them
0:02:50 > 0:02:53are going to have their babies within the month, earlier in that month
0:02:53 > 0:02:58or actually become overdue and sort of, move across into another month.
0:02:58 > 0:03:00So, the whole thing is very unpredictable.
0:03:00 > 0:03:02And then, on top of that,
0:03:02 > 0:03:05we don't know who's going to walk through the door in labour
0:03:05 > 0:03:09with problems, who obviously get a priority because they're in labour.
0:03:15 > 0:03:18Oh, hi, it's Antoinette down on delivery suite here,
0:03:18 > 0:03:22have you got a lady ready for theatre this morning for us?
0:03:22 > 0:03:26Antoinette Connolly is starting her 13-hour shift.
0:03:26 > 0:03:28She's been a midwife for over 20 years,
0:03:28 > 0:03:32and specialises in looking after women with multiple pregnancies.
0:03:32 > 0:03:35All right then, thanks a lot love, bye.
0:03:35 > 0:03:37This morning is a little bit special and particularly busy
0:03:37 > 0:03:40because we've got one of our ladies who's having triplets,
0:03:40 > 0:03:42they're just over 34 weeks.
0:03:42 > 0:03:46And we just need to make sure that the neo-natal units...
0:03:46 > 0:03:48have got spaces for all three in the event
0:03:48 > 0:03:50that they may need to go there.
0:03:50 > 0:03:52Probably most important at the moment will be the beds,
0:03:52 > 0:03:54the cot space for the babies
0:03:54 > 0:03:56and obviously, having three of everything -
0:03:56 > 0:03:59paediatricians have to be on board and the rest of the workload
0:03:59 > 0:04:02carries on until delivery day regardless anyway,
0:04:02 > 0:04:04so, obviously emergencies take precedence.
0:04:04 > 0:04:06So, we're busy generally,
0:04:06 > 0:04:08and probably a little bit short-staffed this morning.
0:04:13 > 0:04:15Aman and husband Pete are having triplets.
0:04:18 > 0:04:21They've booked in to have them delivered by C-section.
0:04:21 > 0:04:24They've just said that there's no beds
0:04:24 > 0:04:26in this section of the hotel...
0:04:26 > 0:04:27The hotel(!) It feels like an hotel.
0:04:27 > 0:04:29There's no beds round here at the minute
0:04:29 > 0:04:32so they've given us a chair which is pretty comfortable,
0:04:32 > 0:04:33looks comfortable anyway. Yeah.
0:04:33 > 0:04:35How long we will be here? We don't know.
0:04:35 > 0:04:37We've not been given any rough estimate of any time.
0:04:39 > 0:04:41Early on, Aman was advised
0:04:41 > 0:04:43that triplet pregnancies were complicated.
0:04:45 > 0:04:48They said it's really risky to keep all three.
0:04:48 > 0:04:52So they said, it's your choice, if you want reduction,
0:04:52 > 0:04:56we can reduce it to two or one, according to your body.
0:04:56 > 0:04:59But I just wanted to keep all of them.
0:04:59 > 0:05:01So I thought, I'm going to just...
0:05:01 > 0:05:03I believe in God, so I said,
0:05:03 > 0:05:05"What meant to happen going to happen,
0:05:05 > 0:05:07"so I'm going to keep all of them."
0:05:07 > 0:05:11And I did and hopefully they come out right and they OK.
0:05:11 > 0:05:13That's the main thing for me.
0:05:17 > 0:05:19Sorry! Collision!
0:05:19 > 0:05:21Hello, sweetheart, how are you?
0:05:21 > 0:05:25We're just waiting for the paediatricians to say we're OK.
0:05:25 > 0:05:28We should be, we're kind of feeling fairly positive.
0:05:28 > 0:05:31You can put your gown on actually, that sounds positive.
0:05:31 > 0:05:34Babies are moving OK? Too much. Oh, bless you.
0:05:34 > 0:05:36I can't wait to see you.
0:05:36 > 0:05:39This is so exciting, we've got three. Back in a bit.
0:05:39 > 0:05:42You want them afterwards? Yeah, just bring them...
0:05:42 > 0:05:45Just bring three for me, Pete, when we're going into theatre. OK?
0:05:45 > 0:05:47She's been there all the way through,
0:05:47 > 0:05:49from the beginning to the end.
0:05:50 > 0:05:53Even today she goes, "Oh, I'm so excited."
0:05:53 > 0:05:55When she found out I'm having C-section today,
0:05:55 > 0:05:59she goes, "Oh, do you know, I'm in, I'm in as well, I'm so excited."
0:06:01 > 0:06:03It's nice, somebody so caring.
0:06:06 > 0:06:08How are you feeling? I don't know.
0:06:08 > 0:06:10Ask me in a couple of hours,
0:06:10 > 0:06:12we'll be parents of three...
0:06:12 > 0:06:14with a bit of luck.
0:06:14 > 0:06:16At the moment, I think...
0:06:16 > 0:06:19I don't know what to think or what to do because it's...
0:06:19 > 0:06:21I think I'm getting nervous now.
0:06:23 > 0:06:27All triplet pregnancies are delivered early at 34 weeks.
0:06:28 > 0:06:32It's a high-risk delivery that requires careful planning.
0:06:32 > 0:06:35Because these are triplets and because they're pre-term,
0:06:35 > 0:06:37we're hoping that they'll be good babies
0:06:37 > 0:06:39but you never can be 100% sure.
0:06:39 > 0:06:41They may have slight little problems
0:06:41 > 0:06:44and, you know, until they actually come out we won't know for sure.
0:06:44 > 0:06:47We won't know the exact size and we won't know how well they are.
0:06:47 > 0:06:49We want a nice and controlled, controlled delivery
0:06:49 > 0:06:51so we obviously wanted to plan the day
0:06:51 > 0:06:54she was going to have her section rather than come in as an emergency.
0:06:54 > 0:06:57Went to the neo-natal unit to be prepared.
0:06:57 > 0:06:59Daytime is always better, there's a lot more staff around
0:06:59 > 0:07:02so we've got a full compliment of paediatricians,
0:07:02 > 0:07:04neo-natal staff...
0:07:04 > 0:07:07obstetricians and obviously, the midwives here.
0:07:21 > 0:07:25Is a shift leader there, please? Thank you.
0:07:25 > 0:07:27Pam Canning is one of the senior midwives
0:07:27 > 0:07:29in charge of the delivery suite.
0:07:30 > 0:07:32ALARM SOUNDS
0:07:32 > 0:07:34When a delivery becomes an emergency,
0:07:34 > 0:07:36everything is put on hold.
0:07:36 > 0:07:38As a shift leader you don't know
0:07:38 > 0:07:40where you're going to be pulled to next.
0:07:40 > 0:07:43This lady wants to push at 27 weeks, where is she going?
0:07:43 > 0:07:45How many weeks? 27 weeks.
0:07:45 > 0:07:47That's the frustrating part of my job
0:07:47 > 0:07:51because I feel like sometimes I can't always get too engrossed.
0:07:51 > 0:07:52Sorry to interrupt you,
0:07:52 > 0:07:55we've just had a 27-week come down from the antenatal ward,
0:07:55 > 0:07:57urges to push, I think it's her second baby,
0:07:57 > 0:07:59I can't remember what the par...
0:07:59 > 0:08:01But I'm just going to ring the neo-natal unit.
0:08:01 > 0:08:03Which room? It's in here, the midwife's in there.
0:08:03 > 0:08:06Where I'm able, I do like to support my midwives,
0:08:06 > 0:08:09you know, at this crucial moment of delivery
0:08:09 > 0:08:12and it's always helpful for the ladies
0:08:12 > 0:08:14to have another pair of hands there helping
0:08:14 > 0:08:17and to encourage them with the pushing.
0:08:17 > 0:08:20Within an hour, Pam has had another call for help.
0:08:20 > 0:08:23Keep going, keep going, keep going, keep going.
0:08:23 > 0:08:25WOMAN SCREAMS
0:08:25 > 0:08:27Come on, chin down, chin down.
0:08:27 > 0:08:3122-year-old Jade and her partner Luke are having their first baby.
0:08:31 > 0:08:34That's it, he's coming, he's coming, yep.
0:08:34 > 0:08:35Come on, keep going, keep going.
0:08:35 > 0:08:39Keep it going, and again come on. Keep going.
0:08:39 > 0:08:43Fantastic, go on, keep it going, go on, Jade, you're doing so well.
0:08:45 > 0:08:48That's your baby's head. Have we got a mirror?
0:08:48 > 0:08:50I don't think there is one in here.
0:08:50 > 0:08:51Jade, with the next few pushes,
0:08:51 > 0:08:54the baby's head is going to advance a little bit further.
0:08:54 > 0:08:57I want you to really listen to what I'm telling you, OK?
0:08:57 > 0:09:00The midwives have concerns that the baby has opened its bowels,
0:09:00 > 0:09:03a sign that the baby could be in distress.
0:09:04 > 0:09:07That's it, slow push, slow pushes.
0:09:07 > 0:09:10Next contraction, we should have a baby.
0:09:10 > 0:09:12If you need to push, big push then.
0:09:12 > 0:09:13Big internal push.
0:09:15 > 0:09:17Push. Push it fairly hard.
0:09:17 > 0:09:20Keep going.
0:09:20 > 0:09:24Well done! Look, here's baby! Come on, he's here.
0:09:24 > 0:09:25Oh, congratulations.
0:09:25 > 0:09:27Oh, he's a big one as well.
0:09:30 > 0:09:31Congratulations.
0:09:31 > 0:09:34He's a little bit stunned there, isn't he? Shall we just put...?
0:09:34 > 0:09:38Just going to take baby to the paediatrician.
0:09:38 > 0:09:40Because of all this poo baby's had, that bowels open,
0:09:40 > 0:09:43I'm going to take him over to the paediatrician
0:09:43 > 0:09:46and he's given me a little cry.
0:09:46 > 0:09:48He is quite floppy, isn't he?
0:09:48 > 0:09:49That's it.
0:09:52 > 0:09:54Come on, little man.
0:09:56 > 0:09:58Jade's baby isn't breathing properly.
0:10:04 > 0:10:05Come on, little man.
0:10:06 > 0:10:09The doctor must work quickly to clear his airway.
0:10:09 > 0:10:10Some core gases, yeah.
0:10:27 > 0:10:29Starting to cry a bit...
0:10:29 > 0:10:31Yeah.
0:10:35 > 0:10:38Inside, your heart's really racing ten to the dozen.
0:10:38 > 0:10:40Oh, come on.
0:10:41 > 0:10:44Those seconds sometimes seem like minutes
0:10:44 > 0:10:47until you hear that baby first gasp, that first breath.
0:10:47 > 0:10:51Put him by your skin and it often helps them with their breathing.
0:10:51 > 0:10:55There you go. He's trying to have a little cry now, isn't he?
0:10:55 > 0:10:59I thought Jade handled her delivery absolutely fantastically.
0:10:59 > 0:11:01For a first-time mum, she did absolutely brilliantly.
0:11:01 > 0:11:04She actually made it look very easy, didn't she?
0:11:04 > 0:11:06Are you going to meet Daddy?
0:11:07 > 0:11:09No, go and meet Daddy.
0:11:09 > 0:11:13You can put him by your skin if you want to, next to your skin, yeah?
0:11:13 > 0:11:14Yeah?
0:11:21 > 0:11:24PHONES RING
0:11:30 > 0:11:32How you doing?
0:11:33 > 0:11:36Right, do you want the good news or the good news?
0:11:36 > 0:11:39The good news. We're doing it. Oh, great.
0:11:39 > 0:11:44After a three-hour wait, Aman and husband Pete are taken to theatre.
0:11:44 > 0:11:46I see you're all set up for three.
0:11:50 > 0:11:52I'm already shaking like a leaf.
0:12:01 > 0:12:03Ah, I'm shaking.
0:12:03 > 0:12:05You're doing well.
0:12:11 > 0:12:14Drop them shoulders. Right, that's a good girl.
0:12:14 > 0:12:15Drop them.
0:12:15 > 0:12:17Good girl, it's OK, it's OK.
0:12:17 > 0:12:19Good girl. Aman, try to stay nice and still.
0:12:19 > 0:12:21Well done, sweetheart. Well done, fantastic.
0:12:26 > 0:12:28It's just kicked me.
0:12:31 > 0:12:34We've got everything ready, we're all completely ready.
0:12:34 > 0:12:35Yep, all systems go.
0:12:37 > 0:12:41A team of 16 staff are needed in theatre to deliver the triplets.
0:12:41 > 0:12:44Twice as many as they need for a single birth.
0:12:49 > 0:12:53It's like a religious tape, yeah, yeah.
0:12:53 > 0:12:56Good... That's it, it's the good...
0:12:56 > 0:12:58God's blessing in prayers.
0:13:03 > 0:13:04OK, just checking your blood.
0:13:07 > 0:13:09Don't worry.
0:13:12 > 0:13:13She's OK.
0:13:16 > 0:13:19Babies out? Not yet. Couple of minutes.
0:13:19 > 0:13:22No, not even started.
0:13:22 > 0:13:24They will guide you through everything, OK?
0:13:27 > 0:13:30I know, they're like my babies, I had her from 20 weeks.
0:13:43 > 0:13:45Lots of pressure now, OK?
0:13:45 > 0:13:47Quite a lot of pressure.
0:13:47 > 0:13:49The first one is coming out. Number one.
0:13:51 > 0:13:53And it's 11-34.
0:13:53 > 0:13:5434 is number one.
0:13:57 > 0:14:02Hello. Nice size, looks nice.
0:14:02 > 0:14:03Crying, crying.
0:14:05 > 0:14:07Lots of hair.
0:14:07 > 0:14:08Aman, loads of hair.
0:14:13 > 0:14:15Second one's coming.
0:14:15 > 0:14:17Oh, hello, baby.
0:14:17 > 0:14:19And 35 is the second one.
0:14:19 > 0:14:22DOCTOR: Can we take the first one away?
0:14:22 > 0:14:26First one is out, second one is out.
0:14:26 > 0:14:28That's your one. Twin one's gone to Sarah.
0:14:28 > 0:14:31You take, you take and I'll take the cot.
0:14:38 > 0:14:40OK, here's two.
0:14:40 > 0:14:44Thank you, I've got number two who's a very noisy one.
0:14:55 > 0:14:57The third one is making...
0:15:01 > 0:15:03Congratulations, all three are out.
0:15:03 > 0:15:04Thank you very much.
0:15:07 > 0:15:10She was hiding as well, I tell you that's what...
0:15:10 > 0:15:13That's something to do with it, you know.
0:15:14 > 0:15:16Are they all boys?
0:15:16 > 0:15:17First and third, definitely boys.
0:15:17 > 0:15:19Second I-I think...
0:15:19 > 0:15:21Yeah, I saw, they are all boys, yeah. AMAN: I hope it's a girl.
0:15:21 > 0:15:24If you say it's a girl, I would be over the moon.
0:15:24 > 0:15:28Thank you, here goes number one, how you doing?
0:15:30 > 0:15:34Number one, give a kiss to mummy.
0:15:34 > 0:15:35DOCTOR: Are they all fine?
0:15:35 > 0:15:37We're just sorting out number three now,
0:15:37 > 0:15:40because obviously that was the last one left inside so... Inside, OK.
0:15:42 > 0:15:44Oh, thank you very much. Thank you very much.
0:15:47 > 0:15:50And number one's over there and having a cuddle, OK.
0:15:50 > 0:15:52There's a problem with the third baby boy.
0:15:57 > 0:15:58He's not happy, is he?
0:15:58 > 0:16:00Bit gruntier than the other two, yeah.
0:16:03 > 0:16:05Just waiting for number three.
0:16:05 > 0:16:08Just having a little bit of oxygen,
0:16:08 > 0:16:10a little bit of CPAP, ventilation.
0:16:12 > 0:16:14Came out breech, was the last one coming out,
0:16:14 > 0:16:16so he's probably not very happy with being born.
0:16:16 > 0:16:19So, when he's OK we'll take him to Mum,
0:16:19 > 0:16:21but they'll all go to special care.
0:16:21 > 0:16:24I think they're all needing a little bit of oxygen at this point.
0:16:24 > 0:16:27They're going to pop a tube down to give them extra oxygen continuously
0:16:27 > 0:16:30so he has a bit of extra help. So that he's not doing all the breathing himself.
0:16:30 > 0:16:33OK, yeah. Cos it's a little bit of a struggle for him.
0:16:33 > 0:16:37He's OK, but he's obviously having to make more of an effort than the other two.
0:16:37 > 0:16:39They'll all go to special care.
0:16:39 > 0:16:40Yeah, all go to special care.
0:16:40 > 0:16:44And he's been trying to cry, he's just finding it quite hard work.
0:16:44 > 0:16:47We're going to get him sent up first and the other two will follow.
0:16:47 > 0:16:50Afterwards. Yeah, great, excellent. Thank you very much, guys.
0:16:50 > 0:16:52See you in a little while. See you later.
0:16:53 > 0:16:56Hiya. Baby? BOTH: Number three.
0:16:56 > 0:16:59She's on her way, she's going to follow you round to the unit,
0:16:59 > 0:17:01OK, and I've got the other two.
0:17:04 > 0:17:07It's fine, we were just kind of hoping...
0:17:07 > 0:17:09that they wouldn't all go to special care
0:17:09 > 0:17:10but unfortunately they have.
0:17:10 > 0:17:12But they're going to be in the safest place,
0:17:12 > 0:17:14and hopefully, especially for the first two,
0:17:14 > 0:17:16it might be very short term
0:17:16 > 0:17:20and they may not need much oxygen, or may not need any so...
0:17:20 > 0:17:24But you can see why it's important that it was a controlled environment
0:17:24 > 0:17:26with everybody ready to accept them...
0:17:26 > 0:17:28because you never can tell.
0:17:28 > 0:17:31Aman will have to recover from her operation
0:17:31 > 0:17:33before she can be reunited with her babies.
0:17:42 > 0:17:44Many high-risk mums are admitted as inpatients
0:17:44 > 0:17:46when complications arise.
0:17:48 > 0:17:5130-year-old Audrey has had a bed on the unit for two days
0:17:51 > 0:17:53and is being induced.
0:17:53 > 0:17:55This might be slightly uncomfortable but shouldn't hurt you.
0:17:57 > 0:17:59You're doing fine.
0:18:03 > 0:18:06It's her second baby, but her partner Donwell's first.
0:18:08 > 0:18:11I'm 37 weeks and they're saying that it's small...
0:18:13 > 0:18:15So...
0:18:15 > 0:18:18they want to induce me, start me off
0:18:18 > 0:18:21so that I can have him before time.
0:18:21 > 0:18:23I would prefer to make it happen naturally.
0:18:25 > 0:18:27Fair enough, keep an eye on me and stuff, yes,
0:18:27 > 0:18:29but to make it happen naturally would be nice.
0:18:31 > 0:18:33Nine years ago,
0:18:33 > 0:18:36Audrey had an emergency C-section to deliver her daughter.
0:18:37 > 0:18:41Basically, me and my daughter nearly died.
0:18:41 > 0:18:43Because of that situation...
0:18:45 > 0:18:49I will do everything in my power to try and avoid it,
0:18:49 > 0:18:50to be quite truthful.
0:18:50 > 0:18:53I really don't want history to repeat itself.
0:18:57 > 0:18:59The midwives have serious concerns
0:18:59 > 0:19:02about allowing Audrey's pregnancy to continue.
0:19:02 > 0:19:05She had a scan just after 27 weeks,
0:19:05 > 0:19:09which showed baby was on the 50th centile and then she had another scan
0:19:09 > 0:19:12just before 35 weeks which showed that baby's growth
0:19:12 > 0:19:14had tailed off slightly.
0:19:14 > 0:19:17And then at 37 weeks she had another scan which showed
0:19:17 > 0:19:21that the baby was growing less than what we'd predicted.
0:19:21 > 0:19:24That's a trigger to us that the baby's growing small
0:19:24 > 0:19:26and might be a problem in utero.
0:19:28 > 0:19:30When babies stop growing, really we're concerned
0:19:30 > 0:19:32that the placenta isn't working as effectively
0:19:32 > 0:19:35and baby isn't being oxygenated as well,
0:19:35 > 0:19:38and that can cause problems for baby's growth and development
0:19:38 > 0:19:41and ultimately it can result in still birth.
0:19:44 > 0:19:48It can take up to 72 hours for the induction of labour to work.
0:19:48 > 0:19:51If it fails, Audrey will be offered a C-section.
0:19:53 > 0:19:55To me, the longer I stay in hospital,
0:19:55 > 0:19:58the closer it's getting to the big C.
0:19:58 > 0:19:59Caesarean.
0:19:59 > 0:20:04And if I do have it, it's like I'm being robbed.
0:20:04 > 0:20:06I want to, I want to, I want to experience that.
0:20:08 > 0:20:10I want to experience...
0:20:10 > 0:20:11I want to experience that.
0:20:15 > 0:20:18Because we've started a process of trying to start the labour
0:20:18 > 0:20:23and once we've intervened, it's not advisable for them to go home, really.
0:20:23 > 0:20:27It's a matter of safety, we need to monitor the baby closely
0:20:27 > 0:20:29and if there's any maternal conditions
0:20:29 > 0:20:32that need monitoring as well, we need to make sure we can do those.
0:20:40 > 0:20:42But after three days of waiting,
0:20:42 > 0:20:44Audrey's labour still hasn't started.
0:20:47 > 0:20:48Hello?
0:20:49 > 0:20:51Yes, darling, I'm discharging myself.
0:20:54 > 0:20:56Yes. In a bit.
0:21:00 > 0:21:03They've asked me to stay...
0:21:03 > 0:21:04because the baby's small.
0:21:04 > 0:21:07That's all they're saying now, is that the baby's small...
0:21:07 > 0:21:08and I don't understand.
0:21:08 > 0:21:11I would be the first to know if something was wrong with my child.
0:21:11 > 0:21:14I'm the one that's carrying it.
0:21:14 > 0:21:17If I don't feel a movement, I would be the first one on the phone.
0:21:17 > 0:21:19Listen, I had another baby before today.
0:21:19 > 0:21:22You know something's up. I don't want a Caesarean section,
0:21:22 > 0:21:24I want to try for a natural birth.
0:21:27 > 0:21:29So, I am discharging myself.
0:21:36 > 0:21:38I've got my phone.
0:21:53 > 0:21:55Have you seen where she's gone?
0:21:56 > 0:21:57Audrey? Yeah.
0:21:57 > 0:22:01I think she's discharging herself. Right, OK.
0:22:11 > 0:22:13It feels awful.
0:22:13 > 0:22:16I don't know what now is going to happen to that lady
0:22:16 > 0:22:17and that is worrying
0:22:17 > 0:22:21because I don't know, will she see sense? Will she come back?
0:22:21 > 0:22:23I just wish she'd said something to me,
0:22:23 > 0:22:25I wish she'd said, "I'm unhappy".
0:22:25 > 0:22:28You know, can you help me?
0:22:28 > 0:22:30My fear's for that baby and that mum.
0:22:31 > 0:22:32You know, that...
0:22:34 > 0:22:36That if they don't get medical help,
0:22:36 > 0:22:37what could happen to them...
0:22:40 > 0:22:42..and I dread to think what that could be.
0:22:59 > 0:23:00PHONE RINGS
0:23:02 > 0:23:05Hello, ward four, midwife speaking.
0:23:05 > 0:23:06At the women's hospital,
0:23:06 > 0:23:10over 2,000 women have their babies by C-section each year.
0:23:13 > 0:23:15Midwife Sam has been assigned
0:23:15 > 0:23:18to look after the women on today's C-section list.
0:23:19 > 0:23:24Some people don't realise how much we take normal pregnancy for granted
0:23:24 > 0:23:26because there are lots of conditions.
0:23:26 > 0:23:29Sometimes, when you think that someone's having an elective section,
0:23:29 > 0:23:31you just think it's cos they just want it,
0:23:31 > 0:23:34but you don't really think about the reasons behind it.
0:23:34 > 0:23:36You know, if they've got complex things going on...
0:23:36 > 0:23:40in their pregnancies then it's... It can be a safer option.
0:23:40 > 0:23:43Up to eight women a day can be booked in for a C-section
0:23:43 > 0:23:45and each will need a bed in the hospital
0:23:45 > 0:23:47for at least two days to recover.
0:23:47 > 0:23:50Monday through to Friday, you fill up with your sections,
0:23:50 > 0:23:52but as the week goes on, you're discharging them
0:23:52 > 0:23:54so come by the weekend,
0:23:54 > 0:23:57you've emptied some more space, some more beds,
0:23:57 > 0:24:01ready to start the process again next week so it is Thursday.
0:24:01 > 0:24:03We are towards the end of the week, so it is just going to be busier.
0:24:06 > 0:24:10His first mum is 40-year-old Selma, who's having a third C-section.
0:24:10 > 0:24:11Try and push your hands,
0:24:11 > 0:24:14try and use your hands to push yourself down
0:24:14 > 0:24:15because we can't pull you. No, no, it's OK.
0:24:15 > 0:24:16There you go.
0:24:18 > 0:24:21She will be quite a complex Caesarean today,
0:24:21 > 0:24:25just because of the high risk of bleeding afterwards,
0:24:25 > 0:24:26a high risk of haemorrhage.
0:24:26 > 0:24:28There's all ready been a scar to that uterus
0:24:28 > 0:24:29and they're having to reopen it.
0:24:31 > 0:24:33So it is a little girl we're having, isn't it?
0:24:36 > 0:24:38Are you a doctor? No, midwife.
0:24:39 > 0:24:42You're so young. Got to keep it interesting, haven't you?
0:24:42 > 0:24:44Got to have a bit of excitement.
0:24:44 > 0:24:47These are the stories you can tell her when she's older. Perfect.
0:24:47 > 0:24:51There are 169 male midwives in the UK.
0:24:51 > 0:24:55And at only 21 years old, Sam is the youngest.
0:24:55 > 0:24:57You either get people that don't believe you,
0:24:57 > 0:24:59so you're having to like, try to prove it or you know,
0:24:59 > 0:25:00there is that thing that,
0:25:00 > 0:25:03"Oh, you're no midwife and you look really, really young.
0:25:03 > 0:25:06"You look about 12, you don't look old enough to do it."
0:25:06 > 0:25:09Cos I think quite a lot of people's perceptions
0:25:09 > 0:25:11of a midwife is someone that's a bit older and matronly.
0:25:11 > 0:25:1321 - she's a lovely, she's lovely and happy,
0:25:13 > 0:25:15made a very good home for her.
0:25:25 > 0:25:28Deep breaths, it will be fine, I promise you.
0:25:29 > 0:25:31Make myself, and other midwives...
0:25:31 > 0:25:33You can do things to make the occasion special.
0:25:33 > 0:25:35You know, trying to build a relationship with someone
0:25:35 > 0:25:38and getting to know them and finding out about their history
0:25:38 > 0:25:41and why they're having a section
0:25:41 > 0:25:43and it's things like that that stay with people.
0:25:46 > 0:25:47I'll just pop down there now,
0:25:47 > 0:25:49because baby will be born any second.
0:25:49 > 0:25:52Yeah? Is that OK? Wonderful so I'll see you shortly.
0:26:06 > 0:26:08Oh, hello there, little one.
0:26:10 > 0:26:13Perfect.
0:26:13 > 0:26:15Let's get you all nice and dry.
0:26:21 > 0:26:24Let's take her over to see Mum.
0:26:27 > 0:26:29Congratulations.
0:26:30 > 0:26:33She's beautiful, shall I tell you how much she weighs?
0:26:33 > 0:26:36Let me go and find out for you? Hey, baby.
0:26:48 > 0:26:51Today, we were told there was only three people on the list -
0:26:51 > 0:26:53on the section list -
0:26:53 > 0:26:57BUT there's actually another lady on the antenatal ward at this moment
0:26:57 > 0:27:00who is going to be having a section as well this afternoon,
0:27:00 > 0:27:04so actually there's four ladies on the list.
0:27:04 > 0:27:06So...
0:27:06 > 0:27:08typical busy list, really.
0:27:09 > 0:27:13Hello, Greg, can I have a bed for the third section down, please?
0:27:13 > 0:27:14Come on, help me out.
0:27:16 > 0:27:18All right, see you in a bit.
0:27:18 > 0:27:20Bye.
0:27:20 > 0:27:22Perfect, they'll send it down.
0:27:27 > 0:27:29With limited beds on the unit,
0:27:29 > 0:27:32and no guarantee of when babies will arrive,
0:27:32 > 0:27:34it's a constant juggling act for the midwives
0:27:34 > 0:27:36to keep the department moving.
0:27:36 > 0:27:38Hi, could I bring O-1 up, please?
0:27:40 > 0:27:43You are kidding me?
0:27:43 > 0:27:46We have a lady on the table in theatre waiting to come out.
0:27:46 > 0:27:49Basically, at the moment there is a bed block going on
0:27:49 > 0:27:52where there isn't actually any physical beds for these ladies
0:27:52 > 0:27:54to go on to after they've had their babies
0:27:54 > 0:27:56and at the moment there's just no beds
0:27:56 > 0:27:59so we're trying to work out what to do, really.
0:28:00 > 0:28:02But this has been like, 15 minutes now.
0:28:02 > 0:28:04Greg, she's not moved into the...
0:28:04 > 0:28:06They need to move her now, now.
0:28:08 > 0:28:10Hang on, here's Greg.
0:28:10 > 0:28:11Hello.
0:28:16 > 0:28:18Right, OK, Tony, can we put her anywhere else?
0:28:18 > 0:28:20Because we need that bed.
0:28:20 > 0:28:22She needs to go somewhere, OK.
0:28:22 > 0:28:25So, Ruth's going to bring a lady up then in five minutes, all right.
0:28:25 > 0:28:28She needs to go somewhere. All right, thanks, bye.
0:28:28 > 0:28:31Did you say you've got a bed on ward three, room C? Yes.
0:28:31 > 0:28:33Can Cassandra have that, her baby's on the unit? Yeah.
0:28:33 > 0:28:36And she was next in line anyway. Yeah, do it, yeah. Fine.
0:28:38 > 0:28:41I've known it be bad before, but not as bad as this.
0:28:41 > 0:28:43I've never known it be such a complete bed block
0:28:43 > 0:28:45that they're thinking about
0:28:45 > 0:28:47cancelling the rest of the electives for the day
0:28:47 > 0:28:50or there's problems actually with getting a bed.
0:28:50 > 0:28:52So, I think this is a very rare situation.
0:28:52 > 0:28:56There's always a situation where they may be not enough beds for everybody
0:28:56 > 0:28:58but we always work our way out of it
0:28:58 > 0:29:00and be able to get people home and get people their beds and stuff,
0:29:00 > 0:29:03but I've never known it be like this before.
0:29:03 > 0:29:06She's gone, so that room's dirty.
0:29:06 > 0:29:10And all the inductions that you had booked for today have all come in. All come in.
0:29:10 > 0:29:12Fabulous, that's brilliant, yeah.
0:29:12 > 0:29:14I'm sorry we couldn't get any more around this afternoon
0:29:14 > 0:29:16but with the bed blockage, it was just...
0:29:16 > 0:29:17It's just been impossible, really.
0:29:17 > 0:29:21There were four postnatal beds between the two floors
0:29:21 > 0:29:25left for the rest of the night so again,
0:29:25 > 0:29:27by morning I think we're going to be in the same scenario
0:29:27 > 0:29:29as we were today having another bed block.
0:29:31 > 0:29:35I'm not here tomorrow. Neither am I, I'm off for a week and I can't wait.
0:29:51 > 0:29:54OK. Watch your fingers, sweetheart.
0:29:54 > 0:29:56You keep your hands in and we'll do the...
0:29:56 > 0:29:58Aman and Pete are going to the neo-natal unit
0:29:58 > 0:30:02to meet their triplets for the first time.
0:30:02 > 0:30:04They've all fallen in love with your babies.
0:30:04 > 0:30:07He's doing very well.
0:30:08 > 0:30:11Is this number three? This is triplet three, yes.
0:30:11 > 0:30:12Yeah, this is the more poorly one.
0:30:12 > 0:30:15He's doing very nicely,
0:30:15 > 0:30:16we're very pleased with him.
0:30:18 > 0:30:20Have I got number...?
0:30:22 > 0:30:23Two.
0:30:24 > 0:30:26AMAN: Hello.
0:30:26 > 0:30:28PETE: Are you going to say hello to your mummy?
0:30:36 > 0:30:39His hands are matching...
0:30:39 > 0:30:41with mine.
0:30:41 > 0:30:43They are.
0:30:43 > 0:30:46We're going to go straight to another one now, and then another one.
0:30:46 > 0:30:47It still doesn't feel real yet.
0:30:47 > 0:30:50Until they all come home together, they're piled up...
0:30:50 > 0:30:52Piled up whichever way you look at it... Stacked up.
0:30:54 > 0:30:57It's going to be a mad one, that is. Mad.
0:31:01 > 0:31:06I'm actually very, very happy because at one point he said,
0:31:06 > 0:31:09"I don't think it's a good idea if you keep three
0:31:09 > 0:31:11"because you're risking the other two as well."
0:31:11 > 0:31:13But I don't know my...
0:31:13 > 0:31:15The people say "mother instinct",
0:31:15 > 0:31:17I was like, "No, I know it's going to be OK,
0:31:17 > 0:31:19"I'm not going to go for a reduction."
0:31:19 > 0:31:23And I'm glad I didn't, so today seeing them, it's-it's...
0:31:23 > 0:31:24It's amazing.
0:31:24 > 0:31:26It's, I think, the best feeling in the world.
0:31:28 > 0:31:30Aw.
0:31:31 > 0:31:33Here's your number one baby.
0:31:52 > 0:31:54It's been two days since second-time mum Audrey
0:31:54 > 0:31:56walked out of her induction.
0:31:59 > 0:32:01After two days of trying to get in touch with Audrey,
0:32:01 > 0:32:04the community midwife has managed to find her this morning
0:32:04 > 0:32:07and actually get into the house, get access into the house
0:32:07 > 0:32:10and then persuade her to come up to the hospital for a CTG.
0:32:11 > 0:32:13It's a massive relief because as that...
0:32:13 > 0:32:16As that midwife, you can't really leave your job at home,
0:32:16 > 0:32:18you're constantly worrying,
0:32:18 > 0:32:20the next shift that you come in of, are you going to hear some story
0:32:20 > 0:32:24that you know, the baby or the mum isn't well
0:32:24 > 0:32:26and something happened to them?
0:32:26 > 0:32:28Because obviously we don't induce women for no reason.
0:32:28 > 0:32:32So, for her to come back and to know that the baby's OK
0:32:32 > 0:32:34and that Mum's OK is a massive relief.
0:32:35 > 0:32:39Wasn't that much persuaded, but I do want to hear his heartbeat
0:32:39 > 0:32:41and to make sure that he is all right.
0:32:42 > 0:32:44But it's just that I don't want to stay.
0:32:44 > 0:32:48My baby is not ready, I'm only 37 weeks.
0:32:48 > 0:32:49He's not ready.
0:32:51 > 0:32:54So, she's induction for suspected IUGR...
0:32:54 > 0:32:58With Audrey reluctant to start the induction process again,
0:32:58 > 0:33:00it's down to consultant Mr Alex Pirie
0:33:00 > 0:33:03to come up with a new plan of care for her and her baby.
0:33:04 > 0:33:06Audrey, is it? Yes.
0:33:06 > 0:33:08Hello there, how do you do? I'm fine, thank you.
0:33:08 > 0:33:11Well, I've been hearing all about you, tell me what's...
0:33:13 > 0:33:16Basically, they says that my baby's small,
0:33:16 > 0:33:18it's like he's dropping off the chart. Yeah.
0:33:18 > 0:33:22Yes, he's small, but he seems perfectly fine in there.
0:33:22 > 0:33:25Is he moving about lots? Constantly. Good.
0:33:25 > 0:33:28So, I don't see what the fuss is.
0:33:28 > 0:33:30What people worry about
0:33:30 > 0:33:33is if the placenta's not feeding the baby,
0:33:33 > 0:33:36the baby can stop growing...
0:33:36 > 0:33:39and can die in the womb.
0:33:39 > 0:33:42OK, the risk of stillbirth.
0:33:42 > 0:33:45Sometimes, the baby's not getting enough sugar and oxygen
0:33:45 > 0:33:50from the placenta and that can cause brain damage in the baby.
0:33:51 > 0:33:55Every mum has a risk of stillbirth, that's part of pregnancy.
0:33:55 > 0:34:00Your risks are a wee bit higher than most.
0:34:00 > 0:34:03Option one is to say, I accept those risks,
0:34:03 > 0:34:08but I'm going to trust my body because this baby's moving about OK.
0:34:08 > 0:34:12Option two, is to say if there's a higher risk of stillbirth,
0:34:12 > 0:34:17or brain damage, I'm either going to go ahead with the induction process
0:34:17 > 0:34:20or I'll have a Caesarean section.
0:34:20 > 0:34:23My body's, like, not ready and to me, he's not ready.
0:34:23 > 0:34:26Even though there is a risk. Sure.
0:34:26 > 0:34:30Let's go for daily monitoring then, that's an option.
0:34:30 > 0:34:32Yes, please. Yep? Daily monitoring.
0:34:35 > 0:34:38Everybody's different, everybody is different
0:34:38 > 0:34:39but I needed to know
0:34:39 > 0:34:42because that's what happened with my last pregnancy,
0:34:42 > 0:34:44they didn't tell me nothing.
0:34:44 > 0:34:47And I think that's why I'm so wary.
0:34:47 > 0:34:50That C word is the trigger point for me.
0:34:50 > 0:34:54I'm ecstatic, the fact that I've got another, another option,
0:34:54 > 0:34:55I'm ecstatic.
0:34:56 > 0:34:58I really am.
0:34:58 > 0:35:00I could do cartwheels but I don't think that's a good idea.
0:35:02 > 0:35:04I think she's much happier now.
0:35:04 > 0:35:06We've given her options
0:35:06 > 0:35:09and she's been able to choose the best option for her.
0:35:11 > 0:35:14You can't make someone do what they don't want to do.
0:35:14 > 0:35:18But it is really frustrating... when you just...
0:35:18 > 0:35:21I think sometimes they don't realise how serious things can be
0:35:21 > 0:35:25and most of the time everything turns out well.
0:35:25 > 0:35:28Which is what we want, we don't want things to go wrong.
0:35:36 > 0:35:40As a high-risk unit dealing with complicated pregnancies,
0:35:40 > 0:35:42Birmingham Women's Hospital helps deliver
0:35:42 > 0:35:45150 sets of twins or triplets each year.
0:35:45 > 0:35:48Sarah is another mum having triplets.
0:35:48 > 0:35:51Her babies can't be delivered safely in a natural labour,
0:35:51 > 0:35:53so she's meeting her midwife Antoinette
0:35:53 > 0:35:57in preparation for an early C-section in three weeks' time.
0:35:58 > 0:36:00How are you, my darling? All right.
0:36:00 > 0:36:03Just a little bit bigger to when I last seen you.
0:36:03 > 0:36:06How you keeping, how you feeling? Heavy, achy.
0:36:06 > 0:36:07Nearly there though, aren't we?
0:36:07 > 0:36:09Yeah, to be expected, I expect.
0:36:09 > 0:36:11Just to the left here is our theatre.
0:36:11 > 0:36:13There are two, one is for emergencies,
0:36:13 > 0:36:16which obviously is the one we use 24/7
0:36:16 > 0:36:18and then the second theatre, which is exactly the same
0:36:18 > 0:36:21is for our planned sections.
0:36:21 > 0:36:24So, this is our theatre, so the first one will be emergency theatre
0:36:24 > 0:36:26and you'll be in the bottom theatre down there.
0:36:26 > 0:36:29We meet them in clinic here and they're having twins or triplets.
0:36:29 > 0:36:30Definitely with the triplets, we say,
0:36:30 > 0:36:32these babies are going to be born early
0:36:32 > 0:36:35and they know that from a very early stage in the pregnancy.
0:36:35 > 0:36:37Because she is at that size now that she could go into labour,
0:36:37 > 0:36:39and we have said to her today,
0:36:39 > 0:36:41"You know, if you have any signs of preterm labour,
0:36:41 > 0:36:42"you mustn't stay at home.
0:36:42 > 0:36:45"You mustn't ignore it, you must come in quickly
0:36:45 > 0:36:47"because the risks are significantly higher."
0:36:47 > 0:36:49I tell you there will be quite a few people in there.
0:36:49 > 0:36:52Yes, I've already, sort of, been expecting that.
0:36:52 > 0:36:54So you would expect...
0:36:54 > 0:36:57You'd expect your paediatricians. Then there'll be...
0:36:57 > 0:36:59Obviously, I'll be in there as your midwife, Dr Singh,
0:36:59 > 0:37:02and there'll be another assistant with her,
0:37:02 > 0:37:03another obstetrician with her.
0:37:03 > 0:37:06You'll have your theatre scrub nurse and a runner
0:37:06 > 0:37:09and then you'll have your anaesthetist and their assistant.
0:37:09 > 0:37:11So that's 11 already.
0:37:11 > 0:37:13Plus us. Plus you, the very important people.
0:37:13 > 0:37:17Really, from the time they actually start making incisions in the skin,
0:37:17 > 0:37:19the babies are out within a few minutes.
0:37:19 > 0:37:23So, it'll be one, two, three. And then all excitement happens.
0:37:24 > 0:37:28I mean it is, it's excitement with one baby and two, but three...
0:37:28 > 0:37:31Obviously, you're prepared for the rest of your life now.
0:37:31 > 0:37:33Every time you go out, anywhere you go...
0:37:33 > 0:37:34Yeah, if we ever go out.
0:37:34 > 0:37:37Oh, you will, oh, I tell you there is life after having triplets.
0:37:37 > 0:37:39It's starting to feel quite real.
0:37:39 > 0:37:44Yeah. And particularly the planning of it feels quite real.
0:37:44 > 0:37:47You know, before it was... Well, it could happen at any time,
0:37:47 > 0:37:48it could be an emergency,
0:37:48 > 0:37:51so you don't get to thinking about what it's going to be like
0:37:51 > 0:37:53to actually go into theatre by your...
0:37:53 > 0:37:54Not by yourself but walk in.
0:37:54 > 0:37:56Walk in, walk in. No, we're walking in nicely.
0:37:56 > 0:37:59Walk in effectively, yeah. Yeah, I've had a couple of operations
0:37:59 > 0:38:02but they've been general anaesthetic so this will be the first time
0:38:02 > 0:38:04I've been awake inside an operating theatre.
0:38:04 > 0:38:06So, kind of nervous, kind of excited.
0:38:13 > 0:38:16Seven months into their pregnancy, Sarah and husband James
0:38:16 > 0:38:19are still getting used to the idea of three more babies.
0:38:21 > 0:38:23That's the blobs.
0:38:23 > 0:38:25Yes, those are the heartbeats.
0:38:25 > 0:38:29We had an early scan at about nine, ten weeks
0:38:29 > 0:38:33and they found a foetal heartbeat and I could see the sonographer's eyes
0:38:33 > 0:38:36flickering between two different points on the screen and I thought,
0:38:36 > 0:38:39"She's looking at something else there as well" and then she said,
0:38:39 > 0:38:43"There's a second foetal heartbeat, congratulations it's twins."
0:38:43 > 0:38:45And at that point I thought,
0:38:45 > 0:38:48"OK, I can cope with twins, we wanted three kids, that's good."
0:38:48 > 0:38:51I know other people who have had twins and they've survived.
0:38:51 > 0:38:53It's fine. And then she had a good look round,
0:38:53 > 0:38:55see if she could see the source of the bleeding
0:38:55 > 0:38:57and spotted the third one
0:38:57 > 0:39:01and said, "Actually, I don't know how to tell you this, but it's triplets."
0:39:01 > 0:39:03At which point I think I cried and laughed.
0:39:03 > 0:39:07It's a huge shock, and I think as soon as you hear news like that,
0:39:07 > 0:39:11immediately you're thinking, "New house, new car...
0:39:11 > 0:39:14"work life balance, everything."
0:39:14 > 0:39:17It's not bad news, but it is life-changing news.
0:39:17 > 0:39:20Once you've found out you're having triplets,
0:39:20 > 0:39:22you're very quickly into a very medicalised process.
0:39:22 > 0:39:27There's risks to the babies, there's risks, obviously, of prematurities,
0:39:27 > 0:39:29because there's three of them sharing the space.
0:39:29 > 0:39:32In all likelihood they will come early,
0:39:32 > 0:39:34it's just a question of how early
0:39:34 > 0:39:37and the earlier they're born, the worse outcomes there are.
0:39:37 > 0:39:39It is a worrying time.
0:39:39 > 0:39:41At the end of the day, these are our children
0:39:41 > 0:39:44and even if they're not born yet, you still worry about them as a parent.
0:39:44 > 0:39:47We want the best for them, we want the best outcome.
0:39:47 > 0:39:50We can't guarantee it, the medical professionals we're dealing with
0:39:50 > 0:39:52can't guarantee it, we wouldn't expect them to.
0:39:54 > 0:39:57And although you don't like to assume that you're going
0:39:57 > 0:40:00to go home with three healthy babies,
0:40:00 > 0:40:03you hope for the best even if you don't...
0:40:03 > 0:40:05necessarily assume it.
0:40:18 > 0:40:22Audrey has been monitored daily for the past two weeks.
0:40:22 > 0:40:23Audrey...
0:40:25 > 0:40:27Are you here sweetheart?
0:40:27 > 0:40:29With her baby's growth still a concern
0:40:29 > 0:40:31and only two days until her due date,
0:40:31 > 0:40:34she's agreed to be induced again.
0:40:34 > 0:40:37Are you Audrey? Hiya, sweetheart, you OK?
0:40:37 > 0:40:39My name's Daisy, I'm one of the midwives,
0:40:39 > 0:40:43I've come to take you round to the delivery suite to get things going.
0:40:43 > 0:40:46OK. Yay! No need. I'm ready.
0:40:54 > 0:40:56SHE LAUGHS
0:40:56 > 0:40:59If you get everything ready, we'll take you round to room 11...
0:41:00 > 0:41:03..and we'll break your waters and get things going.
0:41:03 > 0:41:06Is that all right? Oh, yes, yes, yes, yes, yes.
0:41:06 > 0:41:09Yes, I'm happy, very happy.
0:41:11 > 0:41:13At least I'll be able to try a natural method,
0:41:13 > 0:41:16you understand, and that's the main thing.
0:41:16 > 0:41:18Oh, my son will be here.
0:41:19 > 0:41:21Before it was the waiting game...
0:41:21 > 0:41:23Now let the games begin.
0:41:25 > 0:41:27I think, when people are called round
0:41:27 > 0:41:30and there's a bed and a midwife suddenly available,
0:41:30 > 0:41:32I think some people feel like they've won the Lottery.
0:41:32 > 0:41:35Like, "Yes, this is my chance, it's all going to be over."
0:41:35 > 0:41:37But, of course, it's still only the beginning
0:41:37 > 0:41:39cos they've still got a lot...
0:41:39 > 0:41:42You know, a long way to go with having their waters broken,
0:41:42 > 0:41:45having the drip and then, you know, it could take hours and hours.
0:41:45 > 0:41:47Sometimes a couple of days.
0:41:47 > 0:41:49But hopefully, Audrey will be quick.
0:42:03 > 0:42:06It's 2am on the night shift.
0:42:07 > 0:42:08Hey, look at all three.
0:42:11 > 0:42:14Sarah and husband James have arrived at triage,
0:42:14 > 0:42:18suspecting she's in labour, two weeks before her planned C-section.
0:42:19 > 0:42:21Girl, boy, boy.
0:42:22 > 0:42:23Apparently.
0:42:24 > 0:42:26Well, we'll find out soon enough.
0:42:29 > 0:42:31What time did your waters go again?
0:42:31 > 0:42:32About 20 to 12.
0:42:32 > 0:42:34And it was quite a clear gush.
0:42:34 > 0:42:36Oh, yeah, there was lots of it. Yeah, yeah, good.
0:42:36 > 0:42:38No contractions at the moment
0:42:38 > 0:42:41so there's no mad urgency to do anything at the minute, you know,
0:42:41 > 0:42:42so just chill out.
0:42:42 > 0:42:45You'll get nice monitorings of these three babies
0:42:45 > 0:42:47and then we'll get one of the doctors to review you
0:42:47 > 0:42:49to see what their plan of action's going to be. Sure.
0:42:53 > 0:42:56All right, Sarah, I've brought a lovely doctor with me.
0:42:56 > 0:42:57All right?
0:42:57 > 0:42:59SARAH SPEAKS INDISTINCTLY
0:42:59 > 0:43:02No, its all right. We've done well with that monitoring, haven't we?
0:43:02 > 0:43:04Oh, yes, there's plenty of it.
0:43:04 > 0:43:05Lovely, lovely. Excellent.
0:43:06 > 0:43:09Provided you don't start contracting tonight,
0:43:09 > 0:43:11the best thing would be to leave well alone, I think,
0:43:11 > 0:43:14given that it is the middle of the night. Yeah.
0:43:14 > 0:43:16And then...
0:43:16 > 0:43:18we'll reassess things in the morning. Mm-hm.
0:43:18 > 0:43:23Given that you're now 33 weeks, there is a possibility...
0:43:23 > 0:43:26that we might think about delivering you later on today.
0:43:26 > 0:43:29Good, I'll try and get some rest then.
0:43:29 > 0:43:30Last chance I'll get.
0:43:33 > 0:43:37The plan now is, as she's now contractions,
0:43:37 > 0:43:39is that she... We're going to admit her to the antenatal ward.
0:43:39 > 0:43:42There's no imminent urgency to deliver these triplets
0:43:42 > 0:43:46as there's no contractions, no signs of labour,
0:43:46 > 0:43:48other than her waters have gone.
0:43:50 > 0:43:52Ideally, we would like Sarah
0:43:52 > 0:43:56to go into labour any time after nine o'clock tomorrow
0:43:56 > 0:43:59because its going to make it a much more safer environment,
0:43:59 > 0:44:02we're going to have a lot more staff on
0:44:02 > 0:44:05to deal with this intensive, high-risk case.
0:44:05 > 0:44:08So, we don't want to compromise care,
0:44:08 > 0:44:09and that care could be compromised
0:44:09 > 0:44:13if Sarah was to go into labour any time now, really.
0:44:13 > 0:44:15Because we have skeleton staff on.
0:44:30 > 0:44:33At 4am, Sarah goes into premature labour.
0:44:35 > 0:44:39The team rush her into theatre for an emergency C-section.
0:44:39 > 0:44:41With limited time to deliver the triplets,
0:44:41 > 0:44:43she's been put under general anaesthetic.
0:44:45 > 0:44:47It was extremely frightening for Sarah,
0:44:47 > 0:44:50the fact that she was rushed down.
0:44:50 > 0:44:52She'd gone from virtually not being in labour to,
0:44:52 > 0:44:54"I hope my baby's going to be all right".
0:44:54 > 0:44:56It's all gone from being very controlled
0:44:56 > 0:44:57to very, very, very frightening.
0:45:22 > 0:45:23Hello.
0:45:24 > 0:45:26Congratulations.
0:45:26 > 0:45:28Well done, you.
0:45:30 > 0:45:32Hello.
0:45:47 > 0:45:4922 minutes past.
0:45:54 > 0:45:55Much better.
0:45:57 > 0:45:59INDISTINCT CONVERSATION
0:46:19 > 0:46:21She's absolutely gorgeous.
0:46:21 > 0:46:22Hello, darling.
0:46:30 > 0:46:33Well, you can't keep kicking Mummy any more.
0:46:33 > 0:46:37INDISTINCT CONVERSATION
0:46:39 > 0:46:41It's absolutely wonderful.
0:46:41 > 0:46:46You do feel very privileged to be part of this experience for Sarah.
0:46:46 > 0:46:48You all right, James? All right.
0:46:48 > 0:46:50Glad you were here then?
0:47:01 > 0:47:04All three babies will be monitored at the neo-natal unit
0:47:04 > 0:47:06while Sarah recovers from her operation.
0:47:39 > 0:47:4312 hours after having her waters broken,
0:47:43 > 0:47:45Audrey still hasn't gone into active labour.
0:47:48 > 0:47:51Her body does seem to be contracting but at the moment,
0:47:51 > 0:47:55progress does seem to be quite slow and she doesn't seem to be dilating.
0:47:57 > 0:47:59We do have to put a time limit
0:47:59 > 0:48:02on how long we let her womb contract for
0:48:02 > 0:48:05with little progress or no progress.
0:48:05 > 0:48:08Knowing Audrey over the past few weeks,
0:48:08 > 0:48:09I think her biggest concern
0:48:09 > 0:48:12will be needing to have an emergency Caesarean section.
0:48:12 > 0:48:15She's fought very hard to not have that.
0:48:15 > 0:48:19You remember I said baby's hearts were showing signs of deceleration?
0:48:19 > 0:48:22I'm not ready to get excitement yet.
0:48:22 > 0:48:24Unless you're going to strap me down to the bed.
0:48:24 > 0:48:27I'm not strapping you down to the bed,
0:48:27 > 0:48:30I'm just taking everything into consideration.
0:48:30 > 0:48:32On your behalf, not my behalf. No, no, no.
0:48:32 > 0:48:36If you look at that, that's baby's heart rate.
0:48:36 > 0:48:37Because I'm moving.
0:48:43 > 0:48:47I am worried that maybe complications can arise.
0:48:47 > 0:48:50Maybe her uterus might rupture and if that does happen
0:48:50 > 0:48:53it is a life-threatening situation to both mum and baby.
0:48:56 > 0:49:00At the start of the next shift, Sarah is assigned to Audrey.
0:49:00 > 0:49:03We just have to go with the picture we've got in front of us.
0:49:05 > 0:49:08But I am the canvas. Of course, of course.
0:49:08 > 0:49:10Which is what we take into cons...
0:49:10 > 0:49:12But no-one wants to hear what I want to say.
0:49:12 > 0:49:14We do, I honestly do want to hear what you want to say,
0:49:14 > 0:49:17but I have to advise you at the same time,
0:49:17 > 0:49:20and you might not want to hear what I've got to say.
0:49:22 > 0:49:24Audrey, I really...
0:49:24 > 0:49:25Listen, I don't want...
0:49:25 > 0:49:29We don't want to frighten you, but we wouldn't be doing our jobs
0:49:29 > 0:49:31if we're not telling you the risks...
0:49:31 > 0:49:32and what we would suggest.
0:49:34 > 0:49:37What, to put me on a slab and butcher me up?
0:49:37 > 0:49:38No, not at all.
0:49:40 > 0:49:42I'm getting panic attacks...
0:49:46 > 0:49:50Because I'm frightened now I've come back here. Audrey...
0:49:50 > 0:49:54My daughter, she was bad...she was bad.
0:49:54 > 0:49:55She was bad.
0:49:56 > 0:49:58She was proper bad.
0:49:59 > 0:50:01Nearly dead.
0:50:01 > 0:50:03Yeah, but we don't want to get to that point again.
0:50:06 > 0:50:10Everything you guys have tried ain't worked, simple as, simple.
0:50:10 > 0:50:11Everything.
0:50:13 > 0:50:17I think she still thinks that we're not listening to her.
0:50:18 > 0:50:21Which, it's not that we're not listening to her,
0:50:21 > 0:50:26but I think she still feels very much not in control of the situation,
0:50:26 > 0:50:29which is really important to Audrey, as it is to everyone.
0:50:29 > 0:50:32They still want that bit of control over her delivery.
0:50:32 > 0:50:34She had such a...
0:50:34 > 0:50:36bad birth experience last time,
0:50:36 > 0:50:38that she really didn't want it to happen again
0:50:38 > 0:50:41and I think she just feels out of control again
0:50:41 > 0:50:45and that it's going down the same route that it did last time.
0:50:45 > 0:50:47It's too late now, my bag's broken.
0:50:47 > 0:50:51It's too late, it's not like I can walk off the ward now, that's it.
0:50:51 > 0:50:54My baby's life is in YOUR guys' hands. I know.
0:50:54 > 0:50:55That's it now.
0:50:56 > 0:51:00But please, I know, I know it is like that but...
0:51:00 > 0:51:04No, it IS. Yes, but we're still not going to
0:51:04 > 0:51:06suddenly wheel you off to theatre without you consenting.
0:51:06 > 0:51:09We're not about to do that.
0:51:09 > 0:51:13But in any labour, there's always, as we've explained to her,
0:51:13 > 0:51:16there is a chance that her baby could die.
0:51:16 > 0:51:19We hope not, and it won't come to that,
0:51:19 > 0:51:22but there is that chance which is why we have to act
0:51:22 > 0:51:26when we first see signs of the baby becoming distressed.
0:51:28 > 0:51:31See, I'm getting upset, I need to be unhooked.
0:51:31 > 0:51:32Right, listen to me.
0:51:33 > 0:51:35I don't want to unhook you
0:51:35 > 0:51:38because I don't know what's going to happen to your baby
0:51:38 > 0:51:40when you're not on the monitor.
0:51:40 > 0:51:43So, I'm saying to you, I need you to stay on the monitor
0:51:43 > 0:51:45so we can monitor your baby.
0:51:45 > 0:51:47If you're saying to me, you understand the risks...
0:51:47 > 0:51:49I can't stay here, I've got...
0:51:50 > 0:51:52But do you understand that if you go outside
0:51:52 > 0:51:54and I take you off the monitor,
0:51:54 > 0:51:56I don't know what's going to happen to your baby?
0:51:56 > 0:51:58I'm going in the garden, to the garden right there,
0:51:58 > 0:52:00right there, I'm going in there.
0:52:00 > 0:52:04But-but five minutes is all it takes sometimes, Audrey.
0:52:07 > 0:52:09What do you want me to do?
0:52:09 > 0:52:12Do you want me to leave it with it on and then we'll go out the room?
0:52:12 > 0:52:14No. You want me to take you off it?
0:52:14 > 0:52:16I don't want to...
0:52:16 > 0:52:18I will be back in five minutes.
0:52:20 > 0:52:22I will go and let them know.
0:52:24 > 0:52:25It's a really anxious time.
0:52:25 > 0:52:28You just, you want to be there to support,
0:52:28 > 0:52:31to the woman, but you're looking at a CTG
0:52:31 > 0:52:34and you're seeing that the baby's not happy.
0:52:34 > 0:52:36So I'm hoping that maybe when she comes back,
0:52:36 > 0:52:38she might be calmer...
0:52:38 > 0:52:40and ready to make a decision.
0:52:42 > 0:52:43Are you worried? Yeah.
0:52:50 > 0:52:52Are you going to come back on the monitor? Yeah.
0:53:00 > 0:53:02Are you cold, do you feel cold?
0:53:02 > 0:53:04Yes, I do because I'm hungry.
0:53:04 > 0:53:07That can sometimes be a sign that there's an infection.
0:53:10 > 0:53:13With Audrey's temperature dangerously high,
0:53:13 > 0:53:14and her baby in distress,
0:53:14 > 0:53:17there's no more time to wait.
0:53:17 > 0:53:20I'm just trying to talk a little bit quickly
0:53:20 > 0:53:23because I'm very concerned about you and about your baby.
0:53:23 > 0:53:27OK? Your heart rate is up, it's going up.
0:53:27 > 0:53:28Why do you think it's up?
0:53:28 > 0:53:31It might be, there might be bleeding inside.
0:53:31 > 0:53:33No, it's because everybody's at me.
0:53:33 > 0:53:35What do you want then? Tell me what you want.
0:53:35 > 0:53:37I want you guys to give me a chance.
0:53:37 > 0:53:39You can't...
0:53:39 > 0:53:41Audrey, from our point of view we've given you a chance.
0:53:43 > 0:53:45I know you don't feel like that,
0:53:45 > 0:53:49but we've given... You know, we're here three weeks later.
0:53:49 > 0:53:53Right, Audrey, I don't want to wait otherwise it might collapse a little
0:53:53 > 0:53:55and be really, really serious.
0:54:04 > 0:54:06Audrey, you need to give us this decision.
0:54:12 > 0:54:17Audrey finally makes the decision to undergo an emergency C-section.
0:54:17 > 0:54:23It was probably about an hour from when we wanted to deliver her
0:54:23 > 0:54:25to her actually going to theatre.
0:54:27 > 0:54:28The longest hour of my life, really.
0:54:30 > 0:54:33She did understand eventually that it was going to have to happen
0:54:33 > 0:54:36and she just needed to come to terms with that
0:54:36 > 0:54:39and just put her trust back into us, really.
0:54:39 > 0:54:42So, it was a real relief to get her into theatre
0:54:42 > 0:54:46and to know that her baby will be OK and we'd make her well again as well.
0:54:55 > 0:54:59Just like real relief just to hear that baby cry
0:54:59 > 0:55:03and just know that hopefully it's going to be OK.
0:55:04 > 0:55:06Still feels surreal...
0:55:06 > 0:55:08because he's so laid back.
0:55:08 > 0:55:09He's so chilled.
0:55:12 > 0:55:16I've been saying all along that I could have gone full term.
0:55:16 > 0:55:19He could have gone full term.
0:55:19 > 0:55:20But...
0:55:21 > 0:55:22I'm glad he's here.
0:55:24 > 0:55:25I am glad.
0:55:25 > 0:55:27Yeah.
0:55:32 > 0:55:34You know when you're in that situation it is scary
0:55:34 > 0:55:37to think what could happen
0:55:37 > 0:55:42and because you do have experience of things going wrong,
0:55:42 > 0:55:45you really just don't want that to happen again.
0:55:45 > 0:55:48I think this will stay with me for a very long time,
0:55:48 > 0:55:51probably...forever, I would think.
0:55:52 > 0:55:53Hello!
0:55:54 > 0:55:58Hasn't been easy between me and some of the midwives.
0:55:58 > 0:55:59But...
0:56:02 > 0:56:04I do appreciate their help.
0:56:06 > 0:56:09I'm not the easiest patient to get along with,
0:56:09 > 0:56:11I can tell anybody that
0:56:11 > 0:56:14but I appreciate the ones that have done that
0:56:14 > 0:56:16and did mean it from their heart.
0:56:40 > 0:56:44Four hours after her emergency Caesarean,
0:56:44 > 0:56:47Sarah has recovered enough to meet her triplets.
0:56:53 > 0:56:55Oh, what a little tongue you've got.
0:56:58 > 0:56:59Hello, darling.
0:56:59 > 0:57:00It's amazing, so tiny.
0:57:03 > 0:57:05Feels so vulnerable.
0:57:07 > 0:57:09Feels so new.
0:57:09 > 0:57:11To suddenly have tiny little babies...
0:57:13 > 0:57:15Spent so long...
0:57:15 > 0:57:16just being pregnant
0:57:16 > 0:57:18and then it's so hard to imagine what it's going to be like
0:57:18 > 0:57:21to here it is. It will still take a bit of getting used to.
0:57:23 > 0:57:25So different...from my last.
0:57:27 > 0:57:29Plenty of time for growing.
0:57:31 > 0:57:34This isn't the end, it doesn't matter how we get there as long as we get there...
0:57:36 > 0:57:38And here we are.
0:57:38 > 0:57:41It's good to see Sarah back with them.
0:57:43 > 0:57:45Got lovely long fingers.
0:57:46 > 0:57:48Gorgeous...but I'm biased.
0:57:50 > 0:57:52And I'm very proud of my wife.
0:57:55 > 0:57:58It's not a job really, it's an absolute passion.
0:57:58 > 0:58:01You know, I mean, what a privileged position we're in.
0:58:01 > 0:58:04Do you know, to be there for a birth of a baby is just lovely.
0:58:04 > 0:58:06And people will always remember that,
0:58:06 > 0:58:10it's such an event in anybody's life and they're quite nervous and that.
0:58:10 > 0:58:13I mean, what a privilege we have to be there with them,
0:58:13 > 0:58:15giving them support, advice, guidance,
0:58:15 > 0:58:17and be there hopefully to see the new born baby.
0:58:17 > 0:58:20I love babies anyway so it's perfect for me.
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