Delivery on Demand The Midwives

Hello, ward four, Midwife speaking.

Don't panic, it's going to be over soon.

With the highest birth rate in 40 years...

Look what you've done!

You are just amazing, look at him.

..midwives are under more pressure than ever before.

You are kidding me,

we have a lady on the table in theatre waiting to come out.

We filmed in busy maternity departments

in Birmingham...

Manchester and Cardiff.

Six-eleven, I reckon. He's about six-eleven and a half.

As the midwives deliver the next generation...

The scary thing is, you're all going to be midwives.

..with care...

Oh, please help me.

We're here, we're here, we're here. You're all right.

..and dedication.

My baby's life is in YOUR guys' hands, that's it now.

Not good for the stress levels, this job, at all.

You'll be absolutely fine, I told you I'd be with you, OK?

It does touch you.

This is the reason we do what we do. It's OK.

You smell nice.

It's more than a job, it's...

You're part of somebody's life and they never forget you.

This year, over 8,000 babies will be born at Birmingham Women's Hospital.

The birth rate's actually doubled,

or even more than doubled since I started.

The turnover's faster, much faster.

How was that one?

It's one of the busiest delivery units in the country

and deals with an increasing number of high-risk women.

Keep going, keep going.

Over the years, got used to this very fast pace

and I don't know how to go slower any more.

It's top gear all the time.

ALARM SOUNDS

With only 21 beds, planning for 600 births a month

is one of the toughest parts of the job for the senior midwives.

So there's six, they're all waiting for...

Yeah, and then we've got three.

So, four - no, three.

So there's nine women waiting for ARM. Just write these notes.

We've got quite a lot of ladies

who've been booked for induction this week

but we've got more than we would normally expect to see.

So, we're just going to prioritise now

on a basis of clinical risk and start to look at

moving some of these ladies through the system, hopefully later on today.

Well this lady's due tomorrow...

and she's a GDM on diet and wanted to go a full two weeks,

so she could be...

pushed to Saturday.

Although we've got a number of women who are booked with us

for this month, you don't know then how many of them

are going to have their babies within the month, earlier in that month

or actually become overdue and sort of, move across into another month.

So, the whole thing is very unpredictable.

And then, on top of that,

we don't know who's going to walk through the door in labour

with problems, who obviously get a priority because they're in labour.

Oh, hi, it's Antoinette down on delivery suite here,

have you got a lady ready for theatre this morning for us?

Antoinette Connolly is starting her 13-hour shift.

She's been a midwife for over 20 years,

and specialises in looking after women with multiple pregnancies.

All right then, thanks a lot love, bye.

This morning is a little bit special and particularly busy

because we've got one of our ladies who's having triplets,

they're just over 34 weeks.

And we just need to make sure that the neo-natal units...

have got spaces for all three in the event

that they may need to go there.

Probably most important at the moment will be the beds,

the cot space for the babies

and obviously, having three of everything -

paediatricians have to be on board and the rest of the workload

carries on until delivery day regardless anyway,

so, obviously emergencies take precedence.

So, we're busy generally,

and probably a little bit short-staffed this morning.

Aman and husband Pete are having triplets.

They've booked in to have them delivered by C-section.

They've just said that there's no beds

in this section of the hotel...

The hotel(!) It feels like an hotel.

There's no beds round here at the minute

so they've given us a chair which is pretty comfortable,

looks comfortable anyway. Yeah.

How long we will be here? We don't know.

We've not been given any rough estimate of any time.

Early on, Aman was advised

that triplet pregnancies were complicated.

They said it's really risky to keep all three.

So they said, it's your choice, if you want reduction,

we can reduce it to two or one, according to your body.

But I just wanted to keep all of them.

So I thought, I'm going to just...

I believe in God, so I said,

"What meant to happen going to happen,

"so I'm going to keep all of them."

And I did and hopefully they come out right and they OK.

That's the main thing for me.

Sorry! Collision!

Hello, sweetheart, how are you?

We're just waiting for the paediatricians to say we're OK.

We should be, we're kind of feeling fairly positive.

You can put your gown on actually, that sounds positive.

Babies are moving OK? Too much. Oh, bless you.

I can't wait to see you.

This is so exciting, we've got three. Back in a bit.

You want them afterwards? Yeah, just bring them...

Just bring three for me, Pete, when we're going into theatre. OK?

She's been there all the way through,

from the beginning to the end.

Even today she goes, "Oh, I'm so excited."

When she found out I'm having C-section today,

she goes, "Oh, do you know, I'm in, I'm in as well, I'm so excited."

It's nice, somebody so caring.

How are you feeling? I don't know.

Ask me in a couple of hours,

we'll be parents of three...

with a bit of luck.

At the moment, I think...

I don't know what to think or what to do because it's...

I think I'm getting nervous now.

All triplet pregnancies are delivered early at 34 weeks.

It's a high-risk delivery that requires careful planning.

Because these are triplets and because they're pre-term,

we're hoping that they'll be good babies

but you never can be 100% sure.

They may have slight little problems

and, you know, until they actually come out we won't know for sure.

We won't know the exact size and we won't know how well they are.

We want a nice and controlled, controlled delivery

so we obviously wanted to plan the day

she was going to have her section rather than come in as an emergency.

Went to the neo-natal unit to be prepared.

Daytime is always better, there's a lot more staff around

so we've got a full compliment of paediatricians,

neo-natal staff...

obstetricians and obviously, the midwives here.

Is a shift leader there, please? Thank you.

Pam Canning is one of the senior midwives

in charge of the delivery suite.

ALARM SOUNDS

When a delivery becomes an emergency,

everything is put on hold.

As a shift leader you don't know

where you're going to be pulled to next.

This lady wants to push at 27 weeks, where is she going?

How many weeks? 27 weeks.

That's the frustrating part of my job

because I feel like sometimes I can't always get too engrossed.

Sorry to interrupt you,

we've just had a 27-week come down from the antenatal ward,

urges to push, I think it's her second baby,

I can't remember what the par...

But I'm just going to ring the neo-natal unit.

Which room? It's in here, the midwife's in there.

Where I'm able, I do like to support my midwives,

you know, at this crucial moment of delivery

and it's always helpful for the ladies

to have another pair of hands there helping

and to encourage them with the pushing.

Within an hour, Pam has had another call for help.

Keep going, keep going, keep going, keep going.

WOMAN SCREAMS

Come on, chin down, chin down.

22-year-old Jade and her partner Luke are having their first baby.

That's it, he's coming, he's coming, yep.

Come on, keep going, keep going.

Keep it going, and again come on. Keep going.

Fantastic, go on, keep it going, go on, Jade, you're doing so well.

That's your baby's head. Have we got a mirror?

I don't think there is one in here.

Jade, with the next few pushes,

the baby's head is going to advance a little bit further.

I want you to really listen to what I'm telling you, OK?

The midwives have concerns that the baby has opened its bowels,

a sign that the baby could be in distress.

That's it, slow push, slow pushes.

Next contraction, we should have a baby.

If you need to push, big push then.

Big internal push.

Push. Push it fairly hard.

Keep going.

Well done! Look, here's baby! Come on, he's here.

Oh, congratulations.

Oh, he's a big one as well.

Congratulations.

He's a little bit stunned there, isn't he? Shall we just put...?

Just going to take baby to the paediatrician.

Because of all this poo baby's had, that bowels open,

I'm going to take him over to the paediatrician

and he's given me a little cry.

He is quite floppy, isn't he?

That's it.

Come on, little man.

Jade's baby isn't breathing properly.

Come on, little man.

The doctor must work quickly to clear his airway.

Some core gases, yeah.

Starting to cry a bit...

Yeah.

Inside, your heart's really racing ten to the dozen.

Oh, come on.

Those seconds sometimes seem like minutes

until you hear that baby first gasp, that first breath.

Put him by your skin and it often helps them with their breathing.

There you go. He's trying to have a little cry now, isn't he?

I thought Jade handled her delivery absolutely fantastically.

For a first-time mum, she did absolutely brilliantly.

She actually made it look very easy, didn't she?

Are you going to meet Daddy?

No, go and meet Daddy.

You can put him by your skin if you want to, next to your skin, yeah?

Yeah?

PHONES RING

How you doing?

Right, do you want the good news or the good news?

The good news. We're doing it. Oh, great.

After a three-hour wait, Aman and husband Pete are taken to theatre.

I see you're all set up for three.

I'm already shaking like a leaf.

Ah, I'm shaking.

You're doing well.

Drop them shoulders. Right, that's a good girl.

Drop them.

Good girl, it's OK, it's OK.

Good girl. Aman, try to stay nice and still.

Well done, sweetheart. Well done, fantastic.

It's just kicked me.

We've got everything ready, we're all completely ready.

Yep, all systems go.

A team of 16 staff are needed in theatre to deliver the triplets.

Twice as many as they need for a single birth.

It's like a religious tape, yeah, yeah.

Good... That's it, it's the good...

God's blessing in prayers.

OK, just checking your blood.

Don't worry.

She's OK.

Babies out? Not yet. Couple of minutes.

No, not even started.

They will guide you through everything, OK?

I know, they're like my babies, I had her from 20 weeks.

Lots of pressure now, OK?

Quite a lot of pressure.

The first one is coming out. Number one.

And it's 11-34.

34 is number one.

Hello. Nice size, looks nice.

Crying, crying.

Lots of hair.

Aman, loads of hair.

Second one's coming.

Oh, hello, baby.

And 35 is the second one.

DOCTOR: Can we take the first one away?

First one is out, second one is out.

That's your one. Twin one's gone to Sarah.

You take, you take and I'll take the cot.

OK, here's two.

Thank you, I've got number two who's a very noisy one.

The third one is making...

Congratulations, all three are out.

Thank you very much.

She was hiding as well, I tell you that's what...

That's something to do with it, you know.

Are they all boys?

First and third, definitely boys.

Second I-I think...

Yeah, I saw, they are all boys, yeah. AMAN: I hope it's a girl.

If you say it's a girl, I would be over the moon.

Thank you, here goes number one, how you doing?

Number one, give a kiss to mummy.

DOCTOR: Are they all fine?

We're just sorting out number three now,

because obviously that was the last one left inside so... Inside, OK.

Oh, thank you very much. Thank you very much.

And number one's over there and having a cuddle, OK.

There's a problem with the third baby boy.

He's not happy, is he?

Bit gruntier than the other two, yeah.

Just waiting for number three.

Just having a little bit of oxygen,

a little bit of CPAP, ventilation.

Came out breech, was the last one coming out,

so he's probably not very happy with being born.

So, when he's OK we'll take him to Mum,

but they'll all go to special care.

I think they're all needing a little bit of oxygen at this point.

They're going to pop a tube down to give them extra oxygen continuously

so he has a bit of extra help. So that he's not doing all the breathing himself.

OK, yeah. Cos it's a little bit of a struggle for him.

He's OK, but he's obviously having to make more of an effort than the other two.

They'll all go to special care.

Yeah, all go to special care.

And he's been trying to cry, he's just finding it quite hard work.

We're going to get him sent up first and the other two will follow.

Afterwards. Yeah, great, excellent. Thank you very much, guys.

See you in a little while. See you later.

Hiya. Baby? BOTH: Number three.

She's on her way, she's going to follow you round to the unit,

OK, and I've got the other two.

It's fine, we were just kind of hoping...

that they wouldn't all go to special care

but unfortunately they have.

But they're going to be in the safest place,

and hopefully, especially for the first two,

it might be very short term

and they may not need much oxygen, or may not need any so...

But you can see why it's important that it was a controlled environment

with everybody ready to accept them...

because you never can tell.

Aman will have to recover from her operation

before she can be reunited with her babies.

Many high-risk mums are admitted as inpatients

when complications arise.

30-year-old Audrey has had a bed on the unit for two days

and is being induced.

This might be slightly uncomfortable but shouldn't hurt you.

You're doing fine.

It's her second baby, but her partner Donwell's first.

I'm 37 weeks and they're saying that it's small...

So...

they want to induce me, start me off

so that I can have him before time.

I would prefer to make it happen naturally.

Fair enough, keep an eye on me and stuff, yes,

but to make it happen naturally would be nice.

Nine years ago,

Audrey had an emergency C-section to deliver her daughter.

Basically, me and my daughter nearly died.

Because of that situation...

I will do everything in my power to try and avoid it,

to be quite truthful.

I really don't want history to repeat itself.

The midwives have serious concerns

about allowing Audrey's pregnancy to continue.

She had a scan just after 27 weeks,

which showed baby was on the 50th centile and then she had another scan

just before 35 weeks which showed that baby's growth

had tailed off slightly.

And then at 37 weeks she had another scan which showed

that the baby was growing less than what we'd predicted.

That's a trigger to us that the baby's growing small

and might be a problem in utero.

When babies stop growing, really we're concerned

that the placenta isn't working as effectively

and baby isn't being oxygenated as well,

and that can cause problems for baby's growth and development

and ultimately it can result in still birth.

It can take up to 72 hours for the induction of labour to work.

If it fails, Audrey will be offered a C-section.

To me, the longer I stay in hospital,

the closer it's getting to the big C.

Caesarean.

And if I do have it, it's like I'm being robbed.

I want to, I want to, I want to experience that.

I want to experience...

I want to experience that.

Because we've started a process of trying to start the labour

and once we've intervened, it's not advisable for them to go home, really.

It's a matter of safety, we need to monitor the baby closely

and if there's any maternal conditions

that need monitoring as well, we need to make sure we can do those.

But after three days of waiting,

Audrey's labour still hasn't started.

Hello?

Yes, darling, I'm discharging myself.

Yes. In a bit.

They've asked me to stay...

because the baby's small.

That's all they're saying now, is that the baby's small...

and I don't understand.

I would be the first to know if something was wrong with my child.

I'm the one that's carrying it.

If I don't feel a movement, I would be the first one on the phone.

Listen, I had another baby before today.

You know something's up. I don't want a Caesarean section,

I want to try for a natural birth.

So, I am discharging myself.

I've got my phone.

Have you seen where she's gone?

Audrey? Yeah.

I think she's discharging herself. Right, OK.

It feels awful.

I don't know what now is going to happen to that lady

and that is worrying

because I don't know, will she see sense? Will she come back?

I just wish she'd said something to me,

I wish she'd said, "I'm unhappy".

You know, can you help me?

My fear's for that baby and that mum.

You know, that...

That if they don't get medical help,

what could happen to them...

..and I dread to think what that could be.

PHONE RINGS

Hello, ward four, midwife speaking.

At the women's hospital,

over 2,000 women have their babies by C-section each year.

Midwife Sam has been assigned

to look after the women on today's C-section list.

Some people don't realise how much we take normal pregnancy for granted

because there are lots of conditions.

Sometimes, when you think that someone's having an elective section,

you just think it's cos they just want it,

but you don't really think about the reasons behind it.

You know, if they've got complex things going on...

in their pregnancies then it's... It can be a safer option.

Up to eight women a day can be booked in for a C-section

and each will need a bed in the hospital

for at least two days to recover.

Monday through to Friday, you fill up with your sections,

but as the week goes on, you're discharging them

so come by the weekend,

you've emptied some more space, some more beds,

ready to start the process again next week so it is Thursday.

We are towards the end of the week, so it is just going to be busier.

His first mum is 40-year-old Selma, who's having a third C-section.

Try and push your hands,

try and use your hands to push yourself down

because we can't pull you. No, no, it's OK.

There you go.

She will be quite a complex Caesarean today,

just because of the high risk of bleeding afterwards,

a high risk of haemorrhage.

There's all ready been a scar to that uterus

and they're having to reopen it.

So it is a little girl we're having, isn't it?

Are you a doctor? No, midwife.

You're so young. Got to keep it interesting, haven't you?

Got to have a bit of excitement.

These are the stories you can tell her when she's older. Perfect.

There are 169 male midwives in the UK.

And at only 21 years old, Sam is the youngest.

You either get people that don't believe you,

so you're having to like, try to prove it or you know,

there is that thing that,

"Oh, you're no midwife and you look really, really young.

"You look about 12, you don't look old enough to do it."

Cos I think quite a lot of people's perceptions

of a midwife is someone that's a bit older and matronly.

21 - she's a lovely, she's lovely and happy,

made a very good home for her.

Deep breaths, it will be fine, I promise you.

Make myself, and other midwives...

You can do things to make the occasion special.

You know, trying to build a relationship with someone

and getting to know them and finding out about their history

and why they're having a section

and it's things like that that stay with people.

I'll just pop down there now,

because baby will be born any second.

Yeah? Is that OK? Wonderful so I'll see you shortly.

Oh, hello there, little one.

Perfect.

Let's get you all nice and dry.

Let's take her over to see Mum.

Congratulations.

She's beautiful, shall I tell you how much she weighs?

Let me go and find out for you? Hey, baby.

Today, we were told there was only three people on the list -

on the section list -

BUT there's actually another lady on the antenatal ward at this moment

who is going to be having a section as well this afternoon,

so actually there's four ladies on the list.

So...

typical busy list, really.

Hello, Greg, can I have a bed for the third section down, please?

Come on, help me out.

All right, see you in a bit.

Bye.

Perfect, they'll send it down.

With limited beds on the unit,

and no guarantee of when babies will arrive,

it's a constant juggling act for the midwives

to keep the department moving.

Hi, could I bring O-1 up, please?

You are kidding me?

We have a lady on the table in theatre waiting to come out.

Basically, at the moment there is a bed block going on

where there isn't actually any physical beds for these ladies

to go on to after they've had their babies

and at the moment there's just no beds

so we're trying to work out what to do, really.

But this has been like, 15 minutes now.

Greg, she's not moved into the...

They need to move her now, now.

Hang on, here's Greg.

Hello.

Right, OK, Tony, can we put her anywhere else?

Because we need that bed.

She needs to go somewhere, OK.

So, Ruth's going to bring a lady up then in five minutes, all right.

She needs to go somewhere. All right, thanks, bye.

Did you say you've got a bed on ward three, room C? Yes.

Can Cassandra have that, her baby's on the unit? Yeah.

And she was next in line anyway. Yeah, do it, yeah. Fine.

I've known it be bad before, but not as bad as this.

I've never known it be such a complete bed block

that they're thinking about

cancelling the rest of the electives for the day

or there's problems actually with getting a bed.

So, I think this is a very rare situation.

There's always a situation where they may be not enough beds for everybody

but we always work our way out of it

and be able to get people home and get people their beds and stuff,

but I've never known it be like this before.

She's gone, so that room's dirty.

And all the inductions that you had booked for today have all come in. All come in.

Fabulous, that's brilliant, yeah.

I'm sorry we couldn't get any more around this afternoon

but with the bed blockage, it was just...

It's just been impossible, really.

There were four postnatal beds between the two floors

left for the rest of the night so again,

by morning I think we're going to be in the same scenario

as we were today having another bed block.

I'm not here tomorrow. Neither am I, I'm off for a week and I can't wait.

OK. Watch your fingers, sweetheart.

You keep your hands in and we'll do the...

Aman and Pete are going to the neo-natal unit

to meet their triplets for the first time.

They've all fallen in love with your babies.

He's doing very well.

Is this number three? This is triplet three, yes.

Yeah, this is the more poorly one.

He's doing very nicely,

we're very pleased with him.

Have I got number...?

Two.

AMAN: Hello.

PETE: Are you going to say hello to your mummy?

His hands are matching...

with mine.

They are.

We're going to go straight to another one now, and then another one.

It still doesn't feel real yet.

Until they all come home together, they're piled up...

Piled up whichever way you look at it... Stacked up.

It's going to be a mad one, that is. Mad.

I'm actually very, very happy because at one point he said,

"I don't think it's a good idea if you keep three

"because you're risking the other two as well."

But I don't know my...

The people say "mother instinct",

I was like, "No, I know it's going to be OK,

"I'm not going to go for a reduction."

And I'm glad I didn't, so today seeing them, it's-it's...

It's amazing.

It's, I think, the best feeling in the world.

Aw.

Here's your number one baby.

It's been two days since second-time mum Audrey

walked out of her induction.

After two days of trying to get in touch with Audrey,

the community midwife has managed to find her this morning

and actually get into the house, get access into the house

and then persuade her to come up to the hospital for a CTG.

It's a massive relief because as that...

As that midwife, you can't really leave your job at home,

you're constantly worrying,

the next shift that you come in of, are you going to hear some story

that you know, the baby or the mum isn't well

and something happened to them?

Because obviously we don't induce women for no reason.

So, for her to come back and to know that the baby's OK

and that Mum's OK is a massive relief.

Wasn't that much persuaded, but I do want to hear his heartbeat

and to make sure that he is all right.

But it's just that I don't want to stay.

My baby is not ready, I'm only 37 weeks.

He's not ready.

So, she's induction for suspected IUGR...

With Audrey reluctant to start the induction process again,

it's down to consultant Mr Alex Pirie

to come up with a new plan of care for her and her baby.

Audrey, is it? Yes.

Hello there, how do you do? I'm fine, thank you.

Well, I've been hearing all about you, tell me what's...

Basically, they says that my baby's small,

it's like he's dropping off the chart. Yeah.

Yes, he's small, but he seems perfectly fine in there.

Is he moving about lots? Constantly. Good.

So, I don't see what the fuss is.

What people worry about

is if the placenta's not feeding the baby,

the baby can stop growing...

and can die in the womb.

OK, the risk of stillbirth.

Sometimes, the baby's not getting enough sugar and oxygen

from the placenta and that can cause brain damage in the baby.

Every mum has a risk of stillbirth, that's part of pregnancy.

Your risks are a wee bit higher than most.

Option one is to say, I accept those risks,

but I'm going to trust my body because this baby's moving about OK.

Option two, is to say if there's a higher risk of stillbirth,

or brain damage, I'm either going to go ahead with the induction process

or I'll have a Caesarean section.

My body's, like, not ready and to me, he's not ready.

Even though there is a risk. Sure.

Let's go for daily monitoring then, that's an option.

Yes, please. Yep? Daily monitoring.

Everybody's different, everybody is different

but I needed to know

because that's what happened with my last pregnancy,

they didn't tell me nothing.

And I think that's why I'm so wary.

That C word is the trigger point for me.

I'm ecstatic, the fact that I've got another, another option,

I'm ecstatic.

I really am.

I could do cartwheels but I don't think that's a good idea.

I think she's much happier now.

We've given her options

and she's been able to choose the best option for her.

You can't make someone do what they don't want to do.

But it is really frustrating... when you just...

I think sometimes they don't realise how serious things can be

and most of the time everything turns out well.

Which is what we want, we don't want things to go wrong.

As a high-risk unit dealing with complicated pregnancies,

Birmingham Women's Hospital helps deliver

150 sets of twins or triplets each year.

Sarah is another mum having triplets.

Her babies can't be delivered safely in a natural labour,

so she's meeting her midwife Antoinette

in preparation for an early C-section in three weeks' time.

How are you, my darling? All right.

Just a little bit bigger to when I last seen you.

How you keeping, how you feeling? Heavy, achy.

Nearly there though, aren't we?

Yeah, to be expected, I expect.

Just to the left here is our theatre.

There are two, one is for emergencies,

which obviously is the one we use 24/7

and then the second theatre, which is exactly the same

is for our planned sections.

So, this is our theatre, so the first one will be emergency theatre

and you'll be in the bottom theatre down there.

We meet them in clinic here and they're having twins or triplets.

Definitely with the triplets, we say,

these babies are going to be born early

and they know that from a very early stage in the pregnancy.

Because she is at that size now that she could go into labour,

and we have said to her today,

"You know, if you have any signs of preterm labour,

"you mustn't stay at home.

"You mustn't ignore it, you must come in quickly

"because the risks are significantly higher."

I tell you there will be quite a few people in there.

Yes, I've already, sort of, been expecting that.

So you would expect...

You'd expect your paediatricians. Then there'll be...

Obviously, I'll be in there as your midwife, Dr Singh,

and there'll be another assistant with her,

another obstetrician with her.

You'll have your theatre scrub nurse and a runner

and then you'll have your anaesthetist and their assistant.

So that's 11 already.

Plus us. Plus you, the very important people.

Really, from the time they actually start making incisions in the skin,

the babies are out within a few minutes.

So, it'll be one, two, three. And then all excitement happens.

I mean it is, it's excitement with one baby and two, but three...

Obviously, you're prepared for the rest of your life now.

Every time you go out, anywhere you go...

Yeah, if we ever go out.

Oh, you will, oh, I tell you there is life after having triplets.

It's starting to feel quite real.

Yeah. And particularly the planning of it feels quite real.

You know, before it was... Well, it could happen at any time,

it could be an emergency,

so you don't get to thinking about what it's going to be like

to actually go into theatre by your...

Not by yourself but walk in.

Walk in, walk in. No, we're walking in nicely.

Walk in effectively, yeah. Yeah, I've had a couple of operations

but they've been general anaesthetic so this will be the first time

I've been awake inside an operating theatre.

So, kind of nervous, kind of excited.

Seven months into their pregnancy, Sarah and husband James

are still getting used to the idea of three more babies.

That's the blobs.

Yes, those are the heartbeats.

We had an early scan at about nine, ten weeks

and they found a foetal heartbeat and I could see the sonographer's eyes

flickering between two different points on the screen and I thought,

"She's looking at something else there as well" and then she said,

"There's a second foetal heartbeat, congratulations it's twins."

And at that point I thought,

"OK, I can cope with twins, we wanted three kids, that's good."

I know other people who have had twins and they've survived.

It's fine. And then she had a good look round,

see if she could see the source of the bleeding

and spotted the third one

and said, "Actually, I don't know how to tell you this, but it's triplets."

At which point I think I cried and laughed.

It's a huge shock, and I think as soon as you hear news like that,

immediately you're thinking, "New house, new car...

"work life balance, everything."

It's not bad news, but it is life-changing news.

Once you've found out you're having triplets,

you're very quickly into a very medicalised process.

There's risks to the babies, there's risks, obviously, of prematurities,

because there's three of them sharing the space.

In all likelihood they will come early,

it's just a question of how early

and the earlier they're born, the worse outcomes there are.

It is a worrying time.

At the end of the day, these are our children

and even if they're not born yet, you still worry about them as a parent.

We want the best for them, we want the best outcome.

We can't guarantee it, the medical professionals we're dealing with

can't guarantee it, we wouldn't expect them to.

And although you don't like to assume that you're going

to go home with three healthy babies,

you hope for the best even if you don't...

necessarily assume it.

Audrey has been monitored daily for the past two weeks.

Audrey...

Are you here sweetheart?

With her baby's growth still a concern

and only two days until her due date,

she's agreed to be induced again.

Are you Audrey? Hiya, sweetheart, you OK?

My name's Daisy, I'm one of the midwives,

I've come to take you round to the delivery suite to get things going.

OK. Yay! No need. I'm ready.

SHE LAUGHS

If you get everything ready, we'll take you round to room 11...

..and we'll break your waters and get things going.

Is that all right? Oh, yes, yes, yes, yes, yes.

Yes, I'm happy, very happy.

At least I'll be able to try a natural method,

you understand, and that's the main thing.

Oh, my son will be here.

Before it was the waiting game...

Now let the games begin.

I think, when people are called round

and there's a bed and a midwife suddenly available,

I think some people feel like they've won the Lottery.

Like, "Yes, this is my chance, it's all going to be over."

But, of course, it's still only the beginning

cos they've still got a lot...

You know, a long way to go with having their waters broken,

having the drip and then, you know, it could take hours and hours.

Sometimes a couple of days.

But hopefully, Audrey will be quick.

It's 2am on the night shift.

Hey, look at all three.

Sarah and husband James have arrived at triage,

suspecting she's in labour, two weeks before her planned C-section.

Girl, boy, boy.

Apparently.

Well, we'll find out soon enough.

What time did your waters go again?

About 20 to 12.

And it was quite a clear gush.

Oh, yeah, there was lots of it. Yeah, yeah, good.

No contractions at the moment

so there's no mad urgency to do anything at the minute, you know,

so just chill out.

You'll get nice monitorings of these three babies

and then we'll get one of the doctors to review you

to see what their plan of action's going to be. Sure.

All right, Sarah, I've brought a lovely doctor with me.

All right?

SARAH SPEAKS INDISTINCTLY

No, its all right. We've done well with that monitoring, haven't we?

Oh, yes, there's plenty of it.

Lovely, lovely. Excellent.

Provided you don't start contracting tonight,

the best thing would be to leave well alone, I think,

given that it is the middle of the night. Yeah.

And then...

we'll reassess things in the morning. Mm-hm.

Given that you're now 33 weeks, there is a possibility...

that we might think about delivering you later on today.

Good, I'll try and get some rest then.

Last chance I'll get.

The plan now is, as she's now contractions,

is that she... We're going to admit her to the antenatal ward.

There's no imminent urgency to deliver these triplets

as there's no contractions, no signs of labour,

other than her waters have gone.

Ideally, we would like Sarah

to go into labour any time after nine o'clock tomorrow

because its going to make it a much more safer environment,

we're going to have a lot more staff on

to deal with this intensive, high-risk case.

So, we don't want to compromise care,

and that care could be compromised

if Sarah was to go into labour any time now, really.

Because we have skeleton staff on.

At 4am, Sarah goes into premature labour.

The team rush her into theatre for an emergency C-section.

With limited time to deliver the triplets,

she's been put under general anaesthetic.

It was extremely frightening for Sarah,

the fact that she was rushed down.

She'd gone from virtually not being in labour to,

"I hope my baby's going to be all right".

It's all gone from being very controlled

to very, very, very frightening.

Hello.

Congratulations.

Well done, you.

Hello.

22 minutes past.

Much better.

INDISTINCT CONVERSATION

She's absolutely gorgeous.

Hello, darling.

Well, you can't keep kicking Mummy any more.

INDISTINCT CONVERSATION

It's absolutely wonderful.

You do feel very privileged to be part of this experience for Sarah.

You all right, James? All right.

Glad you were here then?

All three babies will be monitored at the neo-natal unit

while Sarah recovers from her operation.

12 hours after having her waters broken,

Audrey still hasn't gone into active labour.

Her body does seem to be contracting but at the moment,

progress does seem to be quite slow and she doesn't seem to be dilating.

We do have to put a time limit

on how long we let her womb contract for

with little progress or no progress.

Knowing Audrey over the past few weeks,

I think her biggest concern

will be needing to have an emergency Caesarean section.

She's fought very hard to not have that.

You remember I said baby's hearts were showing signs of deceleration?

I'm not ready to get excitement yet.

Unless you're going to strap me down to the bed.

I'm not strapping you down to the bed,

I'm just taking everything into consideration.

On your behalf, not my behalf. No, no, no.

If you look at that, that's baby's heart rate.

Because I'm moving.

I am worried that maybe complications can arise.

Maybe her uterus might rupture and if that does happen

it is a life-threatening situation to both mum and baby.

At the start of the next shift, Sarah is assigned to Audrey.

We just have to go with the picture we've got in front of us.

But I am the canvas. Of course, of course.

Which is what we take into cons...

But no-one wants to hear what I want to say.

We do, I honestly do want to hear what you want to say,

but I have to advise you at the same time,

and you might not want to hear what I've got to say.

Audrey, I really...

Listen, I don't want...

We don't want to frighten you, but we wouldn't be doing our jobs

if we're not telling you the risks...

and what we would suggest.

What, to put me on a slab and butcher me up?

No, not at all.

I'm getting panic attacks...

Because I'm frightened now I've come back here. Audrey...

My daughter, she was bad...she was bad.

She was bad.

She was proper bad.

Nearly dead.

Yeah, but we don't want to get to that point again.

Everything you guys have tried ain't worked, simple as, simple.

Everything.

I think she still thinks that we're not listening to her.

Which, it's not that we're not listening to her,

but I think she still feels very much not in control of the situation,

which is really important to Audrey, as it is to everyone.

They still want that bit of control over her delivery.

She had such a...

bad birth experience last time,

that she really didn't want it to happen again

and I think she just feels out of control again

and that it's going down the same route that it did last time.

It's too late now, my bag's broken.

It's too late, it's not like I can walk off the ward now, that's it.

My baby's life is in YOUR guys' hands. I know.

That's it now.

But please, I know, I know it is like that but...

No, it IS. Yes, but we're still not going to

suddenly wheel you off to theatre without you consenting.

We're not about to do that.

But in any labour, there's always, as we've explained to her,

there is a chance that her baby could die.

We hope not, and it won't come to that,

but there is that chance which is why we have to act

when we first see signs of the baby becoming distressed.

See, I'm getting upset, I need to be unhooked.

Right, listen to me.

I don't want to unhook you

because I don't know what's going to happen to your baby

when you're not on the monitor.

So, I'm saying to you, I need you to stay on the monitor

so we can monitor your baby.

If you're saying to me, you understand the risks...

I can't stay here, I've got...

But do you understand that if you go outside

and I take you off the monitor,

I don't know what's going to happen to your baby?

I'm going in the garden, to the garden right there,

right there, I'm going in there.

But-but five minutes is all it takes sometimes, Audrey.

What do you want me to do?

Do you want me to leave it with it on and then we'll go out the room?

No. You want me to take you off it?

I don't want to...

I will be back in five minutes.

I will go and let them know.

It's a really anxious time.

You just, you want to be there to support,

to the woman, but you're looking at a CTG

and you're seeing that the baby's not happy.

So I'm hoping that maybe when she comes back,

she might be calmer...

and ready to make a decision.

Are you worried? Yeah.

Are you going to come back on the monitor? Yeah.

Are you cold, do you feel cold?

Yes, I do because I'm hungry.

That can sometimes be a sign that there's an infection.

With Audrey's temperature dangerously high,

and her baby in distress,

there's no more time to wait.

I'm just trying to talk a little bit quickly

because I'm very concerned about you and about your baby.

OK? Your heart rate is up, it's going up.

Why do you think it's up?

It might be, there might be bleeding inside.

No, it's because everybody's at me.

What do you want then? Tell me what you want.

I want you guys to give me a chance.

You can't...

Audrey, from our point of view we've given you a chance.

I know you don't feel like that,

but we've given... You know, we're here three weeks later.

Right, Audrey, I don't want to wait otherwise it might collapse a little

and be really, really serious.

Audrey, you need to give us this decision.

Audrey finally makes the decision to undergo an emergency C-section.

It was probably about an hour from when we wanted to deliver her

to her actually going to theatre.

The longest hour of my life, really.

She did understand eventually that it was going to have to happen

and she just needed to come to terms with that

and just put her trust back into us, really.

So, it was a real relief to get her into theatre

and to know that her baby will be OK and we'd make her well again as well.

Just like real relief just to hear that baby cry

and just know that hopefully it's going to be OK.

Still feels surreal...

because he's so laid back.

He's so chilled.

I've been saying all along that I could have gone full term.

He could have gone full term.

But...

I'm glad he's here.

I am glad.

Yeah.

You know when you're in that situation it is scary

to think what could happen

and because you do have experience of things going wrong,

you really just don't want that to happen again.

I think this will stay with me for a very long time,

probably...forever, I would think.

Hello!

Hasn't been easy between me and some of the midwives.

But...

I do appreciate their help.

I'm not the easiest patient to get along with,

I can tell anybody that

but I appreciate the ones that have done that

and did mean it from their heart.

Four hours after her emergency Caesarean,

Sarah has recovered enough to meet her triplets.

Oh, what a little tongue you've got.

Hello, darling.

It's amazing, so tiny.

Feels so vulnerable.

Feels so new.

To suddenly have tiny little babies...

Spent so long...

just being pregnant

and then it's so hard to imagine what it's going to be like

to here it is. It will still take a bit of getting used to.

So different...from my last.

Plenty of time for growing.

This isn't the end, it doesn't matter how we get there as long as we get there...

And here we are.

It's good to see Sarah back with them.

Got lovely long fingers.

Gorgeous...but I'm biased.

And I'm very proud of my wife.

It's not a job really, it's an absolute passion.

You know, I mean, what a privileged position we're in.

Do you know, to be there for a birth of a baby is just lovely.

And people will always remember that,

it's such an event in anybody's life and they're quite nervous and that.

I mean, what a privilege we have to be there with them,

giving them support, advice, guidance,

and be there hopefully to see the new born baby.

I love babies anyway so it's perfect for me.

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