“Look luv”, I say to the woman on the bed, “if you can hop onto the chair I'll carry you downstairs where we can get you to the hospital”.
The woman on the bed lifts one leg high into the air and grunts in pain. I'm not worried, I think that the reason why she doesn't want to get onto the carry chair is because she has poor pain tolerance.
“Your contractions are every three minutes?, I ask her, “your waters are intact, so you've got ages to go before you give birth”.
I'm really not worried, I'm more annoyed that this woman isn't doing as I tell her, namely to pant through the contractions then get on the chair so I can get her in to see the midwives.
“You've had the contractions for only four hours, it takes much longer than that to… Bloody hell! are you pushing? Don't push – you don't want to push do you…”
I turn to my temporary crewmate, fresh out of training school but he seems fairly sensible, “You'd better get the other maternity pack from the ambulance, and the suction, and the oxygen bag. Oh, and ask Control to get us a midwife 'cause it looks like we are going to deliver here. Don't run but, y'know, don't dawdle either”.
He trots down the stairs.
“I'm going to have to take a look”, I tell the woman and she lifts up her skirt to show me her genitals.
In training school there were two things that we were told to be wary of causing offence, the first was traipsing around Mosques in our boots. The second thing was that Muslim women don't want men who aren't their husband looking at their bare flesh – strangely enough, when someone is about to deliver a baby they don't seem to care. I would guess that common sense tends to trump religion when you (and your husband) are scared and in pain.
I tilt my head to one side, trying to visualise exactly where the baby is. Then she pushes again and I deftly side-step the gush of amniotic fluid that jets out of her towards me. The professional in me observes the fluid as it shoots past my ear, it's nice and clear which suggests that the baby hasn't pooed in it. The un-professional part of me gives myself a mental high-five for not getting caught by the spurting body fluids.
My crewmate returns with the kit and I ask if he's ever delivered a baby before, he says he hasn't and that his current family came pre-loaded with grown children. He tells me that the hospital hasn't got a midwife to send so it looks like we are on our own.
I explain everything to the mother to be, and to the father to be, and the brother, and her previous child. The previous child was born by caesarian section, so this is the first 'proper' birth she has done. Luckily it's not my first.
I put on the gloves as she pushes again. This time she pops out a bit of poo. I wipe her (something I thought I'd given up when I gave up nursing) and contemplate that when mothers to be start pooing the baby is often not far behind.
We get the equipment ready – clamps, scissors and blankets. My crewmate and I are both gloved up and ready to go.
Once more the mother sticks one leg straight up in the air and gives a strangled cry.
I can see hair. Which means I can breathe a sigh of relief – not a breach birth. But the hole through which the baby will be making an appearance seems rather smaller than the previous times I've delivered.
I'm not worried, women have managed to give birth in the past and in worse conditions that the one that I find myself in. Heck, I've delivered babies in much worse conditions than this. At least in this case there is light, everyone speaks English and we aren't fiddling around in the back of a car unlike the first delivery I was involved in.
There is some more puffing and panting, some refusal of painkillers and slightly worrying moment when I wonder if the head will ever make an appearance.
Outside the brother is chanting and praying, it seems that he's doing a good job as I can hear him through the door. I'm guessing that it's one of those 'welcome the baby into the world' sorts of things.
Then with a tear, a scream and a pop the head arrives.
A quick feel and I realise that the cord is around the babies neck, so I untangle it. I help with the rotation and with a final big push the rest of the baby arrives and I catch it.
The cord is clamped and cut, and I rub the baby dry, hoping or a cry. A crying baby makes a happy ambulanceman, but baby seems quite content with sniffling and sneezing a bit. Good breathing, a nice strong heartbeat and reflexive movement – I'm quite happy.
The baby is fine, so I hand it off to a relative and check the mother – some slight bleeding, enough to wreck the mattress, but nothing too nasty. She seems a fair bit confused as I explain about the placenta and not for the first time in my career I wonder if anyone ever reads the instruction manual for their body.
She's happy though, the pain is over and she has a baby to show for it – a huge grin arrives on her face.
“Is it a boy or a girl?', the father asks. To be honest I haven't looked, I was more worried about the baby breathing, so we both go delving into the baby wrap to see what sort of equipment it's got between the legs.
It's a girl.
I can relax now, mother and baby are fine, people are congratulating us and all we do now is wait for the midwife to turn up. I try to remember the criteria for the Apgar score, I know that the baby is fine, but it's something nice to put in the documentation. Memory fails so I pull out my phone and look it up on Wikipedia. Baby scores a solid ten out of ten and I learn that Apgar is someone's name and not an acronym.
Then I learn what a backronym is.
I put my phone away.
The midwife arrives and does the mid-wifey things that midwives do, like yanking out the placenta and reminding us that the baby should be kept warm. We know that the baby should be kept warm, for most of us that is the one thing that we can actually remember from our four-hour training session on how to catch a baby.
Mother and child go to the hospital, as mother needs some sutures in a place I'd rather not have a needle anywhere near – but unlike other occasions, our midwife congratulates us on a job well done and makes us a cup of tea in the maternity department tea-room. I ruminate over a biscuit that I've never had a midwife arrive before the baby is born, and how they manage to get their timing that precise.
A good job, everyone is happy and I got a cup of tea at the end of it.
Can't ask for much more than that.