We’d had what felt like an endless stream of lessons and practical sessions on labour and birth. Some of us had perfected the act of the birthing mother, a special mention goes to Doctor Strangelove. What more was there possibly to know? A lot it turned out, and not restricted to midwifery, Cristi’s speciality. All the lessons up to then had been from university’s perspective. Now we had to learn what the Service wanted us to do and, equally s important, what it didn’t want us to do, but more of that later.
She started by grilling us on why we wanted to work in the ambulance service and our experiences on the road with pregnancy and birth. I raised my hand and, before I knew it I had said that I did it ‘for the Doctors’. Cristi had a puzzled look and I just shook my head and said it was an in-joke. We went round the class and all the old pregnancy favourites came out. For about the twentieth mentioned the query ectopic pregnancy I had been to on my first observational placement week. I was looking forward to the day when we all had some new stories to tell, when some of us had delivered babies ourselves and the babies had been named after us. ‘That’s happened to me only once in my career’ said Cristi. ‘My favourite one is the woman who gave birth in the back of a bus. She named it Dennis, after the bus’.
‘We’re called Midwives, but really we’re sex workers’ said Cristi. ‘We work on the by-product of sex, so we’re sex workers. That’s what I tell my husband any way’. I wonder how many times she had said that one. There was, however, some truth in the statement. We were given a lengthy introduction into what was expected of us in our Service Cristi had a captivated audience. By the end each of our little hearts were filled with pride. ‘In the ambulance service, we don’t panic – we swan. It’s fiiiiiiine. Ambulance technicians have got this walk to them, it’s a bit like this’. She borrowed a high-viz jacket from someone in class and sauntered slowly across the room, leaning back and bopping with every step. ‘The mother doesn’t know it’s your first time and your heart is going like the clappers. Don’t tell her. A paramedic a while back told me you do two things, three if they’re pregnant. You hold their hand and stroke their forehead. If they’re pregnant, you rub their belly. You are her person, and she’ll remember you for the rest of her life, no joke. She’ll hold your hand and she won’t let go. If you deliver the baby, your name will be on the declaration of birth – yay!’
I couldn’t tell exactly, but I think she was beginning to win round even those trenchantly un-interested in childbirth. Most notably Esther and Cruella. Now that really would be an achievement. ‘The rest of the time you’re job is body parts, vomit, drugs, violence. You don’t often get to do nice things like babies, so when you do, sieze the opportunity. And you’ll be fine. You will be fine. Out of every 10 births, 9.7 go well’.
‘I see you as generals in the making, because that’s what paramedics are out there in practice, they’re generals. They control the scene, they boss people about. So as student paramedics, you’re generals in the making, so you need to act like one. Question why things are so. When you get called to a birth, ask the midwife about everything. Don’t just sit back and watch, question her, ask if you can help. If you hadn’t guessed, the ambulance service doesn’t employ stupid people. Knowingly, anyhow.’
She told us a few of her stories. ‘Out on the road, you’re going to see some pretty odd things. I was working a shift when there was a Robbie Williams concert going on a few miles away. We had seven mothers come in that night, all of which had given birth or were giving birth at the front of the stage. But I didn’t question them – until after the births that is, then I did. Why the hell were they at the concert when they were due? ‘But I had to see Robbie’ she said in a mock pleading way.’ It was the first of a series of bizarre occurrences she had seen down the line.
We were shown a video of a home birth, the same one we’d been shown in the last lesson with the university midwife lecturer, and the one before that with a different one. We kept quiet out of respect. And everyone likes a good birthing scene don’t they? The home was ‘well appointed’ an estate agent might say. Everything was prepared, with two midwives and a carpet covered with newspaper. ‘You probably won’t go to this said Cristi. ‘It might be a squat, it’ll probably be unplanned. But she’ll deliver, just the same. She’ll do the same movements. The baby will cry the same. Women in labour get stressed if those around them get stressed. As generals in training you need to calm the father. I know you’re all young, but you need an old head’. I wonder just how old some of the fathers might be. Sixteen? Seventeen? Even younger if they were unlucky. That gives me a whole six or seven years on some of them – not so young after all. We’re there to pick up the pieces after all, and one of the significant pieces is teenage pregnancies in unfortunate circumstances.
‘Inside the womb it’s like a cool jazz club’ Cristi said, plucking a double bass in the air’. It’s twilight in there, all sounds are muted. Of course the babies going to cry when they get out, you’ve just taken them out of the nice warm dark club’. So what was it like for the mother? ‘Hah! The mother! Someone said to me once that delivering a baby was like shitting a concrete bollard.’ There was a collective wince around the class. I’ll remember that next time I hear a woman in labour screaming her head off.
‘I want you to write this down now’. We scrabbled around for pen and paper, but we needn’t have. The instructions were straight forward, even I could understand them. ‘When you’re on scene, keep it simple. If she’s in pain, believe her. If she thinks something’s wrong, trust her. And the other thing is, act on the obvious. Oh, and never be afraid to admit you’re wrong or you don’t know something. You’d be lying to two people if you did, not just one’.