Call the Midwife: exclusive extract from Jennifer Worth's memoirs

The author's account of 1950s nursing inspired the hit BBC series. In this entry Trixie discovers there’s no rest for a midwife…

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Call the Midwife: exclusive extract from Jennifer Worth's memoirs
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The practice was extremely busy. Every midwife will tell you the same story. You can tick over comfortably for weeks, and then suddenly there are more women in labour than midwives to cope with them. Some say it's the phases of the moon, others say it's the local beer. 

Trixie had been working all night. A delivery at 10pm and another at 4am had left her exhausted, and she still had a day's work to get through. An hour of sleep after lunch had helped, though the evening visits were heavy. At nine, a long luxuriant bath with her favourite salts had eased her mind, and she was looking forward to the bliss of sleep. 

The telephone rang. "Not me," thought Trixie. "Someone else is on first call," and she sank deeper into the water, turning on the hot tap with her toes. 

A moment later there was a bang on the door. 

"Trixie, old sport. You in there?" Chummy's voice sounded through the door.
"Yes."
"I've got to go out. You're on first call now."
"What! You're joking. I can't be."
"Sorry and all that. But Cynthia is already out on a delivery, and Jennifer has a day off. It's up to you."
"I just don't believe it." Trixie groaned and felt sleep enveloping her.
"What did you say? Never mind, I can't hang around." 

Chummy's footsteps retreated down the corridor. Trixie's tired mind refused to take in the reality of the situation. She felt she might doze off in the bath, but forced herself to get out, dried and into bed, where she immediately fell into a deep and dreamless sleep. 

At 11.30 the phone rang. Usually a midwife on first call will hear it instantly, be out of bed and alert within seconds. The subconscious will keep the mind half-awake, ready for action. But Trixie slept on. Eventually the persistent ringing penetrated her ears, and she awoke confused - "someone had better answer that damned phone," she thought. 

Then she remembered Chummy's bang on the bathroom door. Horrified, she struggled out of bed and picked up the phone. 

"Yes. Nonnatus House here. Who is it?"
"And about time, too! What d'you fink yer playing at? She coulda died afore you answered the telephone," a harsh female voice barked.
Trixie shook her head vigorously, trying to focus her thoughts.
"Who is dying? What is the trouble?"
"Trouble? The trouble is you. You lazy good-for-nothing."
Trixie groaned and sank onto the wooden bench beside the telephone, but her training came to the rescue. Mechanically she heard herself say, "Please give me your name and address and tell me, as clearly as you can, what is the matter."
"It's Meg, from Mile End, and it's Mave, see. Mave's in labour, and you gotta come quick."
The clouds were lifting from Trixie's tired brain.
"But Mave is not due yet. Not for another month."
"Don't you come vat one over me. You just get 'ere at the double, or I'll report yer to the authorities for negligence, refusin' to come to a woman in labour."
Trixie was wide awake now. Mave was thirty-six weeks pregnant. A premature labour would be a serious matter, and dangerous for the baby.
"I'll come straight away," she said and put down the phone.

Trixie hastened into her uniform. But before going to the clinical room for her bag, she went to the Sisters' corridor and knocked on Sister Bernadette's door to tell her that, according to Meg, Mavis was in premature labour. 

"Go and assess the situation and inform me. If premature labour is established, she must be transferred immediately to hospital," were the instructions. 

Trixie collected her bag and attached it to her bicycle. She had a three-mile ride, and a fine drizzle was falling, the sort that gets you damp all over. Her legs were heavy, and turning the pedals seemed like one of the twelve labours of Hercules. 

She reached the Mile End Road, which is broad and straight, and cycled along it looking for the turning, but missed it, and had to go back. "This can't be happening to me," she thought. Once in the narrow street of identical terraced houses, the only light in a window led her to the correct address. She was met at the door by Meg. 

"Call vis straight away, do yer? More like a snail's pace, I call it. You bin twenty minutes gettin' 'ere."
If Meg thought she could intimidate Trixie, she was in for a shock.
"If you can get here any quicker on a bicycle, you are welcome to try. Now, cut the criticism and take me to your sister."

In the bedroom it was hot and stuffy. A big fire was burning, and the windows were closed tight. Mave was lying on the bed moaning pathetically, clutching her stomach with both hands. 

"See, she's sufferin' somefink wicked. Bin like vis for a couple of hours, she 'as. Somefink wicked."
Mave moaned and whimpered. "When's ve baby comin? I can't stand much more of vis. They'll 'ave to take it away. Cut me open."
Meg echoed, "She can't stand no more. It's 'orrible. Too much for 'er, with 'er weak constitooshun."
Trixie took off her coat and sat down beside the bed.
"Ainchoo goin' a do nuffink?" demanded Meg.
"I am doing something," said Trixie, "I'm assessing the progress of labour."
"'Sessin'? Wha choo mean, 'sessin'? She needs treatment. Dr Smellie in 'is book, 'e says the midwife should put ve woman on a birfin' stool."
"Birthing stool! Where do you get that rubbish from?"
"It's 'ere in 'is book. You read it. You're supposed to know about vese fings."
Trixie glanced at the aged book.
"That is two hundred years out of date. Don't cram your head with a lot of stuff you don't understand. No one uses birthing stools any more."
"Look 'ere, I'm not 'avin' you. You can send for someone what knows what to do."
"There's no one else on call. I should be delighted to go back to bed, but there is no one else who could come. You're stuck with me, and if you don't like it you can lump it. Now be quiet. I want to examine Mave." 

Trixie pulled back the bedclothes and palpated the uterus. The head was above the symphysis pubis, but she could not feel anything else definitive. There seemed to be lumps all over the place. She stood still, thinking, head on one side. 

"Well, Miss Stoopid, what you goin' a do now?"
"I'm going to listen to the baby's heartbeat," replied Trixie coldly, trying hard to ignore the woman's insults.
She took out her Pinards and applied it to the abdomen.
"You better get on wiv this and stop messin' abaht. My sister's in labour, I tells yer."
"Be quiet, will you? I can't hear a thing with you making all that noise."
Meg rolled her eyes to the ceiling and sucked in her breath, indicating her total lack of confidence in the procedure. Trixie listened carefully and counted a steady 120 beats per minute. She stood up, satisfied.
"Well, the baby is quite healthy. Now I must ask you some questions. When did you first feel contractions, Mave?"
Meg answered, "About ten o'clock. Came on sudden. Terrible it was". 
"Will you be quiet. I'm asking Mave. Not you."
Trixie was too tired to be patient. She turned to Mave. "And how frequent are the contractions?"
Meg answered regardless: "All ve time. Can'choo see? She's sufferin'." Trixie's slender reserves of patience snapped.
"Will you shut up and get out of here? Either you go or I will go. I'm not prepared to carry on like this." 

Trixie was taking a risk and she knew it. If she deserted a woman in labour the consequences would be severe. But the gamble paid off. Meg left. Trixie could now devote her attention to Mave. She was puzzled because, although she had been observing Mave for at least twenty minutes, and although Mave looked and sounded as if she were in advanced labour, there appeared to be no contractions.

"When did this start?"
"About ten o'clock," Mave groaned.
"And how frequent were the contractions? Did you time them?"
Mave looked pained. "They was all ve time. Never stoppin'. Meg says Dr Smellie says…"
"Never mind what Dr Smellie says. Contractions don't just start and never stop. It's not possible."
Mave assumed her martyr's expression.
"You don't understand. I'm dyin'. You don't care." She hung onto her belly and rolled onto her side. 
"Stop all this fuss," barked Trixie. "You are no more dying than I am. I haven't seen a contraction since I came into this house."
"That's cause you don't know nuffink. Meg, she says…"
"I won't hear any more about Meg. Now tell me, when did you last open your bowels?"
"What?" Mave jerked round to face Trixie.
"You heard. When?"
"I'm not sure. Couple of weeks ago, p'raps."
"You are constipated. And what did you have for supper?"
"Gooseberry pie and custard."
"Green gooseberries?"
"Yes. Two 'elpin's."
"Well, that's the trouble, then. You've got gut ache. You're not in labour at all, you old fraud. Getting me out of bed for a stomach ache!"
Trixie was furious. "Do you realise I have been working for forty hours with no sleep, and you wake me up for nothing. I will give you some castor oil and an enema, and then I am going back to my bed and leaving you to get on with it." 

You can buy the novel Call the Midwife, the first in Jennifer Worth's trilogy, for £7.59 including p&p. Call 01326 569444 or visit www.rtoffer.sparkledirect.com. Contract for supply of goods is with Sparkle Direct.

Watch repeats of the acclaimed first series of Call the Midwife every Thursday at 9pm on BBC2. The series will return later in 2012 with a Christmas special