“That’s it, Natasha, you’re doing great. Just breathe through the pain. Use the gas and air, it’s there to help. The contraction is almost over,” I say, trying to calm this mum-to-be with reassurances and confidence. She looks at me, wild eyed. Her lips are pulled in a feral snarl, her guttural cry of pain sounds muffled through the mouthpiece clamped between her teeth.
Scream, inhale, scream, inhale, scream, inhale.
The violent act of birth rings loudly in my ears. So loud, my hearing aids whistle in protest. They’ve been playing up all day, but right now I don’t have time to figure out what’s wrong with them. Getting this mum through the most demanding hours of her life is my priority. My shift will be over soon. In another hour I’m due to go home but I am determined to help Natasha deliver this baby first. We’ve come this far together, I’m not going to leave her now.
As the contraction subsides, Natasha’s face relaxes slightly. The mouthpiece drops from her lips and her head falls back in exhaustion. A single mum already, Natasha has no one here bar me to support her. Estranged from her family, I am, for all intents and purposes, her only comfort. I am the person she needs to ground her in this room whilst the pain takes her mind to another place.
Scream, inhale, scream, inhale, scream, inhale.
“You can do this, Natasha, don’t fight the pain, use it.”
I love my job. To have the privilege of being the first person to hold such precious life in my hands, however fleeting, is by far the most rewarding feeling. For those few seconds as the newborn is finally released from the safety of its mother’s womb, covered in blood and still attached by its umbilical cord, I feel a peace unlike any other. In those moments there is no singing, no lingering darkness just around the corner.
There is no death.
“I can’t do this anymore,” Natasha says, her face crumpling under the weight of her fear and pain. I take hold of her hand, squeezing it gently. Grounding her with my touch.
“You can, and you will. You’ve got this, Natasha. Trust me, okay. This baby will be born in the next few minutes. You’re almost there. Next contraction, I want you to push right into your bottom. Can you do that for me?”
Glancing at my wristwatch, I know that in less than a minute Natasha’s next contraction will start, and she will be thrown back into a world of pain once more. I’ve been told by mothers I’ve cared for before that the pain of labour is unlike anything they’ve ever felt, that it’s like death has reached up and ripped out their insides. It is wonderous to me that a human being can sustain such prolonged and agonising pain and survive it.
On the surface, some mothers appear to cope with labour better than others, barely making a sound as the contractions take over their physical and mental self. Others scream as though they are being murdered, and no amount of gentle persuasion can get them to breathe through the pain. In those moments, with those mothers, I let them scream and shout. I let them ride the agony of body-splitting torture in whatever way they choose. So long as the baby is not distressed, what does it matter if she is swearing like a fishwife, or screaming loud and true?
Natasha is somewhere in between these two extremes. Right now, she is at the stage of defeat and I know that in a few more minutes her baby will be born. Glancing at the CTG monitor I can see from the baby’s heartrate that all is well, the little one isn’t distressed. But honestly, although I always strap the Toco and Transducer to each mother to record the heartrate and contractions, I really have no use for either. Call it intuition, call it a gift. Whatever it is, I am in tune with both baby and mother, knowing instinctively what they need, when they need it the most.
My colleagues tell me that I am a gifted midwife, that there is something different about me and the way I can pre-empt what a mother and her unborn child needs. I don’t know if I am any more gifted than they are, but they are right in thinking I am different. That difference is not something I ever wish to reveal.
“It’s coming. Oh God, it’s COMING!” Natasha yells in fear, knowing what’s about to happen and knowing there is nothing she can do but ride the wave of agony as best she can.
“You can do this, Natasha. Listen to my voice, you need to push. It won’t be long now; the contraction will be over soon.”
Natasha grips my hand as another surge of pain batters against the last, like the waves of a storm against the hull of a ship. I can see the muscles of her stomach tighten as the vice-like grip of her contraction squeezes. Her cry is animalistic. Brutal. But it doesn’t frighten me. This is mother nature at its most barbaric, and its most beautiful.
Natasha squeezes her eyes shut, her face bright red. A thick vein stands out on her forehead as sweat slides down her cheek, mingling with the silent tears that fall. Some people would find it terrifying to see a woman in so much distress. But not me. Pain means life, that’s what I hang onto, even though death follows me around with its siren’s call.
I am sick of death.
I am sick to death of death.
“Please it hurts, oh God, it hurts.” Natasha digs her nails into the palm of my hand hard enough to make me wince, but I don’t let go. She makes a guttural sound and my hearing aid whistles again, loud enough this time for me to be more than a little irritated by it. With my free hand I adjust the levels, hoping that will help. It only seems to make it worse. Ignoring the squeal in my ear, I concentrate on my mum-to-be.
“Push, Natasha. You must push,” I remind her, pulling her back from the place she has disappeared to. She seems to hear me and bears down with all her might. Her fingers grip onto the bedsheets, her knuckles turn white whilst her face turns a darker shade of red. Contractions contort her pretty face into something infinitely more beautiful. Her body is instinctively doing what it was made to do. Angry red stretchmarks rise up from her pubic bone, a line of flames that mark her skin. Most women hate them but to me they are the scars of motherhood. A branding of strength, love and beauty.
I place my hands on her lower belly, feeling the slight ridges of her scars through the latex gloves I’m wearing, and close my eyes. This baby, it wants to be born. It’s as though he is talking to me through skin and muscle, blood and bone.
“I’m ready to be born, I’m want to live,” he whispers.
“Natasha, it’s time. Your little boy is almost here.” I press my mouth shut quickly, annoyed at myself for letting slip the sex of the baby. That’s the other gift I have, I always know the sex. I’m never wrong. I glance at Natasha, who is too far lost to her own mind to hear my slip.
“The baby’s head is crowning, I want you to slow down. Pant for me, Natasha.”
Her eyes flutter open and she locks her gaze on mine. Good. I want her to use me as her anchor, someone to hold onto during this incredible moment. Normally it is a husband, partner or family member who gets that responsibility, that gift. Today it’s just me, and I will take on that role and give this mum what she needs.
“That’s it, Natasha, concentrate on me. Concentrate on my voice, okay. You’re almost there.”
Natasha grits her teeth and pushes her chin against her chest. She just needs to ride this out whilst the baby’s head crowns and then she can push.
She is on the cusp of losing herself to the act of giving birth. I’ve seen it countless times. No matter the woman, or the labour, the moment it’s time to give that last push they all act on instinct. It’s as if mother nature has risen like a phoenix within their chest, taking over their bodies and giving them the power and strength to do what needs to be done.
“Your baby’s head is coming. Don’t push. Just pant, like you’re blowing out a candle.”
Natasha follows my instructions, blowing air out of her mouth in quick succession, her mouth forming a perfect O. It’s enough to prevent her from pushing when her body isn’t quite ready.
I look down at the baby’s thatch of dark hair mingled with white, gloopy vernix and blood as it slowly emerges. Natasha lets out a gut-wrenching scream. I call it the soul cry. The sound is inhuman, as though a part of her soul is being shorn away at the same time her baby is born. A little piece of her leaving with him.
“Well done, Natasha, your baby’s head is out,” I say, choking on the emotion I always feel at this point. I reach over to take her hand, squeezing it gently. A strand of my silver-blonde hair falls forward and I swipe it out of the way with the back of my hand. Below me, her little boy’s eyes are pressed shut, his tiny mouth puckered as though annoyed with his emergence into the world. A feeling of peace washes over me, and just for a moment I can forget the stench of death that lingers over me always.
“Do you want to feel his head?” I ask, snapping out of my morbid thoughts. I glance up at Natasha, who is both exhausted and utterly awake. Adrenaline is keeping her body going, that and her need to see her baby after months of waiting.
“Can I do that?” she asks, lifting her shaking hands.
“Yes, of course you can.” I help her to move forward slightly and guide her hand to her baby’s head. She lets out a little cry of shock and wonder as her fingers gently flutter across his forehead.
“Next contraction your baby will be here, just one last push.” I squeeze her hand briefly.
“Okay,” she says as I settle her back down. There is relief in her eyes, combined with a huge dose of fear. As the contraction begins to swell once more and Natasha’s body prepares for the final push, another high-pitched squealing pierces my ears and stabs at my brain. My hands fly upwards, and in one quick motion I rip the malfunctioning hearing aids from my head, casting them aside.
“Goddamn it,” I mutter under my breath as I shake the pain away. I don’t need to hear Natasha to know what’s going on. I’ll manage without them.
For a few precious moments, there is nothing but absolute silence. I can’t hear Natasha as she pushes through her final contraction. I can’t hear the machine bleeping, or the clock ticking or even my own breathing. I hear nothing, and it is bliss.
A fraction of a second later, a familiar cold dread flutters up my spine. I hear a voice.
And he is singing.