Edinburgh, the Independent Republic of Scotland
Day 296
Walking into the Labor and Delivery ward gives me the heebie-jeebies. Memories of Josh’s birth come to mind. Twenty-eight hours, a failed epidural, a third-degree tear. It’s not a coincidence we only had the two. At the same time, my stomach clenches with longing. Oh, to be able to do all of this again and hold a tiny newborn, knowing the years of joy stretching out ahead of me.
No crying today. I’m not here to reminisce. My job as a public health consultant at Health Protection Scotland requires reconnaissance. Someone thought it would be a good idea for one of us to see what’s happening in labor wards, as the babies conceived shortly before the Plague make their way into a world their parents never could have imagined.
“Amanda? Hi, I’m Lucy.”
Lucy looks awful; she’s gray with exhaustion. I’ve seen enough nurses and doctors in A and E with this blank stare to know burnout when I see it.
“How are you, Lucy?” I ask.
“We’re not going to be able to talk about that, Amanda,” she says resolutely. “I’m hanging on by a thread here, let’s not snip it.”
“I’ll stick to medicine. Understood. How qualified are you?” I ask. She looks very young.
“Only fifteen months. The job hasn’t been . . . what I imagined.” There’s an understatement and a half.
Lucy takes a deep breath and launches into what is clearly a preprepared spiel. “I’m taking you through to see Alicia. She’s agreed you can watch but she thinks you’re here in your capacity as a doctor, which, technically you are, so I think that’s okay. Alicia didn’t know when she conceived obviously that she would be giving birth in the middle of the Plague and the stress is slowing her labor down. That’s been happening a lot. We banned men from the ward for a while but then it was confirmed that women are hosts so . . .” She shrugs with forced carelessness before continuing. “Of the two hundred eighty-four boys I’ve helped to deliver in the last six months, twenty-nine have survived. The babies tend to fall ill within a few hours and we think it’s transmitted through contact after birth. Once they’re in the world, they’re touched by their mothers and then . . .” Alicia doesn’t know whether she’s having a boy or a girl, which is quite common. I think they like to have hope for as long as possible, but her body’s protective instinct is kicking in so it’s trying to keep the baby in for as long as possible.”
Lucy pauses. I think she wants me to say something.
“Is her husband here with her?”
“No, he died two months ago.”
With that, Lucy leads me through to a dark room with only a few dim lights. She tells me in a hushed voice that Alicia has an epidural and they think they might need to have an assisted delivery or a C-section. I stand in the corner, trying to look as unobtrusive as possible. Two midwives and what looks by her age like a senior registrar are encouraging Alicia to push, but anyone can see she’s not really trying. I can’t blame her.
Thirty minutes later, we’re all scrubbed up and in the theater. The need for a cesarean became obvious. Alicia is weeping in fear and shaking as her mum holds her hand. “I wish Ronnie was here,” she says, and my heart breaks for her. Time isn’t moving as we wait for the baby’s sex to be revealed. There is the usual cutting and violence of a cesarean. The senior registrar pulls the baby out. The whole room catches its breath and I’m imagining the announcement of a boy so clearly, I almost hear it in the tense silence of the room.
“It’s a girl. It’s a girl!” the registrar shouts, her voice’s volume muffled through her mask.
Alicia starts wailing and her mum holds her, cradling her from the shoulders up. One of the midwives takes the baby, cleans her up, weighs her.
“It’s a girl!” the senior registrar repeats, tears choking her voice as she starts stitching up Alicia.
“What’s her name?” the midwife says, handing the baby to Alicia’s mother, who holds the beautiful, pink crying baby by Alicia’s head so they can be close.
“Ava,” Alicia says. “Ronnie always liked that name.”
Lucy and I smile at each other, drunk on relief after the terrible few minutes before Ava was born. I can’t help but think back to the joy in the moments after my labors when finally, finally, it was over and they handed me my beautiful boys. The relief, the happiness, the sheer joy of meeting them and having their whole lives ahead of me. The contrast that appears to me—between my life then and the strange newness of my life now—feels, for a moment, so shocking it’s as though I’ve been punched in the throat. I am a single woman. I have no children. I had children but I don’t have them anymore.
“Let’s leave them to it,” Lucy says, and leads me, dazed and a bit nauseous with dread, to Delivery Room 5. Lucy takes a breath before opening the door. “Now we’re seeing Kim. She already has three girls. Her husband is immune.” My nose stings with tears of jealousy. Lucy looks at me sympathetically. “I know. I had the same response when I was doing her antenatal appointments. She’s just one of the lucky ones.”
“Does she know if it’s a fourth girl?”
“No, but in my experience, the chances are high once you’ve had three of the same.”
We enter the room, which has a much calmer atmosphere than the mood of resistance Alicia’s had. There’s whale music, the smell of lavender in the air and a very attentive husband rubbing Kim’s back.
I introduce myself quietly. Kim has two midwives helping her onto her hands and knees. It’s time to push. Again, I can feel the tension in the room rising and rising as the baby gets closer to being born. Kim is pushing like a champ, keeping each one going for the entire length of her contractions. I’ve read about the statistics on a baby’s sex before. Lucy’s right, once you have three babies of the same sex, chances are you’ll continue producing children of the same sex.
“One final push, my love,” one of the midwives bellows. With a roar Kim digs in and the head is out. A few minutes later the body follows.
“It’s a boy,” the midwife says, her voice hollow. She’s gone white. The other midwife, the quieter one, takes the baby over to the side of the room. He’s crying mightily, has a good color. He looks for all intents and purposes like a perfectly healthy baby boy.
“What?” Kim asks, groggy from the gas and air and pain and shock. “She can’t be a boy. We have girls.”
“It’s a boy, sweetheart,” the midwife says. I turn away as the midwife and Kim work together through the final stages of labor, delivering the placenta. I feel like I’m intruding now. This is too private. I’m watching the beginnings of a funeral.
“Where’s the pediatric team?” I ask Lucy quietly.
“No point,” Lucy whispers. “If he’s immune he’ll live, if he’s not he’ll die. Peds is focusing on treating the girls and immune boys with non-Plague issues now.”
The ruthlessness of this is gutting in the context of a maternity unit. I’m so used to the medical care and attention devoted to newborn babies that it jars, but this is reality now. There’s nothing to be gained from wasting precious time, needles, cannulas, saline and steroids on a baby destined to die in a few days. Kim isn’t crying. She looks shell-shocked and deathly pale. The doctor part of my brain wants to check that she’s not hemorrhaging but I suspect it’s the plain horror of having given birth to a baby who will almost certainly die in days, if not hours. There’s an absence of something and I’m trying to work out what it is, casting my mind back to my own labors, and then I realize. Reassurance. When I gave birth, I was constantly being reassured during and after that everything was going to be okay. “You’ll heal up just fine.” “Gorgeous wee boy you’ve got there.” “The first few nights are the hardest, then you’ll find a rhythm.” There’s no reassurance here. There’s nothing anyone can say.
Lucy and I leave the delivery room and I take a deep breath.
“It’s a horrible environment to be in, isn’t it?” she says.
I nod in agreement. “I honestly don’t know how you’ve been doing this for months. I’m emotionally exhausted and I’ve been here less than two hours.”
“This isn’t why I became a midwife.” Lucy’s eyes are filled with tears and I have a maternal urge to hug her and rub her back. “We spend hours with these women encouraging them to basically rip their bodies apart for the promise of a baby at the end, and for what? To have their hearts broken in a few hours? I can’t do it anymore. I’ve applied to become a general practice nurse.”
I nod again. There’s nothing I can say. Eventually I just mutter, “I understand.” I spend the next two days with Lucy repeating the roller coaster of elation and horror of working in a labor ward during the Plague. I see four more girls born and five boys. At the end of my third day I’m desperate to go home. I cannot see one more woman’s face cave in at the prospect of a dead baby. These midwives are made of sterner stuff than I.
As I’m walking out to my car, bone tired and ready for bed, Lucy runs out after me. I must have forgotten something.
“Wait! Kim’s baby, I just heard!”
“What about him?”
Lucy is beaming, glowing with happiness. “He’s immune! They just did the test. He didn’t have any symptoms after twenty-four hours so we did a blood test to make sure. He’s immune!”
I burst into tears and Lucy hugs me. We hold each other tight on this dark Edinburgh night. Two women brought to tears by the news that one baby will survive.
“He’s gorgeous,” Lucy says. “Absolutely gorgeous.”