Fumbling in the darkness, Ethel threw on her dressing gown and slippers and rushed into Ada's room. Flicking on the light switch, her eyes, adjusting to the light, focused on Ada. She was squatting by her bedside, sweat was glistening off her brow, her hands entwined in the eiderdown, her eyes wide with fear.
"Help me!" Ada called out, "it's started."
Ethel's nursing instincts immediately kicked in. She rapidly stripped the good sheets off Ada's bed and replaced them with the towels that Lady Constance had set aside for this purpose. She then turned to Ada and said,
"Let's get you onto the bed, and then I'll telephone for the midwife."
"It's too early," Ada whimpered, "I can't have the baby yet."
"I'm afraid you may not have a choice," Ethel replied, sounding far more calm than she truly felt, "now, can you stand up?"
Ada nodded, and with Ethel's help, pulled herself up into a standing position, and then climbed onto the bed. Ethel arranged the pillows so that Ada could lean against them and helped her arrange herself into a comfortable position.
"I'm going to the telephone, and I'll be straight back," Ethel reassured.
"Don't leave me!" Ada moaned.
"I'll be as quick as I can," Ethel replied, darting out of the door. She began to sprint along the landing and down the stairs, her slippers slapping against the hard floors as she ran. She reached the telephone table in the hallway, took a moment to compose herself, and then dialled the number of the cottage hospital. It rang and rang.
"Matron speaking," eventually came a groggy response.
"Good, morning, Matron," Ethel replied, aware she had woken Matron up, "one of your patients, Ada Russell, is in labour at Burbridge Hall."
"Russell," mused Matron, rustling through her paperwork, "ah, but she's not due for another month. Are you sure?"
"Yes Matron, I am also a nurse."
"I'm afraid all our midwives are out on calls," Matron replied. Ethel's heart hit her stomach. "I'll send someone as soon as I can," Matron continued, "but I cannot guarantee when that may be."
"Are there any other midwives nearby?" Ethel asked, the panic rising in her voice, "I'm visiting Burbridge Hall from London."
"Nearest would be Oxford, and at this time of night they'll get there no quicker than any of us. Have you any midwifery training, nurse?"
"None formally," Ethel replied, truthfully.
"Keep the patient as warm and as comfortable as possible, and if she can eat or drink something sweet let her, she'll need to keep her strength up. Try not to interfere too much. Nature will take its course."
"Thank you Matron."
Ethel replaced the receiver and sighed. She clambered back up the stairs to Ada's room. As she opened the door she was greeted with the sight of Ada contorted in the midst of a contraction. Ethel took her hand and Ada gripped it fiercely, screwing up her face to prevent herself screaming in pain. As the pain passed, Ada slumped back onto the bed and panted for breath.
"Are the midwives coming?" she eventually managed to articulate.
Ethel did not answer her. Ada immediately sensed that something was wrong. She began to shake, her breathing became rasping and her eyes were filled with terror.
"They're all out on call," Ethel said calmly, "but they'll be coming as soon as they can."
"But, but," Ada stammered, "my baby's coming!"
"Yes they are," Ethel replied, stroking Ada's arm, "but I'm here, I'm going to make sure you're both safe," she added wrapping both arms around Ada.
The two friends sat in a silent embrace for a moment, before Ethel realised the gravity of the situation. She needed to know in what stage of labour Ada was in. She knew she would have to examine her.
"Ada," Ethel whispered, "will you let me examine you? I need to know what's going on."
Ada nodded, and began to manoeuvre herself, but as she did so, she felt a sudden rush of warmth gush down her legs that soaked the bed and the back of her nightdress.
"Well that answers that question," Ethel remarked, "let's get you changed," she added.
Ethel stripped the bed and Ada, replacing the towels under her and placed a dry nightdress over her head, before going into Ada's bathroom and scrubbing her hands and arms. She had made a mental note of the time between Ada's last two contractions. They were closer than she would have liked them to be, knowing that help was not coming soon.
"Ada, I'm going to examine you, alright?" Ethel said. Ada nodded in reply, and instinctively drew her knees up and out. Ethel rubbed her hands together to warm them slightly, took a breath in, said "relax, if you can," to Ada, and inserted her hand into Ada's vagina. Ada gasped at the contact, and Ethel saw her bunch one of the towels beneath her into her hand.
"You're a couple of inches dilated Ada," Ethel told her, "a little way to go yet though." She got off the bed and scrubbed her hands again, before continuing, "I'm going to check how baby is lying."
As Ada nodded in agreement, another contraction began to course through her body. She grabbed Ethel's hand, squeezing through the pain. Ethel's nervous glance at the clock beside Ada's bed told her that there had only been five minutes between her last two contractions. The very real possibility of dealing with active labour, on her own, suddenly dawned.
"When did the pains start?" Ethel asked as the contraction released Ada from its grip.
"I had backache all day yesterday, with the pains getting worse just before supper," Ada admitted, "I didn't think it could be the real thing though, so I had a bath and a brandy and went to bed," she added. She paused for a moment and then remarked, "I did lose something, some blood, in the bath."
It was now five-thirty in the morning, by Ethel's calculations Ada had already been in labour for the best part of twelve hours. She palpated Ada's abdomen. If what she could feel was accurate, Ada had a long way still to go.
"Baby's head is down, but their back is to your back. I'm afraid this usually means that labour is more difficult. It explains the worsening back pain you've had too."
"Thank you, Nurse Bennett," Ada replied, slumping back onto her bed.
Ethel fetched a bowl of cool water and sponged the sweat off Ada's face, neck, and arms. Ada managed to smile weakly in gratitude before saying, "you won't leave me, will you?"
"No, of course not."
Another five hours passed, and the midwife from the cottage hospital had still not arrived. The sun was now beaming through the sash windows of Ada's room, and the whole house was aware of her continuing labour. Ethel had managed to persuade her to have some sugared tea and toast, but she had been faltering for several hours.
"I can't do this for much longer," Ada whimpered as her most recent, and most vicious, contraction released her from its grip.
"Can I see how you're doing?" Ethel asked.
Ada's nod in reply granted Ethel the permission she needed. To Ethel's great relief, she could now only feel the very thinnest rim of Ada's cervix.
"On your next contraction Ada, I want you to push," Ethel said, determinedly.
"I can't," Ada moaned, "I'm so tired."
"Ada," Ethel breathed calmly, rubbing Ada's lower back, "very soon, you are going to meet your baby. You want that don't you?"
"More than anything," Ada whimpered.
"You are so brave and so strong, and you have carried this baby for nearly nine months, you're going to receive the ultimate reward soon. Next contraction, remember how much you want your baby."
They did not have long to wait. At the first inkling of a contraction, Ethel watched Ada take a deep breath in, screw her face up in concentration, and began to push with all of her strength. Unable to resist, Ada cried out in pain, gripping Ethel's hand on one side and the bedpost on the other. It seemed to never end.
"That's it!" Ethel cheered, "now keep breathing, in and out as much as you can."
Ada complied, but almost as soon as she had caught her breath, the next contraction began to erupt inside her. Ethel stayed with her, sponging her face to keep her cool. Contraction after contraction tore Ada apart, she writhed across the bed like a wounded animal. Ethel began to worry. This phase was taking a long time. Too long she thought. She asked Ada if she could examine her again. To her great relief, this time, finally, she could see the baby's head.
"I can see baby's head Ada, just a few more pushes and they'll be here!"
Spurred on by her best friend's encouragement, Ada braced herself for her next contraction and pushed down with all of her might. This time she felt something happen.
"Baby's head is born Ada!" Ethel called, "you're nearly there!"
As Ada slumped back onto her pillows to catch her breath, the bedroom door swung open, and in walked Adelaide and another older woman, dressed in a nurse's uniform and carrying a large leather bag. She looked exhausted.
"Midwife Parkes!" she announced attempting to sound cheerful.
"Can we have some space for the mother please?" Ethel asked, firmly.
At this point Adelaide scarpered. The midwife opened her mouth to protest but before she could say anything, Ethel said, "I'm Nurse Ethel Bennett, this is Nurse Ada Russell, baby's head is born, all seems to be well, though the second stage has been somewhat prolonged." Then in a slightly softer, more wary tone, continued, "I will need your help to manage the third stage."
The exhausted midwife nodded, and then slumped onto Ada's desk chair. Ethel returned her attention to Ada. She supported the baby's head in her hands and said, "come on Ada, one really, really, big push, and you'll meet your baby."
As exhausted as she was, Ada knew what she had to do. Almost on cue, another contraction began to surge through her body. Ada pushed down with all of her might. The baby slid out into Ethel's hands. She was blue-tinged and did not cry. Instinctively, Ethel wrapped her up with the nearest towel, and rubbed her back. There was no response.
"What's happening?" Ada called, "what's happening."
"It's a girl, Ada," Ethel squeaked.
"Why isn't she crying?" Ada answered, panic rising in her voice.
The midwife pulled a mucus extractor out of her leather bag and began to clear the little girl's airways. "Keep rubbing her back," she advised Ethel, "come on little one, come on."
An unearthly silence descended on the room, hanging in the air like a London smog. The longer it went on, the more audible Ada's sobs became, and the harder it was for Ethel to contain her own tears. An unmeasurable time elapsed when, from within the towel in Ethel's arms, the slightest whimper was heard.
"She's alive," Ethel gasped, "oh Ada, she's alive!"
"Let me see my daughter!" Ada demanded.
Ethel placed the wriggling bundle in Ada's arms. The tears that now streamed down Ada's face were mingled with joy and relief.
"We need to cut the cord and prepare for the arrival of the placenta," Midwife Parkes said authoritatively, removing a number of implements from her bag, "well done Nurse" she added, turning to Ethel.
"I think 'well done Nurses' is more appropriate here," Ethel added, smiling at Ada who was cooing over her new daughter, "it's been a very long night for both of us."
"May I take her for a moment?" Midwife Parkes asked Ada.
With a slight reluctance, Ada allowed Midwife Parkes to carry out her work. She tied and cut the umbilical cord and placed it into a bowl, before weighing and measuring Ada's daughter. "Seven pounds five ounces, and just under nineteen inches," she called, "are you really a month early? Perhaps as well!"
"Of that I am most sure," Ada replied.
Ethel watched the midwife's every move with fascination. Sensing that she was being watched by a willing learner, Midwife Parkes said, "once the placenta has been delivered, it needs to be checked for completeness, putting the baby to the breast can hasten the third stage." Turning to Ada, she continued, "would you like to try feeding her?"
Ada adjusted her nightdress and with Midwife Parkes' help, began to suckle her daughter. The sudden rush of love and contentment that washed over her was like nothing she had ever experienced. All those long months of loneliness, of pain, of anguish, suddenly melted away. Eventually, a sudden tightening in her abdomen brought her back to reality. She felt something come away.
"Bowl please, Nurse Bennett," Midwife Parkes called.
Ethel grabbed one of the bowls from under Ada's bed and handed it to the midwife, who positioned it between Ada's knees. Ethel continued to watch on as the placenta slid into the awaiting bowl.
"You see how it is smooth, with no ragged edges?" Midwife Parkes said. Ethel nodded. "It means that the placenta is complete, which is what we want. Now Nurse Bennett, I am going to dispose of this, then we can get mother and baby ready for visitors."
As Midwife Parkes left the room, Ethel climbed onto Ada's bed, and threw her arms around her.
"You were brilliant," Ethel smiled.
"I couldn't have done it without you," Ada admitted, "what on earth would have happened if you weren't here?"
"Don't think about that," Ethel reassured, "what are you going to call her?" she asked, staring between Ada and the tiny bundle in her arms. The little girl was blessed with Ada's almond eyes, a button nose, and a fuzz reminiscent of her mother's dark hair had already appeared across her scalp.
"Let me introduce you to Sarah Constance Ethel Russell. After Sarah, the wife of Abraham, who thought she would never be blessed with a child, and the two women without whom I could never have had her."
"Welcome to the world, little Sarah," Ethel cooed, "you are as beautiful and as precious as your mother. And you are going to be so loved."