Summary: The Midwives' help is needed at a dramatic birth.
Disclaimer: Call The Midwife belongs to the BBC and others - I am simply borrowing their wonderful characters.
Author's note: Cross posted from Archive of Our Own. This is not my usual Patsy/Delia fic. I have tried to write a story that is much more similar to an actual episode of Call the Midwife. I have tried to include most of the regular characters - mainly because I very rarely write some of them. I'm not sure if this sort of story line has been done on the show before as I've only seen series 4 and 5. I think I have captured the emotional feel of the show, but I'd be happy to hear your thoughts about it.
My grateful thanks as always to Sittingonthis for her invaluable input into this. It has taken a long while for me to compose this, and it now looks very different to when I first started it. Thanks too must go to Jlynnsca for her wonderful editing skills.
Two pairs of eyes shot open in alarm when there was a knock at Delia's door at 2 o'clock in the morning. Instantly Patsy rolled from the bed and lay silently on the floor behind it. Delia grabbed the covers and practically threw them over where Patsy lay before heading to the door. She rubbed her face, trying to get her brain to work as she yanked the door open, although she was careful not to open it completely. She frowned as she saw Barbara looking at her anxiously. "What's wrong?" She asked, her voice croaky with sleep.
"I am so sorry to bother you, and I know you technically aren't even on call, but I've just had the most bizarre telephone conversation." Barbara was already breathless and anxious.
"Go on," Delia prompted, squinting into the light of the hall.
"A Mrs Jenkins rang. She said that she's in a lot of pain but is refusing to go to the hospital. She said that she wanted you to come out." Barbara sounded very confused by the request.
"Me? I can't come out. I'm not qualified." Delia was equally baffled.
"I know. I told her that but she was very insistent. I offered to go out and see her, but she said that she only wanted to see you." Barbara looked apologetically at the smaller brunette."Delia, I know this isn't the norm, but would you come with me? I really think someone needs to see her. If she sees you with me, hopefully she'll trust me enough to do an exam."
The Welsh nurse nodded, her mind already picking up speed as she realised the potential severity of the situation. "All right. Can you give me 5 minutes to get dressed and run a comb through my hair?"
Barbara nodded. "Of course. I'll sort you out a bike and some kit."
The second the door was shut, Delia spun round. Patsy got up from behind the bed slowly. "Do you think she saw me?"
"I don't think so. She was too busy worrying about the patient and having to wake me up." Delia smiled. "Is your heart hammering?"
"Can you hear it?" Patsy sounded serious.
"No, you fool. Mine's doing the same. Do me a favour and reassemble my bed while I get dressed."
Patsy slipped back into her own room five minutes later and Delia met up with Barbara at the bicycle shed another minute after that.
"Sorry," Barbara apologised again.
"Don't be silly. We need to help. Do you know where we're going?"
"Yes. I've set the dynamos and there's a bag for you on the back. Ready?" The vicar's daughter asked quietly.
Delia nodded and the two nurses cycled quickly to Mrs Jenkins' residence.
When they arrived, the door was already ajar. Barbara led the way in. "Hello? It's the midwives," she called out clearly.
"Up here." A man's voice beckoned them from upstairs and the two women hurried up to the bedroom.
Inside the bedroom, Mrs Jenkins was lying on the bed. She was pale and sweating profusely. She couldn't appear to stay still. Barbara assumed that was because she was in pain.
"Are you Nurse Busby?" The man asked.
"No, I am." Delia stepped into the room. "I'm sorry, we haven't been introduced?" She looked enquiringly at the man.
"Harry. Harry Jenkins."
"Alright, Mr Jenkins. We're here now. How about you put the kettle on, and give us a few minutes to do an examination?" Delia suggested. He nodded reluctantly and left the room.
"Mrs Jenkins," Barbara began.
"Sally. Call me Sally," Mrs Jenkins insisted.
"Of course. I spoke with you on the telephone. My name is Barbara. I've brought Delia - Nurse Busby, with me, as you asked. Do you trust me to examine you now?"
Sally nodded cautiously.
Delia opened her bag and grabbed a sphygmomanometer and stethoscope. "Sally, I might not be able to do all the exam, but I can do your general observations. Do you mind if I take your blood pressure?"
"You can do what you like, Nurse. I trust you." Sally looked exhausted and pinched.
It took three attempts to get a reading. In that time Barbara had managed to listen for the baby's heartbeat and do an internal exam.
They exchanged anxious looks. "I'm reading it as 80/55," Delia stated.
Barbara kept her face neutral but Delia could see the worry. "Radial pulse?" She asked almost innocuously.
Delia nodded, but grasped Sally's wrist again, almost for her own reassurance. "It's quite thready, but it's there."
Barbara nodded. "Sally, is the pain you're experiencing constant?"
Sally nodded.
Barbara wanted to be sure. "It's not coming in waves, or easing back every now and then?"
"No, Nurse." Mrs Jenkins' face was scrunched up in pain and she was having difficulty breathing. "What's wrong?" She gasped.
"You are crowning, Mrs Jenkins. But I need to arrange an ambulance. You need to be in hospital." Barbara was firm in her assertion.
"I don't want to go back there. Can't I have my baby here?" The question tailed off as Sally began to wail in pain.
Barbara looked anxiously at Delia.
"Sally. I'm going to speak to Harry and ask him to call for an ambulance," the Welsh woman stated as she got up.
"Not you, too. You know I hated it there."
Delia shot Barbara a quick look, before looking back at the pregnant woman. "You're crowning, which means you may well give birth at home. But we need to get you into hospital as quickly as possible. It's the right thing to do for you and baby." She looked steadily at Sally and waited for her to nod agreement before hurrying downstairs.
Within minutes she was back and both nurses donned surgical gowns, caps and gloves before continuing.
Mrs Jenkins was sobbing with pain now, and Barbara asked Delia to administer gas and air, while she managed the delivery.
"Mrs Jenkins, once the ambulance comes, we'll make a decision on where you're at with the labour as to whether we go immediately or not."
Delia had the feeling Barbara was simply appeasing the woman and that they would be making an urgent dash to the hospital as soon as the ambulance crew arrived.
Barbara looked at Delia in frustration. "The trouble is, because Sally is in so much pain, it's hard for me to time any contractions. I have a feeling it could be any moment." She had tried resting her hand on the woman's extended abdomen, but Sally had cried out in pain.
Delia nodded and felt for Sally's pulse at her wrist again. After several attempts she looked at Barbara. "Can you locate a femoral pulse?"
The midwife looked up in alarm, before explaining to Sally where she was about to press. "Yes, it's there." Barbara took a moment, mentally going through the options for labour.
Suddenly Sally tensed again, before going limp. "Sally?" Delia called anxiously, instantly feeling at the woman's neck for a carotid pulse. "Sally!" She shook the woman gently, trying to rouse her, but to no avail. "Barbara, she's unconscious. She's clammy and white."
Barbara nodded and did another pelvic examination. "I'm going to have to do an episiotomy and perform a forceps delivery."
Delia grabbed her bag. "You look after the baby, I'll look after Mrs. Jenkins." She lay Mrs Jenkins down and then moved her to one side, tucking a rolled up towel underneath her.
Barbara located the kit she needed and worked as quickly as she could while Delia held the unconscious woman's leg, giving Barbara the room to do what she needed to.
It felt like an age but eventually Barbara managed to locate the forceps securely and she began to work the baby out. Delia watched the other nurse carefully, but kept one eye on Mrs Jenkins, frequently feeling for a pulse as the woman grew paler and paler.
"The head's clear," Barbara announced, just as the ambulance crew arrived.
"Her pulse is getting weaker, Barbara." Delia's voice remained calm but there was no mistaking the urgency of her tone.
Barbara positioned her hands as best as she could and then pulled the baby again. It came out in a rapid motion, and was followed by a deluge of blood. "Oh, God."
"Concentrate on the baby," Delia instructed.
Even as Barbara clamped the umbilical cord, she knew that they were in dire straits. "The blood supply to the baby has been compromised." She was starting to feel her anxiety rising.
"I've lost her pulse." Delia looked up at the ambulance crew. "Help me with resuscitation. Now." She grabbed the emergency resuscitation kit. "We need to get her off the bed. How's the baby?"
Barbara was already trying to stimulate the baby. Nothing was working. She grabbed the neonatal mucus extractor and tried to clear the airway but that wasn't the problem. "Baby isn't responding."
Delia looked up from where she had been ventilating Sally. "We've got to get them to hospital now."
"We're only allowed to take one patient at a time," one of the ambulance men pointed out.
Barbara looked panicked. "Can't you get another ambulance here? We can't leave someone here alone."
"We're not," Delia stated determinedly. She looked the ambulance man. "Get a carry sheet so we can get Mrs Jenkins downstairs. Barbara, take the baby downstairs now and wait there until we're ready to get in the ambulance. It'll be too cold for baby in the ambulance right now."
"Now hang on a minute, Nurse. I don't know who you think you are, but we're only supposed to take one patient."
Delia affixed him with a baleful stare. "You only take one patient when you have no other assistance. Nurse Gilbert will be looking after baby; we'll be looking after Mrs Jenkins. Now hurry. We've no time to lose." Her tone and demeanour brooked no argument, particularly as she delivered the directive while she was continuing to assist with resuscitation and the man hurried off as instructed without further argument.
Barbara was equally surprised. Delia had just taken charge of the situation as if she had been born to do it. She also knew that her decision was absolutely the right thing to do. Wrapping the baby tightly, she began two-fingered chest compressions as she exited the room, knowing that she could concentrate more on her technique once she was downstairs.
The bed was covered in blood. It was far more than would be expected at a normal delivery. Not overly worrying over the patient's dignity, Delia grabbed a large dressing and plugged Mrs Jenkins up as best she could, before covering her with a blanket. Upon the ambulance man's return, they worked together to get her downstairs while doing their best to continue with resuscitation. Delia had the sinking feeling that it was a lost cause, but she would not give up on her.
The waiting area outside Resuscitation was dimly lit. Barbara sat with Mr Jenkins in silence. When they had arrived at the hospital there had been two teams waiting. One had led Nurse Gilbert and the baby to one area while Delia and the ambulance crew wheeled in Sally. Mr Jenkins had arrived at the hospital some time later, having to make his own way there as there had been no room in the ambulance for him as well. He had been directed to sit down on one of the benches.
When Nurse Gilbert emerged, her face white, he knew it was bad news.
"I am so sorry," she had begun, practically in tears.
Harry had shaken his head in disbelief but said nothing. His baby had died. There was nothing that could be said that would make it better.
The brown-haired nurse had sat next to Harry in an attempt to be supportive. He appreciated the company but Harry knew that she could do nothing to take away the terror of waiting. He couldn't even think about grieving the loss of his baby until he knew what had happened with his wife.
They waited for an indeterminate length of time before the doors to Resuscitation swung open again. A tall, older looking man with grey hair looked over his glasses at them. "Mr Jenkins?" He asked, wanting to confirm the man's identity.
Harry nodded nervously.
"My name is Dr Benson. I'm the obstetrics consultant," the older man introduced himself.
Mr Jenkins stood up, sensing bad news. He could see Nurse Gilbert stand alongside with him.
"What's happened? How's my wife?"
"I'm so terribly sorry Mr Jenkins."
Harry sat back down heavily, not hearing the rest of the words. "Why?" He whispered, his voice cracking.
"Your wife had what's called a placental abruption," Dr Benson explained. "Unfortunately this meant that as she gave birth she began to bleed. We couldn't stop the bleeding in time I'm afraid."
"And the baby?" Mr Jenkins' voice was hollow.
"I'm sorry. Because your wife started to bleed while she was delivering, the baby's blood supply was interrupted. There was nothing we could do for her either."
"Her?" Harry whispered brokenly.
"Yes. You had a daughter." The doctor paused. "I'm so terribly sorry. But this sort of complication is virtually undetectable and incredibly rare. There was simply nothing we could do."
Dr Benson patted Harry on the shoulder awkwardly before excusing himself. "I'll leave you with this nurse," he stated as he retreated.
As he turned around, he saw Nurse Busby staring at him balefully. He frowned. "Tragic case," he muttered. "Almost impossible to diagnose."
Delia looked mutinous. "It didn't need to be like this," she stated coldly.
Dr Benson looked uncomfortable. "I'll be reviewing the case with the team in the morning. But for the moment, this will be recorded as an unanticipated medical emergency."
Delia tensed, clenching her hands in an attempt to suppress her fury, but she said nothing further. There was nothing else to say. The Welsh nurse sat down heavily next to Barbara. She had taken the delivery gown off, but a lot of blood had seeped through and stained her uniform underneath. Her hands looked raw where she had obviously scrubbed them vigorously. "What happens now?" She asked softly.
"We'll wait with Mr Jenkins until a nurse from A&E comes to collect him. Then we go home." Barbara spoke in a monotone. It was clear she was devastated.
It was almost 7am when Barbara and Delia finally returned to Nonnatus House. They had stayed and assisted at the hospital until it was clear nothing more could be done, and had then managed to get a lift from another ambulance crew back to the Jenkins's house so that they could collect their bicycles.
Mr Jenkins had been inconsolable at the hospital, and had clung onto Barbara, desperately begging her to tell him she was wrong and that Sally was all right. The young midwife had done her best to offer support, but had no words of comfort for him. Delia looked on with grim detachment, and determinedly forced down the anger she was feeling. That wouldn't do anyone any good.
The two women entered the Clinical Room and emptied their midwifery bags. It was done almost mechanically, and in silence. All Delia wanted to do was peel her uniform off and have a bath, but she knew that she had to clean the kit and replenish the bag first. She had no idea how she was going to find the strength to attend placement today. She was physically and mentally exhausted.
It was only when she noticed Barbara's shoulders shaking that Delia realised that the midwife was crying. The Welsh nurse closed the gap and embraced the tall brunette.
Barbara felt the pull of Delia's arms and stopped trying to hold her emotions in. She began to sob in earnest. The young midwife couldn't help but think of the family. How would Mr Jenkins be able to cope with the loss of his wife and their baby?
Barbara had dealt with tragedy before. She had always thought that the still-born Bisette baby was the worst situation imaginable. Any death of a baby in childbirth was horrific and it wasn't right to compare. But both mother and baby had been lost in this case. Barbara felt helpless and useless and simply devastated. Added to that, she was allowing herself to be comforted by Delia.
Barbara was very definitely the senior clinician out of the two, and yet it was Delia who had stepped up, taken control and was now providing Barbara with much needed support. Barbara couldn't help but accept the comfort, but at the same time, she felt both guilty and inadequate. It was cold comfort indeed.
For all her cheeky exuberance, it would appear that Delia had the same icily professional approach to emergencies as Patsy. No wonder they spent so much time together. Barbara knew that she was feeling vulnerable and irrational, but she couldn't help but wonder if she was truly cut out for midwifery when compared to the others.
Delia rubbed Barbara's arm gently and let the other woman cry. She knew that Barbara had a habit of wearing her heart on her sleeve and was envious of her ability to deal with her emotions so promptly. It also gave her an excuse not to deal with her own feelings, so she clamped down on them very firmly. Delia was good at dealing with relatively low levels of stress or discomfort, but when things threatened to overwhelm, her fallback position was to cut herself off from thinking about it altogether and distract herself with diversions. It was actually quite a relief to offer comfort to Barbara right now as it meant that she didn't have to face her own feelings.
The two women looked up when they heard footsteps approach. "I've had a telephone call from the hospital," Nurse Crane advised them in a soft voice. "Go to the kitchen. The kettle's boiling. I'll finish up here."
Barbara glanced anxiously at Delia before nodding. "What did the hospital say?" She asked.
"We'll talk about it when I'm done here. I won't be long."
Delia wasn't sure she liked the sound of that but she took Barbara by the hand and led her into the kitchen. They stopped when they saw Patsy and Trixie waiting for them, grim looks on their faces.
Trixie simply nodded towards the table and poured tea into waiting mugs. Delia guided Barbara to sit down, but did not take her own seat, instead gesturing at the front of her uniform. "I need a bath," she muttered. She knew that the others wanted to help and provide support, but Delia wasn't ready for that yet. She wasn't ready to talk about her feelings. She was angry, and she didn't want to have that anger rationalised away. She wanted it to burn inside her for a while. It was the only feeling she could cope with right now.
"I'll run one for you," Patsy offered, stepping towards the shorter woman.
"I can run my own bath," Delia snapped, before inhaling sharply and looking at Patsy apologetically. "I'm sorry, that was uncalled for. I just need to get a move on or I'll be late for work."
"They aren't expecting you on the ward today, Nurse Busby. Take a seat and drink some tea. Sister Julienne will be along presently." Nurse Crane was the epitome of efficiency but her features displayed her concern.
Delia reluctantly sat down next to Barbara. Nurse Crane sat opposite them, with Patsy and Trixie flanking her. Delia felt exposed and uncomfortable, and could sense Patsy staring at her. The Welsh nurse deliberately kept her gaze away from the red-head.
Nurse Crane did not wait for Sister Julienne. "Now then, I think it might be helpful if you tell us what happened," she requested gently.
Barbara shot a pained look at Delia before staring at her hands. She then explained the telephone call and her rationale for taking Delia with her. Her voice was hoarse and strained.
"Why didn't you seek a senior midwife?" Nurse Crane probed.
"I didn't know what the issue was at the time. Sally knows... knew Delia so I thought it would reassure her."
Phyllis regarded the two brunette nurses carefully. "Your empathy does you credit, Nurse Gilbert but it's certainly not standard procedure to visit a patient in the middle of the night with an unqualified midwife."
Delia rolled her eyes but bit down on an angry retort. She wasn't sure what the purpose of this discussion was, but it was not helping her and she wasn't convinced that it was helping Barbara either.
Nurse Crane continued, looking at Barbara. "Hmmm. Once you were there it must have been obvious that something was seriously wrong. Why didn't you summon one of us?"
Delia stiffened. This felt like an exercise in laying blame and there was only one person culpable in her mind. "I instructed Mrs. Jenkins's husband to call for an ambulance, Nurse Crane. That way I could stay with Barbara and assist in whatever way I could." Her voice was barely above a whisper but it was icily controlled.
Nurse Crane nodded. "What treatment did you provide?" She looked back at Nurse Gilbert.
Barbara continued to stare at her hands. "There wasn't much treatment to give. Mrs Jenkins became unconscious and I had to do a forceps delivery. Once baby was delivered, it was obvious that she was haemorrhaging and that the placenta had been compromised."
"Did you raise Mrs Jenkins's legs? What measures did you take to compensate for shock?"
"Nurse Crane, now is not the time to dig into detail." Trixie had heard enough. She could see Barbara crumbling in front of her, and Delia becoming so tense she could snap at any second. Both reactions were perfectly understandable.
"I'm sorry, Nurse Franklin but incidents such as these are so rare, it is important to learn from them."
"She's not a lesson!" Barbara looked up, her face flush with anger. "She's a person. A woman." Barbara choked back a sob. "A wife and mother. And now she's dead. And there was nothing I could do to help her, or the baby." She stood suddenly, her chair flying back and tipping over with the force. "I'm going to lie down. I've got a headache."
"I'm sorry, Nurse Gilbert but I'm afraid there is another task that needs to be completed first." Sister Julienne entered the kitchen accompanied by Sgt Noakes.
"You can't be serious. They aren't in any condition to provide a statement now." Patsy was aghast.
Sgt Noakes looked extremely uncomfortable. "I'm sorry, but we're required to take statements from all those involved with an unexpected death."
Barbara paled. "Am I under suspicion?" She could feel her heart rate accelerating.
"Absolutely not. It's simply procedure," the quietly spoken policeman explained.
Delia stood and righted Barbara's chair, gesturing for the taller woman to sit down. "Take a few minutes, Barbara. Sit with Trixie for a bit. I'll go first," she told her softly, squeezing her arm in support.
"Do you want someone with you?" Patsy asked, stepping forward again. She so wanted to give Delia some comfort but that would be impossible until they had the chance to be alone. She could hear the tremor in Delia's voice and knew that she was barely keeping it together, but she looked more angry than upset. Patsy didn't want Delia to end up saying something she might regret in her statement.
"That won't be necessary, Nurse Mount. I will escort Nurse Busby and then Nurse Gilbert," Sister Julienne advised. She looked at the rest of the staff. "In the meantime, there is still work to be done. While I appreciate that this is a truly devastating set of circumstances, we have other patients to deal with." She looked at Nurse Crane. "I have already sent Sister Mary Cynthia out on rounds and Sister Winifred has gone to the clinic to assist Nurse Turner. Perhaps Nurse Franklin can be placed on telephone duty until the statements have been completed."
Phyllis nodded curtly. "That's a most suitable suggestion." She looked to where Patsy and Trixie were still standing and smiled sympathetically. "I know that you want to help your friends but we need to carry on. Nurse Mount, can you attend your district rounds?"
Patsy sighed, wanting to object, but Delia was already leaving with Sgt Noakes and Sister Julienne. The Welsh nurse hadn't even looked at her before she went. Patsy knew that she was keeping everything contained and that it would only be a matter of time before Delia cracked. She so desperately wanted to be with her for that, but knew that was impossible.
To be concluded...