Heads up

"33 year old female, abdo pain"

Bore! OK, not the enthusiasm that should be expected for a potentially life threatening emergency call but in my experience, 95% of 30 year old females with abdo pain are either on their period, about to start their period or have a non-acute common stomach problem.  We headed off with no other information than that, working our way through the busy London rush hour traffic. The rush hour brings out the worst in drivers, not a moment passes without hearing a horn pressed in anger or an angry swerve to stop someone pulling into the line of traffic. Despite the blues and twos progress was slow so the 2 mile journey took us almost 10 minutes. We pulled up outside the house. We'd spent the journey driving through some of the worst parts of east London I've seen but had ended in up in a rather quaint cul-de-sac with a collection of grand Victorian properties. We grabbed our bags and headed up the garden path. As we rang the bell our radio vibrated violently. This is the message that appeared:

"Called states he thinks the head is showing"

What head and why in god's name is it showing? This isn't what we signed up to! Talk about being unprepared. As the door swung open my crew mate run off back down the garden path to grab the Entonox, PALS kit, paramedic bag and maternity packs. He also called up EOC to hurl abuse about the apparent breakdown in communication and request a second crew. BBA's generally have a second crew dispatched as standard in case both mother and baby need taking to hospital. Whilst all that was going on I went in to meet our patient and 'the head'. I'd been let in by the mother-in-law who told be Kate had been in labour for only 45 minutes. I entered the living room to find her propped up by the sofa, naked and legs akimbo. Her husband who was crouched down by her feet gave me a look of sheer joy and relief! Relief that delivering the baby was no longer his responsibility. Nope! It was mine! Obviously I felt prepared, I mean it was only 2 years ago that I did my 2 day course on maternity.......! Eek! Her husband stepped aside, frantically telling the LAS call taker that the crew had arrived, and I knelt down and introduced myself. 

"Hi Kate, I'm Ella, fill me in on what's been happening"

"Here comes another one..."

I looked down and out came a head. I had no gloves on, no maternity pack, nothing of any use. I reached for my gloves but it was too late, she pushed with the contraction and out she came. It was a good catch if I say so myself! On cue my crew mate burst through the door clutching the entire contents of the ambulance but dropped everything in disappointment when he saw me holding a baby. He'd never delivered one, nor seen one being delivered but nature waits for no one. He clamped the chord and I passed the baby to mum. She was crying, the baby was crying and when I asked dad to cut the chord he started crying. It was a very touching moment. With all the death, destruction, drunks and disease we see it's so refreshing to bring an innocent life into the world. It's a feeling I can't really describe. This lovely couple had just become a family and we were privileged enough to be there for that moment.

After a few minutes I took the baby from mum, put a nappy and clothes on and wrapped her up in a blanket while my crew mate phoned for a midwife. Baby was fine, mum was fine, dad was a wreck and we were beaming. 

"Have you decided on a name yet? Because if you haven't Ella is a lovely name!"

Luckily my suggestion was met with laughter rather than disdain!

"Yes we have, we are going to call her Olivia"

Not as good as Ella I thought to myself! BBA's are not only a lovely job because you are delivering a baby but they take ages! Ages spent in the warm, nowhere near violent drunks. Free of pressure from control and free to just sit there drinking tea and eating the biscuits provided by the moth-in-law! Result! We sat there for 40 minutes, chatting about their lives and ours.

"How many babies have you delivered?" she said to me.

"One!"

"Really?! This was your first?! What about you?" she said to my crew mate.

"None!"

"So neither of you had ever delivered a baby?!"

"Nope!"

Luckily this awkward conversation was interrupted by the delivering of the placenta, and that, I assure you, was gross! Within a few minutes the midwife arrived, delivered by an FRU. We left them to it, not before we were forced to smile in photos and get hugs from all! Had having my photo taken at work! 

It was a great job, one I'll never forget but that aside, the fact neither of us had delivered a baby before scared me. So many 'What ifs?' passed through my mind. What if it was breach? What is it didn't start crying? When if there was a hemorrhage? What if the cord was round the neck? I don't think a two day theory only lecture on maternity is enough and if the public were aware I'm sure they'd agree.  That fact we walk in to someones house dressed in green carrying all the kit in the world fills people with confidence. There is an assumption we know what we are doing and can deal with anything and if we act and sound like we do that illusion can continue. I can assure you, inside I'm a wreck when I'm out of my comfort zone! Unfortunately there are no funds for placements in maternity units so for now we'll continue to improvise, adapt and overcome. At least now I know what I'm doing.........