The Midwife

by Jennifer Worth

  The incense swung furiously, smoke billowing out.

  “And I will say unto my Lord, I am unclean. I am unfit to dwell in Thy Holy Place.”

  Coughing broke out.

  “And I cried aloud What profit is there in me?

  I am undone. I shall go down into the Pit.

  Oh Lord, hear my prayer. Let my cry

  come unto Thee.”

  Eventually, and not before time, Vespers concluded. The Sisters, red-eyed, choking and spluttering, filed out of the chapel.

  It took a long time for Sister Julienne to live down the opprobrium of having filled the chapel with the odour of pigshit, and I am sure that God forgave her long before her Sisters did.

  OF MIXED DESCENT I

  In the 1950s the African and West Indian population in London was very small. The ports of London, like those of any nation, had always been a melting pot for immigrants. Different nationalities, languages, and cultures were flung together and intermingled, usually bound to each other by poverty. The East End was no exception, and over the centuries just about every race had been absorbed and propagated. Tolerant warm-heartedness has always been a hallmark of the Cockney way of life, and strangers, though they may have been regarded with distrust and suspicion at first, were not resisted for long.

  Most of the immigrants were young, single men. Men have always been mobile, but not so women. In those days it would have been virtually impossible for a young, poor woman to go jaunting around the world by herself. Girls had to stay at home. However bad the home, however great the hardships and poverty, however much their spirits longed for freedom, they were trapped. This indeed is still the fate of the vast majority of the women of the world today.

  Men have always been luckier, and a footloose young man in a foreign place, once his stomach is full, is after one thing - girls. The East End families were very protective of their daughters and, until recently, pregnancy out of wedlock was the ultimate disgrace and a catastrophe from which the poor girl never recovered. However, it did occur quite frequently. If the girl was lucky, her mother stood by her and brought up the baby. Occasionally the father of the child was forced to marry her, but this was a mixed blessing, as many a girl found to her cost. Whatever the social hardship for the girl, it did mean a continuous infusion of new blood - or new genes, as we would say today - into the community. This may, in fact, account for the distinctive energy, vitality, and boundless good humour of the Cockney.

  Whilst daughters were protected, married women were in a different situation altogether. A young unmarried girl who became pregnant could not hide from anyone the fact that she was unmarried. A married woman could bear anyone’s child, and no one would be any the wiser. I have often felt that the situation is loaded against men. Until recently, when genetic blood tests became possible, how could any man know that his wife was carrying his child? The poor man had no other assurance of paternity than his wife’s word. Unless she is virtually locked up, he can have no control over her activities during the day while he is at work. All this does not matter very much in the broad spectrum of life, because most men are quite happy with a new baby, and if a husband happens to be fathering another man’s child, he is not likely to know, and, as they say, “what the eye does not see, the heart does not grieve over”. But what happens when his wife brings forth a black man’s child?

  The East Enders had hardly faced this before, but after the Second World War the potential was there.

  Bella was a lovely young redhead of about twenty-two. She was well named. Her pale skin, slightly freckled, her cornflower blue eyes would captivate any man, and her red curls would bind him to her for ever. Tom was the happiest and proudest young husband in the East India Docks. He talked about her incessantly. She came from one of the ‘best’ families (the East Enders could be incredibly snobbish and class-conscious in their social gradings) and they had married after four years of courtship, when Tom was finally able to support her.

  They had a slap-up wedding. She was the only daughter and her family were determined to do her proud. No expense was spared: a wedding gown with a train that reached halfway down the church; six bridesmaids and four pageboys; enough flowers to give you hayfever for a week; choir; bells; a sermon - the lot! That was just to show the neighbours what could be done. The reception was designed to prove the unrivalled superiority of the family to all the friends and relations. A fleet of Rolls Royces, eighteen in all, drove the most important people from the church a hundred yards down the road to the church hall hired for the occasion. The rest had to walk - and got there first! The long trestle tables had been spread with white cloths, and nearly collapsed under the weight of hams, turkeys, pheasants, beef, fish, eels, oysters, cheeses, pickles, chutneys, pies, puddings, jellies, blancmanges, custard, cakes, fruit drinks and, of course, the wedding cake. Had he seen the wedding cake after he had constructed St Paul’s Cathedral, Sir Christopher Wren would have broken down and wept! It was seven storeys high, each layer supported on Grecian columns, with towers and balustrades and flutings and minarets. It boasted a domed roof bearing a coy-looking bride and bridegroom surrounded by lovebirds.

  Tom was a bit abashed by all this, and didn’t quite know what to say but, as he had said the all-important words “I do”, none of the family really cared whether he said anything else. Bella was quietly enjoying being the centre of attention. She was not a loud or showy girl, but her enjoyment of being the occasion for such extravagance was notable. Her mother was in her element, and bursting with pride. She was also just about bursting out of her tight-fitting purple taffeta suit. (Why is it that women always dress so outrageously for weddings? Look around you, and you will see middle-aged women in things that should have been left behind with their twenties, drawn tightly across expanding backsides, pulled in at the waist, emphasising folds of flesh that would be better covered; ridiculous hairdos; ludicrous hats; kamikaze shoes.) Bella’s mother and several of her aunts had fashionable veils to their hats, which made eating rather difficult, so they pushed their veils up, and pinned them to the tops of their heads, which made the hats look even more absurd.

  Bella’s father held the floor for forty-five minutes whilst he gave his wedding speech. He spoke at length of Bella’s babyhood, her first tooth, her first word, her first step. He went on to discuss her brilliant school career, and how she had got a school certificate which was now framed and hanging on the wall. No doubt he would have gone on to the swimming certificate and the cycling test had Bella’s mother not said, “Ow gi’ on wiv it, Ern.”

  So he turned his attention to Tom, and told him what a lucky chap he was, and how all the other chaps had been after her, but that he (Ern) had reckoned that he (Tom) was the best of the bunch, and would look after his little Bella, because he was a good hard-working lad, and would remember that success in life and marriage depends upon “early to bed and up with the cock”.

  The uncles guffawed and winked, and the aunts affected to look shocked and said to each other, “Ow, ’e is a one, ’e is.”

  Tom turned pink and smiled because everyone else was laughing. It was possible that he didn’t understand. Bella kept her eyes firmly on her jelly, it being prudent that she shouldn’t be seen to understand.

  After the delights of the honeymoon spent in one of the best boarding houses in Clacton, they returned to a small flat, near to Bella’s mum. Flo was determined that her daughter should have the best of everything, and had purchased fitted carpets in their absence. Such a luxury was virtually unknown in the East End in those days. Tom was bemused and kept rubbing his toes up and down the soft pile to see how it moved. Bella was enchanted, and it triggered an orgy of spending on household items, most of them relatively new and unheard of among her neighbours: an upholstered three-piece suite; electric wall lights; a television; a telephone; a refrigerator; a toaster; and an electric kettle. Tom found them all very novel, and was glad that his Bella was so happy playing the little housewife. He had to take on more and m
ore overtime to keep up the payments, but he was young and strong, and didn’t mind, as long as she was content.

  Bella booked with the Nonnatus Midwives for her first pregnancy, because her mother advised it. She attended antenatal clinic each Tuesday afternoon, and was perfectly healthy. She was about thirty-two weeks pregnant when Flo came to see us one evening. It was outside our routine hours, but she seemed agitated. “I’m worrit about our Bell, I am. She’s depressed or summat. I can see it, an’ Tom can see it an’ all, ’e can. She won’t talk, she won’t look at no one, she won’t do nuffink. Tom says, ’e says, often the dishes aren’t even washed up when he gits in, an’ the place is a real pigsty. Somefinks up, I tells you.”

  We said that clinically Bella was quite healthy, and the pregnancy was normal. We also said that we would visit her at home, in addition to her Tuesday antenatal clinic.

  Bella was certainly depressed. Several of us visited, and we all observed the same symptoms - lethargy, inattention, disinterest. We called in her doctor. Flo made heroic efforts to try to get her out of it, by taking her out to buy piles of baby clothes and various paraphernalia considered necessary. Tom was very worried, and fussed and fretted over her whenever he was at home; but as he worked such long hours, even longer now in order to pay for all the baby things, most of the burden fell on Flo, who was a solicitous and devoted mother.

  Bella went into labour at full term. She was neither early nor late according to her dates. Her mother called us around lunchtime to say that the pains were coming every ten minutes, and that she had had a show. I finished my lunch, and stocked up on two helpings of pudding as a precaution against missing my tea. A primigravida with contractions every ten minutes is not an emergency.

  I cycled in a leisurely manner round to Bella’s house. Flo was waiting on the doorstep to greet me. It was a sunny afternoon, but she looked worried. “She’s like I says, no change, but I’m not ’appy. Somefink’s up. She’s not ’erself. It’s not normal, it’s not.”

  Like most women of her generation, Flo was an experienced amateur midwife.

  Bella was in the sitting room on the new settee, digging her fingernails into the upholstery. She was pulling out bits of stuffing. She stared at me dully as I entered and ground her teeth. She continued grinding her teeth for some time after she had withdrawn her attention from me. She didn’t say a word.

  I said, “I must examine you, Bella, if you are going into labour. I need to know how far on you are, and what the baby’s position is, and listen to its heartbeat. Could you come into the bedroom, please?”

  She didn’t move. More stuffing came out of the sofa. Flo tried to coax her along. “Come on, luvvy, it won’t be long now. We all has to go through it, but it’s over in next to no time. Yer’ll see. Come on, now. Into ve bedroom.”

  She made to help her daughter up, but was pushed roughly away. Flo almost lost her balance and fell. I had to be firm.

  “Bella, get up at once and come with me into the bedroom. I have to examine you.”

  She looked like a child who knows the voice of command, and came quietly.

  She was two to three fingers dilated, foetal head down, a normal anterior presentation, as far as I could assess, and waters unbroken. The foetal heart was a steady 120. Bella’s pulse and blood pressure were good. Everything seemed perfectly normal, except this curious mental state, which I could not understand. The tooth-grinding continued all through the examination, and was getting on my nerves.

  I said, “I’m going to give you a sedative, and it would be better if you stayed in bed and slept for a few hours. Labour will continue while you are asleep, and you will be refreshed for later on.”

  Flo nodded wisely in approval.

  I laid out my delivery things, and told Flo to ring Nonnatus House when contractions were every five minutes, or sooner if she was worried. I noted with satisfaction that there was a telephone in the flat. We might need it, I thought, in view of Bella’s mental state. Post-partum delirium is a rare and frightening complication of labour, requiring swift and skilled medical attention.

  The phone rang about 8 p.m., and Tom’s voice asked me to come. I was there within ten minutes, and he let me in. He seemed anxious but excited.

  “This is it, then, nurse. Cor, I hopes as ’ow she’ll be all right, her an’ the baby. I can’t wait to see my li’l baby, yer know, nurse. It’s somefink special, like. Bell’s bin a bit down of lates, but she’ll perk up when she sees the baby, won’t she, now?”

  I went into the bedroom just as Bella was starting a contraction. It was powerful, and she was moaning in pain. Her mother was wiping her face with a cold flannel. We waited for and timed the next contraction. Every five minutes. I thought, I doubt if it will be long now. The girl looked drowsy and lethargic between contractions, and I did not want to give more sedative or analgesic if delivery was close.

  “How is she?” I said to Flo, slightly tapping my head to indicate my real meaning.

  She replied: “She hasn’t said a word since you lef’, not a word she ’asn’t. She wouldn’t even look at Tom when ’e comes ’ome, nor say nothin’ to ’im neither. No’ a word, nuffink. Poor lad, ’e feels it, ’e do.”

  She patted her heart to indicate the feeling.

  With the next contraction the waters broke, and Bella’s breathing became more rapid. She grabbed her mother’s hand.

  “There, there, my pet. It won’ be long.”

  The contraction had passed, but Bella still clung to her mother’s hand with a vice-like grip. Her eyes were staring wildly.

  Bella gave a low scream - “No!” then, with her voice rising with every reiteration, “No! No! No! Stop it. You gotta stop it.”

  Then she emitted horrible high-pitched gurgling sounds. She threw herself around the bed, making this dreadful noise, something between a scream and a laugh. It was not a cry of pain, because she was not having a contraction. It was hysteria.

  I said, “I must ask Tom to ring for the doctor at once.”

  Bella cried out, “No! I don’ want no doctor. Oh Gawd! Don’ chew understand? The baby’s goin’ to be black. He’ll kill me, Tom will, when ’e sees it.”

  I don’t think Flo understood what she had said. So uncommon were black people in the East End at that time that her daughter’s words didn’t make any sense to her.

  Bella was still screaming. Then she swore at her mother and yelled at her, “Can’ chew understand, you silly ol’ cow. Ve baby’s goin’ ter be black!”

  This time Flo understood. She leaped away from her daughter, and stared at her in horror. “Black? Yer jokin’. Yer must be. You mean it’s not Tom’s baby?”

  Bella nodded.

  “You filthy slut, you. Is this what I brings you up for, is it? To disgrace me and yer dad!”

  Her hand flew to her face, and she drew in breath with a horrified gasp.

  “Oh my Gawd,” she whispered to herself. “They’ve got a big knees-up planned for yer dad at the Club, an’ they was keepin’ it a surprise. He’s President this year, an’ the lads wanted a real old knees-up when ’is first gran’child’s born. It’ll be the joke of all Poplar, it will. He’ll never live it down. They won’t let ’im.”

  She wrung her hands silently, then screamed at her daughter. “Oh, I wish you’d never been born, I do. I ’opes as how you dies now, you an’ that bastard inside yer an’ all, I ’opes.”

  Another contraction came on, and Bella screamed with pain. “Stop it. Don’t let it come. Stop it some’ow.”

  “I’ll give you ‘don’t let it come’,” screamed Flo. “I’ll kill you afore it comes, yer filthy bitch, you.”

  They were both screaming at each other. A terrified Tom appeared in the doorway. Flo turned on him, her face red with passion. “Get out of here,” she said. “Vis is no place for a man. Just get out. Go for a walk, or somefink. An don’t come back ’til termorrer mornin’.”

  Tom withdrew with speed. Men were accustomed to being ordered about in that
way when it came to childbirth.

  His appearance must have made Flo think more clearly. She became practical. “We’ve gotta get rid of it,” she said. “No one mus’ know, least of all ’im. When it’s born I’ll take it away and put it in an institution. No one will know.”

  Bella grabbed her hand, her eyes alight. “Oh mum, will yer? Will yer do that fer me?”

  My head was spinning. Up to that moment I had been flattened morally and emotionally, by all the noise, and the high drama going on between mother and daughter. But this was a new turn of events.

  “You can’t possibly do that,” I said. “What are you going to tell Tom when he gets home tomorrow?”

  “We’ll tell ’im it’s dead,” said Flo confidently.

  “But you can’t do that in this day and age. You can’t spirit away a living baby and announce that it died. You would never get away with it. Tom thinks he’s the father. He would ask to see the baby. He would ask why it died.”

  “He can’t see ve baby,” said Flo with less confidence. ” He’s got to think it’s dead and buried.”

  “This is ridiculous,” I said. “We are not living in the 1850s. If I deliver a living baby, I have to make my report, and that has to go to the health authorities. The baby can’t just die or disappear. Someone will have to account for it.”

  Just then another contraction came on, and the dialogue had to be suspended. My head was racing. They were mad, both of them, beyond all reason.

  The contraction passed. Flo had also been thinking furiously and making her plans. “Well you go away, then. Say you ’ad to go to another patient, or summat. I can deliver the baby myself, an’ I don’t ’ave to make no bleedin’ report to no bleedin’ authority. I can just take the baby away when it’s born, an’ no one’ll know where it’s gorn to, they won’t. An’ Tom’ll never see it.”