The Midwife

by Jennifer Worth

  Len said: “She’s bin doin’ this every ’alf ’our since six o’clock. Then they both ’ave a little sleep, an’ she does it agen. She said ’e won’t die, and ’e won’t, yer know. She knows ’ow to look after ’im.”

  I checked that she was not bleeding unduly, and left. I had to get back to Nonnatus House to report, and to request a district nurse to monitor the blood transfusion when it arrived. The smog was beginning to lift, and one could just about see across the road. It felt as though the world was filling with new life as the foul smog cleared, and I cycled back with a light heart.

  Sister Julienne herself prepared a huge breakfast of double bacon and eggs for me “to keep the wolf from the door”, as she put it, and then took my report in the dining room whilst I was eating. She said, “I have never cared for such a premature baby myself, but a Sister in one of our other Houses has experience. We will consult her. Conchita will have to be watched very carefully for further blood loss.”

  She found the whole story astonishing, and said, quietly, “God’s will be done.” She then went away to make arrangements for covering the blood transfusion.

  Conchita didn’t lose any more blood. After the transfusion colour returned to her cheeks, and also to Len’s. She was weak, but all danger had passed. The baby lay on her breast, day and night, fed in the manner that I have described about every half hour. All the lay staff and Sisters from Nonnatus House came to see the two of them, it was such a beautiful and unusual sight. On the fourth day I weighed the baby in a handkerchief. He was 1 lb. 10 oz.

  After three weeks, Conchita began to get up for short periods. I had thought ahead, and had wondered what would happen to the baby. Obviously Conchita had also been thinking ahead, and knew exactly what was to be done. She had asked Liz to acquire from the dressmakers several lengths of the finest unbleached silk. With the help of her skilled eldest daughter, she fixed a kind of sling or firm blouse around her shoulders and breasts, tight underneath, but loose above. The baby was carried in this for five months, between his mother’s breasts, never leaving her.

  Who had taught her this? I have never before or since, in any literature, heard of such a way of caring for a premature baby. Was it purely maternal instinct? I remembered back to the delivery, and to her monumental struggle when they tried to take the baby. I had the impression then that she was trying to think, trying to remember something; and the sudden clarity and conviction with which she said, ” No morirá.”

  Had she remembered seeing a peasant or gypsy woman carrying a tiny premature baby like this when she was a child in Southern Spain? Had this fleeting memory of times half forgotten been the cause of her conviction that her baby would not die?

  Some years later, when I was night sister at the Elizabeth Garrett Anderson Hospital in Euston, I cared for several premature babies of about the same gestation and weight. They were all nursed in incubators, and I do not remember any fatalities. The hospital staff prided themselves on the excellent modern care which preserved the life of the baby. The hospital way, and Conchita’s way, are poles apart. Incubator babies are alone, day and night, lying flat on a firm surface, usually in strong light. Only hands and clinical equipment touch the baby. Food usually comes as formula cow’s milk. Conchita’s baby was never alone. He had the warmth, the touch, the softness, the smell, the moisture of his mother. He heard her heartbeat and her voice. He had her milk. Above all, he had her love.

  Possibly today, her decision to refuse hospitalisation for the baby would have been over-ruled by Court Order, the assumption being that only trained staff and advanced technology can adequately care for a premature child. In the 1950s we were less intrusive into family life, and parental responsibility was respected. I am forced to the conclusion that modern medicine does not know it all.

  Admittedly Conchita was lucky. The speed of delivery might have caused brain damage to the baby, but this did not occur. Apart from that, the great danger for a premature baby arises from immature vital organs, especially lungs and liver. The baby did indeed become very jaundiced, more than once, in the first few months, but each time it passed. It was a miracle, after I had heedlessly left the baby in a kidney dish, that his lungs were not wholly, or even partly collapsed from birth. I can take no credit for that. However, the fact is, he breathed. I like to think that by holding him upside down, and tapping his fragile back with a finger, I facilitated his first breath. His mother was advised to do the same after each feed, because, if fluid enters the trachea, a premature baby cannot cough as a full-term baby would. She was also given a very fine suction tube, and shown how to use it.

  Apart from that, which was very little, the baby received no medical treatment. The constant temperature of his mother’s skin kept his body temperature stable. Possibly the constant rise and fall of her breathing helped him over the first critical weeks. I am sure that her feeding policy - a few drops of breast milk placed on the lips at frequent intervals - was the right one. She even did this all through the night, I was told. Conchita took no precautions about sterilising her feeding equipment. I doubt if she had ever heard of such a thing. The saucer and the glass rod were simply wiped clean after each use, ready for the next time. The baby survived. Either he is the ultimate survivor, or we put far too much emphasis on technology and techniques, I thought.

  We visited three times a day every day for six weeks, then twice a day for a further six weeks. Domiciliary care was good in those days. At four months he weighed six and a half pounds and was responding with smiles, and turning his head. He reached out a tiny hand to grasp a finger. He gurgled and chuckled to himself. I was told he hardly ever cried.

  Several times in those post-natal months I thought of that dreadful night when he was born, and remembered Sister Julienne’s words to me as I left. “God be with you, my dear. I will pray for Conchita Warren and her unborn baby.” She had not just said that she would pray for Conchita. Nor had she assumed that the foetus would be born dead. She had said, with equal emphasis, that she would pray for them both. In fact, she prayed for us all.

  One happy day in midsummer I made a routine call to check the weight of the baby. Laughter was coming from the downstairs kitchen as I descended the stairs. The baby was lying in a cot with his brothers and sisters around him. They were all laughing. A delicious smell wafted towards me. Conchita, smiling and in full command, was standing over the steaming copper boiler making plum jam. The copper boiled ferociously as she stirred with a huge wooden spoon. Thank God she had had the wisdom and the strength not to let the baby go, I thought. Had she done so, I felt sure that she would have died, and all the happiness of the household would have died with her.

  OLD, OLD AGE

  Whilst I was fascinated and captivated by Sister Monica Joan, I could not for the life of me decide if she really was verging on senility or not. I could not avoid the suspicion that she might craftily be manipulating us all, in order to get her own way - an old lady’s prerogative down the ages! Without doubt she was highly intelligent, well informed, and in some ways deeply learned, though it was often hard to disentangle the muddled strands of her discourse. In view of her history, fifty years professed nun, nurse and midwife in the East End of London, there could be no doubt of her Christian vocation. Yet her behaviour was often far from Christian. She was often selfish and inconsiderate. Flashes of brilliance and flashes of senility crossed and recrossed each other in lightning streaks; goodness and cruelty rubbed shoulders; memory and forgetfulness were intertwined. The old are deeply interesting and I watched her often. Which was the real Sister Monica Joan? I could not tell.

  No doubt she had always been eccentric. Even the manner in which she went to church was singular. She would leave Nonnatus House, walk swiftly down Leyland Street, round the corner and straight across the East India Dock Road, without so much as glancing to right or left. Lorry drivers would slam on their brakes, tyres would scream, lorries would come to a shuddering halt, whilst this elderly nun, gown and veil billow
ing out behind her, crossed the busiest road in London.

  One day a mounted policeman on a jet black horse was proceeding sedately down the centre of the road. He wore a magnificent white helmet and long white gauntlets, which gave him a kind of Ruritarian, operatic appearance. He saw Sister Monica Joan and, anticipating what would happen, turned his horse sideways in the road, raised his gloved hands to halt the traffic in both directions and indicated that she could cross. As she passed, Sister turned, looked up at the horse and rider, and said, quite clearly and loudly, “Thank you, young man, that is very kind. But you need not trouble yourself. I am perfectly safe. The angels will take care of me.” She tossed her head and walked swiftly on.

  That incident occurred years before I knew her, so clearly her idiosyncrasies had always been there although perhaps they had become more accentuated as she grew older. Sometimes I wondered, though, if her celebrated eccentricity was not an affectation, assumed for the childish delight of drawing attention to herself. Like the incident with the cellist. Poor fellow, it must have shattered him, and I tremble to think what it did must have done to the pianist.

  All Saints, East India Dock Road, was and still is a prestigious church, commanding a favoured position in the diocese. Built in classical Regency style, and beautifully proportioned, the interior is a gem and the acoustics beyond reproach, making it an excellent place for concerts.

  The Rector had managed to persuade a world famous cellist to perform. Cynthia and I were given the evening off in order to attend the concert. At the last minute we thought how nice it would be to take Sister Monica Joan. Never again!

  To begin with, she insisted on taking her knitting. Neither Cynthia nor I remonstrated as we should have done, but that was only with the wisdom of hindsight. We entered the church, which was full, and Sister Monica Joan wanted to sit in the front row. Like a dowager duchess she sailed down the central aisle, with Cynthia and me trotting after her like a couple of lady’s maids. She sat down middle centre, directly opposite the chair placed in readiness for the cellist, and we sat on either side. Everyone knew Sister Monica Joan, and from the outset I felt conspicuous and uncomfortable.

  The chairs were too hard. Sister Monica Joan fidgeted and grumbled, trying to adjust her bony bottom to the wooden chair. We offered her a kneeling pad, but that was no good. Cushions had to be found. Curates ran hither and thither poking into sacristy cupboards, but with no luck. Church paraphernalia contains everything but soft cushions. The nearest thing was a length of velvet curtaining. This was folded up, and placed under her bony prominences. She sighed at the young curate, who was new and eager to please.

  “If that’s the best you can do, I suppose it will have to do.” Her sharp tone erased the smile from his face.

  The Rector stepped forward to welcome the audience, and said that coffee would be served in the interval.

  “And now it is my great pleasure to welcome—”

  He was cut short.

  “Do you have decaffeinated for those who do not drink coffee?”

  The Rector stopped. The cellist, one foot on stage, paused.

  “Decaffeinated? I really don’t know, Sister.”

  “Perhaps you would be good enough to find out?”

  “Yes, of course Sister.”

  He signalled to a curate to go and find out. I had not seen the Rector look uncertain before; it was a new experience.

  “May I continue, Sister?”

  “Yes, of course.” Very graciously she inclined her head.

  “ ... my pleasure to welcome to All Saints the renowned cellist and pianist ... ”

  They bowed to the audience. The pianist seated herself at the piano. The cellist adjusted his stool. Silence fell on the audience.

  “She’s wearing brocade, my dear.”

  Sister Monica Joan’s articulation was faultless, and, as I have said, the acoustics at All Saints are superb. Her stage whisper, which at its best could penetrate a railway station at rush hour, reached every corner of the church.

  “We used to do that in the 1890s; cut down some old curtains, and make a second best dress out of them. I wonder whose curtains she got hold of?”

  The pianist glared, but the cellist, being a man, had noticed no insult, and started tuning up. Sister Monica Joan was fidgeting beside me, trying to get comfortable.

  Satisfied, the cellist smiled confidently at his audience and raised his bow.

  “It’s no good. I can’t sit like this. I shall have to have a cushion at my back.”

  The cellist let his arm fall. The Rector gazed helplessly at his curates. A lady from the back came forward. She had providently brought a cushion for herself, and Sister Monica Joan was welcome to use it.

  “How very kind. It is greatly appreciated. So kind.”

  Her regal graciousness could have out-queened the Queen Mother. She felt the cushion, and decided she would sit on the cushion and have the cloth at her back. Cynthia and the Rector adjusted all this, whilst the cellist and pianist sat quietly looking at their instruments. I was squirming, trying in vain not to be noticed.

  The recital started and Sister Monica Joan, comfortable at last, took out her knitting.

  Knitting during a recital is not common. In fact I have never seen anyone do it. But Sister Monica Joan was not concerned with what other people did or did not do. She always did exactly as she chose. Nor is knitting generally considered to be a noisy occupation. I had frequently seen Sister Monica Joan knitting in absolute serenity and silence. But not on this occasion. The knitting was of a lacy pattern, requiring three needles, and this produced absolute mayhem.

  She dropped the needles repeatedly. They were steel knitting needles, and each time they fell they clattered on to the wooden floor. Cynthia or I had to retrieve them, depending on which side the needle had dropped. The ball of wool fell and rolled under several chairs. Someone about four chairs down kicked it back towards her, but the trailing piece of wool caught around the leg of a chair and pulled tight, thus pulling several stitches off the work in Sister Monica Joan’s hands. “Be careful,” she hissed at us as the cellist approached a particularly difficult cadenza, his eyes closed in rapture. He opened his eyes sharply, and an unexpected bum note sounded from the strings. Seeing Sister Monica Joan fumbling after the wool, the cellist, with true professionalism, launched into his cadenza. He finished the movement in masterly fashion.

  The slow movement started very quietly and peacefully, but the ball of wool was not so easily dealt with. The person four chairs down tried to retrieve it and push it back the way it had come, without success. The ball rolled backwards, and got tangled around the feet of someone sitting behind, who picked it up, causing the trailing end to pull tight again, pulling several more stitches off Sister Monica Joan’s needle.

  “You are ruining it,” she spat out to the man behind.

  The pianist was playing a hauntingly tender passage. She turned from the piano and looked daggers at the first row.

  As the final cadence approached another needle dropped to the floor with a resounding clatter, destroying the plaintive cry of the cello in the dying fall of the movement.

  The Rector, with a desperate look on his face, came forward and whispered to Sister Monica Joan to be quiet. “What did you say, Rector?” she said loudly, as though she were deaf - which she wasn’t. He backed off in alarm, fearing that he might make things worse.

  The third movement was an allegro con fuoco, and the duo played it faster and with more fire than I have ever heard.

  Cynthia and I, who were just about dying with mortification, were counting the minutes until the interval when we could take Sister home. I was grinding my teeth in fury, and plotting murder in my heart. Cynthia, who has a sweeter nature than mine, was patient and understanding. But worse was to come.

  The musicians brought the third movement to a triumphant close. With a magnificent gesture the cellist swept the bow upwards, and raised his arm aloft, smiling confidently at the audience.


  Only a few seconds were to elapse before the applause began, but it was time enough for Sister Monica Joan to make her exit. She stood up abruptly.

  “This is too painful. I cannot put up with this a moment longer. I must go.”

  With knitting needles dropping all around her she passed the musicians and, in full view of the entire audience, swept down the central aisle towards the door.

  Tumultuous applause broke out from the Poplar audience. Stamping, cheering, whistling - no musicians could have asked for a greater ovation. But they knew, and we knew, and they knew that we knew, that the applause was not for them or their music. They bowed stiffly, faces set in a grim smile, and left the platform.

  Black fury took possession of me. I greatly respect musicians, knowing their years of intensive training, and I could not excuse this last gratuitous insult, which I saw as deliberate. I could have hit Sister Monica Joan, hard, in front of a couple of hundred people. I must have been shaking with rage, because Cynthia looked at me in alarm.

  “I’ll take her home. You stay and find a chair at the back somewhere, and enjoy the second half.”

  “I can’t enjoy anything after that,” I hissed through clenched teeth; my voice must have sounded strange.

  She laughed her soft, warm laugh. “Of course you can. Get yourself a cup of coffee. They are playing the Brahms Cello Sonata next.”

  She gathered up the knitting needles, extricated the wool from around the chair legs, put it all into the knitting bag, blew a kiss with a whispered “cheerio”, and ran off after Sister Monica Joan.