Australian Midwives

by Paula Heelan

  Gayle arrived at the hospital at 2.15 am and rushed into the ward to find Angie surrounded by nurses and her husband, Andy. She greeted them cheerfully. Everyone looked to her with relief on their faces. ‘Outwardly I stayed calm,’ she says. ‘Inwardly, I was nervous and stressed.’ But with experience and training kicking in, Gayle instantly knew what she needed to do. She began taking the obs, checking the labour stage and the baby. Everything was fine and the labour and birth went smoothly. ‘At 3.18 am we welcomed a gorgeous baby boy, making it two girls and two boys for Angie and Andy.’

  But it wasn’t quite over. ‘The placenta was not delivering,’ Gayle says. They waited an hour, but nothing happened. After several telephone talks with obstetricians, they decided they needed to take the two-hour trip to Emerald by ambulance. Luckily, an ambulance from a bigger centre was already there – they had a hospital on wheels.

  Gayle hopped in with Angie and her baby and Lea, the director of nursing (DON), followed in Gayle’s Toyota. Halfway to Emerald when they reached the turn-off to Gayle’s cattle property, Medway Station, they swapped. Lea joined Angie in the ambulance and Gayle drove into her homestead. She was exhausted and freezing cold, but still running on adrenaline. There was no time to sleep – she and Rob had a plane to catch in a few hours’ time. ‘I was worried about Angie, so I texted Lea to make sure everything was okay.’

  The ambulance arrived in Emerald as the sun was rising. The placenta still hadn’t delivered, so Angie was taken into theatre, where it was removed without complication. Later that morning on her way to the Emerald Airport, Gayle called into the hospital. She filled out the birth registration forms and had a little time to check on Angie and her baby, who were doing extremely well. ‘It was a wonderful outcome and made me realise how much I miss the birthing part of midwifery.’

  Angie says when she arrived at the Alpha Hospital she was feeling quite calm, despite knowing she wasn’t where she should be. ‘I was supposed to be in Emerald waiting for the baby there, but I really didn’t mind that I ended up in Alpha,’ she says. ‘I’d had an uncomplicated pregnancy. I was really pleased when Gayle walked in. I’ve known her since my eldest child was born and it was reassuring to have her with me.’

  Gayle grew up in an idyllic country lifestyle in central Queensland on a cattle property outside Rockhampton with her parents and two brothers. Moving to Brisbane in 1985 to train in nursing at the Princess Alexandra Hospital was not easy. ‘I had never left home before and I was terribly homesick,’ she says. ‘But I made some really lovely friends in the nurses’ quarters and they looked out for me and convinced me to stay. I travelled home on the bus quite often and when I started going out with a Japanese boy in my second year, I got over the homesickness.’

  Though the relationship became serious, when Gayle went to Japan to meet her boyfriend’s parents, she discovered they were wealthy and had already planned an arranged marriage for their son.

  ‘So I finished my final year carrying a broken heart. But my lovely friends looked after me and I poured myself into the study.’ Gayle went on to sit the state exam and topped the class. ‘I was a bit of a dork, but I still enjoyed taking part in the antics. One day the girls sent me off to theatre to collect some fallopian tubes. I fell for their tricks every time.’

  Gayle’s training was hospital-based, so she spent six weeks learning the ropes before being ‘let loose on the general public’, as she describes it. ‘We were supervised, but really just got thrown in the deep end.’ Gayle finished training in 1988. ‘If we’d had to go to university I probably wouldn’t have been able to do nursing. My parents didn’t believe in tertiary education and probably couldn’t have afforded to send me. They were of the mind that you just finished school and got a job – that’s just how it was.’

  Gayle returned to Rockhampton to work at the Base Hospital. ‘I was put to work in theatre, but I didn’t really like it. It’s a very sterile environment and everyone’s asleep. I preferred the patient contact. So I applied for a job at Aramac, a small, rural town in the Barcaldine Shire and 530 kilometres west of Rockhampton. I worked there for seventeen months and got my first taste of working in a remote hospital.’ At the time, women could still have their babies in Aramac, so Gayle had the opportunity to help out with quite a few births and it was here she saw a baby born for the first time. ‘I felt very emotional,’ Gayle recalls. ‘I looked at the woman and her partner and could see so much love between them at that moment. It hit home how incredible it was when new life came into the world, particularly when you are part of it. I knew then I wanted midwifery to play a large part in my career. I realised, too, that even though most circumstances are happy, there are often times when it can be a bit sad. Sometimes you see beautiful babies born and then when you carry them out to the car on discharge, you see the family situations are not always ideal for a newborn child.’

  Before the 1990s, all the small hospitals had maternity wards for delivering babies. Gayle realised if she wanted to continue with rural nursing, midwifery was going to be an essential part of her career.

  Outback Queensland was new to Gayle and she took to the lifestyle quickly. In Aramac something new happened every day. ‘The variety was amazing – we dealt with whatever came through the door. There were busy periods and quiet periods and my social life was always busy. There was something on every weekend – a B&S ball to get to, someone’s property to visit. I had a boyfriend who worked on a sheep property out of Aramac and I used to visit him.’

  Gayle moved to Townsville to do her twelve-month midwifery course at the former Kirwin Women’s Hospital. Alternating between antenatal, postnatal and labour wards and clinics, it was hands-on learning. ‘I loved everything about it and this is where I did my first independent delivery.’ It was on 26 September 1990. It was the mother’s first baby and the labour was fairly long. Gayle had looked after the mother through her shift and stayed back after work to be with her for the birth. She was very keen to do her first birth. After all, that’s why she was there. As she tended to the woman and the birth drew close, Gayle was extremely nervous and worried. ‘I thought, I just want to get this done. I want it to be over, so I can get on with things.’ Everything went to plan and Gayle helped birth a little girl weighing 2.66 kilograms. But she forgot to milk the blood from between the two clamps before the father cut the umbilical cord. When he cut it, blood sprayed everywhere, creating momentary chaos. ‘I only made that mistake once. I can remember the father wasn’t a lot of help really – but at least he was there. I felt relieved afterwards and then I just wanted to do more.’

  For Gayle, the best thing about working in maternity is that 98 per cent of the time the outcome is good. ‘Most of the time it’s a well woman having a beautiful, healthy baby. In Townsville, I’d be in the shopping centre and people would come up to me to say hello and show me how their baby has grown. I’d often forget their names – but they were always very grateful – it’s such a lovely area to work in.’

  In Townsville Gayle met Liz Jane, who was in her midwifery group. Liz remembers Gayle as the country girl come to live in the city to train for her mid. ‘Gayle was the most naive young woman I’d met. You could string her along over anything. Blessed with an infectious, sunny nature, she assumed good in everybody. Coming to Townsville was a bit of a wake-up call for her. It was an army town and some confronting cases were coming through the wards. They weren’t all beautiful families having babies. We had to deal with some pretty rough stuff.’

  The midwives in training were eager to notch up their twenty required births to pass. ‘In the maternity ward it’s one on one and you are on duty for eight hours – you’re taking obs, overseeing an epidural, holding hands tightly, talking through the labour and finally a little head is on view. One day this had all happened to me and just as I put the gloves on to birth the baby, the tyrant nurse-in-charge walked in with a young, glib-looking medical student. Gloves off, nurse, she said. This student doctor will deliver. I was
furious. After all my hard yards, he would deliver and I’d be sent back in later for the post-care and clean-up. I went down to the pan room to vent some anguish and Gayle walked in.

  ‘What’s wrong, Liz? she asked. I told her how Dr Smooth had taken over. She understood and agreed he and the tyrant nurse were awful.

  ‘Would you like me to go down there and distract him, Liz? I’ll get him out of the room and you can duck back in and deliver that baby.

  ‘Gayle was serious – she would have done that for me. What’s more, as a stunning 22-year-old, she would have succeeded. The next day I told the other midwives what had happened and what a great friend Gayle was – so loyal and sweet. Then weeks later when we were on night duty, Dr Smooth was in the corner reading some papers. He looked up and saw Gayle. Hey, Gayle, he said, I hear you want to see me?

  ‘Gayle glared at me, red-faced. She was mortified. The rest of us fell about laughing. Gayle was very easy to play a joke on – she was always the victim. But we did all look after one another and Gayle and I have been dear friends ever since.’

  Gayle’s second birth experience soon after the first was another little girl. ‘When you are birthing a baby you focus so much on what’s happening with the mother and the baby, you become oblivious to whatever else is happening in the room. I remember going to the postnatal ward every day after my first few births to check on the babies. They were very special to me.’

  The scariest experience Gayle had in Townsville was cutting her first episiotomy. ‘I had to cut the perineum to make it easier for the baby to birth. I put in a local anaesthetic and then cut where the skin is very thick. I was glad when I got the first one of those done, too.’

  Gayle loved the labour ward, but her charge nurse was very fierce. ‘Gosh we were made to do some terrible jobs,’ she says. ‘I remember a weekend chore for the student midwives was to clean the “placenta muncher”. But we always seemed to laugh when we did it, even though it was disgusting. It was a tough twelve months all in all, but we stuck together and supported each other. We had to learn it all in such a short time – then pass state exams.’

  With midwifery completed, Gayle got a job at the Alpha Hospital, where she still works part-time today. ‘When I started it was a busy little hospital and the infamous flying obstetrician Jim Baker would fly in regularly.’ The late Jim Baker set up the Roma-based program in Queensland’s southern inland region in conjunction with Queensland Health in 1988. He would fly to any one of 30 hospitals spread across the vast distances of the state’s country areas. ‘We often had to wait for him to fly in for emergencies or if there was a complication with a birth,’ Gayle says. ‘He was a larger-than-life character and he made a big difference to the delivery of health care in the bush. It meant women didn’t have to travel out – he’d come to them. And he was always available to give advice on the phone. Time and again we were relieved to see Dr Baker step off the plane – whether it be for an emergency caesarian, a retained placenta or perhaps a forceps delivery. I know for sure that that man saved the lives of many babies and mothers in outback Queensland.

  In addition to Jim Baker, Longreach-based doctor Bob Spence would fly in every four to six weeks to perform surgical procedures, and there was also a full-time doctor, Melissa Butini, who’s now a highly qualified obstetrician at the Wesley Hospital in Brisbane. Alpha could be a hectic place, and because there were only two midwives, Gayle would be called in regularly.

  Very soon after Gayle started at the Alpha Hospital an obstetric emergency took place and she was brusquely introduced to maternity in the outback. It was fortunate that on the day, two midwives were on duty, including Gayle, as well as a doctor with a keen interest in obstetrics. The mum was having her first baby and labour was going along well until an examination revealed a cord prolapse had occurred. This happens when the umbilical cord slips through the dilated cervix and into the birth canal before the baby during labour. ‘The cord is baby’s lifeline and if it becomes compressed by the baby’s head it can be life threatening to the baby,’ Gayle says. ‘The treatment for a cord prolapse is to hold the baby’s head away from the cord by putting the mother on her hands and knees and for the midwife or doctor to physically hold the head off the cord with their fingers. And a caesarian is usually needed as soon as possible.’ In a large maternity hospital a caesarian can be organised in minutes. But in the tiny town of Alpha it was quite different. ‘Staff needed to be called in to organise the theatre and the theatre nurse lived an hour out of town. Dr Jim Baker was contacted and asked to fly in as soon as he could.

  ‘This all took time. We were all busy keeping the cord from being compressed and helping the mother and her support people to keep calm during a very scary time.’

  Gayle was a newly qualified midwife accustomed to working in a major facility with everything at her fingertips – she was extremely nervous. ‘The wait for everyone to arrive felt like an eternity,’ she says. ‘But we were very fortunate to have Melissa with us – she led us through it magnificently and we did have plenty to do while we were waiting. Melissa kept the head off the cord and we midwives and nurses prepared for the theatre sister’s arrival. We got the baby warmer ready and organised someone to pick up Jim from the airport. Before he arrived, someone had to go down and clear the airstrip of kangaroos and any other obstacles. Had it been at night the lights would have had to be turned on for the plane to land. Back then, if the weather was too bad for landing, patients had to be transferred by ambulance to the larger airports at Barcaldine or Emerald. Today the airstrip is fully fenced and the lights can be turned on by the RFDS pilot flying in.’

  Gayle will never forget the feeling of relief when Jim entered the theatre and scrubbed to perform the C-section. ‘We all knew the baby needed to be birthed quickly and we worked as fast as we could to make it happen. Each one of us was worried for the baby. Miraculously, everything came together and through some incredible teamwork, a very healthy baby girl was handed to her mother.’

  There were often some over-zealous parents. ‘We’d look at the length of the birth plan when women came to the labour ward and raise our eyebrows. Most mothers and their partners drew up a birth plan of what they wanted to happen. Often some mothers – especially schoolteachers – would arrive with pages and pages of a birth plan with very strict ideas. Sadly these plans often went belly up. They would come in declaring they didn’t want any pain relief and then end up with an epidural because they couldn’t bear the pain. Often the labour went on for a very long time. Then you’d get the twenty-year-old woman with no plan come in and she’d birth the baby naturally after a 30-minute labour.’

  Gayle advises mothers now to have a bit of an idea of what they’d like to happen, but to just go with the flow. ‘I say to women, Tell your partner what you want, but be open to whatever happens.’

  Having worked at Alpha since 1991, Gayle has started caring for expectant mothers she had delivered as babies. ‘A couple of years ago I was looking over the chart for a mother I was seeing for antenatal visits when I recognised the handwriting on the card – it was mine. I realised, with a small degree of shock, I had delivered this young woman many years previously in the Alpha Hospital. That’s what I love about my job now. Even though mothers don’t routinely deliver in Alpha, I care for them while they are pregnant and then have the joy of watching their babies grow. If I worked in a busy labour ward, generally I would just see the birth and probably not see the baby again. In rural areas we become very involved and part of the families’ lives. I think I am really lucky.’

  One Sunday Gayle was at the hospital caring for a woman in labour. Being a midwife in a small town she would stay with a woman from the start of her labour until the birth and stay on until she was sure both mother and baby were well. On this day, Gayle birthed a beautiful baby boy. The dad was overjoyed as their first child was a girl and he was thrilled to be welcoming a little boy. ‘After everything was sorted and mum and baby were settled, the dad popped a bot
tle of bubbly and was very insistent that I have a glass to celebrate the birth with them,’ Gayle says. ‘Now you have to remember that I had been at work for more than ten to twelve hours with very few breaks and not much food to eat. Needless to say after the bubbly I left the hospital feeling quite intoxicated – luckily I was overnighting there and didn’t have to drive home.’

  Gayle was born on 31 January, 1967. Her husband, Robert, was born in the same hospital the day before. They met for the first time 25 years later in Townsville. ‘I gave him my phone number, but he didn’t call me.’ She laughs. ‘Then we met again at an Australia Day ball in the Alpha town hall in 1992. He was helping his brother Ian on one of the family cattle properties out of town and ended up going to the B&S ball. ‘When I saw him again I thought, He is hot. I really need to get to know him.’ They danced most of the night and the next day Rob rang the Alpha Hospital and asked to speak to Gayle. ‘In those days there were no mobile phones, so he had to ring the hospital and ask to be put through to the nurses’ quarters. It took a bit of courage on his part. Then he came to visit me and bought me a rose for Valentine’s Day and before long we started dating, despite being a few hours’ drive from each other. He was living at the property he grew up on near Capella in central Queensland most of the time, but worked on whichever family place needed him most. He was unmarried and with quite a few family properties in the area he got shifted about a lot.’

  Rob and Gayle married a year after they met in Rockhampton. They flew to Melbourne for their honeymoon, hired a car and drove to Canberra. It was a new experience for both of them. Born and raised in the country, neither had travelled much outside Queensland. ‘We drove through all the little rural towns off the beaten track and stayed in country pubs,’ says Gayle.