CERVIX
Inch-long passage at the low narrow neck of the uterus; generally closed
PLACENTA
A liverish circular organ grown solely for the nurture of the baby inside the uterus
VAGINA
Four-inch tube of muscle leading from cervix to outside world; among other of its sobriquets: the birth canal
PERINEUM
Area of muscle fibre and blood vessels between vagina and rectum
BABY
LUCINA
Goddess of Childbirth
ACT I
Scene A hospital room, with a discreetly glittering and flashing battery of equipment. On a high bed lies the woman, a metal belt monitor girdling her thirty-nine-inch forty-week globe. Beside the bed is a carpet bag from which spills: a plant spray; a Japanese fan; a large stop-watch; a thermos of ice cubes; a wooden back roller. The midwives are checking the monitor’s screen, making entries on the partogram chart at the bottom of the bed. A cassette-player by the bed plays Edith Piaf’s ‘Non, Je Ne Regrette Rien’. The wall clock shows 8 p.m.
CHORUS
The baby’s heartbeat’s strong. Unstrap her now.
Let’s check her notes again. Ah yes. We guessed.
Another fan of Nature’s ancient wisdom,
Not wanting pain relief nor intervention,
No forceps, see, nor oxytocin drips
To speed things up. OK, that’s fine by us.
Whether she thinks the same in six hours’ time
Need not concern us since that’s not our shift.
WOMAN The last couple of weeks have been spellbindingly hot and still. I confined myself to the garden, granted temporary immunity from duty, sympathy, even normal politeness towards other people by reason of being impregnably pregnant. The steady, almost solid, golden air along with the damp clean smell of my own skin were all I cared about. I felt powerful, magnificent, and perversely free. My liberator rested too, biding its time, making the occasional dolphin movement when the sun was strongest on my belly (unborn nine-month eyes perceive sunshine on the other side as a warm geranium-shaded lamplight). Then this afternoon the weather broke. There was a new agitation in the air. The neighbourhood cats were slinking around, birds chirred, the trees shook their tops even though there was no wind. The air turned grey, a milky blue-grey, and its temperature dropped suddenly though it was still thick to breathe. Flies buzzed in the kitchen. Then came the first casual thunder and I was grinning like a warrior, suddenly savage and excited. The rain came in isolated splashy drops at first, then soughed into the flowerbeds releasing passionate garden smells, purling down the windows, pattering across limp green leaves and my own still-warm powdery skin.
I went inside and finished packing my bags, swapping my chosen tapes at the last minute, exchanging Dire Straits for Carmen, Spem in Alium for Eekamouse. How on earth do you choose music by which to give birth? The National Childbirth Trust recommends whale music, those sweet mournful subaquatic sea lullabies sung by toothless baleen whales. Only the males (and then generally only the hump-backed sort) sing these intricately phrased half-hour songs, and then exclusively during the mating season. But in my current incarnation of flesh, whale music sounded almost too much of a creature comfort.
CHORUS
The baby sucks its thumb and bides its time
Buoyant inside its water-bottle world
Of amniotic fluid. But nine months on
The reckoning arrives. Placenta’s tired.
The food’s less good. Time to move on. So long.
Sometimes the cervix’s cork provides a sign,
A show, to free the geni from his jar.
Sometimes the waters break, which happened here,
A rush of straw-pale almond-smelling sap,
So, high and dry, the baby must descend.
WOMAN When the storm took hold of the afternoon and shook the house until its windows rattled, that was the beginning of the end of our time together. I was sad when I realised that this baby will not be one of the rarities born in a caul, delivered with the unruptured membranes covering its face, because that would have meant the impossibility of its death by drowning. Now it has lost its own individual ocean and must take its chance along with the rest of us. Soon afterwards, at groin-level or just above, arrived certain dull central pangs. I ignored them for a few hours, dealt with some bedding plants, trailing lobelia and a batch of yellow-eyed heartsease – easy to do, since these pangs were unalarming through familiarity, the usual monthly dullards. But when they grew uglier, pestering me every five or six minutes and hanging around for a minute at a time, so that I was having to stop and grip the garden trowel and concentrate, then, after a final pot of raspberry-leaf tea1, I came here.
ACT II
The wall clock shows 9 p.m.; from the casette-player comes the Toreador’s Song. The woman moves slowly round the room changing positions at intervals, leaning against a wall with forehead on folded forearms, sitting backwards astride a chair, kneeling on all fours, etc.
CHORUS
Carmen again. She’s keen on opera.
Six centimetres dilatation. Good.
In four more hours perhaps – or even less –
The baby will be set to disembark;
Then, Steady as She Goes, and, Land Ahoy!
But now it waits, head down, in its old home
The uterus, that muscled bag of tricks,
Which pulls and squeezes with increasing force
Tugging the cervix up over its head
A little more with every strong contraction
On average one centimetre an hour,
Until there is no length but only width.
(In the same way, Caruso’s head was perched
Neckless upon his shoulders – that great voice
A direct product of its shortened passage.)
Eight score contractions for a first-time child
And half that count for each one after that;
Slow work, irksome, and most laborious.
WOMAN Come home with your shield or on it, said the Spartan mother to her son. When we were children we used to play dares, stay silent through a two-minute Chinese burn, grip a stinging nettle and not cry. I don’t know what we thought would come from this, but something did, some sort of safety. I knew before I was eleven that I wasn’t a scaredy cat and I still know it. What’s about to happen may well be another less childish sort of mettle detector. Excuse me for a minute …
(Woman falls silent, concentrates on the clock, fetches quick shallow breaths like a cat in hot weather.)
CHORUS
That’s right, relax your jaw and shoulders now;
Keep your eyes open, focus on that clock
And concentrate, still while your body works.
We only shut our eyes for pleasant things,
Kissing, and other stuff that leads to this.
WOMAN The approach of labour is unnerving because nobody seems to agree on the nature of the pain involved. Susan told me, think of the worst possible pain you can imagine and it’s a hundred times worse than that. Her labour lasted twenty-four hours, during the course of which she progressed from deep breaths of laughing gas, which made her dopey but did not take away the pain, to injections of pethidine, which made her sick and vague but did not take away the pain, to an epidural (the plastic tube of numbing liquid inserted through a hollow needle between two vertebrae in your spine), which took away the pain but also removed her capacity to work with her body’s pushing urges and so necessitated the baby’s forcible forceps removal, which, what with tearing and bruising and stitches both internal and external, meant several more weeks’ pain afterwards.
On the other hand, Nicola said that most of her first birth had been no worse than very bad period pains, except at the end, when it felt like an extremely constipated bowel movement involving a coconut.
CHORUS
This talk of pain relief and active birth’s
All very well, bu
t what they really need
Are more midwives with more experience.
We have more patience and more creature feeling
For our own sex; know to leave well alone,
Don’t crave control or intervene through pride
Like certain doctors we could mention. No.
We watch, wait, check, cheer, wait, and give advice.
Before, we’d see each drama to its close,
Before, that is, shift-work became the rule.
Now, though, our drop-out rate’s eighty per cent.
Long training with no money at the end,
This no-strike policy and powerlessness
Do not encourage us to persevere.
Good luck, dear, we’re off now to Burgerland.
Here comes the next shift ready to take over.
Remember us. Women should help each other.
And this, if nothing else, is women’s work.
(Second chorus of midwives enters room, checks charts, exchanges pleasantries, yawns; woman carries on alone, practising her positions and concentrating.)
WOMAN All the pain so far has been well below the belt and I imagine it will remain that way. So I shall stay upright, whether standing, sitting or kneeling, for as long as I can, right to the end if possible. That way I’ll be on top of it. Whenever I’ve heard contractions described with any attempt at vividness it’s always been in melodramatic terms: ‘great breakers surging in the black sea of the body,’ and so on. I will try to avoid such clichés. Still, to be fair, now I’m actually in the middle of it, I can appreciate the maritime imagery. Contractions do come in waves, each building to a crest and leaving a respectable breathing space in between. Otherwise I wouldn’t be able to talk to you like this, even if I am speaking rather fast.
Last year I had a violent fortnight down on the French south Atlantic, where the coast follows a pencil-straight line for hundreds of kilometres. I have never known bathing like it. It tugged off swimming costumes and teased out mad laughter and screaming. This sea was not to play with but to play dares against. Cross-currents and the suction of incoming waves kept up a continual state of tension only just this side of pleasure. Sometimes, watching the water rear up a few yards from you, towering in a curved wall to block the light, you quailed and forgot to swim into it; then it would break over your head, sweep you off down underneath, nose and mouth filled with brine in a dark, stinging thuddingly silent world. Sometimes, best of all, you steered into and on top of a great boiling wave which had not quite broken, and then you were riding blithely on its crash and roar. You have to keep your spirits up against that sort of sea, shout and sing and concentrate hard on anticipating the violence while holding your body quiet and prepared.
ACT III
The clock shows 4 a.m. The woman is sitting restlessly astride a chair, head on hands on chairback, making an assortment of noises – muttering, grunting, singing disjointed phrases.
2nd CHORUS
She’s reached the state which marks transition
From waiting into thrustful energy.
Contractions double up and lose their rhythm,
Heavy to ride, intractable, austere.
The baby’s almost ready – but not quite –
Must wait until the cervix’s front edge
(Otherwise known as the anterior lip)
Withdraws in self-effacement round the skull
At last allowing space for exodus.
WOMAN What I forgot to take into account about pain at the start of all this was the way it wears you down when it goes on and on. I’ve been at it now for nine hours. Excuse me.
Mmmmarrh. Mmmmarrh. I’ll give you one-O. Green grown the rushes-O.
When I time a contraction by the second hand of my watch, I now find it’s lasting almost two minutes, while the rests in between are getting so short that sometimes there’s no breathing space at all. Then just when I think I’m managing, it turns into something else so that I’m wrestling with unknown quantities like the strong man in the myth. It’s not fair.
Mmmmarrh. Mmmarrh. What is your one-O? Mmmarrh. One is one and all alone – lalalalaLA – and evermore shall be so.
And that’s a lie as well. One isn’t one. One isn’t quite oneself at all today. One is, in fact, almost two.
And ANOTHER. Come on you Spu-urs. Come on you Spu-urs. You’ll nev-er walk alone.
(Shouts colourfully.)
I’ve had enough of this. It’s got beyond a joke. They told me at the classes to do without pain relief if possible. ‘Better for the mother.’ RUBBISH! ‘Better for Baby.’ B***** Baby! I should have had that injection in the spine at the start of all this, the one that paralyses you from the waist down, the one where you can play scrabble during it. It was all the talk of scrabble that put me off. Every time the word epidural was mentioned, scrabble came up too. I hate scrabble. GIVE ME AN EPIDURAL NOW!
2nd CHORUS
Too late, dear, sorry, much too late for that.
You’re nearly there. An epidural now
Would take too long to work, would slow you down.
Nor can we give you pethidine – too late!
It might slow down the baby’s breathing speed.
Why don’t you try a little laughing gas?
(They hand her a mask, show her how to put it over her face; she sucks in deep breaths.)
They all do this, the nature’s-children set,
Leave it too late then yell for pain relief.
(To woman)
Not long now dear. Be patient. Don’t push yet.
Try lighter breathing – Hoo Hoo Ha Ha Ha.
WOMAN Who? Who? Ha! Haha!
ACT IV
The clock shows 5 a.m. The woman is sitting propped against pillows, high on the delivery bed, sideways on to the audience. The midwives stand around her, showing more animation than they have done up till now. From the cassette-player comes Lone Ranger’s ‘Push, lady, push’, the reggae song whose chorus runs, ‘Push, lady, push, lady, push; Push and make a youth-man born’.
2nd CHORUS
Strongly embraced by each contraction
The baby, hugged and squeezed, waits upside down
Until the lock’s enlarged before it’s launched
Headfirst, chin tucked to chest, in slow motion
Through vaults of bone, branched pelvic arabesques,
And down along the elastic boulevards.
WOMAN Ah, the relief! No more forcible dawdling, no more long-suffering waiting in the wings! Now I can get some work done.
Hgnagggh! Hgnagggh!
(Makes other serving-for-match-point noises.)
And here’s my whole body working away like a pair of bellows, sweating with aspiration, intent on exhaling a brand-new bellowing homunculus.
(Roars.)
See these women staring so avidly between my legs? These are my trusty accoucheuses who have whiled away much of this drama’s time with hypothetical knitting, but who now wait, breath bated, for the first gasp.
(Roars again.)
2nd CHORUS
The baby’s nearly here – we see its head,
We glimpse the unfused soft-skulled fontanelle.
Now it draws back again. Stop pushing, dear,
Or else you might get torn. You don’t want that.
Breathe very lightly, puff from West Wind cheeks,
Hold baby back with candle-flickering breaths.
Keep your mouth soft and you’ll be wide down there.
WOMAN So that accounts for all the pouting that goes on. I wondered what was behind it. Well, prunes and prisms, prunes and prisms, prunes and prisms.
(Takes shallow panting breaths.)
Gently they receive its head; they lead out each shoulder in turn. And now – it – glides – into – the – world … away from me.
(The midwives crowd in, obscuring the woman from sight. A thin infantile wail rises, gathering strength.)
ACT V
The wall clock shows 6 a.m. T
he woman lies on the bed. The baby is at her breast. The midwives are still grouped round her lower half, obscuring the view.
2nd CHORUS
After the birth must come the afterbirth.
A shot of syntometrine in her thigh
Will speed things up. Contractions start again;
We tug the rainbow cord still linking them,
Its two-foot length still beating with their blood,
And out slides the placenta. Animals
Gulp down this liverish morsel routinely –
Its succulence keeps up the mother’s strength –
And even among certain human tribes
It’s called the midwife’s perk. Once in a while
Some earthy type who’s read too much insists
We pack it up for her to cook at home.
Not this one. Quite the opposite in fact;
She hasn’t even noticed what’s gone on.
WOMAN You were storm-blue at first, covered with white curds of vernix. Next you turned pink like a piece of litmus paper. They gave you a lick and a promise, then handed you back to me, your limbs lashing, your face a mask of anger. I felt like a shipwreck, but you fell silent, little Caliban, and latched on. After that spread-eagling storm we were washed up onto the beach together. Now you’re quiet as a limpet on a piece of driftwood.
How can I ever think of love again?
(Midwives still grouped staring between her legs. A hand is seen, rising and falling, wielding needle and thread.)
2nd CHORUS
Congratulations, dear. Only one stitch.
You hardly tore at all, you lucky girl.
If Doctor had been here you would need more.
The commonest operation in the West,
Top favourite, is episiotomy,
With one hour’s careful stitching afterwards.
They cut the perineum – to make space
For baby’s head, they say – unkindest cut
Of all, through muscle layers. Less haste, we say,
Four Bare Legs In a Bed Page 7