Midwife Marley: "This was the first time I misjudged the childbirth situation"

My 24-hour shift is about to start, I'm taking over from a colleague

While I clamp the phone between my ear and shoulder, I sit down at the kitchen table and start up the laptop. From home, we can log into our software system. In the logbook, I can see exactly which calls have been made today and in the calendar, which postnatal visits are scheduled for tomorrow. I read that my colleague visited the Italian Lesli around five o'clock. Lesli is exactly 40 weeks pregnant today. Expecting her first child and moved to the Netherlands halfway through her pregnancy. Her mother is Dutch, so she speaks reasonably good Dutch, but with a heavy accent.

Lesli called the clinic today because her water broke and the contractions started after lunch

She referred to them not as contractions, but as big waves. Grandi ondate. My colleague went to check, but wasn't quite impressed yet. 'The cramps were there, but they weren't strong and powerful and were still short. I don't expect too much from it yet. Maybe they were just some pre-labor contractions?', says the colleague on the phone. 'She also found the contractions quite painful, so I gave her several tips to relax properly. I'm curious if she'll call you later.' 'We'll see,' I say. 'It could still progress, of course.'

We will go over the further details

After 20 minutes, I'm all caught up. We disconnect the call and I decide to tackle some emails. Once I'm done with that, I feel cold. The blood has drained from my hands from typing; they're white. My nails are a bluish purple. A warm shower will probably do me good. I place the service phone on the edge of the sink, the ring volume set to the highest level. You never know who might call. I drag that thing everywhere with me, even to the toilet. I don't want to know how many people I've spoken to from the smallest room in the house. In the shower, I always seem to become the world's greatest philosopher. Many thoughts come and go, while I sing the same song for the fourth time that just won't leave my head.

Just as I'm lathering my hair, the phone rings

I turn off the tap and hop out of the shower cabin, dripping with water. Shivering from the cold on my wet body, I grab the phone. I hear Giuseppe's voice. He speaks in a panicked mix of English, Italian, and a language I can barely understand. Besides a lot of gibberish, I only make out his 'Beebie, beebie. Pain Lesli pain...'. It's best that I just go and have a look. I'm curious to see what I will find. I squint my eyes because shampoo is dripping into them and it stings a lot. I look at myself in the mirror and burst into laughter. I look like a scatterbrained professor, with the large white cloud of shampoo on my head. The streaks of mascara under my eyes make me look like a panda. I quickly turn the shower back on to rinse off. I don't blow-dry my hair, but tie it up in a bun on my head. After cleaning my face, I go downstairs without any makeup on. Bag in hand and off I go.

Ten minutes later, I drive into the neighborhood where Lesli lives

Rows of portico flats stand one behind the other. It's a rainy cold evening, so to prevent getting completely soaked, I don't hesitate for long. I only grab my visiting bag from the trunk. It contains my Doppler to listen to the heartbeat and the blood pressure monitor. The midwifery bag with instruments can still be picked up later, but Lesli wants to give birth in the hospital anyway, so I think I won't need it at all. I walk to the correct front door and ring the bell. It takes a while for the door to the stairwell to open. Raindrops beat against my face and leak into my neck.

When I enter the small apartment a little later, the heat hits my face

I glance at the thermostat: 27 degrees. The windows are fogged up with condensation. The apartment is messy, which honestly surprises me. Lesli is usually a graceful lady. She always looks neat, with her hair up and perfectly applied lipstick. Even now, she stands beside the kitchen table in a negligee, all dolled up. ‘Buonasera,’ she says softly. The shiny satin accentuates Lesli’s silhouette.

The royal blue dress looks stunning against her olive skin and fits tightly around the pregnant belly

Giuseppe, on the other hand, is lying on the couch in a grubby tracksuit, and his shirt is stained with sweat. He fiddles with the cap on his head. 'Contrazioni di assestamento, ad un minuto l'una dall'altra.', he says hastily. I don't speak Italian, but before I can ask what he means, Lesli already supplements him. 'He's right-e.', she says calmly and with the stereotypical, recognizable sound of Italian: the addition of vowels after almost every syllable. 'The contractions are coming faster-e, they are really increasing. It seems like they're every minute-i.' I observe. Look at the calm woman. It's a trick you learn as a midwife during training. It's a kind of helicopter view. You can assess the situation within a few seconds. I see that the partner is tense (unmistakable), but it seems like Lesli is not yet in active labor. The contractions are coming every five minutes, but she hardly needs to sigh. This could turn into night work. I look at my watch: 8:31 PM.

‘Shall we do some checks anyway?’, I ask

Lesli nods and leads me to the bedroom. She first sits on the edge of the bed and breathes through a contraction with great control. I take my Doppler and a pair of gloves out of my bag. This afternoon, Lesli had a firm cervix with no dilation, the colleague reported. Her body didn't seem ready to give birth at that time. Seeing her now, it might have progressed a bit, but probably not very far in the process. Yet, I am mistaken and the internal examination surprises us both! She is fully dilated at 10 centimeters! I can't believe it, my judgment has failed me! I carefully feel again, to make sure I'm not wrong. But I don't feel any edge of the cervix, I immediately encounter the baby's head. 'You're fully dilated, Lesli!', I say cheerfully. It seems to encourage Lesli. She suddenly swaps her breathing for soft grunting. Her abdominal muscles reflexively start to tighten more, the urge to push is presenting itself. And while I watch with raised eyebrows and a cheerful expression, my mouth suddenly drops open in astonishment. The full size of the head appears within a single contraction. Oh wow.

This is going very fast

‘Shit. I left my bag with all my stuff still in the car,’ I say into the void. No one responds. I think and do the math. The staircase down to the car, grab the bag, and the same route back. If I run it might take me about 5 to 7 minutes, but that turns out to be too long. Lesli has her eyes squeezed shut and is now pushing along, Giuseppe stands at a distance with eyes wide as saucers. He looks like a statue, so petrified. Between the panting, Lesli talks to Giuseppe. I recognize the word sweetheart (tesoro) and towels (asciugamani puliti) from my holiday in Verona a while back. Quickly, Giu grabs a stack of clean laundry from the cupboard and throws it on the bed. I manage to snatch a clean towel from the pile just in time and right after that, the baby is born. With a little arc, he lands in the pile of soft towels.

The little one starts crying immediately

I watch Lesli as she throws her head back into the pillow and exhales. Next to the bed, Giuseppe is squatting, watching the scene. I quickly dry off the crying baby and place him on Lesli's chest. The alarm clock on Lesli's bedside table shows it's 20:41. That's quite a rapid delivery for a first baby! I'm glad everything went well and that I didn't need to use the items from my midwifery bag. That's exactly why I love midwifery so much, I think with a smile. No day is the same!

MARLEY