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cervix.
“It’s still quite posterior. That means it is pointing towards your back passage,” Sue remarked. Helen breathed out slowly again.
“It makes it a little more awkward, I’m sorry.” Helen nodded and smiled at Sue, although she felt vulnerable.
“Once you are in labour your cervix will be more central and easier to reach. It should be easier next time you are examined,” Sue explained. “Right now though, I have to make sure that I put the Prostin behind your cervix, and that’s not easy to do when your cervix is posterior.”
The Prostin was inserted using a plastic applicator, which Sue guided with her fingers.
“Now, you must stay here on the bed while we monitor your baby for a while longer, about 45minutes, just to make sure everything is all right. After that you can do whatever you like, have a walk around, a bath, whatever.
“What score did you give my cervix? It was three on Monday.”
“I’ll just work that out for you now,” Sue replied, taking her gloves off and putting them in the tray. She covered Helen’s legs with a small sheet and then went to her notes to work out her assessment using a chart.
“Well, you have made a little bit of progress,” Sue said, “But not a lot. Your Bishop’s score is four. The score is worked out by how far down your baby’s head is, and by the position, length, and consistency of your cervix, and whether or not it has started to open. You
need at least a seven or eight before we can break your waters.”
Helen felt a pang of disappointment. She had hoped that she would be ready, or at least closer to being ready.
“What happens next?” she asked.
“This afternoon we do the whole thing again,” Sue replied. “I’ll check your cervix; if I think we could break your waters and the labour ward is not too busy we can take you down to start you off. We can’t start your labour until your cervix is ripe. If it’s not ripe then you can have another dose of Prostin.” She explained. “Have you thought about pain relief at all?”
“I’m not sure,” Helen replied. “I thought I would decide as I go along. I don’t think I want an epidural, but it depends how it goes.”
“You may get some pain from the Prostin,” Sue advised her. “A couple of paracetamol and a warm bath might help, but if you get a lot of tightenings or each tightening seems to last a long time let me know. The Prostin seems to affect some women more than others.” Sue checked the monitor and turned the volume down. Helen’s baby’s heartbeat quietly and steadily mumbled on. The call button was on the bed. Helen nodded and Sue left them.
“How long is a long time for a tightening?” Nigel asked, returning from his retreat by the window.
“You heard all that then. I don’t know, but I suppose I’ll have an idea when it happens, and I can always
ask,” Helen suggested.
“How does it feel?”
“I’m a bit uncomfortable after the internal,” She replied. “But otherwise nothing much, but I will let you know, don’t worry about that.”
While Helen was being examined another woman had been admitted to the bed opposite. She was also being induced. Helen recognised the same verbal routine above the rapid gentle beat of her baby’s heart, even though they were talking quietly; they could hear the woman’s midwife as she explained the induction process to her.
Helen was taken off the monitor about three quarters of an hour later. “That looks fine,” Sue remarked and then she was gone.
Helen and Nigel decided to take a walk across a courtyard over to the hospital shop, holding hands, where they browsed for a while, bought a magazine and some chocolate, and then sat in the courtyard. The sun was shining and people were going about their business. This was a strange time, for both of them. It felt unreal, suspended.
Nigel flicked through the magazine, unable to read, sensitive to Helen’s every movement; while for Helen each little twinge created its own expectancy and sometimes came with an involuntary pang of fear.
They wandered back to the ward. The woman from the next bed was sitting on a birth ball
rocking and, at times, would make laboured breathing sounds. Helen found her obvious discomfort disconcerting, like watching a preview of what was to be her own experience.
She had lunch, and then, for want of something better to do, a bath. Nigel came with her. Their surroundings became more familiar and his anxiety settled. He appeared to be resigning himself to waiting. Helen had become aware of a discomfort, an ache low down in her belly, close to her baby’s head, and like a toothache it left her unable to settle comfortably. The bath helped, but as soon as she was out of the water it was the same as before, so she asked for some paracetamol.
When she returned to the bay the woman in the bed opposite smiled at Helen.
“Hi my name is Vicky,” she said. “Is this your first?”
“Yes it is,” Helen replied, “And I’m finding it all a bit scary.”
“Are you overdue?”
“Yes, I seem to have been pregnant forever.”
“Me too, at least something’s happening now. This is my second baby. Last time I went into labour at 39 weeks so this pregnancy has been almost three weeks longer, although it feels more like three years” Helen sat on her bed and tried to relax for a while. Nigel picked up a magazine.
At 2.30PM a different midwife came to connect Helen back onto the monitor. “Sue went to the
labour ward,” she explained. “It’s mad busy down there. There are more women in labour than there are midwives to look after them!”
This midwife was business-like and quick. She introduced a new element to Helen’s experience, efficiency without empathy, although she was not unpleasant. She moved so quickly Helen couldn’t read her name badge. Helen tried not to feel anxious.
After she'd finished with Helen, the midwife went over to Vicky and connected her up to a monitor.
“Do you think she will be doing my next internal?” Helen whispered to Nigel when she had gone.
“She’ll be quick at least,” he replied. “She’s like a pike. We may not see her coming next time.”
“That’s what I’m afraid of,” Helen said.
The woman in the next bed was called Lynn. Lynn had come in to hospital in early labour during the night. Time went on and she began to moan softly with each contraction. Her moans sounded involuntary; she was not fussing, in fact she continued chatting with her friend, in between contractions.
Every now and then a newborn baby could be heard crying from another bay. The ward was an antenatal and post-natal mix.
Half an hour went by and the efficient midwife returned, with her tray and gloves. “I’m sorry I didn’t introduce myself before, I’m Sally,” she said. “Did Sue explain? I need to check to see if you need more Prostin.”
Helen nodded. She looked nervous and Nigel stayed to hold her hand this time. Sally was quick, but gentler than Helen expected. “You do need another Prostin,” she said, and Helen nodded while trying her best to breathe out slowly and relax. Sally sat on the bed to record her findings in Helen’s notes. “Your Bishop’s score is five, Helen,” she said. “We will monitor you now, and again later on this evening. Let us know if anything is happening, or if you need anything. Tomorrow morning we can give you another Prostin if you need it, but with a bit of luck this one might do the trick.”
“What do you mean, if anything is happening?”
“If the pain gets too much, we can give you something; or if you start having regular contractions, or contractions that seem to last a long time; or you feel wet, you know, a sudden gush or a trickle of fluid.”
“How long is a long time?”
“Each contraction should last a minute or only slightly longer. Also, you might have a small ‘show,’ a spot of mucous and blood, after the examination, that’s to be expected.”
Helen nodded. Nigel took hold of her hand, and they resigned themselves to a long wait. It seemed unlikely that anything would be happening today.
About an hour after this second Prostin Helen became very uncomfortable. She began to experience
sudden sharp pains, which appeared abruptly with tightening of her stomach and lasted about 15 to 20 seconds.
“If I had some sort of warning each time the pain was coming, I think I could prepare myself, like they told us in the class,” Helen explained to Nigel. “But they are so sudden, and take me by surprise each time.”
While this was happening Helen was in pain, whatever she did. She tried different positions, walking around, sitting on the birth ball. All of these things had only short-term benefits. A bath helped, but she couldn’t stay in the water for the whole afternoon. Other people wanted to use the bath, and her fingertips were corrugated from so much exposure to water.
“What’s labour going to be like, Nigel/ I’m not even in labour yet and the pain is already hard to bear.” This was the most worrying thing.
The next couple of hours were long and painful. Anne came in to visit in the early evening. The pain Helen felt earlier had subsided, to some extent. Still, she found it difficult to chat about trivia.
Anne had not been there for more than ten minutes when there was a commotion at the next bed. Lynn’s waters had gone, creating a large puddle from her bed on to the floor. The pool of liquor crept under the drawn curtain, bringing with it a slightly metallic aroma. The midwife came to her call bell, and there was a loud exclamation from behind the curtains.
“Well, you’ve really come on,” Sally said, and
rushed off for a wheelchair to take Lynn to the labour ward.
Lynn’s main concern was that her husband was not there. “He’ll be on his way, in the car, so won’t answer his phone.”
“I’ll get someone to telephone him right now, and leave a message. If he comes up here first we’ll send him straight down to the labour ward,” Sally promised. She helped Lynn into the wheelchair. In a few minutes Lynn was on her way. A nurse came to clean and make her bed.
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