Bedlam Maternity - Sample Sunday May 15th

As last week, this is a first draft.  The first half of the chapter has had some work, the last third was written today, and finished just a few moments ago.  So as with last week, it will be interesting to see how this chapter looks in the published manuscript.

You probably won't get more, until launch.  Probably.

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Chapter Two

Rose Templar walked the frosty streets in the dark before the dawn.  Later on that day, a minor royal personage would be officially opening the maternity unit now under her tender care.  Not that she was in charge of all of it, in fact, she was just one of the tiny cogs in a massive machine named the National Health Service.   She had been given the duty shift that would see her ensuring that no ‘bother’ interrupted the press call and she’d found herself awake, and fretting, a couple of hours before the alarm clock.  So she’d decided she may as well just get on with it, and get to work early.

She usually enjoyed the long walk to and from work.  When her wreck of a Victorian hospital had been demolished and the new spanking bright and very expensive one they’d all dreamed of for years had finally been started, she’d been faced with a choice.  She could have moved out of her old flat, its mortgage paid off in the divorce settlement, and bought something snazzier near the new unit.  However, no matter how much house prices had risen in her old area, the new unit was in a now quite expensive and trendy part of the East End.  Her salary gave her a reasonable standard of living with no mortgage to pay and moving would cut into to that.  Equally, she’d spend a lot of money on transport if she’d stayed where she was.  When trying to make the ends meet in her mind, she’d determined that two birds could be killed with one stone.  She’d started to spread out around her waist, hips and butt, in a most annoying and middle aged fashion; which was appropriate in her mid-50s, but she detested it.  Exercise was something she knew she should be doing, but when to find the time?  And the average day in the wards saw her standing and walking for hours, wasn’t that enough?  Observing her clothes tighten as her breath quickened on stairs, she decided it wasn’t.  Faced with financial problems no matter what route she took to the new unit, she’d decided to take to the streets and walk the 4 miles every day, there and back. 

Everyone had scoffed at the idea, and declared she’d be shelling out bus or Tube fare quickly.  And, as she’d struggled through the first two weeks, done thankfully when she was on leave, she’d thought they were right.  It was madness.  But Rose very rarely left off on anything that she’d set her mind to, and by the time the new unit had opened up enough for her to start work there, she could do the 4 miles in 45 minutes if she had to, and in an hour and 15 minutes on most days.  The walk home took longer, as it would, after a 12 hour shift.  She’d slowly dropped a dress size and found a lot of her clothes more comfortable to wear as a result.  She hadn’t faced winter yet, ‘tho, and had ordered a pair of ice grips well ahead of time.  The weather proof clothing she’d bought had been more than a match for London so far.  She’d always enjoyed walking in the rain anyway.

The walk had become her down time, a soothing space to settle herself into.  Time to relax into the day on the way there, and unwind from it on the way back.  It was particularly useful in coping with shift work and she’d wished she’d found this balm long before economics had pushed it on her.  But there was no peace to be found this morning: she was just winding herself up with all the thoughts that could go wrong.  Some of those thoughts were about what could go wrong with the opening ceremony, the security, the minor royal who was famed for rubbing the patients up the wrong way when chatting to them, and the general behaviour of her team.  Most of the worries were for her women ‘tho, which is how she thought of her patients.  Labour and birth had their own rhythms.  Unlike most areas of a hospital, it couldn’t be controlled, scheduled and made to conform to routine.  At least, not here, not yet.  She’d spent two months in New England, working on an exchange of medical knowledge programme, and had been horrified by how American business has taken over birth.  She’d certainly learned a lot when there, and used that knowledge to bolster her in fighting encroachment here.   Echoes of that worry were pinging through her thoughts.  The new Chief Executive of the Trust had a very presidential attitude to both the patients, and the staff.  Fresh from working on a team that had lost millions of pounds of tax payer’s money on the railway system, he’d taken over his new fiefdom with a massive grin for the cameras and an iron grip on resources.  He’d already made it clear he wanted no cries, screams, sweaty labouring women or bloody babies being spotted when the press were in the building.  Particularly the bloody baby.

He’d actually used those words whilst looking directly over to Rose.  She knew she’d been scheduled in for the labour ward Supervisor during the visit, in order to keep everything under control.  She’d just sat, absorbing his idiocy silently, nodding every now and then: her normal method of coping with totally incompetent and ill versed management.  It was one reason she kept her position of some authority, both in the pecking order of staff, and the management structure.

She’d even given up seething silently under her breath: life was too short.

But it was worrying her now, as she turned the corner to see the hospital glowing like the Starship Enterprise in front of her.  The shiny new sign signalling the real problem with seeing anything but a cute, clean, asleep advert baby, in any mother’s arms today.

Bethlehem Maternity Unit

She flinched inside every time she saw it.  But he would not be told, oh no he would not.  When the focus group presented several options for the new unit, based on its Moorfields’ history and the locale, he’d insisted that ‘Bethlehem’ be put high up as the potential new name.  He was seeing Virgin births (no doubt without sweat, screaming or blood) being photographed for the papers with a holy glow, with himself cast as all three Kings.  In a world of fear for jobs the protests had been easily quashed.  The staff had warned him, the local community had shuddered, and the original Bethlehem Hospital, still operating elsewhere in London, had let their displeasure be known.  Everything had been swept aside in his march for making his name for himself.  He seized on the ten square feet the new unit possessed, that had been part of the acres of the old hospital and announced it was true to the roots of the hospital in the community.  He paid for an expensive inter-faith focus group that ‘proved’ that none of the massive underprivileged population the hospital served would be offended by the name.  He disparaged every other attempt at a sensible naming.  He was determined and he got his way.  He signed the cheques, after all.

And on the day it was announced, he was phoned up by the local newspaper and asked how he felt to be in charge of Bedlam Maternity?

She’d actually found it funny, at that point.  He just would not be told...

Of course, he wasn’t dealing with it on a day to day basis, it wasn’t a tiresome thorn in his side.  She swallowed the temper down as she changed into her blues.  It was still two hours until her shift started, but Lucy Manning, the current supervisor, would be glad for the extra pair of hands, not annoyed. 

Lucy was delighted to see Rose, and the reason for it soon became apparent.  Shafiah Begum had gone into labour a couple of weeks early, and the entire unit was in a tizz.  As Rose came up to speed on the notes, Lucy confided that she’d almost called Rose in.

‘Today of all days...’

Rose nodded.  Oh yes, today of all days...  The superstitious part of her twitched at the coincidence.  Lucy obviously had the same itch, from the worried look in her eyes, and the slight shortness in her tone.  Most nurses and midwives were superstitious to some degree.  Years on the wards, seeing life come, observing life go, brought an awareness of more than the eyes could see and the ears hear.  You kept it in a box, you moved it out of the way if it ever popped out of its box... but you always knew it was there.  A sense that some things were going to be different, somehow.  Rose had known that Shafiah was going to be different, and not just because of the way she’d begun her pregnancy journey, but from how she’d chosen to end it. 

Shafiah was in her mid-20s and a delightful, intelligent and well mannered young woman with no past, other than the pregnancy.  She was clearly from a Bangladeshi family, that had probably been here for two if not three generations and had likely worked its way out of abject poverty.  She was educated and worked in paid employment somewhere close to the hospital; of that Rose was sure.  She was a devout Muslim and wore hijab as a matter of choice, something she’d taken time to explain to the staff at the unit.  She was also unmarried.  Her pregnancy was not a matter of rejoicing for her.  Rose’s heart ached for Shafiah.

Four months earlier, Shafiah had calmly strolled into the hospital, made her way over to the maternity unit, and requested a private chat with a midwife.   Rose had been on her way home after a heavy shift, and had happily taken Shafiah to a private room for a chat.  Shafiah had unfolded her tale.  She was, she thought, about 5 months pregnant, and both medical care and an adoption would need to be arranged through the maternity unit.  She was not foolish enough to think her secret could be kept via her GP’s office, or in any way that meant her family knew she was attending any medical facility regularly.   She would come into the unit, be checked over, meet the social workers, arrange the adoption and deliver, then go home.  Could the midwives help her set all this up?

The midwives, most of whom who had encountered a Shafiah in previous places and times, could indeed help set all this up.  Rose herself had contacted Social Services, and been present at the first meeting.  Apart from refusing to give a home address or a date of birth, Shafiah had done everything expected of her in her pregnancy.  She attended the unit directly for ante-natal checks and had cared for herself.  She did not drink, smoke or use drugs and she ate well, resisting the impulse to restrict eating, or use vomiting as a method of weight control.  Rose had known a few Shafiahs in her professional life, and often they resorted to bulimia to mask their thickening waists and swelling stomachs.   Food had to be consumed at the family table or bring questions, so it was often vomited up afterwards.  It was not good for either baby or mother.  Shafiah, however, had hijab to aid her and it had been a faithful friend.  She was a tall and slender lass, and had carried the baby high up, with very little evidence of it.  She came from a culture where no one saw another naked, or changing clothing, and hijab covered a multitude of sins.  Or in this case, just one.

Some of the younger midwives and the trainees who’d been involved in her care, had not believed such a thing was feasible.  The more experienced ones, like Lucy and Rose, knew not only how often it occurred, but how often it was a completely successful operation.  Usually the only factor in being uncovered was the woman’s own psyche.  Some would buckle, and confide in their own mother, or in another family member.   Some would just leave the area and disappear, transferring far away and starting again before the pregnancy was finished.  Most carried on, and simply walked away the day the baby was born.   An event that scarred every member of staff on duty, and that made every birth thereafter, for a week or so, a special type of pain for everyone.

Rose noted that Amber Purcell was on duty and had ended up being Shafiah’s midwife, given everyone else had been busy.  She sighed.  Amber was the only member of staff to really object to treating Shafiah.  She was just qualified and extremely young in some attitudes.  There had been no leavening by experience with Amber, not yet.  No wonder Lucy had been so glad to see Rose.  She finished reading the notes and made her way down to the room that held Shafiah and Amber.

Amber had the grace to contain how pleased she was that Rose was there, and how delighted she was about her suggestion she go for a short break whilst Rose took over.  Rose watched her sign off the notes and hurry out the room, although she did bid Shafiah a professional good bye.  Midwives often changed over on labours during shift changes, and Shafiah seemed unperturbed.  She was labouring well and keeping herself contained within herself, which was what Rose had expected.  Rose did not doubt that Amber would have been professional with Shafiah, otherwise she’d not have been allowed to attend.

Rose settled into the rhythm of the birth with Shafiah.  To be ‘with woman’ was her calling and vocation and it was a duty she treasured.  Shafiah had been well informed, as had Rose, and she stood as silent attendant to the dance that the young woman was undertaking with her body.  Staff came and went, with Rose forwarding the occasional soft word, or giving a gentle touch to a shaking shoulder.  On full shift change, as Shafiah’s body moved to birth, Caron Gonzalez took over as official midwife whilst Rose held her post as watcher: it was going to be soon and they had to be quick.

  Shafiah brought forth a primal scream and a perfect little boy as the rest of the hospital slowly woke to its day.  Caron cut the cord whilst Rose swaddled the baby in a cloth and cradled it in her arms.  She moved forward and held his tiny head to Shafiah’s mouth.  Shafiah whispered the name of God into his ear then turned her face away.  Rose immediately left the room, placing the baby in the receiving station waiting in the hall.  With luck they could... it was not to be.  As soon as he was placed down, the baby erupted into a massive cry of life, and they wheeled him away as fast as they dared in order to take the cries from the mother’s ears as quickly as humanely possible.

Rose and a nursing auxiliary attended to baby Mohammed, as all Muslim boys were known until they were named by their family.  He was perfect, if slightly small and in fine fettle.  As Rose filled in the paperwork, Bex, the auxiliary, held the baby to try and soothe him.  With no warm skin on his, the baby knew he was without a mother and was not to be consoled.  Tears formed in Bex’s eyes.  Rose patted her on the shoulder.

‘I don’t know how she can...’

‘Then hope to never walk a mile in her shoes.’

‘But... why...?’ Tears were streaming down Bex’s face as she shushed the boy, looking at the baby as his mother should have.  Rose felt the familiar twinge, an ache so deep her bones sat on top of it.  She neatly side stepped it; anything was easy with practice, after all.

‘There is no why.  There is only her wishes, and us following them.  It’s not our choice, or our life.’

Bex nodded.  ‘It’s just so hard.’

‘Only as it’s now so rare.  It used to happen a great deal more often.’

Bex looked surprised.  How old was she, 22, 23?  Younger than Shafiah probably was.

‘Really?’ 

It was Rose’s turn to nod, and she carried on talking as they finished the assessment, placed the baby down on a bassinet, covered it with the regulation see through plastic cover it had to have, a baby cloche, in order to wheel him to his bed upstairs in the neo-natal unit.  His cries meant the conversation was discreet and private to the two women even in the bustle of the over loaded unit. 

‘My first Shafiah was a young Catholic girl who called herself Mary.’  Rose smiled at the memory.  ‘Not long after I qualified, she did exactly the same, just walked into the unit one afternoon.  She did tell her family ‘tho, and she went off to a home for unwed mothers.’

‘Unwed?’  Bex’s tones made Rose feel very old, and very tired.

‘Yes, unwed.  Even then, at the end of the 70s, there were still vestiges of such places and attitudes.  The matron I trained under made sure we were all aware to give young women a private space to talk, if they just walked into the unit.’ 

The two women fell into silence as they stood in the lift, the baby’s cries bouncing around the walls.  Rose started up again as they wheeled him down the long corridor.

“They were usually called Mary or Teresa, or Rachel and Hannah.   Mostly they’d crumble, and end up going to a home to birth and give up for adoption there.  Sometimes they’d manage it to the end, and just walk away.  Keeping their family from shame no matter the cost.’

Bex looked down at the screaming baby and then back up to Rose, searching for answers. ‘Do you think she will... just walk away... just leave?’

‘Yes, I think she will.  She’s very strong.’

They fell silent once more, as they delivered Mohammed over to the neo-natal unit, for feeding and observation.  As he was slightly early and a little underweight, he would probably spend his first week of life here before going to a foster home.  Rose felt the loss as she handed him over to the charge nurse.  How arms that had felt fulfilled, now felt empty; derelict.  She and Bex rode the lift back down in crashing, awkward, painful silence; the absence of cries cutting both to the quick.  Rose spoke both their thoughts as they walked back into the ward.

‘It’s better than finding a baby in a plastic bag in a shop doorway.’

Bex nodded and hurried away, eager to finish the shift and get home and hug her mother.  As she worked the day out, she vowed to herself that when her time came, she’d  never be separated from her own newborn for a second, No Matter What.

Rose checked on the state of play in the rest of the unit, then went to oversee Shafiah’s discharge.  This was the part that was going to need the most care.  Doorways had to be left open without intruding.  Information had to be passed on without preaching.  The girl had to have her chance.

Shafiah was clean and dressed and sitting drinking tea with the female social worker that had been assigned her.  She was pale and missing the heavy kohl makeup she usually wore, making her look more washed out.   She sipped her tea silently.  As Rose took her through the paperwork on taking care of herself post-birth, large tears formed in Shafiah’s eyes and dripped down.  Rose kept her voice gentle and even, open and listening.

‘As I explained before, you can have medicine to dry your milk.’

Shafiah shook her head. ‘No drugs.’

‘Then you’ll need these.’  Rose handed over written instructions on how to cope with the breasts drying naturally, as well as emergency helplines in case of bleeding or infection.

Shafiah shook her head.

‘I have read everything I need to know.  I will not be taking anything with me.’

The social worker spoke up.  ‘I would ask you to sign this paperwork.’

Shafiah scrawled her name across several pieces of paper.  Her tears had dried and she wrote confidently, as if in a hurry.  The social worker spoke to her as she did so.

‘You have a right to change your mind.  You can come to us at any point, for the first 21 days.  If you change your mind after that, it will be harder, but you can still do so.  I need you to sign this form, to state you’ve been told that you have a right to change your mind.’

With no name, no date of birth, no address... the signature was useless anyway.  All three women in the room knew this.  But protocols had to be followed.  Rose signed as witness.

The social worker took the forms and left.  Rose sat and waited for Shafiah to speak.

‘Can I go?’

Rose nodded.  ‘Yes, of course.  It’s your choice.’

Shafiah stood up, hesitated.  Sat down.

Rose sat.

‘I... I... I need to know.  Was everything okay?  Was he alright?’

‘He is perfect, perfect.’

‘Good.  I’m glad.’

‘Would you like to see him?’

Shafiah shook her head violently.  ‘No!’ 

Rose sat.

Shafiah waited out the emotion that was riding through her.  She looked straight to Rose, her gaze direct.

‘You can come back at any time, Shafiah.  He is safe, and he is here for a couple of days at least.  You know where we are.’

Again, she shook her head violently. 

‘No.  Thank you, but no.’ Collecting her strength to her, Shafiah stood.  ‘Thank you, you have been very kind.’

She left the room as she’d entered the hospital: quietly and with no fuss.  Rose sat for a few moments, gathering her own strength.  The nag she’d felt when she’d noticed Shafiah’s name on the roster when she came in, repeated.  There was a sense of wrongness that she could not define.  If she’d had Shafiah on the wards, she’d be having her checked more often than the others.  Instinct was telling her something was wrong.  But given what had just occurred, how could she not be feeling that?

Rose sighed.

She had four women in labour in the rooms around her, and all her staff needed her.  She shook off the pain and went back to work.

No doubt as it was a special day, the wards were buzzing.  Women were arriving at an amazing rate and for one horrible moment, Rose thought one mother might deliver in the middle of the corridor.  That was going to look so good in the papers... but a room became free at the last moment and all the panics were contained. 

Rose was grateful for how busy it was, as it was easier to fall into work, and not thinking, when you were run off your feet.  Two photogenic mothers, one black, one white, had been identified by the hospital’s media consultant as ‘correct’ to be visited by the minor royal.  Their babies were one and two days old, and had the required level of both cleanliness and calmness, spending most of their young lives in milk induced sleep.  Rose supervised both mothers being bedded side by side in a small bay off the main ward corridor and the mothers were signing releases for their photographs as they primped themselves for their public.  Everything was a clean and set up as could be, and there shouldn’t be any complications before the press and officials came up to the ward after the plaque in reception had been unveiled.  Hunger drove her out of the ward and over to the cafeteria just before the press were allowed in to set up.

She thought she’d get back before the big moment, but the sheer crush of people in the perpex polytunnel that connected the main hospital to the maternity unit slowed her down.  By the time she’d fought her way into the hexagonal reception area she was hemmed in by a sea of bodies.  The temperature rocketed as she stood, despite the chill air outside.  A perspex bubble designed by an architect to be about the ‘transparency’ of birth might be put forward for awards, but it was going to be hell on earth come June.  Which they’d told them...

It’s not as if management weren’t told about these things before they happened...

Rose settled to have to wait out the opening ceremony before making it back upstairs to her ward.  She wasn’t an official part of anything and was confident everything was in place upstairs.  She noted with interest the clashing colours of the scarf the minor royal was wearing as the flashguns around her exploded: where did they get this stuff?

The feeling of someone walking over her grave, drew her into herself, a moment before the shadow crossed everyone’s vision.  The noise was what exploded in her senses, in everyone’s senses.  The massive impact of splatter, and rupture, that preceded the heart beat’s silence before the screams began.  Like everyone, Rose looked up.  Unlike most, her gaze stayed where it had rested: ignoring the blood runnels streaming across the transparent roof.  Whilst everyone was screaming, moving, shrieking and panicking, Rose kept her gaze firmly on the face above her, as the light in the eyes failed.  She felt the moment of passing as Shafiah Begum’s body gave its last, smashed to smithereens on the jagged outcroppings of the reception area’s roof.

The camera shutters went mad.