It is 4.30am when my phone rings. Surprised, I look at my phone for a few seconds. When my consciousness returns I realise I am on duty and quickly answer. 'Yes hi,' I hear on the other end of the line. 'I didn't want to call you awake but I'm losing a lot of water and I don't think it's urine,' says the woman on the phone. 'How far along are you pregnant?' I ask as I try to start up my IPad. 'I believe I am 35 weeks pregnant.'
Immediately I sit up straight because under 37 weeks is too early and is called premature. I ask a few more short questions while trying to put on my clothes with one hand. 'Has the baby descended into your pelvis? ' I ask before hanging up. 'No,' she says quickly. 'I'm coming to check on you,' I tell her. 'Now?" she asks in surprise. I confirm her question, hang up and put on the rest of my clothes. I give my husband a quick kiss before I leave. Out of habit actually because he only notices I'm gone after his alarm has gone off anyway.
Fifteen minutes later, I step into their house. 'She's upstairs,' says her husband. When I enter the bedroom, she sits half upright in bed and looks at me cheerfully. 'Good morning to you too!' she says cheerfully. I smile back and explain to her what I am going to do. External examination of her abdomen, listening to her heart, taking blood pressure, taking her temperature and checking that whatever fluid she loses is really amniotic fluid. The baby is doing well, her blood pressure is normal and I do indeed note that she is losing amniotic fluid. I also explain to her that the baby has not yet descended into the pelvis. If she were to stand up and keep moving, a hand or umbilical cord could drop down and that could be dangerous to the baby's health or birth.
'Your water broke too early to deliver at home. We want the best possible care for your baby at the hospital, so that's where we're going now,' I say calmly. 'Does it have to be right now? I was going to get a haircut today!' she says slightly disappointed. 'Your baby's health takes precedence over dead hair tips for now,' I say airily. She doesn't seem unsettled by this and talks endlessly about how she would have liked to organise the day differently. 'Because the baby has not descended properly, I prefer to keep you lying down. Therefore, I would like to call an ambulance to transport you safely'. She nods absently and is already digging around her for her things.
She sends her husband to all corners of the house to prepare a bag. Meanwhile, I call the ambulance and inform the on-duty obstetrician at the hospital. While on the phone, I see the husband come in with a pair of his wife's little-covering thongs. 'I'll put your underwear in the bag in advance,' I hear him say to her. Next to me is a maternity package, I open the box and take out a packet of sanitary pads. While calling, I open the pack and take out a sanitary towel, which I hold up to Mr. 'Would these fit in the 'underwear?', I ask with a wink. 'Oh, they're not going to fit in these,' he says laughing and holds up the thongs. I shake my head.
Moments later, the doorbell rings. When Mr. opens the door for the paramedics, they soon come upstairs. Once in the bedroom, I greet them and they greet me and madam. The moment I want to hand over care to them I see her face leave. 'It's really going to happen huh?' she whispers towards me. I nod, 'I am careful with mother and child. You are both doing well now and I want to keep it that way. That includes safe transport now and a paediatrician later.' Suddenly, she starts crying uncontrollably. I ask her where her tears are coming from. 'Because they are inside now!' and she points to the paramedics. 'They're going to take good care of you though,' I try to reassure her. 'I believe that,' she says sobbing. 'But now it's real.'
Moments later, she is in the ambulance on her way to hospital. Once she arrives, contractions start and that same day she gives birth to her son. The little boy does well and is allowed to go home after just a few days. After a week, I step into their home for a maternity visit. 'Congratulations! How are you?", I ask as I enter. 'Well I understand those knickers,' she says immediately. 'That's where those mega pads should go!' I have to laugh and nod affirmatively. 'Just think what that would have looked like if you only had thongs!' I say with a wink.