Theatre of pain

Ten days ago I wanted a natural birth, now I want a general anaesthetic
April 19, 2001

Amniotic fluid smells like tea. When I say this to Martin, he says, "I thought that was just tea." There is a lot of amniotic fluid in Unit 3. At least three of us have had our waters broken that afternoon, and as evening approaches we sit draining into strips of unbleached cotton and watching each other, jealously, for signs of pain.

Pregnancy smelt like grass. Sort of. It certainly smelt of something growing; a distinctive and lovely smell that belongs to that family of grass, and ironed cotton, and asparagus pee. But the smell of tea is beginning to get to me. There are pints of it. I'm like some Birco boiler with the tap left open. It flows slowly, but it will not stop. For hours I have been waiting for it to stop, and the mess of the bed is upsetting me. It upsets the housekeeper and the schoolgirl in me. The sanitary pads they hand you are school-issue and all the nurses are turning into nuns.

The breaking of the waters was fine. The nurse did whatever magic that makes sheets appear under you while other things are folded back, and the obstetrician did something deft with a crochet hook. There was the sense of pressure against a membrane, and then pop. It felt quite satisfying and the rush of hot liquid that followed made me laugh. I don't think a lot of women laugh at this stage in Unit 3, but why not? We were on our way.

After which, there was nothing to do but wait. As the afternoon wears on, the pink curtains are pulled around the beds. The ward is full of breathing; the sharp intake of breath and the groaning exhalation, as though we were all asleep, or having sex in our sleep. One woman sobs behind her curtain. From the bed beside me the submarine sound of the Doppler looking for a foetal heartbeat; a sonic rip as it is pulled away, then the sigh and rush of an unseen woman's electronic blood.

Then there is tea. Actual tea. The men are sent out, for some reason, and the women sit around a table in the middle of the ward. There is a woman with high blood pressure, a couple of diabetics, one barely pregnant woman who has such bad nausea she has to be put on a drip. There are at least three other women on the brink, but they stay in bed and will not eat. I am all excited and want to talk. I am very keen to compare dressing gowns-it took me so long to find this one, and I am quite pleased with it, but when I get up after the meal, the back of it is stained a watery red. I am beginning to hate Unit 3.

After tea is the football. Portugal are playing France and when a goal is scored, the men all come out from behind the curtains to watch the replay. Then they return to their groaning, sighing women. I keep the curtain open and watch Martin watching the game. I am keeping track of my contractions, if they are contractions. At 9.35pm Martin looks at me over the back of his chair. He gives me a thumbs up as if to say "Isn't this a blast? And there's football on the telly!" At 9.35 and 20 seconds I am, for the first time, in serious pain. I am in a rage with him for missing it, and call to him quietly over the sound of the game.

A woman in a dressing gown comes to talk to me. She is very big. I ask her if she is due tonight but she says she is not due until September, which is three months away. She is the woman next to me, the one with the Doppler machine. They couldn't find the foetal heartbeat because of the fat. She stands at the end of the bed and lists her many symptoms. She has come up from Tipperary and she is going to have a caesarean at 31 weeks. I am trying to be sympathetic, but I think I hate her. She is a weakness in the room.

When I have a contraction I lurch out of bed, convinced that I have to go to the toilet, but there is no food inside me; there hasn't been for days. I am in what Americans call pre-labour, what the Irish are too macho to call anything at all. "If you can talk through it, then it's not a contraction," my obstetrician said when I came in a week ago, convinced that I was on my way. This week, she says she will induce me because my blood pressure is up; but it may be simple charity. Ten days ago I wanted a natural birth, now I want a general anaesthetic. I want to lay my head in the road, with my belly stuck up on the kerb.

A woman answers her mobile "No Ma, nothing yet. Stop calling! Nothing yet." Pain overtakes the woman two beds down and the curtains are drawn. When they are pulled back, you can tell she is delighted. Oh this is it. This must be it. Oh I'm going to have a baby. Then more pain-agony, it looks like. "Oh good girl! Good girl!" shouts the midwife, as the man collects her things and she is helped out of the Ante-Room to Hell that is Unit 3. Another bed is empty. Damn. Is she in labour too? "She went out, anyway," says Martin. "Hanging on to the wall."

It is a theatre of pain. It is a pain competition (and I am losing). Martin says that Beckett would have loved Unit 3. We wonder whether this is the worst place we have ever been, but decide that the prize still goes to the bus station in Nasca, the time we went to Peru without any jumpers. All my paper pants have torn and I sit knickerless on the sheet, which I have rolled into a big wad under me. My bump has shrunk and gone slack. When I put my hand on it, there is the baby; very close now under the skin. I just know it is a girl. I feel her shoulder and an arm. For some reason I think of a skinned rabbit. I wonder are her eyes open, and if she is waiting, like me. I have loved this child in a drowsy sort of way, but now I feel a big want in me for her, for this particular baby-the one that I am touching through my skin. "Oh, when will I see you?" I say.

This could be the phrase of the night, but instead it is a song that repeats in my head. "What sends her home hanging on to the wall? Boozin! Bloody well boo-oozin." I count backwards from five when the pain hits, and then from five again. Was I in labour yet? Was this enough pain? "If you can talk, then it's not labour." So I try to keep talking, but by eleven o'clock the lights are switched off, I am lurching into sleep between my (non)contractions for three or five minutes at a time, and Martin is nodding off in the chair.

My cervix has to do five things: it has to come forward, it has to shorten, it has to soften, it has to thin out, it has to open. A week earlier the obstetrician recited this list and told me that it had already done three of them. In the reaches of the night I try to remember which ones I have left to do, but I can't recall the order, and there is always, as I press my counting fingers into the sheet, one that I have forgotten. My cervix, my cervix. Is it soft but not short? Is it soft and thin, but not yet forward? Is it short and hard, but open anyway? I have no sense that this is not a list but a sequence. I have lost my grasp of cause and effect. My cervix, my cervix: it will open like the clouds open, to let the sun come shining through. It will open like the iris of an eye, like the iris when you open the back of a camera. I could see it thinning, the tiny veins stretching and breaking. I could see it opening like something out of Alien. I could see it open as simple as a door that you don't know you've opened, until you are halfway across the room. I could see all this, but my cervix stayed shut.

At 2.30am I give in and Martin goes off to ask for the painkiller pethidine. I know I will only be allowed two doses, and I want to save the second for the birth, but in my heart of hearts I know I'm on my way to an epidural now. I don't know why I wanted to do without one, I suppose it was that Irishwoman machismo again. Mn? na hÉireann. MN?? na hÉireann. FIVE four three two...one. Fiiiive four three two one. Five. Four. Three. Two. One.

Once I give in and start to whimper, the (non)contractions are unbearable. The pethidine does not come. At 3am there is a shrieking from down the corridor, and I realise how close we are to the labour ward. The noise is ghastly, Victorian: it tears through the hospital dark. Someone is really giving it soprano. I think nothing of it. I do not wonder if the woman is mad, or if the baby has died, but that is what I wonder, as I write this now.

Footsteps approach but not for me; they are for the woman from Tipperary who is crying, with a great expenditure of snot, in the bed next door. The nurse comforts her. I want to shout that it's all right for her, she's going to have a fucking caesarean, but it is 45 minutes since I realised that I could not do this, that the pain I had been riding was about to ride over me, and I needed something to get me back on top, or I would be destroyed by it, I would go under-in some spiritual and very real sense, I would die.

At 3.30am, I get the pethidine. After this, I do not count through the (non)contractions, or try to manage my breathing. I moan, with my mouth a little open. I low. I almost enjoy it. I sleep all the time now, between times. I have given in. I have untied my little boat and gone floating downstream.

At 5am a new woman comes along and tells Martin he must go home. There follows a complicated and slow conversation as I stand up to her (we are, after all, back in school). I say that I need him here, and she smiles, "What for? What do you need him for?" (for saving me from women like you, Missis). In the end, she tells us that there are mattresses he can sleep on in a room down the hall. Oh. Why didn't she say so? Maybe she's mad. It's 5am, I'm tripping on pethidine, at the raw end of a sleepless week, and this woman is a little old-fashioned, in a mad sort of way. Wow. We kiss. He goes. From now on, I stay under, not even opening my eyes when the pain comes.

I think I low through breakfast.They promise me a bed in the labour ward at half ten, so I can stop lowing and start screaming, but that doesn't seem to be happening. I am sitting up and smiling for the ward round, which is nice, but I am afraid that they will notice that the contractions are fading, and I'll have to start all over again. Then the contractions come back, and my body is out of pethidine. I spend the minutes after half past ten amused by my rage, astonished by how bad I feel. Are these the worst 100 seconds I have ever been through? How about the next 100 seconds-let's give them a go.

At noon, one last contraction and we are out of Unit 3. The whole ward lifts as we leave, wishing us well-another one on her way. I realise I have been lowing all night, keeping these women from sleep.

The room on the labour ward has its own bathroom and a high-tech bed. I like the look of the midwife; she is the kind of woman you'd want to go for a few pints with. She is tired. She asks if I have a birth plan and I say I want to do everything as natural as possible. She says, "Well you've made a good start," which I think is possibly sarcastic, given the crochet hook, and the pethidine, and now an oxytocin drip. Martin goes back to pack up our stuff, and I start to talk. She keeps a half-ironic silence. For months, I had the idea that if I could do a bit of research, get a bit of chat out of the midwife, then that would take my mind off things-but she won't play ball. I run out of natter and have a little cry. She says "Are you all right?" I say "I just didn't think I would ever get this far, that's all." And I feel her soften, behind me.

I don't remember everything that followed, but I do remember the white, fresh light. I also remember the feelings in the room. I could sense a shift in mood, or intention, in the women who tended me, with great clarity. It was like being in a painting. Every smile mattered: the way people were arranged in the space, the gestures they made.

I have stopped talking. The midwife is behind me, arranging things on a stand. Martin is gone, there is silence in the room. She is thinking about something. She isn't happy. It is very peaceful.

Or: She tries to put in the needle for the drip. Martin is on my right-hand side. I seem to co-operate but I won't turn my hand around. The stain from the missed vein starts to spread and she tries again. I am completely uninterested in the pain from the needle.

Or: A woman walks in, looks at me, glances between my legs. "Well done!" she says, and walks back out again. Perhaps she just walked into the wrong room.

Even at a low dose, the oxytocin works fast. It is bucking through my system, the contractions gathering speed: the donkey which is kicking me is getting really, really annoyed. The midwife goes to turn up the drip and I say, "You're not touching that until I get my epidural." A joke.

A woman puts her head round the door, then edges in. She says something to the midwife, but they are really talking about someone else. She half turns to me with a smile. There is something wrong with one of the blood tests. She tells me this, then she tells the midwife that we can go ahead anyway. The midwife relaxes. I realise that, sometimes, they don't give you an epidural. Even if you want one. They just can't. Then everyone has a bad morning.

The midwife goes to the phone. Martin helps to turn me on my side. The contractions now are almost continuous. Within minutes, a woman in surgical greens walks in. "Hi!" she says. "I'm your pain relief consultant." She reaches over my bare backside to shake my hand. This is a woman who loves her job. Martin cups my heels and pushes my knees up towards my chest, while she sticks the needle in my spine, speaking clearly and loudly, and working at speed. I am bellowing by now, pretty much. FIVE, I roar (which seems to surprise them-five what?) FOUR. THREE. (Oh good woman! That's it!) TWO. One. FIVE. They hold me like an animal that is trying to kick free, but I am not, I am doing this, I am getting this done. When it is over, the anaesthetist breaks it to me that it might be another ten minutes before I feel the full effect. I do not have ten minutes to spare, I want to tell her this, but fortunately, the pain has already begun to dull.

The room turns to me. The anaesthetist brushes down her gown and smiles. She is used to the most abject gratitude, but I thank the midwife instead, for getting the timing spot on. Then the midwife tells me that she is finishing up now, Sarah will see me through. This is a minor sort of betrayal, but I feel it quite keenly. Everyone leaves. Martin goes for a sandwich and Sarah runs ice cubes up my belly to check the line of the epidural. There is no more pain.

Sarah is lovely: sweetness itself. She is the kind of woman who is good all the way through. It is perhaps half past one and in the white light, with no pain, I am having the time of my life. Orla, the obstetrician, tells me that my cervix has gone from practically zero to eight centimetres open, in no time flat. The heavens have opened, the sun has come through. Martin is called back from the canteen. He watches the machines as they register the pain that I cannot feel anymore. He says the contractions are off the scale now. We chat a bit and have a laugh, and quite soon Sarah says it is time to push. Already.

For 20 hours women have been telling me I am wonderful, but I did not believe them until now. I know how to do this, I have done it in my dreams. I ask to sit up a bit and the bed rises with a whirr. Martin is invited to "take a leg" and he politely accepts: "Oh, thank you." Sarah takes the other leg, and braces it-my shin against her ribs. Push! They both lean into me. I wait for the top of the contraction, catch it and ride the wave. I can feel the head, deliciously large under my pubic bone. I can feel it as it eases further down. I look at Martin, all the while-here is a present for you, Mister, this one is for you-but he is busy watching the business end. Orla is back, and everyone willing me on like football hooligans, Go on! Go on! One more now and push! Good girl! I can hear the knocking of the baby's heartbeat on the foetal monitor, and the dreadful silence as I push.

Then, long before I expect it, Sarah says, "I want you to pant through this one. Pant." The child has come down, the child is there. Orla says, yes, you can see the head. I send Martin down to check the colour of the hair. (A joke?) Another push. I ask may I touch, and there is the top of the head, slimy and hot and-what is most terrifying-soft. Bizarrely, I pick up Martin's finger to check that it is clean, then tell him he must feel how soft it is. After which-enough nonsense-it is back to pushing. Sarah reaches in with her flat-bladed scissors and Martin, watching, lets my leg go suddenly slack. We are mid-push. I kick out, and he braces against me again. Orla commands me to, "look down now, and see your baby being born." I tilt my head to the maximum; and there is the back of the baby's head, easing out beyond my belly's horizon line. It is black and red, and wet. On the next push, it slowly turns. And here it comes-my child; my child's profile. A look of intense concentration, the nose tilted up, mouth and eyes tentatively shut. A blind man's face, vivid with sensation. On the next push Sarah catches the shoulders and lifts the baby out and up-in the middle of which movement the mouth opens, quite simply, for a first breath. It simply starts to breathe.

"It's a girl!" Sarah says afterwards that we were very quiet when she came out. But I didn't want to say the first thing that came to mind-which was "Is it? Are you sure?" Newborns' genitals are swollen and red and a bit peculiar looking, and the cord was surprisingly grey and twisted like a baroque pillar. Besides, I was shy. How to make the introduction? I think I eventually said, "Oh, I knew you would be," I think I also said, "Oh, come here to me, darling." She was handed to me, smeared as she was with something a bit stickier than cream cheese. I laid her on my stomach and pulled at my T-shirt to clear a place for her on my breast. She opened her eyes for the first time, looking into my face, her irises cloudy. She blinked and found my eyes. It was a very suspicious, grumpy look, and I was devastated.

Martin, doing the honours at a festive dinner, cut the cord. After I pushed out the placenta, Orla held it up, twirling it around on her hand like a connoisseur: a bloody hair net, though heavier, and more slippy.

The baby was long. Her face looked like mine. I had not prepared myself for this: it really astonished me. I said, "she looks like me," and Martin said, (an old joke), "yeah, but she's got my legs." At some stage, she was wrapped rigid in a blue blanket, which was a mercy, because I could hardly bear the smallness of her. At some stage, they slipped out, leaving us to say "Oh, my God" a lot. I put her to a nipple and she suckled. "Oh my God," said Martin. I looked at him as if to say, "Well, what did you expect?" I rang my mother, who said, "Welcome to the happiest day of your life," and started to cry. I thought this was a little over the top. In a photograph taken at this time, I look pragmatic and unsurprised, like I had just cleaned the oven and was about to tackle the fridge.

I am not stricken until they wheel us down to the ward. The child looks at the passing scene with alert pleasure. She is so clear and sharp. She is saturated with life, she is intensely alive. Her face is a little triangle and her eyes are shaped like leaves, and she looks out of them, liking the world.

Two hours later I am in the shower. When I clean between my legs I am surprised to find everything numb and mushy. I wonder why that is. Then I remember that a baby's head came out of there, actually came out. When I come to, I am sitting on a nurse. She is sitting on the toilet beside the shower. The shower is still going. I am very wet. She is saying "You're alright, I've got you." I think I am saying, "I just had a baby, I just had a baby," but I might be trying to say it, and not saying anything at all.