PART ONE
One
Buenos Aires, 2001:
The Day I Delivered My First Baby
It was the third time in a week that the air-conditioning had gone down at the Hospital de Clinicas, and the heat was so heavy that the nurses had taken to holding battery-operated plastic fans over the intensive-care patients in an effort to keep them cool. Three hundred had come in a box, a present from a grateful stroke survivor in the import-export business, one of the few users of the state hospital who still felt dollar-rich enough to give things away.
The blue plastic fans, however, had turned out to be almost as reliable as his promises of further drugs and medical equipment, and all over the hospital, as it dripped in the noisy heat of a Buenos Aires summer, you could hear the sudden ‘¡Hijo di puta!’ of the nurses – even the normally devout ones – as they had to beat them back into life.
I didn’t notice the heat. I was trembling with my own cool fear, that of a newly qualified midwife who has just been told that they will be delivering their first baby. Beatriz, the senior midwife who had overseen my training, announced this with a deceptively casual air and a hard slap on my shoulders with her plump dark hand as she went off to see whether she could steal any food from the geriatric ward to feed one of her new mothers. ‘They’re in Two,’ she said, gesturing to the delivery room. ‘Multigravida, three children already, but this one doesn’t want to come out. Can’t say I blame it, can you?’ She laughed humourlessly, and shoved me towards the door. ‘I’ll be back in a few minutes.’ Then, as she saw me hovering by the door, hearing the muffled wails of pain inside, ‘Go on, Turco, there’s only one end it can come out, you know.’
I walked into the delivery room with the sound of the other midwives’ laughter still in my ears.
I had planned to introduce myself with some authority, to reassure myself of it as much as my patients, but the woman was kneeling on the floor pushing at her husband’s face with a white-knuckled hand, and mooing like a cow, so I thought a handshake inappropriate.
‘She needs some drugs, please, Doctor,’ said the father, as best he could through the palm against his chin. His voice, I realised, held the deference with which I addressed my hospital superiors.
‘Oh, sweet Jesus, why so long? Why so long?’ She was crying to herself, rocking backwards and forwards on her haunches. Her T-shirt was drenched with sweat, and her hair, scraped back into a ponytail, was wet enough to reveal pale lines of scalp.
‘Our last two came very quickly,’ he said, stroking her hair. ‘I don’t understand why this one won’t come.’
I took the notes from the end of the bed. She had been in labour almost eighteen hours: a long time for a first baby, let alone a fourth. I fought the urge to shout for Beatriz. Instead I stared at the notes, attempting to look knowledgeable, and tried mentally to recite my way through medical checklists to the sound of the woman’s keening. Downstairs, in the street, someone was playing loud music in their car: the insistent synthesised beat of cumbia. I thought about closing the windows, but the idea of that dark little room becoming even hotter was unbearable. ‘Can you help me get her on the bed?’ I asked her husband, when I could stare at the notes no longer. He jumped up immediately, glad, I think, that someone was going to do something.
When we had hoisted her up, I took her blood pressure and, as she grabbed at my hair, timed her contractions and felt her stomach. Her skin was feverish and slippery. The baby’s head was fully engaged. I asked her husband about previous history, and found no clues. I looked at the door and wished for Beatriz. ‘Nothing to worry about,’ I said, wiping my face, and hoped that there wasn’t.
It was then that I saw the other couple, standing almost motionless in the corner of the room by the window. They did not look like the normal visitors to a state hospital: they would have been more suited, in their brightly coloured, expensive clothes, to the Swiss hospital on the other side of the plaza. Her hair, which was expensively coloured, was pulled back into an elegant chignon, but her makeup had not survived the sweltering 40-degree heat, and had settled in lines and pools around her eyes, slid down her shining face. She held her husband’s arm and stared intently at the scene in front of them. ‘Does she need drugs?’ she said, turning to me. ‘Eric could get her drugs.’
The mother? I thought absently. Somehow she looked too young. ‘We’re too far along for drugs,’ I said, trying to sound confident.
They were all looking at me expectantly. There was no sign of Beatriz.
‘I’ll just give her a quick examination,’ I said. No one looked like they were going to stop me so I was left with no option but to do one.
I placed her heels against her buttocks and let her knees drop. Then I waited until her next contraction and, as gently as I could, felt around the rim of the cervix. This could be painful in advanced labour, but she was so tired by then that she barely moaned. I stood there for a minute, trying to make sense of it. She was fully dilated, yet I couldn’t feel the baby’s head . . . I wondered, briefly, if this was yet another trick played on me by the midwives, like the doll they had asked me to keep warm in the incubator. Suddenly I felt a little leap of excitement. I gave them all a reassuring smile and moved to the instrument cupboard, hoping that what I was seeking had not yet been looted by another department. But there it was – like a small, steel crochet hook: my magic wand. I held it in my palm, feeling a kind of euphoria at what was about to happen – about what I was about to make happen.
The air was rent by another wail from the woman on the bed. I was a little afraid to do this unsupervised, but I knew it was not fair to wait any longer. And now that the foetal heartbeat monitor no longer worked I had no way of knowing if the baby was in distress.
‘Keep her still, please,’ I said to the husband and, timing carefully between contractions, reached in with the hook and nicked a tiny hole in the extra set of waters that I’d realised were blocking the baby’s progress. Even above the woman’s moans, and the traffic outside, I heard the beautiful tiny popping sound as the soft membrane conceded to me, and suddenly there was a gush of fluid and the woman was sitting up and saying, with some surprise, and not a little urgency, ‘I need to push.’ At that point, Beatriz arrived. She noted the tool in my hand, the renewed determination on the woman’s face, and, supporting her with her husband, nodded that I should carry on.
After that I don’t remember much clearly. I remember seeing the soft, shocking thatch of dark hair, then grabbing the woman’s hand and placing it there so that she could be encouraged by it too. I remember instructing her to push, and to pant, and that when the baby began to emerge I was shouting as loudly as I had when I went to football matches with my father, with relief and shock and joy. And I remember the sight of that beautiful girl as she slithered into my hands, the marbled blue of her skin turning a rapid pink, like a chameleon, before she let out a welcome lusty cry of outrage at her delayed entry into the world.
And, to my shame, I remember that I had to turn my head because, as I clipped the cord and laid her on her mother’s chest, I realised that I had begun to cry, and I did not want Beatriz to give the other midwives something else to laugh about.