My continuity patient first texts me Wednesday morning at 6. I groan and roll over, grabbing for my phone and fumbling for the right buttons. I hope my roommates haven’t been woken up. She has some spotting, mild contractions and is coming in to the clinic. Since she is booked for a prenatal this morning, I decide to go in early for my clinic shift to do her prenatal and give her some instructions for early labour, then she won’t have to wait to see me during prenatal clinic and can hopefully head home for some sleep. I find nothing wrong with her, despite the telling signs of early labour and send her home to rest, meanwhile, I look forward to a long day at the clinic. After prenatal clinic, I attend class, write a quiz, grab some lunch, and attend another class. It is 5:00 before I finally get back to the house. Matet texts, saying she is doing fine and still resting. I figure I should try to sleep while I still can and spend a couple hours laying in bed trying to do just that. Not working. I watch a movie with Rahel, trying to banish the thoughts running around in my head for awhile. By 10 I am once again trying to force myself into a state of sleep and manage to doze off and on until 12 when Matet texts to say her contractions are getting more painful, but she is still doing well. I curl up in my bed with my phone tucked under my chin and dream crazy, fitful dreams about continuity patients until 2 when Matet texts to say she is heading to the clinic. I get up, put on my scrubs, load up my backpack and rummage around in the cupboards, coming up with some crackers to munch on while I wait for the guard to come pick me up.
The blast of air con when I climb into the ambulance has me wide awake and I glance reproachfully at Kuya sitting behind the wheel in his jacket. This must be some trick they have cooked up to make sure midwives woken up in the middle of the night are on full alert. Matet is already waiting when we get to the clinic, pacing back and forth in front of her bed. It is quiet, the only other patients are recuperating in the postpartum area across the hall. Three midwives are sprawled in a corner across beds and tables, books and computers scattered everywhere as they study. I check Matet’s vital signs, glad they are all normal, and when I do the internal exam, I am glad to find she is already 6cm along. It looks like this baby will defy the odds and arrive on the day she is due. She spends the next hour walking up and down the stairs, stopping intermittently for me to check her and the baby. Just as I open the door again to check on her, the lights dim, flicker, and die. Everything is suddenly silent; no whir of fans, no hum of the fridge. The glow of a single emergency light cuts through the darkness of the birth room. I grab a flashlight and prop it up in the bathroom so Matet doesn’t have to face the complete blackness inside. Soon she becomes much more active in labour, and Kuya moves the light so it is as close as possible to the cubicle. Midwives pull out their cell phones and turn on the flashlights. I have to apologize to Matet,”I am sorry for all the people observing you, but we need them to hold the lights.” As Matet begins trying to push her baby out, concern soon ripples around the cubicle. I check and find her body swollen, blocking the baby’s head and Matet’s efforts. Ate’s experienced fingers replace mine, working some sort of magic. But it seems to have come to late. The baby’s heart rate begins an alarming roller coaster, alternately galloping and plodding along. There is no hesitation, lights are held as someone inserts and IV and someone else grabs the papers for transportation. We are going to the hospital. Inside my head I am having a bit of a tantrum, “umm God, I need this one. It’s turning out awful, like my last continuity patient. Where is my nice, normal, happy birth with healthy mum and baby? You know, the last one I need for graduation requirements? Why do I have to take another one to the hospital, where she will be alone, without her husband while they try to get the baby out?” People whirl around me with forms and lights and medical equipment. I feel useless as I stand still, holding the doppler probe against Matet’s belly, listing to the steady beat of the baby’s heart. Wait, steady beat? The action begins to slow as the steady tock registers with others too. It continues, through 1 minute, then two, and finally for three. Matet gives a heroic push, and we can see several cm of the baby’s head. Clean, clear fluid from the bag of waters flows over Ate’s hands, not the green/brown fluid of a distressed baby. My fingers now replace Ate’s, feeling the wrinkles of the baby’s head under them. Not a minute later I am holding a screaming baby girl in my hands, and I can’t believe how healthy she is for the scare she gave us. I still can’t help but coo over the little girl 10 minutes later as the sun warms the sky outside, giving light, and warning us that a day without fans is likely to be much hotter than a night without fans.