Birth(indi) I was climbing stairs; my partner’s rear end at my eye level, so steep were those decrepit steps. I was lugging two bags up these stairs, one containing a full oxygen tank, the other containing drugs and assorted first aid essentials. Gauze, combines, bandages, sterile sheets and a cuff. My partner carried the long board, the drug kit, and the AED.
When we reached our destination two things could’ve happened, either we would’ve found a person injured in some way by the many dangers that lay about this doomed apartment building, or we would find a dead person, A DOA, or a person seconds away from asystole; still worth our efforts.

With each step the two of us took, the screams got louder; hard to tell whether they were the cries of a woman in pain, or a woman enduring the pain of another. Out of the darkness, thick with the smoke of burning elicit substances and weed came the landing. I stepped on to it after my partner. We heard a strangled yell. It sounded like someone was being tortured. I was alarmed and thought I should have worn my stab vest. Whatever was hurting that poor woman was either an illness, or another person or animal which could hurt us. Fear stabbed at my guts, wrapped itself around my heart, constricting it as I stepped through the door after my partner.

The room was pitch black, and seemingly empty. My partner raised his voice, “Ambulance”.
There was a woman in the corner, breathing hard, panting, and crying in pain. She couldn’t respond but she knew we were there. I turned on my penlight and shone its dim light over to the corner from whence the sound was coming. The sight that revealed itself to my light was, if anything, more sickening and indecent than anything which had crossed my mind since entering this rancid place.

The woman, our patient, was filthy, wearing a ripped, dirty dress, soaked in blood and water at the hem. Her hair was matted, she had bruises on the left side of her face, and her right eye was swollen, cut above the brow. Her nose was bloody and, the cherry on top of this poisoned cake: she was pregnant. And by the way she was doubled over in pain, she had to be in advanced labour.
She looked up at the light sauce, her eyes shying away. She looked back down and tried to speak but the words were lost in an involuntary effort to expel the child.
My partner was still standing there, appearing to have lost the ability to speak or move. I stepped past him whispering, leave this stuff with me and call for back up, and police.´ He nodded, dropped his equipment and turned around, walking out and back down the stairs.

I walked towards the woman. Kneeling down with her. She was kneeling on a blanket which was soaked with blood and water like the back of her dress.
“My name is Sam, I’m a paramedic, what’s your name?” I asked. Looking up into her face which was half covered by her hair. She was properly panicking now. Wheezing in between contractions. She tried to speak but instead, shook her head and pushed. Head back, knees stuck out, her weight supported by the balls of her feet.

I shone my light down.
“Mind if I have a look?” I asked. A second passed and there was no response. I lifted the dress up. Between her heels there was a hanging blood clot. Stuck to the fibres of the blanket and the very top of the baby’s head at the same time. Her contractions were so close the head came out and retracted all the way, backing in about once every four seconds.
I looked up at her face, she was silently pleading with me to help her. She was breathing hard, fast, almost hyperventilating. She couldn’t hold her body up any more and sat on the blanket. Grabbing her knees. I knew I had to act fast and my partner could be gone for some time.
“Look Miss, we haven’t got much time, your baby’s coming. You listen to me alright…” I asked her trying to sound calm. “Look at me…” she looked up at me, eyes watering. “Slow it down, in and out, deeper.” I told her, looking into her eyes while placing a sheet underneath her. She was now breathing slower and deeper. It was then that she finally spoke.
“I need to…” but she couldn’t finish the sentence.

She grunted, totally involuntarily focusing her energy into her pelvis. This hurt to watch. She knew it would hurt but she had no power over this. I looked down and saw the head had crowned.
They call this stage the ring of fire. She screamed. I put my gloved hand under the head as it showed itself, too fast. “Stop. Stop… breathe for me, no pant… fast, shallow breaths for me, that’s it.” I said as she focused on suppressing the urge to push. She started to pant, eyes open, squinting, looking at me. I had to look back into her eyes. But I also had to watch the head. I increased the pressure on the head. I felt it brush against my fingers. She pushed. And its face hit my hand. I could feel a nose, a mouth…

I smiled. “Good, good on you! Stop pushing for a minute. I know this is hard to do but just pant. Like before.” I showed her while I ran my fingers around the baby’s head and neck as it turned to the left. No cord, sweet. “One more push and you can meet your baby”. I said. I looked at her. She looked past any more exertion, utterly depleted, she had hit the wall, but she just couldn’t sit here with a head hanging out of her. I waited. She shut her eyes, panting. “You have to push one last time, one massive one! Come on!” I said, half yelling. She placed her hands on the blanket, and scrunched them, clenching the rug in her fists. She took a deep breath and bowed her head to her chest, her face went red as she pushed, giving herself to it. I saw one shoulder pop out as I gently pushed the head down, then the arm, which fell up, over the head. I lifted the head up and the second shoulder slid out, followed by the other arm. “Keep Going!” I yelled, she yelled, a strangled yell, half a yell half a sigh of delight. The rest of the baby’s body slid out into the world, onto the sheet. Staining it with blood and soaking it with the water that followed.

I rolled the child over and saw its once blue head start to pink up. But it wasn’t crying. I had gone blank with happiness for the mother. But the baby was floppy as I wrapped him in the sheet. I began rubbing his back. I grabbed the bulb from the OB kit and sucked the goop from his nose and mouth. He gurgled and coughed. But still no sound. He was turning back to the deep blue colour I’d seen him before. I lifted him up to my mouth. The mother whimpered as she saw the almost lifeless baby. I breathed a short puff of air into his tiny lungs, once, twice, three and four times. I rubbed his back. I lost it and slapped him on the back side. He moved. He gave a little cough and he screamed.

It was a different sound to that of the mother screaming. It was delightful. It was the sound of an innocent life that had been saved. In between his screams I could hear him inhaling. His little chest heaved. I lifted him, sheet and all, onto the mother’s stomach. She was now leaning on the wall. Knees still propped up. She wrapped her arms around the sodden cloth covered child.

It was then that I finally heard her say “Oh my god” as she caught her breath. Coughing and blinking tears out of her one good eye. She was smiling. And the smile eclipsed her injuries. Making her shine. She looked at me and said “thank you, so much… I almost gave up...” I reached in and pulled a little of the sheet back to reveal the baby’s face. Pink… no longer blue. Ironic because it was a boy. He was then peacefully sleeping. Opening and closing his little fists round his mother’s index finger.
She kissed his little blood spattered forehead.

I felt the pulse in the cord. It was weak. I couldn’t move her then. We had to either cut the cord, and then move her, or wait until the placenta came and transport them both then. I could hear my partner coming up the stairs.
He came in followed by two police officers.
I’d forgotten I’d asked for them. “No need guys, sorry. Hey it’s a boy.” I said and I couldn’t help but smile as the pulse in the cord faced and died.

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