crackedmirrors and angelpie

I walk down the corridor and turn the corner – and stop.
Outside the room stand an official looking woman and a uniformed policeman. What have I not been told?

‘Who are you? Why do you want to go into the room?’ The questions are blunt, and whilst not hostile, certainly not friendly. I feel that actually it is I who should be asking them the same questions. I identify myself and my purpose, and then politely ask the ‘visitors’ why they are there.

‘I’m Susan Brown, a social worker from the local social services department, and this is Sergeant Smith from the local police. It is important that Rosie doesn’t know that we are here.’

I feel increasingly confused, and a growing hostility towards this couple. I have previous experience of looking after women prisoners giving birth in the local NHS maternity unit, on one occasion shackled to the bed throughout labour. Compassion and common sense are not words that were in the forefront of my mind.

The social worker speaks to me; ‘As soon as Rosie’s baby is born we will make it a ward of court and remove it. Rosie doesn’t know, she doesn’t know that we are here, and she must not know – we don’t want to risk her absconding.’

I’m not sure whether to laugh or cry. The ‘risk of the mother absconding’ argument has been made to me before, by the prison officers who insisted that a mother remain shackled to the bed throughout labour. The same prison officers (and others before them) tried (unsuccessfully) to insist that they remain in the same room as the labouring mother to avoid any risk of her absconding. I can only conclude that these men have not accompanied their partners during labour, and that this particular female social worker has not herself had a baby. The idea of a half-undressed woman, distressed by the pain of active labour running out of the hospital and fleeing the city is risible.

I summon all the professionalism that I am not feeling. ‘Am I allowed to know why her baby is being taken away?’
‘Yes, she’s a drug addict. Her baby will be at risk.’

Why don’t I know this already? I often see women who are deemed to have high risk pregnancies during the antenatal period. I quickly review her notes and find that her drug use seems to have been stable, that she has apparently none of the medical risk factors that can accompany drug use, her baby has been developing well.

All this makes me even angrier about this situation. This young woman seems to be coping quite well – but she certainly won’t cope if her baby is taken away. However I know that there is no point in arguing with the social worker, that there are no arguments that I can make at this stage. Rosie’s fate is sealed, and I have to go and make some sort of relationship with her based on a lie. At this moment I want shout, to rage, to make these two solid officials display some feelings, some evidence of humanity. I understand (not for the first time) why people do stupid things to authority figures and to symbols of officialdom. For these two people Rosie has long ceased to be a person (if indeed she ever was one). She is a feckless specimen of humanity, fallen outside polite society through her drug addiction, a sponger, a criminal, undeserving of any kindness or compassion, and now compounding her sins through the irresponsible action of becoming pregnant. There is only one person to be considered here, and that is the unborn baby.

Ironically of course the unborn baby has no legal status in UK law, hence the need for my two oppressors (because that is how I now see them) to stand guard and await that moment of birth.

In the moments before I enter the room I have a frantic debate with myself. Should I introduce myself to Rosie and tell her what I know? I would like to – it would make me feel better because at least we’d be starting from a position of honesty. But would it make her feel better? She will have to complete however many hours are left of her labour knowing that it is entirely pointless. It will be worse for her than for the tragic mothers who have to complete their labours with a dead baby. She will know in advance that she has to endure the agony of hearing her baby cry – but then see it being removed. I don’t even think about how things will be if she needs an emergency Caesarean section.

If I don’t tell her, how can we establish a trusting relationship? The answer is that we can’t. Every word that I say to her is a betrayal. This is possibly the worst thing that I have ever done in my professional career. Once her baby is born, and she realises that her midwife and I have known all along what was going to happen, but behaved as though we had no knowledge of it, she will quite rightly hate us. Much worse, the job of any healthcare professional in the future is going to be a million times more difficult, because she will never trust them. If (when) she has another baby she will probably avoid any antenatal care, and may well try and deliver her baby at home without any professional help.
I enter the room. Rosie is a slender young woman, smiling between contractions, screaming with pain during them. I introduce myself and we talk briefly – I am a pro at contraction-interrupted conversations. We talk about her drug use after I have explained that I need to know so that I can help her through labour. She is friendly and articulate. I have switched off the empathic, ‘walk in your shoes’ part of my brain and am friendly but professional. This feels very alien, inauthentic, contrary to everything that I believe about my job.

Some hours later it is clear that Rosie should achieve a vaginal delivery. I have been making regular visits to ensure that she is comfortable and that all is well. Each time she greets me with a smile; each time I remain friendly and professional. I ensure that her pain relief is adequate and that her midwife is happy.

Cowardice takes over. I cannot stay in the room for the delivery (and strictly speaking there is no need for me to do so). I walk out of the room, turn the corner, and walk back down the corridor to the office.

Minutes later the anguished screams ring out.

They will stay with me until I die.

 

24 June 2014

(This event took place over ten years ago and remains fresh in my mind. Names have obviously been changed and medical details are deliberately hazy.)