From The Guardian:

Call 999!

With the midwives stuck in traffic and his wife going into labour, Leo Hickman had to turn to the emergency services

I never thought it was worth writing a birth plan. Before I left for work in the morning, my wife, Jane, had said to me that “today could be the day” and that she just had a feeling when she had woken up. Jessie, our second child, had been born at hospital after a 45-minute labour, so we had been advised to have our third at home - it was likely that there would simply not be enough time to get Jane to hospital.

I wasn’t too alarmed by Jane’s prediction that morning. I arrived at the office with my mobile phone close to hand and fully charged, but was quickly distracted by the office. “Typical man,” some have since said. But I had been calmed by the midwives who had reassured us that they could be at our home in a few minutes if necessary.

The call finally came at just before 5pm. “Jane wants you to come home now. I think it might be starting,” said Jane’s mother, Margaret, who was staying with us to help look after Esme, our eldest, and Jessie during the birth. About 10 minutes earlier, Jane had woken from an afternoon nap. She thought as I only had an hour of work left it might be worth getting me home. By the time Margaret was off the phone, the contractions had started.

Thank God taxis can travel along bus lanes - I was home within 20 minutes. I unlocked the door to find a scene of mild panic. Esme and Jessie were in the sitting room watching a cartoon at full volume (to drown out the sound of their mother in labour); Margaret was shouting at me from the bathroom upstairs.

“The midwives are stuck in traffic. Call 999 now … “

17:28:12 999 call answered

Transcript of Leo’s 999 call

Operator: Emergency ambulance. What’s the problem? Tell me exactly what’s happened.

Leo: Hello, my wife is in labour and is having the baby at home, but she is really feeling the urge to push and the midwife, who is stuck in traffic trying to get here, said to call you if that’s the case.

Operator: OK, what’s the address you want the ambulance to come to, please?

Leo: Gives address.

Operator: And the postcode, please?

Leo: Gives postcode.

Operator: And the telephone number you’re calling from, please?

Leo: Gives telephone number.

Operator: And are you with her now?

Leo: Yes.

Operator: And how old is she, please?

Leo: She’s 34.

Operator: And is she conscious and breathing?

Leo: Yes, she is.

Operator: How many weeks and months pregnant is she?

Leo: She’s one week overdue tomorrow.

Operator: Is the baby completely out?

Leo: No. No, she is just having the urge to push and the midwives said to call you.

Operator: Can you see any part of the baby now?

Leo: Er, hang on. I’ll just check.

Operator: Thank you.

Leo: Pause. No.

Operator: Is she having contractions?

Leo: Yes.

Operator: Is this her first delivery?

Leo: No, her third.

Operator: How many minutes apart are the contractions?

Leo: After asking Jane: About a minute apart. The last labour was 45 minutes for her second child.

Operator: OK. Is there any serious bleeding?

Leo: After asking Jane: Er, no.

Operator: Have you had any high-risk complications with the birth?

Leo: No, we haven’t had any high-risk complications.

Operator: OK, I’m organising help for you now. Just stay on the line and I will tell you what to do next. Do not try to prevent the birth. Do not allow her to cross her legs or sit on the toilet.

Leo: OK.

Operator: Allow her to sit in the most comfortable position and have her take deep breaths between contractions.

Leo: OK.

Operator: Pause. Right, where is she now?

Leo: She’s in our bedroom.

Operator: Is she laying down?

Leo: She is laying against the bed with her knees on the floor.

Operator: Is that the most comfortable position for her?

Leo: Yes.

Operator: Has she got her clothes removed below her waist?

Leo: Yes, she’s totally got everything off. Sound of Jane experiencing a contraction in the background.

Operator: Have you got clean towels and blankets?

Leo: Yep.

Operator: Upon hearing the contraction: Does she want to push?

Leo: Yes, I think she does want to push.

Operator: Right, I want you to look at her vagina very closely to see how close the baby is to being born. Pause. OK, do you see any part of the baby now?

Leo: Yeah, I think I can see a head. Yes, I think the top of the head. I think.

Operator: OK, you think, yeah?

Leo: I can’t quite tell.

Operator: OK, what we need to do is …

Leo: Yeah, I can.

Operator: With each contraction, place the palm of your hand against the vagina and apply firm but gentle pressure to keep the baby’s head …

Leo: To keep it in?

Operator: No, you do not want to keep it in. Place the palm of the hand against the vagina and apply firm but gentle pressure to keep the baby’s head from delivering too fast and tearing.

Leo: OK.

Operator: Do you understand?

Leo: Yeah.

Operator: As the baby is delivered I need you to support the baby’s head and shoulders and hold the hips and legs firmly. Remember the baby will be slippery so try not to drop it.

Leo: OK.

Operator: OK, how is she doing now?

Leo: To Jane: You’re not having a contraction now, are you? To operator: No.

Operator: Stand by. Pause. Is there anyone else there with you?

Leo: We’ve got two kids downstairs who the grandma is looking after.

Operator: Could you ask one of them to open the front door?

Leo: OK, I’ll do that now.

Operator: Is it a house?

Leo: Yes, we’re on the first floor.

Operator: Pause. How’s she doing? Can you still see the head?

Leo: Pause. Er. It’s retreated a little bit now that the contractions are over. It’s closed up a bit more. OK, there’s another contraction happening now.

Operator: OK, remember what I said?

Jane: Screaming: Ohhh, I need to push! I NEED TO PUSH!!

Leo: She needs to push.

Operator: Have you got the palm of your hand against her vagina?

Leo: Yes. Jane moaning and screaming in background. If the head comes out, what do you want me to do?

Operator: If the head starts coming out, you’ve got to hold the head, OK? And stop it being delivered too fast. You want to deliver it, but not too fast, OK?

Leo: I can feel it. OK, the head’s coming!

Operator: The head’s coming? OK, right. As the baby is delivered, you’ve got to support the baby’s head and shoulders. Can you see the shoulders?

Leo: Hang on. Wait, wait, wait. Yeah, it’s coming, I think.

Operator: You need to support the baby’s head and shoulders and hold the hips and legs firmly.

Leo: Hang on. Long pause while Leo does an examination.

Operator: How are you doing?

Leo: OK, you know, I don’t think it is the head actually. (Leo is very scared now: instead of a smooth baby’s head, what he is looking at has become rippled and ridged in appearance and blotchy in colour. He realises that telling the operator he has doubts that it is a head will frighten Jane, but he knows he has to tell the operator everything.)

Leo: Something’s coming out, but I don’t know what it is. Jane moaning in background.

Operator: You don’t know what it is? Jane experiencing another contraction in background.

Leo: I think … I think it’s part of the sac.

Operator: Part of the sac?

Leo: … which hasn’t burst yet. Jane moaning in background.

Operator: OK, how far is it from coming out?

Leo: It’s got liquid in it.

Operator: Sorry?

Leo: It’s got liquid in it.

Operator: Liquid in it? Have you got a safety pin there?

Leo: It’s not the baby. Jane moaning and screaming in background.

Operator: Long pause. Right, if the sac hasn’t burst, you need to go and get a safety pin in case the baby is born in the sac.

Leo: I can’t hear you!

Operator: Right, you need to get a safety pin in case the baby is born in the sac.

Leo: Say that again.

Operator: Right, you need to get a safety pin in case the baby is born in the sac. You need to burst the sac. You need to do that now.

Leo: OK. To Jane: OK, wait there, Jane. Jane moaning and screaming in background. (Leo leaves the bedroom. He runs out on to the landing and freezes, trying desperately to think where he might find a safety pin. Did the girls have a badge he could use? But surely it would need to be sterilised? Would one of the barbecue skewers downstairs in the kitchen drawer be suitable? After 30 seconds of panic and incoherence, he returns to the bedroom to see that the waters had now started to break.)

Jane: There’s loads of meconium! Moans.

Leo: Re-enters room. You OK?

Operator: Is she OK?

Jane: There’s loads of meconium!!

Leo: There’s a lot of meconium. (Meconium - the baby’s first poo - can cause complications, especially in a home birth.)

Operator: There is? Pause. OK, you’re still going to need to support the baby. Is it the sac coming out? The baby must be in the sac.

Leo: Yep.

Operator: Is the head coming out?

Leo: OK, the head’s coming!!

Operator: OK, you need to support the baby’s head and shoulders.

Leo: OK.

Operator: Are the shoulders coming out?

Leo: Yep.

Operator: Right, you need to support the head and shoulders and hold the hips and legs, OK? It will be slippery so don’t drop him!

Leo: OK. Jane breathing heavily. Come on, little baby.

Operator: Is it in the sac?

Leo: No, I can see the head. I can see the face!! (The baby’s eyes and mouth are closed and there is no movement in his face at all. Leo had expected the baby to breathe as soon as the head was born, so is feeling frightened now.)

Operator: OK, that’s fantastic. Just keep supporting the baby, OK.

Leo: OK. Pause. Jane, you’re doing really well.

Operator: Tell her she’s doing fantastic, OK.

Leo: You’re doing really well, Jane. Pause. The shoulders are out.

Operator: OK, just keep supporting the head.

Leo: OK. Pause. There’s lots of waters breaking. Come on, little baby. Jane screaming and moaning. OK, one shoulder’s coming. (One arm is now out - in the panic, Leo has said “shoulder” by mistake.)

Operator: OK.

Leo: Come on, little baby. Jane screaming. OK, the baby’s out!!

Operator: Is the whole baby out?

Leo: It’s quite messy. There’s a lot of meconium.

Operator: Right, what I want you to do is wipe the baby clean. Pause. Right, is the baby crying or breathing?

Leo: It’s not fully out yet. (Perhaps it is the sight of the thick umbilical cord that makes Leo say this? The baby has in fact been born; he is covered in meconium, including all over his face. The clean towel referred to earlier is now dirty and of no use. Leo is on his knees holding the baby up off the floor, unable to put him down to run for a towel. Jane is unable to turn round to hold him because she can’t get her leg over the cord. Both parents are worried because the baby is not crying. He is only making very small body and facial movements. He looks very blue in colour.)

Operator: Tell me when the baby’s completely out.

Jane: Get Mum!

Leo: Shouting downstairs. Margaret! Pause. OK, the baby’s completely out!

Operator: Is the baby crying or breathing?

Leo: Yes, it’s crying. The baby is making small crying noises.

Operator: Right, what I want you to do is gently wipe off the baby’s mouth and nose. And dry the baby off with a clean towel. Then wrap the baby in a clean, dry towel, OK.

Leo: OK.

Operator: Just wipe the baby’s mouth and nose first. Yeah?

Leo: (There is still no towel.) Shouting downstairs: Margaret! Quick!

Jane: Lift him up! Baby crying in background.

Operator: Have you got a boy or a girl?

Leo: Shouting downstairs. I need a clean towel! Quick!

Operator: You need a couple, OK. One to dry the baby off with and one to wrap him up with. Is it a boy or a girl?

Leo: Laughing. Er, I don’t know yet. Pause. A little boy.

Operator: Congratulations.

Leo: Margaret enters room. Quick, quick. Baby crying.

Jane: Oh, my baby.

Leo: Any towel! Long pause as towels arrive and baby is cleaned and swaddled. Shall I give the baby to Mum?

Operator: Is he wrapped up in a towel?

Leo: Yes.

Operator: Don’t pull the cord too tight and put the baby in mother’s arms. Now make sure to keep the baby and the mother warm.

Leo: OK.

Operator: Did you wipe off the baby’s mouth and nose?

Leo: Yeah, I tried to. It’s quite messy though.

Operator: Oh, all right then. That’s fine.

Leo: There’s a lot of meconium.

Operator: OK. Pause. Right, the ambulance is really close to you now.

Jane: Is it OK?

Leo: Yes. Pause. Knocking heard downstairs. OK, I think the midwife or the ambulance is now here.

Operator: It must be the ambulance. I’ll have a look.

Leo: The mum’s got the baby now in her arms.

Operator: How’s she doing?

Leo: OK.

Operator: She’s doing OK?

Leo: I think so, yeah.

Operator: How’s the baby?

Leo: She’s a bit … He’s a bit quiet, but he’s making kind of gurgling noises.

Operator: He’s still breathing, yeah?

Leo: (Two midwives enter the room.) OK, the midwife is here now.

Operator: OK, do you want me to leave you with her? The ambulance is extremely close now. It’ll be with you soon. You’ve done a fantastic job. Congratulations. (Two ambulance crews enter - there are now six professionals doing checks on Jane and baby Jacob.) Thank you. Goodbye …

17:39:28 Recording ends.

The cavalry had arrived. They immediately examined the baby and Jane, expressing some concern about his blue/grey colour. But once they saw the umbilical cord pulsing they felt reassured that his colour would return, and in five minutes or so he was a more healthy-looking pink. Soon they weighed him and he came in at 3.6kg (8lb). About an hour and 20 minutes later, with the baby already having had his first feed, Jane gave birth to the placenta in the bathroom and the remaining ambulance crew was stood down by the midwives. Once back in the bedroom, Esme and Jessie came to meet their new baby brother.

It was only once Jane and Jacob were asleep, and the girls were in bed, that Margaret and I had our first stiff drink of the night. I never did discover the name of the operator - I still only know her as “CAC1821″ from the London Ambulance Service call centre at Ilford, Essex - but none the less we toasted her too.

Oh dear…I’m getting broody!