I think your waters have broken, Mrs. White.

She clamped her eyes shut and wrung her rosary beads.

Not another! Delia Garrett heaved onto her side and pulled the pillow over her head.

I wished we had anywhere else to put the grieving mother but this room.

I told Honor White, You’re a few weeks earlier than expected, but don’t worry.

I felt her abdomen. The foetus’s bottom was at the top, as it should be. But instead of finding the hard arc of the spine, my fingers sank into a hollow before they reached the head. The foetus was faceup. This was common enough in late pregnancy, and the awkward positioning might explain why Honor White’s amniotic sac had broken already. Hopefully it would revolve to facedown before it was time to push. Otherwise it could mean a long, painful back labour, a bad rip, maybe even (if worse came to worst) forceps…

I got out the ear trumpet and moved it around till I found the faint but lively beat low down on her right flank.

I told her, You’re progressing nicely now the waters have broken. I’m just going to wash my hands and see what the story is before we change your bed.

I put Honor White on a bedpan first to make sure her bowels and bladder were empty. Then I got her to lie back in her soaked sheets. She opened her legs without a murmur.

I was feeling to make sure the cord hadn’t prolapsed, because sometimes a loop came out first and could get pinched by the skull. But to my astonishment Honor White was wide open already; my gloved fingers could detect only a thin lip of cervix. I felt awful for not having checked her before.

Have you been having pangs, Mrs. White?

She nodded and coughed.

Where, in your back?

Another nod.

For how long?

A while.

You should have said.

Her face was stone.

So! You’re well on the road now.

Nearly ready to push, I would have added if her foetus had been facing her spine.

Usually in this situation, the doctor would give the mother a draught of morphia and we’d cross our fingers that her contractions would turn the foetus while she was asleep, but Honor White would refuse the drug, and in any case, there just wasn’t time.

For a breech birth (wrong way up), I might have tried to persuade the tiny passenger to flip over by pressing the abdomen, but for this presentation, it was best to use gravity. I got Honor White out of bed and sat her on a chair. Lean forward, please, Mrs. White. Hands on your knees.

Bridie helped me put a fresh nightdress on her and then we stripped and made the bed, working smoothly together.

Out of the corner of my eye, I saw Honor White hold her breath and redden.

No bearing down yet, Mrs. White!

She let out her breath in a splutter of coughing.

I told her, It’s the angle your baby’s at, the head’s pressing so, it tricks you into thinking you’re ready.

She stifled a groan.

Bridie bundled up the wet sheets for the laundry.

I asked, Once you’ve dropped that down the chute, could you find Dr. Lynn and tell her Mrs. White has a persistent posterior presentation and she’s almost fully dilated?

I saw Bridie mutter the phrase to herself silently, trying to memorise it.

Just say posterior.

She nodded and rushed off.

Now that I was looking out for it, I could see the tightening in Honor White’s face when the next pang came. She let out a cough so ragged, I passed her the sputum cup. She hawked up something dark.

Mary O’Rahilly spoke up, eyes shiny with concern: If you don’t mind my saying, Mrs. White, I found the chloroform such a help.

No answer.

Would you not take an inhaler for a minute to soothe your cough, even? Save your strength for the pushing?

But the woman shook her head savagely.

She worried me, this one. I’d been assuming that Honor White was simply the stoic type, but perhaps she was putting herself through this labour in a spirit of grim penance for what the nuns called her second lapse, her second offence. I’d occasionally been called in to see a woman who’d been labouring away at home quite unsupported, and it often went badly, even after my arrival; it was as if the isolation had sapped her spirit. That wasn’t only the unwed either. One wife near fifty was so embarrassed to find herself in that condition again at her age that she hadn’t told a soul, not even her husband—she’d been wheeled into this hospital with a tiny live foot sticking out of her, and Sister Finnigan and I had spent a long hard night saving them both.

Now, Mrs. White, I said, stand up and lean on the bed and rock your hips, would you?

She blinked.

Come on, it’s to get your baby into the right position.

She obeyed, facing the wall and swaying backwards and forwards in a slow, incongruous dance.

The O’Rahilly baby let out a goatish wail in her crib.

I picked her up and showed Mary O’Rahilly how to change the nappy.

Green slime!

That’s how it comes out at first, I told her.

Disgusting, she said fondly.

What are you and Mr. O’Rahilly thinking of calling your daughter?

Maybe Eunice, for my aunt.

Lovely, I lied.

Afterward we got little Eunice on the breast again.

Bridie had come in silently and was rubbing Honor White’s back. The woman paid her no attention but didn’t rebuff her either. Bridie reported, Her legs are shaking something awful.

Honor White grunted. Can’t I just lie down and push?

Not quite yet, sorry.

(Feeling her bump for any hint of the foetus revolving yet.)

I told her, The doctor should be here very shortly.

(Please, God, let Dr. Lynn arrive in time for this delivery. What if the skull got jammed and everything swelled, and there was nothing I could do to rescue mother and child from each other, from their joint and private hell?)

Delia Garrett had her magazine out as a shield for her eyes.

Mrs. White, I said, let’s try you on the bed on hands and knees.

Like a dog? Mary O’Rahilly asked, mildly outraged on her neighbour’s behalf.

But Honor White climbed onto the mattress, leaning on Bridie’s skinny arm. She rocked back and forth in a kind of fury. Oh, oh, I need to—

Let me check you again. Stay right where you are.

I scrubbed and gloved and lotioned. I felt inside her and there was no trace of the cervix at all.

Please!

Even if the foetus was still facing upwards, I couldn’t say no to this overwhelming urge of hers. As long as the back of the skull was leading and the chin was well tucked in, it should be possible to deliver now, shouldn’t it?

All right, time to lie down on your left and push.

(I was praying for one of those last-minute miracles that nature sometimes worked—the foetus finally, suddenly, gloriously corkscrewing into place, then into the light.)

Honor White dropped down heavily, head to the wall, a martyr of old.

I crooned, Good woman yourself.

Temperature no higher; pulse just a little too fast, and thready. I was about to listen to the foetal heartbeat for any sign of distress when her next pang made her start to groan.

Chin down, I said, hold your breath, and give a fine strong push.

I saw all her muscles harden and the strain move right through her.

Feel free to make noise, Mrs. White.

She stared past me.

I looped a towel around the top rail for her to pull on. She was the wrong way round to be able to brace her feet on anything but I didn’t want to move her now. This primitive little storeroom!