It all seemed so simple. We turned up at the house for what appeared to be yet another "maternataxi". An ambulance being called to a woman in early labour for simple transport, where after nine months of preparation, buying clothes, painting nurseries, and building cots, no-one had thought about how to get to the hospital. Either that, or it's just that we're the cheapest option. Taxis cost money, as does parking, so an ambulance that will deliver you (sorry) to the front door and not cost a penny is a very attractive proposition.
Zara had two days to go according to her notes, but babies rarely arrive exactly when expected unless it's by planned Caesarean. Whoever called the ambulance told the call taker that the contractions were two minutes apart, whereas in reality it was nearly five. Her waters hadn't broken, this was her first pregnancy, and she wasn't too troubled by the contractions even when they did occur. Her husband said he'd make his own way in the car. He could have taken Zara too, but probably feared the mess if she delivered on route. Either that or he panicked. I gave him the benefit of the doubt as it was their first baby.
"Which hospital are you booked into?"
"Faraway hospital," she answered. Not the answer we'd hoped for. There were at least five other maternity units that were nearer in all directions, but if that's where she was booked, that's where we were taking her. It was over half an hour away, if the traffic was bad it could be double that, and the only reason she wanted to go there was because she had heard from friends that it was a good place to go. She never quite took into account the fact that she actually had to get there, and possibly in a hurry.
"Lucky you're not booked into Edinburgh hospital!" I commented, only half joking, trying to hide the nervousness I felt at a long trek with a labouring mother-to-be. Zara's husband stuck his head back in and asked if we would take the luggage as well and then he'd follow us to hospital.
"I'll be right behind you. Don't have the baby without me!" I hoped Zara's husband was right. We told him that if the traffic was particularly bad, we'd cheat and use the lights, and he had to make sure that he got there safely, even if it meant a slight delay.
I was fairly new, with only one delivery under my belt, an easy home birth where the midwife turned up less than five minutes too late. I was working with a partner who'd long ago lost interest in treating patients. He was working out the years until his retirement and spent most of his time driving the ambulance, ignoring both patients and crew mates alike.
"She'll be fine," he said, "we'll make it there with enough time for us to grow the coffee beans and still drink them before she has this baby." With that, he shut me and the patient in the back, and started gently trundling to hospital. Half way there, something about the way she was contracting changed. The look on her face was more anguished, the mix of gas-and-air in the bottle with the chipped blue paint no longer worked its magic quite so effectively. I called through to the front and explained what was happening. My crew mate looked up briefly in the mirror, switched on the lights and pushed the engine a little harder. The engine roared a response, but the actual change in speed was barely perceptible. Zara certainly didn't seem to notice the difference. I placed a maternity kit on the trolley, just by her feet, hoping the clear plastic case would remain sealed.
We called ahead to the hospital and asked them to make sure we were met by the front door, as it was notoriously difficult to get into the unit in a hurry. It involved two doors that required remote access, and a lift in between the floors where the doors were located. Waiting at each stage could easily add ten minutes to the journey. The lights and sirens had no real effect on the speed, but at least we could weave a little easier through the daytime traffic. Fifteen minutes and six or seven sets of strengthening contractions later, we pulled up outside the hospital. As expected, despite our prior warning and plea, there was no one there to meet us.
Zara screamed. She yelled about needing to go to the toilet. Desperately. There are two sets of patients who tell us that. One set is those having some sort of cardiac event, who if allowed to go will probably collapse, or worse. The other set is mothers in labour who are about to deliver their babies. As we lowered the trolley out of the ambulance, I was in a way glad of Zara's panic. It was doing a great job of masking mine. We pressed the button and waited for what seemed like an eternity until someone answered. We didn't need to identify ourselves, Zara once again did it for us.
"Get the lift down here, and get these doors open!" yelled my crew mate. It was the first time I'd seen any sense of urgency about the man.
Dragging the trolley up a slight ramp into the building, I prayed for the lift doors to open, and a midwife to be standing inside. Neither happened. I pressed to call the lift, and the square button lit up, its dim red light stopping us from proceeding. As the lift arrived, the light went off and a bell chimed to announce the blindingly obvious. Another chrome button, this time with a large "2" embossed both as a regular numeral and in braille. Once again I cursed hospitals everywhere for not having all maternity units on the ground floor.
We stopped on the first floor, a frightened looking mother and child taking one look inside and deciding to wait for the next time round. Another delay, another contraction, another scream. I frantically looked for the button that closed the doors again, only to find that there wasn't one. Instead I pressed the number 2 again, willing the lift to move. Zara had practically finished the entonox, and I promised her that there was more on the unit. All she had to do was hold on another minute.
I timed it. Forty-five seconds from when we stopped on the first floor, until we starting rising again, another thirty for the doors to open on the second door. As we landed, Zara contracted once again, and begged us not to move until it was over. We stood, waited, and prayed.
"It's coming!" She yelled. "Now!"
My crew mate got out the lift and pressed the buzzer to ask the staff to let us in. A distance of no more than five metres. As he got out and pushed the button, Zara pushed the baby.
There was a gush of water as the amniotic fluid escaped from the sac, and a scream as the baby's head appeared an instant later. The scream was Zara's, but it might as well have been mine. In the meantime, the unit's doors remained firmly shut, the magnets holding them in place still secured by an electrical circuit. Finally, training took over from panic, and I gently held the babies head as it turned. The next contraction didn't move anything, and in between the pains my crew mate resorted to bashing on the ward doors instead of pressing on the buzzer. But it was too late.
One more contraction, and Zara was able to hold her beautiful baby girl.
"Time of delivery - 13:14. Born in a lift."
She seemed, from my limited experience at the time, to be quite a big baby. Thirty seconds after she made an appearance, a midwife finally came to open the doors.
"What gives you the right to make such a noise? We're very busy in there, and if we don't answer the door, you'll just have to wait!" She emphasised each of the last four words through gritted teeth.
"Unfortunately," I said, somewhat cooler than I'd imagined possible given the circumstances, "this young lady couldn't wait any longer." I pointed to Zara and the little bundle she was cuddling, each wrapped in an appropriately sized ambulance issue blanket.
Instantly, the attitude changed. We were led inside, shown into a delivery room, and assisted Zara to move across from our narrow and uncomfortable trolley onto the hospital bed. There was the small issue of the cord and placenta to deal with, of which the midwives now took charge. The baby was taken to be cleaned and weighed, a shout from across the room announcing that what I'd guessed at being 'quite big' turned out to be well over four kilos, some nine-and-a-half pounds.
Zara was given an injection in her thigh, and with that chemical encouragement, the placenta too was delivered. She was free to hold her baby again now she'd been cleaned, and at that point her husband appeared. He was puffing and panting as if he'd been through the labour himself.
"I thought I told you to wait for me!" he gasped, leaning over to kiss both his girls.
"Have you got a name for her yet?" asked the midwife who'd initially let us in, now suddenly full of smiles.
"Not yet," they answered in unison.
"I'm too tired to think about it right now." Zara replied. Single tears from each eye took a gentle stroll down both her cheeks as she gazed lovingly at her newborn daughter. "Why don't we just add it to the shortlist?"