Chapter 4 #2
“His next struggle is breathing.” Ellen distilled what she’d learned in midwifery and obstetrician lectures, keeping it to the barest of essentials.
“His lungs weren’t ready for him to be born.
Lungs are one of the last things that develop for babies.
So we need to make it as easy for him to breathe as possible.
This means keeping him upright. Clearing his nose and throat with a suction bulb—I’ll give you one before I leave—turning him upside down and thumping his chest like I did earlier.
“And feeding. This will be the hardest because of his little mouth. He probably won’t be able to get it around Krishna’s nipples.
” Ellen had long lost her modesty in discussing these things, and Himesh was so intent upon saving both his wife and son he didn’t seem to care, either.
“Now, I will leave a glass dropper for you to help feed him. This baby needs all the milk he can get. If Krishna’s milk hasn’t come in by tomorrow, let me know and we’ll find another mother willing to donate some milk or perhaps even goatmilk. ”
Himesh blinked at her, obviously trying yet struggling to comprehend and remember everything she said.
Ellen put a hand on his arm. “I’ll be back tomorrow. So will Doctor Amelia. You won’t be alone.”
He gave a shaky sigh. “What about our girls?”
“They need to stay away as long as possible.” Ellen paused. “Do you know what childbed fever is?”
“My grandmother died from it.”
“It’s very easy for small and puny babies to catch illnesses and for Krishna to contract childbed fever,” Ellen explained. “Ideally, both the baby and Krishna should be in hospital for a few days, just for support and observation.”
Himesh frowned. “No,” he said firmly. “No hospitals.” He glanced across the room, where Krishna writhed and moaned, heaving. “Do you think those white, rich doctors in their starched white coats would care properly for my brown wife and my weak son?”
Ellen wanted to tell him he was wrong. But that was the reason she didn’t work at a hospital, besides the fact that she hadn’t officially studied medicine.
She knew her ideas and thoughts would be shut down by men confident they already knew everything they needed to know, and that pale, pink skin was more valuable than warm, brown skin.
None of London’s hospitals had begun using French incubators, that she knew of anyway, and so there was little good a hospital could do for little Pradip anyway.
Better for the Patel family to stay at home and keep visitors away.
“Very well,” Ellen said. “We aren’t taking your son anywhere.”
Krishna screamed behind her.
“Ellen, we need you!” Amelia’s cheerful voice held an undercurrent of strain. “Second twin coming!”
Ellen held her breath as she settled beside Krishna, taking her hand.
“Squeeze as hard as you like, my dear.” The second twin always did worse than the first. They were almost always smaller, weaker, and more battered from the contractions.
If one of these babies didn’t survive, Ellen expected it would be the second one.
Still, she grinned at Krishna. “Think of the story you can tell your mother-in-law tomorrow!”
Krishna gritted her teeth and groaned, pushing for all she was worth.
“And here is your second son!” Amelia’s voice sounded even more chipper than before. Ellen didn’t like it when Amelia got that chipper, it meant something might be wrong.
Ellen pried her hand free of Krishna and took the wriggling, cheesy, gray baby.
Heart in her throat, Ellen wiped the baby’s face free of the vernix caseosa and turned him upside down, thumping hard to loosen any mucus in the lungs.
This baby was smaller, but still had good color, she noted.
Perhaps over four pounds, which was still very large for a seven-month baby.
She thought of the notes of a French study done at a Parisian hospital four years ago.
Incubators increase the survival rate of infants of at least four and a half pounds from 35 percent to 62 percent.
Ellen would give her right arm for one of those fancy French boxes. She smiled cheerfully and handed the infant to his mother.
Poor Krishna panted on the mattress, skin gleaming with sweat. She hardly noticed when her body expelled the placenta, or when Amelia massaged her belly to encourage the uterus to contract.
Ellen didn’t give Krishna instructions. Instead she knelt at Krishna’s head and bathed her brow, then brought a cup of water to her lips.
“Two beautiful, strong boys,” she told her. “You’ve done so well. The worst is over. You got them here alive.”
Krishna gave an exhausted, triumphant smile. “Do they look like me?”
“Yes,” Ellen said, raising the cup to Krishna’s lips again. “Spitting image of you. Lots of curls and adorable eyes.” I pray they last the night. Please, little boys, last the night.
Cleaning up after labor took a long time.
Ellen focused on the babies and Himesh, who eventually held both on his chest. His large hands covered each back, terror shining in his eyes.
Ellen understood that terror all too well.
She forced that tendril of fear back down where it belonged, where no one in the room could see it.
Amelia cleaned Krishna, teasing her that one advantage to tiny babies was little chance of tearing, and then helped Krishna hobble upright to the chamber pot on the far side of the room.
Ellen turned away to give Krishna a semblance of privacy, changing the sheets of the pallet, while Amelia held Krishna upright, cooing and humming and whispering encouragement, then settled her down on the freshly made pallet.
Amelia and Ellen helped Krishna initiate a feeding session with both babies, to encourage her milk to come in. Thank goodness she’s done this twice before, Ellen thought. This might work after all.
They finished past one in the morning. Ellen had made sure the family had food in their cupboard, gotten Krishna a fresh pitcher of water so she wouldn’t have to budge, knocked on their mother-in-law’s door to give an update, and repeated her instructions to both Himesh and Krishna about keeping the babies skin to skin, upright, and fed.
“If you can get their mouths attached to you, that’s wonderful,” Ellen said while looking at those tiny, pinching mouths.
“But they may need to grow first. It may take a couple of weeks. Instead, hand express into a cup and Himesh will show you how to use the dropper. I already showed him. We’re out of hand pumps, but I think we have a bottle or two when they’re ready for more than a dropper.
” Ellen hoped a church group or women’s charity circle would donate more items soon, so they could in turn offer much-needed supplies to new parents.
Amelia sagged against the door, hair askew and dress rumpled. “We’ll call on you in the morning. If there’s an emergency, send someone to my rooms above my office. You know where I live.”
Ellen looked critically at her friend. Amelia had been working longer than Ellen and appeared ready to drop from exhaustion. She nudged her aside and opened the door.
Cool, damp London air wafted in. Ellen shoved Amelia out the door and slammed it shut behind them. The air could be deadly for those babies.
They stood together on the stoop, shoulders touching.
“That was terrifying,” Amelia said. She glanced at Ellen. “How are you?”
All the emotion from the past few hours welled up and Ellen thought she might burst into tears. So she nodded instead.
Amelia shuddered. “I hate twin deliveries. I hate premature deliveries.” She groaned. “I’m a doctor, not a midwife. Why did I agree to deliver her baby?”
Ellen chuckled softly. “You always ask me and I always tell you. Because you’re the best, smartest, and most amazing woman I know.
And you’re saving lives. Now come on, let’s catch you a cab.
” They staggered down the steps and up the passage way, back toward High Street. Gas lamps flickered in the distance.
“Ellen, do you think those babies will live?” Amelia’s voice came thin and wavering in the night air.
Tears sprung to Ellen’s eyes. “You’re the doctor, you tell me.”
“You’re the expert in these cases, and you know it. I can treat broken bones and head injuries all day long, but you know more about premature births than anyone I know. Maybe even more than the midwives at the Nightingale Training School.” She paused at a sniffling noise. “Ellen?”
“I’m fine.” Ellen waved away her friend’s concerns with one hand while she wiped tears away with her other hand. “I’ll be fine. It just...brings back memories.” She forced a laugh. “Thank goodness Krishna hadn’t been itching or I would’ve been no help at all.”