more mobile. And Delia Garrett was bleeding more than before.
But our policy was to give the placenta an hour to come out on its own. Up to two if the patient had been given chloroform, which could slow down this stage.
A whisper from Bridie: Can’t you give the cord a yank?
I shook my head. I didn’t say that it might break off or I might rip out the whole womb. I’d seen the latter happen to a worn-out grandmother, forty-seven years old, even though Sister Finnigan had been scrupulously careful, and whenever I recalled the moment, I thought I’d throw up.
Delia Garrett’s curls were flattened on the pillow. I put the sticky back of my hand to her throat to be sure she had no fever. Give nature an hour, I reminded myself.
But I had a bad feeling. The placenta might be stuck to the inner wall, and if so, the longer it clung on, the more likely she’d get an infection.
I should wait for Dr. MacAuliffe. Or send Bridie again and tell her not to come back without him. Except what did that youngster know about this woman’s insides?
A warm scarlet wave brimmed and flowed onto the sheet. Oh, Christ. The afterbirth must have ripped partly away. This was how so many mothers began to die.
I rubbed the uterus hard to help expel it, squeezed her like a lemon. Here you go, Mrs. Garrett, one more push now—
The cord’s burden slithered out, a dark-maroon side of meat.
There!
But relief drained away as I spotted what I was dreading: half the afterbirth was missing. The red tide was rising, soaking the bedding.
I remembered the rule: A midwife should never risk manual removal of the placenta unless all other methods for controlling haemorrhage have failed and no doctor is available to perform the procedure. But there was no time, and if I dithered any longer, Delia Garrett was going to bleed to death.
At the sink, I scoured my hands so hard, the nailbrush left red lines on my skin and the carbolic burnt. I sensed the bone man just outside the door. He’d claimed one small life already before any of us had realised, and now he was hovering close by, doing his rattling dance, swinging his smirking skull like a turnip in his bony fingers. I soaped my hands and tugged on a pair of rubber gloves.
I parted Delia Garrett’s legs with my elbows and poured dilute disinfectant over the torn parts.
She whimpered.
I said, I’ll be as quick as I can. Hold her knees open, Bridie, while I get the rest of it out.
Until now, I’d done this procedure only on an orange. In my third year of training, Sister Finnigan had talked me through a manual removal on a big loose-peeled Spanish one.
I put my left hand on her softened belly and grasped the ball of the uterus through the abdominal wall. I pressed it down to bring it within my reach and held it as steady as I could while I closed my right hand into a cone. I pushed in.
Delia Garrett howled.
A cave behind a waterfall; hot red past the gloves, all the way up my arm. I found the cervix. I went through it as slowly as I could while she wept and thrashed from side to side.
Bridie had her by the shoulders, pinning her. She crooned, Brave girl yourself!
I was in. Immediately I curled my fingertips back so as not to damage the uterine walls. I was a fearful burglar, creeping around a lightless chamber.
Delia Garrett tried to clamp her thighs around my arm but Bridie pulled them back and urged her, Let Nurse Julia fix you, it’ll take only a minute.
How could she promise that? I was lost in here. I couldn’t tell what I was touching through these rubber fingertips.
There, a shape under the heel of my cramped hand—unmistakeable.
Delia Garrett sobbed, Stop, stop.
Just a second.
I ran my little finger behind the afterbirth and raked its strings, sawing it free. I got two fingers behind it, then three, peeled the awful fruit with my awkward gloved hands. Come away, I found myself begging the thing. Release your grip on her.
Please, Nurse!
But I couldn’t show mercy, not yet.
Bridie held Delia Garrett down, soothing her like a mother.
I worked on till I had it. All of it? I twisted the messy bundle and rolled up its membranes in my palm, a slippery tangle of flesh. Coming out now!
(Incongruously cheerful.)
Through the hard round lock I pulled my hand