Baby, look at you now
Evening Standard | 24 May 1995
ANNA Gonta has been in labour at Queen Charlotte’s and Chelsea Hospital since 5am. It’s now 10am. Her baby’s heart is fluctuating. Anna, who’s had an epidural, says she doesn’t feel any pain. But Arthur, her husband, clutches his stomach. ‘I feel pain here,’ he says. ‘I didn’t have this with the first one.’ Anna smiles weakly.View transcript
ANNA Gonta has been in labour at Queen Charlotte’s and Chelsea Hospital since 5am. It’s now 10am. Her baby’s heart is fluctuating. Anna, who’s had an epidural, says she doesn’t feel any pain. But Arthur, her husband, clutches his stomach. ‘I feel pain here,’ he says. ‘I didn’t have this with the first one.’ Anna smiles weakly.
Now it’s 2pm. Anna, pushing and moaning, looks anguished. ‘The baby’s getting tired and distressed,’ says the midwife, in a plastic apron. The baby is in a difficult position, with its head facing upwards. Suddenly its head starts to appear. The midwife performs an episiotomy, cutting the perineum, but the cord is wound tightly round the baby’s neck. A bell is rung frantically.
Suddenly there are eight of us in the room. The baby’s heart rate is low, its breathing poor, its face blue-grey. It doesn’t cry. It’s not responding. It looks dead. The paediatrician rushes the baby over to a resuscitating unit, giving it oxygen, massaging it. A short time later the baby is well, pink and crying happily.
Next door Lindsay Bull is having an easier time. She’s had no pain relief. ‘Good girl, keep it coming,’ coaxes midwife Fiona Allison. Her husband sprays Lindsay’s face with Evian. Now she’s kneeling and wailing. Now pursing her lips. ‘Put your hand down and see what’s there,’ says Fiona. The baby’s head. ‘Oh my God,’ says Lindsay. The baby, her first, is born after just four hours. What are they going to call him? ‘Bradley?’ Lindsay replies, quizzically. ‘Er, all right then,’ says her husband, blankly. Queen Charlotte’s and Chelsea Hospital (QCCH) is one of the world’s foremost maternity hospitals, a place of pioneering research and a centre of excellence, which has trained a third of the country’s consultant obstetricians and gynaecologists. And where they delivered the progeny of Patricia Hodge, Cilla Black, Karen Keating and the Aga Khan. But it’s also a hospital with an uncertain future – of not knowing whether it will be merged with Chelsea and Westminster or relocated to the Hammersmith. The problem is, of course, money.
In 1990 QCCH had a deficit of £1.5 million and faced closure because the governing body was unable to finance its relocation. Now the Hammersmith Hospital NHS Trust – of which QCCH is part – has a deficit of £8.5 million. The redoubtable Bunty Lewis, immaculately dressed and coiffured, looks as if she could run the hospital single-handed. Instead, she administers the appeal office on a full-time but voluntary basis. ‘I probably subsidise it a bit,’ she admits. She resurrected Queen Charlotte’s Birthday Ball and runs a ‘Babies’ Bawl’ children’s tea party for 300, raising £600,000 in six years for research and equipment. But hospitals should not rely on Bunties’ and debs’ photo-calls for funds.
We visit the Special Care Baby Unit – pronounced ‘Scibu’ in nursespeak. ‘Hands must be washed on entering and leaving unit,’ warns one sign. ‘Switch off all mobile telephones,’ alerts another. Kylie Ross, wearing floral dress and mournful expression, strokes 2lb Bailey’s back. Her baby is attached to tubes and breathing apparatus.
Joanne Tucker sits between incubators containing her two seven-week-old babies. She had given birth to triplets. ‘The third passed away after 14 days,’ she says. Now Joseph is 3lb 7oz and George five ounces lighter. ‘They’re my first but not my last,’ she confides. ‘Never again,’ stage whispers Joanne’s mother, Daisy Webster, joking. ‘I’m getting her sterilised.’
Nearby is the neo-natal ward. Here newsreader Pamela Armstrong’s son, AJ, lay 18 months ago. ‘When my baby was born, he wasn’t breathing and he didn’t have a heartbeat,’ says Pamela. He was rushed into a nuclear resonance magnetic imager – a magnet the size of a room – to check for brain damage. ‘Happily he was all right. But soon after he looked like spaghetti junction, millions of tubes going in and out. Other babies weighed less than a bag of sugar. They looked like stick insects.’ Miraculously most of these 11b babies thrive.
Sister Christina Tom-Johnston, a kindly midwife, counsels bereaved parents. ‘When a mother is about to lose her baby, I’m called to see her at the delivery suite,’ she says. Recently she saw someone whose baby was anencephalic (born with no brain). ‘Due to her religious beliefs, she didn’t want a termination.’
When a baby dies, Christina helps arrange the funeral, accompanies the parents to it, and follows up by telephone. She also runs support groups, and annual remembrance services at Acton Hill Church. ‘We had a congregation of 150 this year, representing 50 dead babies over three years,’ she says. ‘I give the parents daffodils and a candle bearing their baby’s name. The parents come forward when I call out the babies’ names. I’m usually crying myself by this time. Then I light the candle and put it on a table and it burns until the end of the service.’
Fortunately new-born deaths are a rarity. For 99 per cent of the babies born at the hospital – nearly 4,500 babies a year – the outcome is happy. QCHH is a world leader in fetal medicine, boasting Britain’s largest Centre for Fetal Care. Here Professor Nick Fisk’s team has become the first in the world to offer ‘tele-medicine’, which allows the transfer of distant ultrasound scanning images down phone lines to waiting specialists. They received one of the country’s first Siemens scanners allowing detection of any foetal abnormality before the 12th week of pregnancy, often permitting it to be corrected in utero. Here they showed last year for the first time that the unborn child can feel pain in the womb. And here Dr Michael de Swiet, one of only two obstetric physicians in the country, specialises in the medical problems of pregnancy.
It’s also QCCH that pioneered ultrasound; fetal heart monitoring; screening expectant mothers for rubella; Maggie Campbell’s innovative One-to-One midwifery practice – allowing the woman the same midwife throughout her pregnancy and post-natal period for continuity of care – human milk banks, special care baby units, fetal blood sampling, in utero blood transfusions, the mobile epidural; plus the country’s only post-natal depression clinic. This month they’re also starting the country’s first clinic for teenagers, allowing them to discuss gynaecological difficulties in confidence.
Now senior obstetrician John Malvern is running an antenatal clinic, wearing white coat and name label. His current patient, 26-year-old Carol Brown, is on her sixth pregnancy since 1989. ‘A decent sort of gap between pregnancies,’ says John, with an ironic smile. He’ll need his sense of humour. He’s delivering my first born in June.