Nakba in the heading means ‘catastrophe’ and is the word used by the Palestinians to describe their forcible eviction from their homeland in 1948. After 70 years the process still continues, although not in such an overt fashion. On the night of December 26th/27th 2016 my family endured its own Nakba. At a home birthing my first grandchild, James Edward Milnes Gaskell, son of my Charles and his girlfriend Valerie (the children) was born full term but never drew breath.
At about 5:00am on the 27th December I found myself standing next to Dr. Liburd in the emergency section of the hospital. Many things are now a blur, including that conversation, but I do know that very gently he was encouraging me to write to try to discourage home birthings. You have a lot of influence, he said. I demurred, but let us see. Here is an incomplete story of our home birthing Nakba.
Celia and I went to England in May 2016. On our return in early June, the children told us how happy they were that Valerie was pregnant. We shared their delight. They would plan a home birth, they said. I was against this, saying that if anything went wrong, which most likely it would not, then the hospital would have the equipment, drugs and experience needed. I was insufficiently persuasive. Indeed I felt warned off the subject. I expect I should have insisted and insisted, but who knows. This is only one of the “what ifs” that form the chain of events bringing about our Nakba. Please go to see the gynaecologist in St Kitts. He has a good reputation. They checked him out and made an appointment. They came back from their visit tremendously happy. They liked him and thought him very professional. He took ultrasound pictures, perhaps unfortunately using an invasive technique. Two days later, Valerie ran a very high fever, and this turned them away from the Medical Profession, and back to natural childbirth at home. For this they knew they had to have a midwife. One was found. She came to check Valerie on two occasions. On December 14th Valerie registered at the Alexandra Hospital ‘just in case’ and the next day she saw Dr. Essien and had an ultrasound. This showed the baby in a breech position. She told the midwife that same day. This should have been a red flag for a home birth. It was indicated that one of the midwife’s ‘helpers’ could turn the baby. She couldn’t. The midwife made an appointment to check Valerie on December 23rd but she cancelled.
The children were innocent, and naive. All they wanted was to give their little boy, to be called Jem in the family, the most natural and easy entrance into the world, where he would stay with his mother, and not be removed by others for weighing, measuring, checking under bright hospital lights. Friends of theirs in the Federation had had ‘happy events’ successfully at home. Theirs would be no different. It was. It is our Nakba.
The family had a joyous Christmas. Valerie was excited about the impending birth. At 6:40am the next day her waters broke, contractions began and a diary was kept describing the contractions and their timings and their communications throughout the day with the midwife. The midwife came at 6.30pm. Her two helpers arrived later.
This family believes, or at least I do, as a Journalist, that the only way to advance is to acknowledge the facts and to depict them truthfully and accurately. We try to forgive ourselves and others for our deficiencies and inadequacies. We relied upon the professionalism of the midwife. It was a misplaced trust.
So, midwife, I address you. More of the ‘if only’ and ‘what if’. Why did you not, when you knew the result of the ultrasound, say that a home birth was potentially dangerous? Why did you pay no attention to the requests of the mother when she said some three hours before the birth that she did not feel normal and wanted to go to the hospital? No woman in extreme labour is in a fit condition to insist. Your helper ‘M’ told her that it was her first baby and she should rest and have some tea. Why did you not over rule your helper who is not a midwife and instead, accompany Valerie to the hospital or send for the ambulance? At 11.00 pm, a little over three hours before the baby tried to emerge, you checked and found that the cervix had dilated only 2 cms, a measurement entirely inadequate for birthing. This was, as you knew some 16 hours after labour began, as clear an indication of an emergency as one in your profession could ever expect. Was that not a mandatory ‘rush to the hospital’ situation? Another concern. Why did you not lay out all your equipment and not have to ask your ‘helpers’ to find it? It seems that you did not even check if a vital piece of equipment, the ambu bag, was working. Why not? You told me in the car as we returned from the hospital that the baby came too quickly, but do not convince yourself that you could not have acted differently before his sudden attempt to join the world. You will know, won’t you, in your heart of hearts that a ‘C’ section might have produced a very different outcome and there was time for it to have taken place? So I say to you, if you wish to continue in your profession, do it within the confines of a hospital, where you will be well supported, overseen by a qualified staff, and where the equipment will work. To all who may consider a home birth let this be a warning. The hospital is not perfect, but it is less risky. Note that, after HIV/AIDS, maternal deaths, are, worldwide, the second biggest killer of women of reproductive age. We are so relieved that Valerie is okay. The emotional scars left on each member of my family are greater than I could have imagined. We are at the bottom of the pit just taking our first steps up on to the bottom rung. We know that the death of Jem, our future, will always be with us. He would have lived in a privileged family, where that privilege was the unconditional love that would have been bestowed upon him. We know also, that pangs and flashbacks may hit us at any time and that there may be many different random conversations, words or events that cause them. We prefer not to see the midwife or her ‘helpers’ again. Above all, do not approach us with a breezy ‘how are you?’ smile and expect the standard response. We want to try to heal. This we shall do by being positive and trying to help out in our community.
We are most grateful and thank friends for their support. Charles and Valerie are very well liked, and it has been heart warming to see just how upset for them some of their friends have been.
We buried our Jem at the family burial spot at Wards Estate, where he now lies next to my brother Tom. This was done on the last day of 2016, so we can start afresh this year. A friend made the most beautiful simple casket ever seen in these islands. It was for a beautiful perfectly formed baby Jem. Lucky we were with the weather. Rain all day except for the one hour appointed for the burial. It was fitting that Thelma’s assistant for the day was Garrick Hunkins who at been at the Charlestown Preparatory School with Charles and Valerie. It was also fitting that Pastor Ron Daniel, also a friend from school days conducted the short service. ‘Mexie’ with his backhoe played his part. It was nice to hear him say to Valerie ‘I’ve been with the family a long time’. We have deep roots here and anything with deep roots will flourish anew. At present the clouds lie heavy. We trust that eventually the sun will break through.