The Welfare State and Me.

Last night, I went to see I, Daniel Blake. Responses to this film are predictably polarised. Left-wingers see it as an indictment of Tory Britain. Right-wingers see it as gross exaggeration, if not a complete fiction. A journalist in the Daily Mail has posed the question of why there are no characters like White Dee from Benefits Street in this film, and why everyone is portrayed simply as a good, honest, caring person who has fallen on hard times. 'It just doesn't ring true,' the journalist says. I went to see the film with a friend of mine who is a GP in the area of Newcastle where it is set and who is also carrying out research into health inequality in Britain. For her, the film rings very true indeed.

The main female character has just come to live in Newcastle, having been sent out of London because capital rents are too much of a drain on the housing benefit system. She has two children. Her benefits have been sanctioned because she got lost while looking for the JobCentre and ended up late for her appointment. She has no money and no way of feeding herself or her children, except through the food bank.

I discussed this with a friend of mine, who said something along the lines of, 'But how did she get into that state in the first place?' The implication here was that Katie must have brought her poverty on herself, most probably by refusing to work, or by making what the government refers to as 'bad choices.' We never do find out how Katie ended up in that situation, and perhaps we don't need to. The important thing is that in this country, there is enough food to go round, and those who are hungry need to be fed without judgement.

Katie's circumstances made me think of someone I knew a long time ago, when I worked in a children's home, where three young people under sixteen lived. These were the children who couldn't live with their parents and whose foster placements had all broken down. They had all been excluded from mainstream school and instead a teacher used to come to the house to help them with basic literacy and numeracy. They were what many people refer to as 'the dregs' - the children whose backgrounds are so horrific, they cannot function in wider society. No one wants to look after these children because their behaviour, on the whole, is deeply unappealing: theft, assault, self-harm, running away and prostitution are among some of the things I dealt with.

There was a girl at the home. Let's call her Frankie. Frankie was fifteen years old. She'd lived away from her mother on and off since she was removed from her care at the age of six because her mother was a violent alcoholic. No one knew where her father was. Over the previous nine years, Frankie had been to five different foster homes, two secure units and three children's homes. Staying at the home I worked in was her final chance: if she ran away, or stole, or did anything else against the law, she would be back in a secure unit. She wanted to give it a go, and for three months, she managed it. She got out of bed before eight every day, she went to her lessons, she did extra work, she didn't drink, or self-harm. She was co-operative with staff, she spoke openly about her problems instead of smashing up furniture and she was, in so many ways, a delight to be around.

At the time I met Frankie, her mother was two years into a ten-year prison sentence for manslaughter of Frankie's younger brother. The story goes that Frankie's mother was a recovering heroin addict and had been prescribed methodone. She left the drug on a table and her two-year-old son took it. Afraid that he would be taken away from her, she didn't call an ambulance and he died later that day.

To fund her heroin addiction, Frankie's mother worked as a prostitute. She had a pimp who persuaded her to rent out Frankie as soon as Frankie turned twelve. Soon after the death of her brother, Frankie was removed from her mother's care again and sent to a foster home. She ran away many times, back to her pimp, and eventually was sent to a secure unit. Later, she was released from the secure unit and came to the children's home, where I met her. I was her keyworker and worked closely with her for three months. Things went well. Then they didn't.

One Sunday morning, I arrived at the home at 10 to start my shift. The handover staff told me that one of the other children had run off in the night (by climbing out of an upstairs window) and returned with alcohol, which he shared with Frankie. She got drunk and hurled all her furniture around the room, then took a knife from the kitchen and slashed her arms so badly she needed hospital treatment.

Soon after this, I left. There were many reasons why, the main one being that I knew there was no way I could make a difference to Frankie. The damage had been done, a long time ago. The last I heard of her was about fourteen years ago, when a colleague from the home told me she'd run away, had a brief stint as a prostitute again and was back in the secure unit. She was not yet sixteen.

Since then, I have often wondered what became of her. The outlook for children like Frankie is bleak. Care leavers are among the people most vulnerable to homelessness. Young women are likely to enter abusive relationships. They are also likely to commit suicide. What they will almost certainly never do is enter steady, regular employment. They simply do not have the mental strength for it. Neither do they have the education. Frankie didn't have a single GCSE. For children like Frankie, ambition is an alien concept. The role of the fairies in A Midsummer Night's Dream and the ins and outs of Pythagoras's theorem are all meaningless to a fifteen-year-old girl whose main aim is simply to get to the end of the day without a middle-aged man sticking is penis in her mouth.

If she is still alive, then the very best that can hoped for is that Frankie has a roof over her head, paid for by housing benefit, and enough other state money to keep her warm and fed. That is the very best scenario.

When she was fifteen, if you asked Frankie what she most wanted in life, she would answer, 'A family.' She wanted a baby. Those of us who knew Frankie knew that having a baby would be a disaster for her. She had a good heart, but not the first idea of how to look after another person. She could barely cope with the smallest levels of self-care. She didn't have the self-worth for it.

But she wanted a baby because she wanted someone to love. It is very likely that she had a baby as soon as she could, perhaps when she was sixteen, perhaps a little older, but she will almost certainly have had one. She will almost certainly not have had the finances or the emotional strength to care for that baby.

There is a school of thought that says, quite simply, that if you can't afford a child, you shouldn't have one. There is some material and social sense in that. But Frankie was a child, and she was ill. She was far more fragile than most and therefore more prone to making mistakes. Ultimately, Frankie was human, and to my mind, that is the root of why we fail people like Frankie. It is because we fail, at some very fundamental level, to grasp the fact that other people are as human as we are.

So as a civilised, affluent country, what do we do with people like Frankie? A Tory MP has recently argued that homeless people need to be 'eliminated'. He didn't say how he thought this elimination should be carried out, but I am willing to bet that it won't be by providing them with houses, which would probably be the most straightforward method.

It is easy for those of us who are hard-working parents who do only what is right for our children to completely fail in our understanding of what life is like for those children whose parents have failed them. Unfortunately, there will always be arseholes in the world. There will always be parents who abuse their children and children who therefore grow up without the ability to survive in a tough world. Their best chance at remaining safe is simply for the state to provide them with housing and food until their (usually) short lives are over. By removing or cutting their benefits, people like Frankie or like Katie from I, Daniel Blake will not miraculously go out and get jobs. They simply cannot do it. Instead, by removing or cutting their benefits, the government takes one step closer to rendering these people homeless, and brings the end of their lives ever closer.

For this, and many other reasons, I will always, always, vote for a government that will rebuild the welfare state and leave it intact.

Being Human: Into and out of Climate Despair

According to a recent Facebook quiz, I am 20% hippie. I’m pretty sure I only accrued those points because I said I would prefer water from a stream to a tequila slammer. I do not live in a yurt in rural Devon, or have my own smallholding; the most I have ever grown myself is a pot of basil; I drive a car; I eat meat and fish; I fly sometimes; I’ve had two babies; they both wore disposable nappies.

            So I am not a tree-hugging hippie. All I really have is a deep love of the Lake District and an awareness that there is a link between walking for miles in nature and an increase in mental well-being. That’s it.

            My interest in climate change came when a friend mentioned with some despair how apathetic and ill-informed most people seemed to be about the issue. So I decided to read about it.

            I was expecting to find debate. I knew about the climate controversy. I’d heard arguments against the primary cause of climate change being humans blasting billions of tonnes of CO2 into the air. I knew some people said it was the sun and others said it was because of natural cycles and others said climate change wasn’t happening at all.  

But I didn’t find debate. What I found was the history of a battle between scientists and non-scientists. Among scientists, there is no debate about climate change. A consensus exists of 97% that climate change is human-caused and will be catastrophic if we don’t take action now.[i]

The debate is among politicians, the oil industry and, as a result, the public. When climate change first became an issue in the 80s and 90s, huge amounts of money from the oil industry were poured into George Bush's quest to 'discredit the science'.[ii] The people who carried out the research were intelligent individuals, but they were not scientists. They pointed out that the earth’s climate has always changed, that the activity of the sun affects the climate and put forwards other reasons for the rapid rise in the earth’s temperature that have all been proven wrong by scientific research.[iii]

Many commentators now compare political denialism to the tobacco industry's attempts to discredit the proof that smoking was linked to lung cancer. This denialism has become part of the public psychology of climate change, but it has no basis in science. Every scientific body and academy in the USA has produced a statement that that human-caused global warming is happening.[iv]

I went on reading. I read how politicians blundered their way through two decades of mounting evidence that climate change was the greatest threat humans now faced. George Bush refused to believe the science and as result, when world leaders met in Kyoto in 1997 to try and stabilise the global climate by cutting CO2 emissions, the USA refused to sign up. His approach to climate change echoed Ronald Reagan’s before him, who referred to climate scientists as ‘a bunch of tree-hugging hippies’ and asked, ‘How many trees do you need?’[v] In fact, the only politician in the 1980s who fully engaged with and respected the science was Margaret Thatcher, whose degree was  in chemistry and who was a practising scientist before entering politics. She predicted, when she left office in 1991, that ‘the environment would become the dominant theme of politics in the twenty-first century.’[vi]

            Years went rolling by. There were discussions by world leaders about what to do, but with nearly 200 countries joining in, all with conflicting interests, agreements could never be reached and crucial summits ended in deadlock. Scientists, in the meantime, went on researching. The world went on not listening. More and more arguments against climate change appeared in the international press and on the television. The public zoned out. Even those who accepted the science turned away from it because the problem was too huge. There was nothing they could do, except wash out a few yoghurt pots, and what good was that when – Oh, my God, have you seen the size of the average American car?

            But then things started happening. Freak weather in Britain, droughts in California, typhoons, hurricanes, floods, English roses budding in December. People began to link these events to the possibility that climate change had arrived.

            But still nothing was done. World leaders went on meeting, negotiations went on failing. Politicians from those countries most immediately affected by climate change wept openly when, at the Copenhagen Summit in 2009, just after Typhoon Haiyan had struck south-east Asia and killed 6,300 people in the Philippines alone, no agreement to curb carbon emissions could be made.

            Climate scientists despaired. There had now been three decades of inaction and the world was changing drastically. Nothing they could say seemed to change anything. They put the message out that the climate was changing and would have desperate consequences, but the world was not going to hear it.

            What now existed was a huge gap between what scientists knew and what the public understood about climate change. Very few people realise just what was at stake in the Paris talks. Anyone could be forgiven for listening to Barack Obama’s speech and thinking the man had come over hysterical.

            This was the point the world had reached when I started reading about climate change. I had no idea, when I picked up the first book, what awful knowledge awaited me.

To date, the average global temperature has risen one degree since pre-industrial times. The Climate Change Summit in Paris began as an attempt by world leaders to restrict the rise to 2 degrees by 2100. Beyond such a rise, the impacts of climate change will no longer be dangerous, but catastrophic. Even if the average global warming is limited to 2 degrees, areas that are today home to 280 million people will slip under the waves.[vii]

However, based on global emissions levels of the last ten years, together with the three decades of inaction that they presumed would continue, climate scientists have been saying that we are on course for a rise of 4 degrees in the average global temperature by the end of this century. If this were to happen, it is unlikely that any life at all could exist on Earth.

We have reached a point of crisis in the human inability to live with the natural world. Since 1970, the planet has lost half of its wildlife population. This is an unprecedented rate of extinction, due not just to climate change, but to deforestation, which in turn increases the rate at which the planet warms.

The Amazon Rainforest is home to half of the wildlife species on Earth and is being cut down at a rate that means extinctions are happening rapidly – so rapidly that scientists are now calling the period we live in The Sixth Great Extinction. In none of the other five great extinctions in the Earth’s history have extinction rates been this quick.

The impact of deforestation on the earth can be seen from space.

 

  There can be no question that the earth is suffering at the hands of its dominant species. Humans are intelligent, but ultimately, not yet intelligent enough to be able to live with other life forms. Unless we can work together to stop it, we will soon begin the very real process of grieving for a planet.

            James Lovelock, the  brilliant, independent scientist who developed the Gaia Theory of Earth, has put forwards his view about how humans will change. He wrote his book A Rough Ride to the Future at a time when a 4 degree rise appeared to be inevitable. His vision is that the coming catastrophe will result in the global population being reduced to around one billion. He predicts that human survivors will live in air-conditioned cities and around them, the natural world will flourish. Tropical forests will rejuvenate, wildlife will thrive, and out of environmental catastrophe, humans will develop planetary wisdom. They will be able to sense, think about and act upon any behaviour that could be detrimental to the well-being of the planet. He sees climate catastrophe as a major step in the evolution of humans towards true intelligence and the ability to share the world with other species.

            Since Lovelock’s book was published, the leaders of 200 countries from across the world have met in Paris to discuss once again their ambitions to keep the earth from warming beyond 2 degrees. This level of warming would still result in food shortages, still result in freak weather and floods, and still result in a loss of land mass that will displace millions of people. It will result in an even greater loss of wildlife than that which has already been seen. But it is better than 4 degrees.

            However, last week world leaders somehow managed to come together and agree that they would not let this happen, if they can help it. They changed their ambition from a 2 degree rise to a rise of 1.5 degrees. There is a long way to go, but the world has started to pull together to try and prevent catastrophic climate change and ensure the survival of the human race. The deniers of the 80s and 90s have gone from politics. Everyone is on board now.

            Last night, I watched the final episode of David Attenborough’s documentary The Hunt. He addressed some of the issues we are now facing. He talked about the Indian tiger population – once 300,000; now 2,000. But tigers have become an Indian triumph. Not long ago, they were almost extinct. One of the reasons for this has been that as the human population of India has grown, people have expanded into the tiger’s habitat. Forests have been cut down and the space tigers need to hunt is limited. To combat this, the Indian government has paid humans to move out of the countryside and into the city, so that tigers can own the forest again.

            Similar things are happening in Africa. Humans, instead of killing lions, are beginning to move away from the wilderness and into the city and lions are making a comeback.

            Among the horror, good things are happening. Fringe groups of environmentalists have always worked hard to protect the natural world, but as the natural world recedes, these groups are growing, with the aim of bringing it back to us. All over Africa, huge groups of young conservationists are forming, determined that the continent’s wildlife will survive the human impact upon it.

As I watched this documentary – the movement of people to cities so the natural world can thrive again, and the steady determination of people to prevent greater crisis – I was reminded of Lovelock’s prediction. The future for humans will be in the cities, and we will be able to live with, not against, the natural world. This vision already exists in Japan.

The decision of world leaders to finally come together and pledge to bring us back from the precipice we are now at might be looked back on as  a turning point in  human evolution. The rest of this century will see the drama of climate change played out, but if the world co-operates as leaders have just pledged, time will also see us working together, so that as one disaster strikes, another might be averted. And always, we will be taking certain steps to a better world, a better state of being human.

 

 

---

[i] The Union of Concerned Scientists, http://www.ucsusa.org/

[ii]  Kyoto Protocol Climate Conference, http://www.globalissues.org/article/183/cop3-kyoto-protocol-climate-conference

[iii] http://www.skepticalscience.com/tcp.php?t=home

[iv] NASA, Global Climate Change, http://climate.nasa.gov/scientific-consensus/

[v] Quoted in Don’t Even Think About it: Why our brains are wired to ignore climate change by George Marshall

[vi] Quoted in A Rough Ride to the Future by James Lovelock

vii NASA, Global Climate Change, http://climate.nasa.gov/scientific-consensus/

Birth

Bonnie

The doctor pulled out her tape measure and serious expression, but surely couldn't expect me to find them alarming anymore.  In much the same way that other women come to hate the smell of tea, or the sight of their partner, my pregnancy had brought a vicious loathing of measuring tapes.

            At twenty-eight weeks, I'd gained about five pounds.  I couldn't even claim self-denial as the reason.  Since the moment of conception, I had given in to every sugary feast the little girl inside me demanded: dolly mixture, candy shrimps, sweet cigarettes . . . My partner despaired and brought me oranges.  But pregnancy was my place of accidental rebellion.  I went to Waitrose for salmon and green vegetables, and stopped on the way home for a Big Mac and fries.  In those first twelve weeks, when what I ate was crucial to my child's brain, nervous system and . . . well, everything, I could stomach only crap.

            My Dail Mail-loving grandmother rang me at ten weeks with the news: What happens in the womb dictates how well a child does at school.  So there it was.  Failure.  Already.  Probably just as well – a university education these days is about the same price as a continent, and we didn't even own a house yet.  But still, the Mail's allegations of a candy shrimp effect haunted me.  I played plenty of Mozart in the weeks that followed. 

            But time wore on, the sickness passed, I managed to spend the first two weeks of August walking Coast-toCoast across England, and brown rice and pasta found their way back into my life.  In October, we had a scan.  Casually, they mentioned a low-lying placenta.  Then they mentioned a girl.  A girl!  Huckleberry became Hucklebetty.  Tentatively, I bought her some clothes and arranged her a husband.

            And then the third trimester was upon us.  There was a suddeness to this.  Without warning, despite the minimal weight gain and the barely-visible bump, I could no longer bend over to put my shoes on.  I was shocked to find I could hardly walk for ten minutes when just a few months ago I'd gone 192 miles, and then the baby's feet lodged themselves beneath my ribs, meaning that I spent most of my time lying flat on my back with my arms above my head, telling myself it would all be worth it in the end.

            And this, right when my body was failing under the weight of its baby, was when the midwife began to arm herself with the tape measure.  At every appointment from then on, she would apply it to my bump, frown and say, 'You're measuring [insert any number between four and eleven] weeks smaller than your dates.'  And off I would go for a scan, and another scan, and another scan, until I began to feel we were invading the baby's privacy.  Everything about her was displayed on screen - heart, brain, liver, spine -  raw, vital organs that were meant to be wrapped in skin, unseen.  And then the sonographer would shatter the energy I'd put into nights of worry and say,  'I have no concerns at all about this baby.  Is there anything you'd like to ask?' 

            Yes. 

            'Is she ginger?'

            She laughed a dainty, stern kind of laugh that immediately left me chastised by the entire NHS.  I shouldn't be so flippant in the face of my baby's health.  Two-weekly scanning was serious.  But I knew by now that the baby was fine, and I was getting quietly resentful of these constant, unnecessary dramas.  My baby was there inside me, active as oceans.  And every week, in feisty foetal defiance of the measuring tapes, her movements grew larger and stronger.  I was shutting down now.  I was refusing to be concerned.   

            And yet here I was again, a day after the last scan, facing yet another medical professional and a tape measure.  As baby-monitoring went, it was a pathetic and archaic piece of equipment, like a leftover from days when women carried sewing baskets and no doubt measured their bumps to relieve the tedium of darning stockings.

            'You're showing twenty-nine weeks' growth instead of thirty-seven.'

            'I know.'

            'But I'm not worried.  You're smaller than average, so it's likely you'll have a baby who is smaller than average, too.'

            Shock.  A new simplicity.  It took me aback.

            She continued, 'But your most recent scan shows you still have a low-lying placenta.  It finishes just two centimetres from the cervix.'  The serious expression grew a shade more serious and she looked me straight in the eyes. 'This means you will have to deliver your baby by caesarean section.'

            Oh, hallelujah.  Oh, thank you, God.

            Frankly, I had never, ever wanted to deliver a baby by any other means.  The condition – fear of childbirth - is called Tocophobia, and generally not taken seriously (women have, after all, been doing this for thousands of years – ok, some used to die, but these days most survive to tell tales of agony, forceps, tearing, stitches, a worn-out pelvic floor and a lifetime of incontinence).  It's the result of many factors, ranging from too much Casualty back when social angst forced a teenager on the sofa every Saturday night, to a more serious fear of violation and also, probably, of death.

            The doctor, now thinking she was breaking the devastating news of how I was about to be denied my lifetime's desire to push a giant human head through my fanny, had obviously not read my notes.  Somewhere towards the front was the correspondence I'd had with the consultant obstetrician two years previously, where she and I and a counsellor had decided together that the best – in fact, the only – possible way for me to have the baby I was too afraid to even conceive was by granting me an elective caesarean.

            It was a fact I mostly kept to myself, from fear of the NCT.  But now here I was, being handed an excuse, a reason for opting out of natural birth and escaping judgement from even the most pro-vagina-busting of birth fanatics.

            The doctor carried on talking.  'Low-lying placenta is a life-threatening condition.  You are at high risk of haemorrhage and need to be admitted to hospital before the birth of your baby.  If your placenta ruptures, you could lose all your blood in ten minutes, so we need to keep you near theatre and make sure we've cross-matched enough donor blood.'

            I laughed at this.  The doctor nodded sympathetically.  Obviously, I was hysterical, a little in denial, a little in shock.  I shrugged.  My blood group was an uncommon one.  There was no way they'd save me. 

            I could have got anxious, except that I didn't believe it.  Any of it.

            The doctor left the room to speak to the consultant.  I sat and waited, ten minutes from death.  There was something quite giddily bleak and Victorian about it. 

            She came back.  'The consultant says everything's fine.  You can go home.  We'll see you in two weeks for the birth of your baby.  Make sure you don't have sex in the meantime.'

            So I went home, stopping on the way to buy an industrial-sized pack of maternity pads from Mothercare.  It seemed like the only thing to do, as I am a believer in preparation for major dramatic events, and my partner would never deal with the demands of mopping up eight pints of blood.  He can barely assemble a chest of drawers without vast unnecessary mess and a need for anger management training. 

            Placenta Previa.  It came with a list of instructions, the most important being not to go into labour.  My caesarean section was booked for Friday, 19^th February, and all I could do was wait for the date to roll around, and take an optimistic view.

           

As ever, Valentine's Day went unmarked in our house, but Pancake Day was another matter altogether. 

That night, I ate:

2 pancakes with lemon juice and sugar

1 pancake with pineapple  

1 pancake with lemon juice, sugar, pineapple and maple syrup

            Afterwards, I couldn't move much.  I read a chapter of a novel.  I wrote a Facebook status update:  'When pancakes are competing with a full-term baby for space inside you, you know you've eaten too many.'     

            I went to bed, full of pancake remorse.  My partner fell asleep in minutes.  I lay there for a while, then got up.  Oh.  Water everywhere. 

            A hand on my belly, and the baby was even closer, just there beneath my skin.  From the bathroom, I called my partner.  'We need to go to hospital.  My waters have broken,' I said, and sounded calm.

            'Ok,' he called back.  Then he appeared naked on the landing.  'What do we do?'

            'We go to hospital,' I told him.  I shook a lot as I spoke.  I was hours away from major surgery.  I'd planned the next two days to prepare myself for it and now, the days were gone.  I thought about labour, and continued to shake.  I rang my mum, who was asleep.  'Don't worry' she said groggily. 

            It was 12.30 by the time we left, and from the car I sent text messages: to the friend who was meant to be coming for lunch tomorrow; to the other friend who worked in a pub and might still be up; to my step-mother.  Courage, said the friend who was meant to be coming to lunch.  Having delivered a premature, 1lb 8oz baby ten months ago, she knew what she was talking about.  The others all stayed silent.

            When we got there, the hospital's maternity unit was in full swing.  They took us to a room in the delivery suite, and I thought what a nice touch that was – to call it a suite, as though they wanted me to think I was in a hotel, rather than a human abbatoir.  In the rooms all around us were women in various stages of labour – some were lowing, others wailing.  Some noises were indescribable, and not human at all.  I opened the door to head for the bathroom and immediately shut it again as I caught glimpse of a poor, wretched woman being walked round the corridors, a midwife on each arm, sweat bouncing off her face like hailstones.

            The Delivery Suite certainly won the prize for being the worst place I'd ever spent a night – it even eclipsed the Sinai desert, back when I was 21 and convinced I'd been led there by a Bedouin tribe for no other reason than to feed me poisoned kebabs and steal my spleen.  At least then I was seeing things through a haze of drug abuse. 

            'Thank God I don't have to do this,' I said to my partner.

            He agreed.  Thank God.  But then there was football on the telly, and his experience of the Delivery Suite became quite different to mine.

            A doctor came and put a canulla in my hand, so I was ready for the caesarean whenever they decided to do it.  Then a midwife  came in and  wired me up to a machine that monitored the baby's heartbeat and my contractions (excuse me, but I was never, ever meant to have these – not even for a minute, not even one).  'I've spoken to the registrar on duty.  Because of your low placenta, he doesn't want to do the caesarean until daylight hours.  It won't be for some time yet.'

            I checked the time.  1.30am.  Oh, God.  'Why?' I asked, and caught the pathetic note of desperation in my voice.

            'Because of the risk of heavy bleeding.  We need a full team of staff on to deal with a dangerous procedure.  Now, you're unlikely to have strong contractions between now and then, but let me know if the pain gets severe.'

            She left the room.  I turned to my partner.  'When does it get light?'

            'About eight.'

            Jesus.

           

The pain kicked in around 3.15  I walked.  I breathed.  I did not moan.  I walked.

            It was ok.  It was fine.  I walked.  I breathed.

            3.45.  I returned to the room.  I hadn't prepared for this.  I'd paid a small fortune for a hypnotherapist to deliver messages to my subconscious about the jubilant beauty of being butchered by a surgeon's knife, but I'd done nothing at all to deal with natural labour, except arrange a way out of it. 'It's getting quite bad,' I said stoically.

            'Maybe you should tell the midwife.'

            'No.  I think it's ok.'  I decided to time the frequency of the contractions.  One . . . 4.00 . . .

Two . . . 4.02.  'Actually, maybe I will tell her.'

            I found her sitting behind the desk at reception, humming cheerily to a song on the early-morning radio.  This was mildly annoying – that someone could sing while I was in pain.  Ok, not bad pain, but pain nonetheless, and a pain I hadn't signed up to.

            'This is hurting,' I told her.

            She barely looked up.  'I cannae examine you.  You've got placenta previa.  It could cause a haemorrhage.'

            'When can I have the caesarean?'

            'It won't be til at least 9.30.  I suggest you go back to your room.'

            'Can I have some water?'

            'No.  You cannae have anything before an operation.'

            'Nothing?'

            'Nu-uh.' 

            I went back to my room.  My partner opened his eyes.  I had a few contractions.  I went walking again.

            The midwife was getting tetchy.  I had interrupted her tea and toast with my breathing.  Goddamn you, woman.  I need water.

            'You cannae have water.'

            'But when I came for my caesarean preparation class, they said we could have water.'

            She shook her head.  'I'm sorry.  They gave you the wrong information.'

            'Can I just swish some round my mouth and spit it out?' 

            'No.  You cannae.  Go back to your room and I'll get the obstetrician to examine you.'

            Back I went again.  I was supposed to lie on the bed, but I'd developed a compulsive need to walk.  I paced the floor.  'There's not enough space in this bloody room.'

            My boyfriend smiled sympathetically.  He was lost.

            4.30.  The midwife returned.  'The obstetrician's on his way.'

            'Will he give me water?'

            'No.'

            She left again.

            'She's a bitch,' I said as she shut the door.  I expect she heard me.

            My boyfriend – who I admit is much, much nicer than me, but in my defence, was not in labour and being denied water at the time - looked genuinely confused.  'Why?' 

            I might have lost my temper, but the obstetrician came in with the midwife.  He was smiling, waving white gloves.  'Hello, Sarah.  I'm just going to see how far you are from going into labour, then we'll make a decision about when to do the operation.'

            I stared at them both.  'So is this not labour?  Is this just the beginning?  Because this is the pits.'

            The midwife nodded.  'Just the beginning, sweetheart.'  She might as well have added, 'You fucking posh wimp.'

            The obstetrician got to work.  I made a fuss.  He was, I felt sure, taking an unnecessarily long time over it.

            He stopped, looked at me, and said, 'You have a choice.  We can set up the caesarean section now.  It will take forty minutes to prepare the theatre, but we can give you something to stop  the pain.  But you need to know that the baby's head is clear of the placenta and you are eight centimetres dilated.  You can  have your baby naturally if you wish.'

            I looked ahead of me at natural birth – the pushing, the forceps, the head – the head! - the cord that always got wound their necks, the denial of oxygen to the brain and inevitable cerebral palsy, the tearing, the stitches, the shock.  'I want a caesarean,' I said.

            It was not the answer they were looking for.  But when presenting a woman who is eight centimetres dilated with a major decision, there is always a risk that she'll make the wrong one.  They went off to find the anaesthetist.

            I had another contraction, during which I flung my arms and legs wide across the bed, with some frenzied notion that the opening up of my body would be easier if I spread out and gave it space.  (Oh, God.  The pancakes.)  My partner took it as evidence of torture and stood back, helpless and guilty.

            The midwife and obstetrician returned with the anaesthetist.  Clearly, it had become the anaesthetist's job to talk me into Doing it Naturally.  'I can stop your pain in five minutes,' she promised.  'If you have a caesarean, it will take forty-five minutes.  Your baby is small.  Pushing won't be hard.  She'll be here in two hours.'

            Here we were again.  Not a tape measure in sight, and yet still all this talk of a small baby.  'How small?' I asked.  'Too small?'

            There were some words of reassurance, some more promises of drugs and an easy delivery.  In between the talk, I went on contracting.  'I can't make a fucking decision like this.'

            'By now, you will be nine centimetres dilated,' the anaesthetist said.  'There really is no point in having major surgery.'

            And so there I was, agreeing to natural birth, tricked by my own baby.

            Action!  Midwives appeared.  Someone offered me a wheelchair.  I laughed, 'I'm not a cripple.  I can walk.'  They looked a little doubtful, and held on to me during the short trip to the delivery room.  'This was a great decision,' one of them enthused.  'Really great.  You'll be able to drive, you can look after your baby.  It's the best thing.'

            I nodded.  

            They helped me on to the bed.  'Is there anything you want?'

            'Water.  I just want water and an epidural.'

            An entire jug of water appeared.  My partner poured me a glass and tried to administer it to my lips as though I were a frail old woman.  I grabbed it from him and downed it in seconds.  'More,' I gasped. 

            They wired me up to a drip.

            The anaesthetist set up the epidural – a low dose, she explained, just to take the edge off the pain, but I would need to feel everything in order to push the baby out.           

            'How long will it take to work?'

            'Ten minutes.'

            'I haven't got ten minutes.'

            Someone I hadn't met came into the room wanting keys to the cleaning cupboard.  I nearly lost it.  Tactfully, they ushered her away.  The epidural was administered.  The anaesthetist left.

            'Where's the anaesthetic lady?' I asked when the pain had worn off.

            'She's gone.'

            'I'm sorry I swore before.  You really haven't been seeing me at my best.'

            They checked one of however many monitors I was attached to.  I was fully dilated, but they wanted to wait an hour for the baby's head to descend before the proper drama could start.  My partner rang  my mum to tell her what was going on.  She was in the shower, so he spoke to my step-dad instead, who didn't ask enough questions, so my mum rang back.  We had a five-minute conversation while the baby's head – or was it just a giant shit? - started to come down.

            Afterwards, I lay there drinking water, feeling no pain and a lot of pressure in my pelvis.  But despite this lack of pain, I still, to my surprise, began to go slightly mental.  People were talking all around me - two midwives and one paramedic, who'd come for the experience of observing a birth.  My partner was somewhere, but I wasn't sure where.  He was probably hiding behind the drip.

            What I wanted to do was tell them all to go away – to go away and leave me to get on with this by myself.  I said, 'This baby's head has descended.  I'm ready.'

            Action again.  There was some suspense while we waited for a contraction, and then there I was, doing what I'd vowed I'd never do: lying on a hospital bed, my legs in stirrups ('because your pelvis is so small – we need to open it'), while my own personal squad cheered me on.  'Come on!  You can do it!  Push!'

            I pushed.  There was no way I could do this.  I didn't have what it took – whatever that was – to push a baby out of me.  I decided I just had to lie back, do what they told me, and see what happened.  What I was expecting, by this stage, was not a baby, but a shit the size of a horse.

            The drip dripped fluid into my veins, the catheter dripped it out again, and my squad went on cheering.  They told me I was doing brilliantly, but I wouldn't believe them – they were just words they said to everyone, to keep them going, to keep them all from sitting back and saying, 'I'm too knackered for this.'         

            There were more contractions, more pushes, and some bother with the baby's heartbeat.  The midwives were keeping cool about it, but the earnest paramedic kept asking questions.  'Why is the baby's heartbeat slowing like that?'  'What does it mean?'  'Is the baby in danger?'

            The midwife said, 'The baby is a little tired, and this monitor isn't doing a good job of picking up the heartbeat.  Sarah, can I have your consent to attach a monitor to the baby's head?'

            'Yes.'

            The monitor was attached.  The heartbeat was back.  We went on.  I caught sight of my partner out of the corner of my eye and apologised for not talking to him.  He said it was ok.  I made some more inhuman noises.  'Sorry about all this,' I said again to the midwives.  'I don't usually sound like that.  But this really does feel like the very worst case of constipation anyone has ever had.  Am I getting anywhere?'

            'You're doing brilliantly.'

            Someone asked me if I consented to something else, and something else.  I had no idea what they were talking about.

             'I consent to everything,' I told them.

            The midwife and the paramedic went on talking about the heartbeat.  The other midwife kept cheering.  I pushed.  'Come on, Sarah!  You're nearly there.  You're nearly there.'

            I didn't believe them.  Then suddenly my partner appeared amidst the throng of heads between my legs.  'You are.  You're nearly there,' he said, and so it became true.  I was nearly there.

            'We need to get the resusitation table ready,' someone said.  Then she said, in soothing tones, 'Sarah, your baby is getting tired, just like you are.  We need to get her out, so with the next contraction, I'm going to make a little cut . . . Do I have your consent to this?'

            I saw the scissors.  I said yes.  She administered a local anaesthetic.  The contraction came, the scissors got to work, I pushed, and a baby fell out of me.

            It was over.  I looked up.  My partner was crying.  He cut the cord.  He went on crying.  I handed him the corner of my sheet.  A voice said, 'Look how quickly she pinked up.'  They took the resusitation table away.  There was no need for it.

            'Do you want her skin-to-skin?' the midwife asked.

            'Yes,' I said, and a baby appeared on my stomach.  My partner couldn't talk, but he did laugh.  I couldn't see the baby's face, and there was no way of adjusting her, because my legs were still in stirrups and I had a drip in my arm.  I studied her feet.  They were long and thin.  'She has piano playing toes,' I said.

            The midwife who'd done the episiotomy said, 'I'm sorry about that ending.  All we have to go on is what the machine is telling us, and it's not always reliable.'

            'That's ok.' 

            Someone came to stitch me up.  The earnest paramedic watched and was given a lesson: Degrees of Tearing in Labour.  The woman with the needle and thread talked about everything in detail, from first degree tears (skin only) to fourth (skin and muscle all the way to the rectum, requiring reparative surgery in theatre).

            'And what sort of tear is this?' the earnest paramedic asked.

            I said, 'Do we have to talk about this?'

            They stopped talking about it.  The earnest paramedic then said, 'You're doing an excellent job.'

            The woman with the needle and thread spoke with great pride, 'I've been doing this for thirty-five years.'

            Thirty-five years of stitching up fannies. And I thought I'd had some bad jobs.

            They weighed the baby.  6lbs 1oz.  'Is that big enough?' I asked.

            'It's perfect.'

            I waited for the ecstasy, the near-insane high that I'd been told comes in the delivery room and then never wears off.  It didn't come.  What came instead, and settled, was utter, deep-soul calm because my baby was beautiful and healthy and here. 

            'What are you like?' I wondered.  Almost immediately, people had started imposing a personality on her.  The shock of her arrival made her feisty, in charge.  The lack of crying made her contented and laid-back.  The drama at the breast – that vigorous, frenzied, wild-eyed sucking from which she gained over a pound in two weeks – made her slightly bonkers.  She was all of these things, and she was none of these things.  She is Bonnie.  A clean slate, entirely herself.