Kate Atkinson

Kate Atkinson

Dear NHS,

Thank you for the drugs. I don’t know if you can get them any more – probably not – but they were good. Trust me, I’m not a doctor.

I’m talking here with particular reference to childbirth, how it used to be back in the Stone Age or, to be more precise, 1974, because the older I get the more my past feels like living history. So this is how it was then.

In my defence here, I’d like to point out that I was very young in 1974 and had no idea about anything, but particularly not babies. I had never held a baby; I’m not sure I’d ever even seen a baby. We lived in a cottage on a farm in Fife with one dog, two goats, five cats, six chickens and quite a lot of rats. I swear to God that I genuinely thought having a baby would just be like getting another kitten. I didn’t even have a washing machine, it was my mother who pointed out to me that I probably needed one and it was my mother who bought it as, I’m ashamed to admit, she bought nearly everything the baby needed. Those were my careless days.

My mother had given birth to me in a private nursing home in order to draw a discreet veil over my illegitimate status (it was 1951). She spent what was then a standard three weeks in the home, mostly in bed. It was the middle of a very cold winter and she came out with chilblains and a conviction that I had been accidentally swapped with another woman’s baby. ‘I’m sure I know who your real mother was,’ she occasionally said to me when I was growing up. I always suspected I had the wrong mother so I guess that made us evens.

Maternity care had evolved by 1974, but perhaps not much. I had one antenatal check-up and one scan, that was it. Nobody took their scans home and cooed over them in 1974; nobody considered trying to find out the sex of a baby. Nobody was obsessed with natural childbirth. Babies were just something that happened to people. I did have a book (of course I had a book). It was titled something like Having a Baby and I had been about to read it when I went into labour three weeks early.

The most troublesome thing at the time was that we lived on the other side of a very wide river and the only way to cross it was by a toll bridge, so we had to spend some precious time scrabbling around looking for change. (We were not just young, we were also poor.) Looking back, I’m pretty sure that they would have let us over without paying, but you never know. She could have been the first baby born with ‘Tay Bridge’ for ‘place of birth’ on her birth certificate. Because she was a girl – something that I had been one hundred per cent convinced of from the very beginning. (I’m pretty good at predicting the sex of a baby, one of my many wasted minor talents.)

I know what I was wearing when we eventually arrived at the hospital – a long, black, velvet cloak. It drew some odd looks. I had been married in it too. Everyone got married young in 1974. I had two favoured items of clothing during the later stages of pregnancy – both long cotton nightdresses made for my grandmother when she was visiting her war-bride daughter in Canada in 1948. We weren’t hippies, just students who didn’t know any better.

It was the middle of the night by the time we crossed the bridge. A solitary midwife was in attendance when we arrived at the hospital; she was Irish, middle-aged, red-haired. I can see her now. Don’t worry, we’re getting to the drugs.

Pethidine! A strong opioid. No consultation, the midwife just whacked it in. I’m looking at it now online – I have four contraindications to taking it. Four. It was great, like Valium, but better. It was four in the morning, the time of least resistance. And magically, after hardly a twinge of pain, there was a baby. A baby! I think I was still half expecting a litter of kittens.

The midwife, the most focused woman I’ve ever encountered, let her brain go off shift immediately. ‘It’s a boy,’ she said. I shot up, despite the strong opioid, and said, ‘No, it’s not.’

‘Oh, you’re right, it isn’t,’ she agreed and disappeared, never to be seen again. She was replaced by a doctor, the first and last time that I saw one that night. A man, needless to say. (Again – 1974.) He arrived just in time for the pethidine to have worn off. He ‘sewed me up’, anyway. I didn’t even realise I’d had an episiotomy until that moment, thanks again to the pethidine. Being sewn up without an anaesthetic ten minutes after you’ve given birth is bad! Very, very bad.

But then it got good again because, in those days, they kept you in hospital for a whole week (no MRSA to fear then). They didn’t care whether you got out of bed or not and brought you endless milky drinks and biscuits and they took the baby away every night and did God knows what with it. We mothers certainly didn’t know because we were given a very strong sleeping tablet every night. Amazing! It was the only time I’ve ever had sleeping tablets and it was lovely. You just floated off until you were woken with tea and toast the next morning and handed a placid baby that had obviously been pumped full of formula all night.

I was on an old-fashioned, fourteen-bed Nightingale ward and I was the only one breastfeeding. That’s 1974 for you. You can imagine it’s quite difficult to breastfeed when you’ve had pethidine (breastfeeding being one of those contraindications), as well as sleeping tablets and said baby is already being clandestinely bottle-fed. If only I’d had time to read that book I might have known these things, might have put up a weak cry of protest. But, dear God, those were the seven best nights’ sleep I’ve ever had. So, thank you, NHS.

Second time around, 1981, was a different world. In and out in twenty-four hours, no drugs, just yoga breathing, no episiotomy – I seem to remember shrieking, ‘Don’t cut me!’ to someone. And I didn’t need a book because I’d had that first baby to practise on. Still, 1974, I salute you.

Kate x

P.S. Thanks also for the penicillin that probably saved my life in 1958 and then again in 1972. And probably 1999 as well.

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