Feature / Short Story and Poetry Contest / Summer 2011
Delivered

Read the Winner and Readers’ Choice favourite in the 2011 Alumni Short Story Contest


Photo: Getty Images

Kat placed her hands, palms warmed, gently on to the heaving belly. We never should have let Christina wipe the board clean, she thought to herself as the woman before her trembled, a wave of pain rolling from her. Something was wrong. Kat looked at the fetal heart rate monitor, everything seemed OK, not perfect, but OK. It was too much too fast, that was what nagged at her. The woman before her had gone from mild labour to severe pain in very little time. Kat tried to piece together what was happening. Working labour and delivery had a way of tucking doubt and magic into the fog of late-night shifts and Kat’s superstitions began to rise in her.

The winners of the 2011 Alumni Short Story and Poetry Contest are Brittan Coghlin (BScN 2007) for her story “Delivered” and Emily Swinkin (BSc 2010 Victoria) for her poem “The Children of Fishermen.” Coghlin and Swinkin each received $1,000.

Our judging panel selected “Maquila Bird,” by Laura Rock (BA 1986 St. Michael’s) as runner-up in the story contest and “The Mynah,” by Laboni Islam (BA 2002 UC, BEd 2003 OISE) as runner-up in the poetry contest.

In online voting, readers also selected Coghlin’s story “Delivered” and Swinkin’s poem “The children of fishermen” as their favourites.

About the Judges

That night had dragged on with no patients showing. Any woman that arrived was always noted up on a chalkboard roster for the unit. The last patient’s name had been left on the board, even though she had been delivered hours before. Christina, badly tinted hair and lips pressed firmly in a tight line, had jumped up from her stool by the bank of monitor screens.

“I’m cleaning the chalkboard,” she’d said. Numerous objections erupted from around the desk. Everyone believed that wiping the board was tantamount to calling forth disaster. Kat remembered the last time the board had been cleaned, a woman came in psychotic from pre-eclampsia, she’d seized and then died.

Christina had picked up the brush anyway, she’d cleaned the whole board down, it gleamed at Kat, naked and unpredictable. It was only an hour later when Serena had walked in, already 5cm dilated and ready to crawl out of her skin from the pain.

Kat approached Serena with a practiced quiet, movement like someone coaxing a wild animal, every muscle careful. Her fingertips traced the baby’s head under Serena’s skin, it was low and facing down. The skin grew taught, a contraction stretching and tearing flesh within. Kat’s fingertips waited, the skin did not slacken. There was no reprieve for several minutes. Kat listened to the galloping heartbeat from the fetal monitor.

“Is everything OK?” Serena’s husband, Gerard asked as he stroked his wife’s hair. Serena was  shaking again. “Should she be doing that?”

“Totally normal,” Kat replied. Her responses had become automatic over the years. Kat turned up the volume on the heartbeat. It was a sound she heard in her sleep and the undertone of her waking hours. Thump thump, thump thump, thump thump. A baby’s heart rate is fast and insistent. The next contraction took Serena again, her back arching, her eyes distant, lost in the excruciation. The baby’s heart rate dipped, it formed a long U shape on Kat’s monitor and recovered slowly.

“I wanted to do this naturally,” Serena said as she recovered. She looked at Kat imploringly, as if there were some secret that Kat was withholding from her. Kat watched the screen, waiting for the next contraction.

Serena’s words sat lumpy and cold in her stomach. Kat was tired of most everything these days. Shifts seemed to drag at her feet and pull on her lower back. Innocent questions grated on her nerves. Birth was not something you could plan, but women insisted on trying, on itemizing and prioritizing their experience. They were afraid the doctors wouldn’t hear them. But life, Kat knew, was just too messy.

Kat watched Serena try to cope with the next contraction. Serena gave off a controlled scream and writhed beneath Kat’s palms.

“It feels like my uterus is ripping apart!” Serena said as she jumped up towards the head of the bed, unsure of what else to do but move, as if she could outrun it.

“Take some breaths with me,” Kat urged and exaggerated big deep breaths, encouraging Serena to follow along with her.

Serena was not getting through the contractions anymore, Kat could feel her starting to unravel, could see her mind starting to unhinge from the pain. Kat herself felt bloated and stiff, she felt exhausted. Fuck Christina, she thought as she looked at the clock.

It was 4:00am and Kat hadn’t been able to sleep throughout the day before her shift. She recalled that at home that morning, she had bled a lot more than ever before. No clots this time, the  fetus had been too early. She had looked for them in the toilet bowl when it was all over. She couldn’t see anything. She had tried, had wanted to see what she’d lost, to make it real.

The memory was searing and Kat shook her head, trying to come back to Serena and her job. She sat on the edge of the bed, Serena’s legs were bowed and pushed up around her hips. Kat reached inside Serena, her fingers grazed a small tuft of hair and slid around to find that, yes, the baby was facing down, right where it should be. Serena had also dilated even more, the baby was coming soon.

“I can feel your baby’s head,” she said. The couple looked to one another with awe. It made Kat retch a little, vomit coming up into her throat, she choked it down. She heard the baby’s heart rate dip again, the slowed thumping instantly caught by her ears, her ears that were always listening, tuned in to the beating. She tickled the top of the baby’s head, the heartbeat stayed slow. Kat got Serena to move around, she opened up her IV, she did everything she knew to help the heart recover, it continued to thud slowly, deafeningly, as another contraction drew tight around the baby. Finally, Kat rang the call bell and asked for the on-call doctor.

“What’s happening?” Gerard asked.

“The baby is just having some trouble with the contractions, I want it to be checked out,” she said, scribbling down the events of the last few minutes into her notes.

“It’s going to be OK, right?” Gerard asked, squeezing his wife’s hand as she opened up into a star-shape on the bed, the pain sending her limbs in all directions. Kat pretended not to hear the question, she watched the beats on the screen, they were intuitive to her, like reading lines of music.

“The baby is a girl,” Serena spoke up between gasps, “we’re going to call her Cara.”

The operating room lights glared at Kat as she hooked Serena’s intravenous bag up by the table. It was now 5:00am and Kat could feel the weight of sleep following her every step. She had just rushed down the hall with Serena on a stretcher. Christina was scrubbing in and Kat was preparing Serena for her C-section. Serena was crying a little now, she was scared and Kat tried to keep her calm, she held her hand and breathed audibly, in and out, it was one of the few things she could offer women. Just keep breathing.

The team splayed Serena out naked on the operating table, strapped her arms down as if laying her on a cross, her large belly continuing to tense and seethe. She started to shake again, her whole body wracked with a deep cold in the stark room. Kat took out a warm blanket and wrapped it on top of Serena’s shoulders.

“The OR is cold, the shaking is normal,” she soothed. Serena’s eyes were darting around the room and Kat felt for the first instant a moment of empathy, a moment of connection, she held Serena’s glance and spoke in a whisper. “Everything is fine, I’ll bring Gerard in soon, we’ll all meet Cara together.” Serena nodded.

It was these rare moments that brought Kat in to work each day, despite her fatigue, despite how the babies made her ache, how they made her feel rejected. Her own uterus barren, empty, it often felt hollow inside like someone had scraped it clean. Sometimes she saw it in her mind, like the inside of a carved pumpkin, all the pulp scooped out. She couldn’t help but feel a sense that the women she helped through birth were more worthy, they were softer somehow, plush and open. Like gardens in bloom, bursting with papery, fluttering flowers.

Kat had grown hard and closed, she found it difficult to recall her early days as a nurse, the way she had felt a kind of presence coaxing her to call forth life into the world. There had been beauty back then and power, a feminine divinity in her hands and the world a place of wonder. That was before the miscarriages, before she lost the first, the one she was going to call Grace. And then there had been three more, each one draining her of faith, sucking creation out of her.

The resident came in then and painted Serena’s belly with antiseptic wash. Kat pulled up drapes around the table so Serena couldn’t see when the doctors cut into her. Serena’s eyes followed Kat around the room.

Christina looked over at the heart monitor. “Something is wrong?” she asked from behind her surgical mask. Kat ignored her and walked over to push the call bell.

“Can you bring the husband in now?” she asked.

The doctor swung through the OR doors with Gerard behind her. Kat knew before they even opened Serena up that Christina never should have wiped that board clean. The doctor made a small incision at the base of Serena’s belly and then she and the resident reached their hands inside and pulled open the first layer of skin. It was better for tissue to be torn, rather than cut, and they proceeded in this way through each layer of flesh, down to Serena’s uterus. Kat saw them tear at the uterus, shearing it like a piece of wrapping paper.

“You’re going to feel a lot of pressure now,” she said to Serena, warning her of the sensation of the two doctors pushing down on the top of her uterus and simultaneously pulling up on the baby. Serena groaned then and winced, she struggled to catch her breath as if punched in the gut. Kat waited for the sound of a small cry. She still held her breath until she heard it, the first cry. She waited. The room grew silent, the air deepening into an abyss of quiet. Serena continued to groan and the doctors continued to pull and push, still, nothing.

“The baby is stuck in the pelvis,” Christina whispered beside Kat.

The doctors continued to struggle, blood spilled over the sides of the table and into the plastic gutters of the drapes. The doctors remained elbow deep inside Serena fighting with her body.

“The placenta detached?” the doctor asked in a whisper, Kat met her eyes, they were serious and direct.

“I can’t get her out,” the resident replied.

The seconds dragged on and Serena’s eyelids fluttered. Kat imagined that the baby was drowning inside and that Serena herself was bleeding out. They still couldn’t get hold of the baby. Gerard was patting Serena’s cheek gently, trying to keep her eyes open. The room was so quiet you could only hear the soft whirring of the suction machine.

“Fuck Christina,” Kat said under her breath. Kat felt in her gut that the baby would die, and possibly Serena as well. In the years before she would have asked for intervention from some unnamed force that she spoke to in her head, she would have pleaded to save them both. She didn’t do that this time, her belief in good was gone. Her own losses bearing down on her as Serena’s blood began to splatter onto the clean, white linoleum. She thought about Serena, about how she would mourn this child.

She herself had never had more than clots to mourn. When she’d lost Grace she had been in bed, the clots passing had woken her up, the sheets soaked in blood. Kat’s husband had come home from work that afternoon to find her, staring off the back deck, unblinking, unmoving, cradling the clots in the baby blanket her sister had mailed to her from Vancouver. When he’d tried to take it from her, she had flown into a rage. He’d cried and begged her to come inside. She wouldn’t speak to him. She stayed there all night, sheltering the blanket when the summer rain had come. Kat didn’t know how to mourn a clump of cells.

No, she had no faith. She didn’t pray or speak to anyone as she watched Serena’s body dismantle. Rather, Kat felt only the unraveling, a deep void that was swallowing the operating room and all of them there in it.

“Anyone have any ideas?” the doctor asked, her face exhausted.

“Let me try to push,” Kat said as she grabbed a pair of gloves. She wasn’t sterile, but no one else was free to do so. The doctor nodded, OK, and Kat reached up through Serena’s cervix, pushing Serena’s knees back as far as she could make them go at the same time. She felt the same tuft of hair on the baby’s head, the same rounded smoothness and she pushed and pushed. The baby’s head budged, and finally unlocked.

The doctor pulled her out up through Serena’s abdomen. Kat withdrew and grabbed a baby blanket, holding herself ready, knowing she’d see the baby blue and unmoving. She was ready to resuscitate.

Then there was a small cry. Kat took the baby to the warmer. She looked down, and saw her, pink and squirming, she cried out strong then, as if she’d had no trouble at all coming in to the world. Kat placed her stethoscope over the baby’s heart and heard the reassuring, thump thump, thump thump. The baby reached out at Kat. She looked completely healthy.

Kat wrapped her tightly in a blanket. Serena and Gerard were holding each other and crying on the other side of the curtain. She handed the baby to them. They greeted her joyfully. Kat left them and returned to work as the doctor stapled Serena’s belly. Kat dressed the surgical wound and began to clean up Serena’s body.

“That was a miracle that baby came out OK,” Christina said as they took down the curtain from around Serena.

Kat looked at the new family, they were huddled together and caressing each other. She watched the couple and felt no sense of awe or wonder, she couldn’t see a miracle. She felt only the cold creep back over her, sleep heavy on her eyelids and an ever-expanding emptiness. The baby cried. Kat left the room and erased Serena’s name from the chalkboard. In its place she scrawled: delivered.


Reader Comments

# 1
Posted by Bob McKeon on April 19th, 2011 @ 8:34 am

Very well written. I was reading and wanting more

# 2
Posted by Nancy McKeon on April 22nd, 2011 @ 11:08 am

Wonderful!!!

# 3
Posted by Irene Staron on April 25th, 2011 @ 7:53 pm

Riveting….the pacing of the events, the unveiling of the characters – a metaphor of birth itself…… you deliver as promised. I look forward to reading more of your work!

# 4
Posted by angelika pangemanan on April 29th, 2011 @ 8:10 pm

great story !!

# 5
Posted by Diana on April 30th, 2011 @ 1:20 am

Wow, at the edge of my seat. Wow

# 6
Posted by Maureen Dunne on May 18th, 2011 @ 10:01 am

Fabulous story – so many layers to be examined. The juxtaposition of two child-bearing experiences was brilliant. The tension between the professional and the personal was absolutely critical to the theme and the outcome. The tension between joy and grief was poignant without being maudlin. I couldn’t read it fast enough – totally engaging story. Congratulations on having written it and also for winning the competition.

# 7
Posted by Roy MacSkimming on May 27th, 2011 @ 11:03 am

A moving and memorable story. It has an emotional honesty, grit and directness that you don’t often find in literature.

# 8
Posted by Liz Hendriks on June 6th, 2011 @ 11:53 pm

Congratulations Brit! This story is absolutely beautiful and so very impressive. You are a true artist.

# 9
Posted by Elizabeth Bream BA,%205T8 on July 11th, 2011 @ 1:31 pm

Such a well-written story, so engaging. I really enjoyed reading it.
Congratulations on your win, and keep up the good work!

# 10
Posted by Joanna Holland MD%202001 on July 20th, 2011 @ 2:47 pm

That was beautiful and very real, and it hit close to home for me as I’ve been in a very similar position to your protagonist. I’ve passed this story on to several friends, all of whom have been moved to tears.

# 11
Posted by Scott Anderson on July 21st, 2011 @ 11:19 am

I was surprised to see a language warning in the print edition of the magazine accompanying Brittan Coghlin’s award-winning story. After reading her moving, painful prose, I was disturbed by it. Do the editors truly believe that the University of Toronto community is so sensitive that the presence of two expletives that expressed frustration in a painful situation requires a cautionary note? Some people don’t like profanity, but I shudder to think that anyone might have skipped over such a wonderful story for fear of being offended.

Jacob Schiff
HBA 2002

# 12
Posted by Emily on July 22nd, 2011 @ 5:22 pm

Very well written. My first child’s birth was very much like that one – the writing gave me shivers remembering.

# 13
Posted by Scott Anderson on September 29th, 2011 @ 3:12 pm

I was distressed to read the award-winning story “Delivered” by Brittan Coghlin in the summer issue. The story takes considerably more license with the truth than many TV dramas!

First, the author failed to make any mention of anesthesia during labour or the caesarian section. I can only assume that neither the contest’s judges nor the author had ever experienced or attended such an operation. The anesthesiologist is vital to provide pain relief and resuscitation, and can even advise an inexperienced obstetrical surgeon. Certainly no “team” is going to “splay Serena out naked on the operating table, strapping her arms down as if laying her on a cross.” Every woman wears an operating gown with short sleeves, a paper hat, and sometimes cotton leggings for warmth. When the anesthetic is effective, a screen is placed to separate the mother’s head and neck from the surgical field. Frequently the husband or special friend, who is gowned and masked, is invited to hold her hand while the anesthesiologist monitors the I.V. and vital signs and comforts the patient (who is awake) as the other arm is restrained to guard the mother’s hand from entering the surgical field.

Second, I have never seen a white linoleum floor in any operating room or delivery room.

Third, after a traumatic delivery, the anesthesiologist is often needed to resuscitate and even ventilate the baby if the pediatrician hasn’t yet arrived.

This story could scare any woman even thinking of pregnancy. I strongly advise every woman and her partner to attend the free prenatal classes and discuss all possibilities with her nurses and doctors. Expectant parents can take comfort that Canadian maternal death rates are half what they are in the U.S. – mainly due to our universal medicare.

Dr. Elizabeth Oliver (Malone)
MD 1957
Niagara-on-the-Lake, Ontario

# 14
Posted by Scott Anderson on September 30th, 2011 @ 12:52 pm

Brittan Coghlin responds:

Readers may be interested to know that I am a registered nurse who has worked in labour and delivery. I am confident in the story’s medical details. Though the events are representative of an emergency scenario, and are luckily uncommon, they do represent real lived experiences. There was no mention of an anesthesiologist (I left out other medical details, too), because this did not serve to tell the story of these two women. Ultimately I was writing fiction and not a medical text or public health announcement. This was a story that focused on the work of a nurse; all too frequently the limelight goes to others.

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