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attend to, not least of which was to separate the baby from his mother – and she had only one set of cord clamps in her bag, which she had used for the first baby. So she cut a gauze swab in half, tied each piece firmly to the cord, and cut between the knots. ‘Always improvise, ’ her midwifery tutor had taught.
    The baby was small, but looked perfectly formed and healthy. Ruth picked him up, and he whimpered. She held him upside down, and he cried lustily. ‘That’s what I like to hear,’ she thought, ‘cry some more, little baby. Your lungs are only small, and this is the best way of inflating them.’ The baby obliged by screaming. She nodded in satisfaction and laid him with his mother to keep him warm.
    Then she began wondering what to do with him. Ideally both he and his brother should have been bathed, examined thoroughly, weighed and measured, and put into a clean cot near to a fire. But she had no hot water, no soap, no clean towels, and the room temperature was far too cold to expose his naked body. To wrap him up warm was the immediate challenge. She looked around the room for something – anything she might use. She saw a cupboard in the corner and opened it, hopefully, but all she found was a lot of broken mechanical equipment. Then she saw the clothes that Kathy had taken off – a skirt, a jumper and a thin, cheap jacket. ‘That will do,’ she thought, ‘better than nothing, anyway.’ The garments were still quite warm, so she wrapped the baby up in them, and tucked him into the second drawer. ‘Phew!’ she thought, ‘this has been a night. What next?’
    What happened next was more than she, or anyone else for that matter, could have imagined in their wildest dreams.
     
    Ruth sat down once more on the chair beside the mother, to await the third stage of labour. She had time to reflect on the situation. After a twin birth the uterine muscles are stretched and tired and can take up to half an hour to contract again for the expulsion of the placenta. Kathy lay sleeping, her fragile yet strong young body exhausted from a twin birth, and soothed by the blessed relief from pain. Ruth sat beside her and leaned her head on the wall. She glanced at her watch. What had happened to the time? Less than an hour had passed since she had got out of bed to answer the telephone. She tried to recall the sequence of events: the cycle ride through the night, the girl standing out in the street, the race to get upstairs, the waters breaking on the landing, and the birth of one baby, then two. It had been like a speeded-up film. What did time mean, anyway? There were some who said that time does not exist, others who said that past, present and future are one and the same. What did anyone know about time? Least of all herself. And Kathy was sleeping, blissfully sleeping.
    Ruth placed her hand on the fundus of the uterus to assess progress of the third stage and stiffened with shock. The uterus still felt full, hard and bulky. ‘There’s something wrong here,’ she thought, ‘this doesn’t feel like a placenta.’
    She carefully palpated the abdomen. ‘It’s definitely not a placenta. It can’t be ... It’s not possible ...’
    She picked up her foetal stethoscope, applied it to the abdomen in several places and heard a rapid, regular heartbeat. Her mouth went dry, and she had to sit down again. Another baby! Undiagnosed triplets, no antenatal care, no assistance available, and apparently no one else in the building to summon help. She shivered as much from shock and fear as from the cold. Thoughts were racing through her mind. Would the delivery be normal? She had been lucky twice, but the third baby might be lying in any position. He might be a transverse lie, or a shoulder or a brow presentation ... or anything. She palpated the abdomen but could not feel a head or a breech. The foetal heartbeat was a steady 150 beats per minute, which was undoubtedly high, but might be normal for a third baby. She had