Alicia slips out of her jeans and t-shirt and pulls on the green birthnurse uniform, corporate logo emblazoned in large yellow letters across her breast: ‘MegaMaternity Inc’. She stows her clothes and bag in the locker, walks out of the staff room and down the corridor to her clinic room and picks up the flexi-screen on the desk, scrolling down for information about the day ahead of her. Mostly antenatal check ups, mostly primips, interspersed with some day 5 baby checks. It didn’t look too busy. Alicia sighs with relief, tugs her curly, black pony tail higher up her head and moves towards the door to the waiting room to call in her 9am.
The Municipal Birth House is a small utilitarian-looking building on the edge of town. Built in the ’50s during the Great Leftish Uprising, it is already looking shabby. It has 5 birth rooms, some clinic rooms, one obstetric theatre, a postnatal ward and a small neonatal intensive care unit. The interim Leftish Government had intended it to be used by families who could not afford to pay, but as soon as the Uprising was quashed, MegaMaternity had taken it over. It caters for parents who have insurance, and the money to avoid The Great Queue, but who cannot afford to pay the huge fees required to go to the state of the art hospital in the next town, run by Taramco, a global mega-corporation. Alicia has worked here for 3 years and has an unusual background; her mother was a community underground birthworker and she had learned from her as a child and teenager, attending births alongside her. It is uncommon for underground, unregulated birthworkers to cross over and qualify as Birthnurses, but a combination of luck and some artful deception has meant that Alicia now has a steady job and the ability to add some of the old, sagefemme techniques to her work.
Alicia keeps her thoughts very much to herself at work; keeping her history under the radar and doing good by stealth. Yet her colleagues sense something and avoid her as much as they can. They smell danger on her and want nothing to do with it. For a start, Alicia’s clients seem to avoid theatre and breastfeed their babies in far greater numbers than the clients of any of the other Birthnurses. Women come in and ask for Alicia and smile when they learn she is on shift that day. It causes jealousy and bad feeling in the staffroom, because the birthnurses are paid per client. There is a palpable atmosphere that Alicia is profoundly aware of. She’s not stupid – she knows there are people who would gleefully report her to management, given half a chance, and pocket the extra money her absence would create.
But Alicia doesn’t earn as much as her colleagues assume. Payments are calculated on a per-intervention basis. Birthnurses are taught to be salespeople, schooled in the art of persuasion. The purple prose selling the blissful benefits of extra scans and tests, epidurals and syntocinon is in bold on page one of their staff induction folder. Insurance covers the basics, but each intervention that is apparently vital, each extra observation, even the facilitation of skin to skin contact between mother and baby, or food and drink for new parents, costs extra and can add up to many hundreds of New Euros. Alicia shies away from the hard sell, keeping her lips closed and her eyes and ears wide open, just as her mother taught her. And so, most months, she goes home with a very basic salary, her colleagues none the wiser. The management have noticed, however. Her productivity quota is low and with each payslip comes an email, entreating her to try harder. Alicia suspects they put up with her because, for reasons unknowable to the suits upstairs, Alicia brings in the customers.
Day to day, though, Alicia is avoided and manages to slip in and out of the hospital almost invisible, floating through her day, from one client to another, quietly listening to their questions and woes, whispering suggestions and sharing a secret: we are born with all the tools we need to give birth in our turn, if only we can trust ourselves…a treacherous, anti-capitalist message that Alicia has become adept at murmuring quietly in private to her clients.
It’s a lonely existence. She has no one to talk through births with; to share theories or ask questions. None of her colleagues would describe themselves as facilitators of childbirth; rather they follow the book to the letter, thinking of the money in their pocket, rather than the preferences or comfort of their clients. To them, currency is king; money to be worshiped. New Euros provide not only security and the approval of the community, but also a sense of self worth that is taught from childhood: Capitalism is the natural order of things – survival of the fittest is just the way evolution works, a fact not be be denied.
So when Alicia meets Basma in the park, as they both watch their kids play, there is an instant connection – at least on Alicia’s part. Basma is scared and suspicious at first; if the capitalist-cops or the Taramco Security Agents catch a community birthworker, the punishments are harsh. But slowly a friendship develops. During their weekly meetings in the park, Basma and Alicia become allies, learning how much they have in common, sharing their fury at the system that punishes all birthing people – both the haves and the have nots – benefiting no one but the corporations like Taramco and MegaMaternity. By the time they have known each other six weeks, the two women can be seen sitting closely together, heads bowed as though in prayer or conspiracy.
And conspiracy it is. They are hatching a plot, one that could result in Alicia being accused of crimes against capitalism, if discovered. But the allure of the plan is impossible to resist. The seed of the idea had come to Alicia during a night shift. 97% of people giving birth at the Municipal Birth House have their labours artificially started during office hours and no labour should last more than 8 hours, according to the handbook, so night shifts are usually very quiet. There is almost always at least one birth room empty, no management, no security guards and no senior desk-bound Birthnurses. Usually it’s just Alicia and one other Birthnurse or Birth Assistant and a desk clerk to answer the phones.
‘What if’, Alicia had thought, ‘I could smuggle in women from the community with no insurance when they need help that the community birth workers can’t give? If they need synto for bleeding, or antibiotics. I even know how to use forceps if truly necessary. We could smuggle them in and out with no one noticing if it’s at night. And it wouldn’t happen that often. Basma tells me their outcomes are generally really good if they have worked with a woman throughout pregnancy.’
It is a batshit crazy idea, but when Alicia shares it with Basma, it takes hold of their imagination and will not let go. Can they really do this? How much are they risking? What plans can they put in place to minimise the chances of discovery? They talk long after the children have got bored and are begging to go home, kids and adults alike shivering in their thin jackets.