Aware that nothing aside from the birth would be happening quickly, Jem pushed the Entonox mouthpiece to Madina’s lips. “Here, here, breathe on this. It’s for the pain. Big deep breaths, good, perfect.” She keyed her radio. “Hey, Ryan. Birth imminent. Backup and a midwife would be great, if you’ve got anything.”

“I have a paramedic solo on the way to you, ETA six, but ETA on HART is upward of an hour. I’ll give Maternity at West Penn a ring now.”

“That’s fine. Tell the solo to leave the bus next to my RRV, grab a torch, and wade down.”

“Will do. Good luck.”

She rolled her eyes and tossed the radio next to a pile of knitted baby clothes. Madina had sagged back against the wall, her brightly coloured salwar hobbling her at the ankles.

“How’s about we get you untangled from these, eh?” Jem said, unhooking one foot and then the other. She felt surprisingly sanguine for someone tasked with delivering a baby in a power cut, with flash floods crippling the region. Being on the RRV, she had seen an exponential rise in her tally of home births, and she usually enjoyed the experience, provided it was complication-free.

“I need the hospital,” Madina said. “He’s breech.”

Jem stopped shoving an incontinence sheet beneath Madina’s bottom. “Of course he is,” she said, grabbing the maternity notes and finding the date for a planned caesarean and an entry detailing a failed attempt to turn the baby. Fuck. She squeezed Madina’s hand. “We’ll manage, I promise.”

Anything else she might have said was lost beneath Madina’s screech of pain as a sudden gush of black-stained fluid saturated the sheet.

“Not here,” Madina cried. “Not here.”

“Hands and knees,” Jem said, almost dragging her into position. “That’s it, good girl. He’s going to need space to come out.”

“Hallo? Jem?” The hail preceded a pounding of boots up the stairs, and Jem smiled as Amira stuck her head around the door. “Holy shit,” Amira whispered as, right on cue, a tiny pair of legs presented themselves.

“My sentiments exactly,” Jem said, gauging the baby’s progress. “Grab the oxygen and the neonate bag and mask, and switch the pads on the defib. Just…just get everything ready, okay?” Using her forearm, she supported the baby’s torso, preparing to deliver his head. “You’re doing really well,” she said to Madina. “You’ve definitely got a boy.”