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4
Birth
A.J. Cronin
 
In this excerpt from The Citadel, Andrew Manson, newly out of medical school, 
has just begun his medical practice as an assistant to Dr Edward Page in the 
small W elsh mining town of Blaenelly. As he is returning from a disappointing 
evening with Christine, the girl he loves, he is met by Joe Morgan. Joe and his 
wife, who have been married nearly twenty years, are expecting their first child.
Though it was nearly midnight when Andrew reached Bryngower, he found Joe 
Morgan waiting for him, walking up and down with short steps between the 
closed surgery and the entrance to the house. At the sight of him the burly 
driller’s face expressed relief.
“Eh, Doctor, I’m glad to see you. I been back and forward here this last 
hour. The missus wants ye — before time, too.”
 Andrew, abruptly recalled from the contemplation of his own affairs, told 
Morgan to wait. He went into the house for his bag, then together they set 
out for Number 12 Blaina Terrace. The night air was cool and deep with quiet 
mystery. Usually so perceptive, Andrew now felt dull and listless. He had no 
premonition that this night call would prove unusual, still less that it would 
influence his whole future in Blaenelly.
The two men walked in silence until they reached the door of Number 12, 
then Joe drew up short.
“I’ll not come in,” he said, and his voice showed signs of strain. “But, man, 
I know ye’ll do well for us.”
Chap 4.indd   34 11/29/2024   2:26:15 PM
Reprint 2025-26
Page 2


4
Birth
A.J. Cronin
 
In this excerpt from The Citadel, Andrew Manson, newly out of medical school, 
has just begun his medical practice as an assistant to Dr Edward Page in the 
small W elsh mining town of Blaenelly. As he is returning from a disappointing 
evening with Christine, the girl he loves, he is met by Joe Morgan. Joe and his 
wife, who have been married nearly twenty years, are expecting their first child.
Though it was nearly midnight when Andrew reached Bryngower, he found Joe 
Morgan waiting for him, walking up and down with short steps between the 
closed surgery and the entrance to the house. At the sight of him the burly 
driller’s face expressed relief.
“Eh, Doctor, I’m glad to see you. I been back and forward here this last 
hour. The missus wants ye — before time, too.”
 Andrew, abruptly recalled from the contemplation of his own affairs, told 
Morgan to wait. He went into the house for his bag, then together they set 
out for Number 12 Blaina Terrace. The night air was cool and deep with quiet 
mystery. Usually so perceptive, Andrew now felt dull and listless. He had no 
premonition that this night call would prove unusual, still less that it would 
influence his whole future in Blaenelly.
The two men walked in silence until they reached the door of Number 12, 
then Joe drew up short.
“I’ll not come in,” he said, and his voice showed signs of strain. “But, man, 
I know ye’ll do well for us.”
Chap 4.indd   34 11/29/2024   2:26:15 PM
Reprint 2025-26
Birth
35
Birth 35
Inside, a narrow stair led up to a small bedroom, clean but poorly furnished, 
and lit only by an oil lamp. Here Mrs Morgan’s mother, a tall, grey-haired 
woman of nearly seventy, and the stout, elderly midwife waited beside the 
patient, watching Andrew’s expression as he moved about the room.
“Let me make you a cup of tea, Doctor, bach,” said the former quickly, 
after a few moments.
Andrew smiled faintly. He saw that the old woman, wise in experience, 
realised there must be a period of waiting that, she was afraid he would leave 
the case, saying he would return later.
“Don’t fret, mother, I’ll not run away.”
Down in the kitchen he drank the tea which she gave him. Overwrought as 
he was, he knew he could not snatch even an hour’s sleep if he went home. He 
knew, too, that the case here would demand all his attention. A queer lethargy 
of spirit came upon him. He decided to remain until everything was over.
An hour later he went upstairs again, noted the progress made, came down 
once more, sat by the kitchen fire. It was still, except for the rustle of a cinder 
in the grate and the slow tick-tock of the wall clock. No, there was another 
sound—the beat of Morgan’s footsteps as he paced in the street outside. The 
old woman opposite him sat in her black dress, quite motionless, her eyes 
strangely alive and wise, probing, never leaving his face.
His thoughts were heavy, muddled. The episode he had witnessed at 
Cardiff station still obsessed him morbidly. He thought of Bramwell, foolishly 
devoted to a woman who deceived him sordidly, of Edward Page, bound 
to the shrewish Blodwen, of Denny, living unhappily, apart from his wife. 
His reason told him that all these marriages were dismal failures. It was a 
conclusion which, in his present state, made him wince. He wished to consider 
marriage as an idyllic state; yes, he could not otherwise consider it with the 
image of Christine before him. Her eyes, shining towards him, admitted no 
other conclusion. It was the conflict between his level, doubting mind and 
his overflowing heart which left him resentful and confused. He let his chin 
sink upon his chest, stretched out his legs, stared broodingly into the fire. 
He remained like this so long, and his thoughts were so filled with Christine, 
that he started when the old woman opposite suddenly addressed him. Her 
meditation had pursued a different course.
“Susan said not to give her the chloroform if it would harm the baby. She’s 
awful set upon this child, Doctor, bach.” Her old eyes warmed at a sudden 
thought. She added in a low tone: “Ay, we all are, I fancy.”
He collected himself with an effort.
“It won’t do any harm, the anaesthetic,” he said kindly. “They’ll be all right.”
Chap 4.indd   35 11/29/2024   2:26:15 PM
Reprint 2025-26
Page 3


4
Birth
A.J. Cronin
 
In this excerpt from The Citadel, Andrew Manson, newly out of medical school, 
has just begun his medical practice as an assistant to Dr Edward Page in the 
small W elsh mining town of Blaenelly. As he is returning from a disappointing 
evening with Christine, the girl he loves, he is met by Joe Morgan. Joe and his 
wife, who have been married nearly twenty years, are expecting their first child.
Though it was nearly midnight when Andrew reached Bryngower, he found Joe 
Morgan waiting for him, walking up and down with short steps between the 
closed surgery and the entrance to the house. At the sight of him the burly 
driller’s face expressed relief.
“Eh, Doctor, I’m glad to see you. I been back and forward here this last 
hour. The missus wants ye — before time, too.”
 Andrew, abruptly recalled from the contemplation of his own affairs, told 
Morgan to wait. He went into the house for his bag, then together they set 
out for Number 12 Blaina Terrace. The night air was cool and deep with quiet 
mystery. Usually so perceptive, Andrew now felt dull and listless. He had no 
premonition that this night call would prove unusual, still less that it would 
influence his whole future in Blaenelly.
The two men walked in silence until they reached the door of Number 12, 
then Joe drew up short.
“I’ll not come in,” he said, and his voice showed signs of strain. “But, man, 
I know ye’ll do well for us.”
Chap 4.indd   34 11/29/2024   2:26:15 PM
Reprint 2025-26
Birth
35
Birth 35
Inside, a narrow stair led up to a small bedroom, clean but poorly furnished, 
and lit only by an oil lamp. Here Mrs Morgan’s mother, a tall, grey-haired 
woman of nearly seventy, and the stout, elderly midwife waited beside the 
patient, watching Andrew’s expression as he moved about the room.
“Let me make you a cup of tea, Doctor, bach,” said the former quickly, 
after a few moments.
Andrew smiled faintly. He saw that the old woman, wise in experience, 
realised there must be a period of waiting that, she was afraid he would leave 
the case, saying he would return later.
“Don’t fret, mother, I’ll not run away.”
Down in the kitchen he drank the tea which she gave him. Overwrought as 
he was, he knew he could not snatch even an hour’s sleep if he went home. He 
knew, too, that the case here would demand all his attention. A queer lethargy 
of spirit came upon him. He decided to remain until everything was over.
An hour later he went upstairs again, noted the progress made, came down 
once more, sat by the kitchen fire. It was still, except for the rustle of a cinder 
in the grate and the slow tick-tock of the wall clock. No, there was another 
sound—the beat of Morgan’s footsteps as he paced in the street outside. The 
old woman opposite him sat in her black dress, quite motionless, her eyes 
strangely alive and wise, probing, never leaving his face.
His thoughts were heavy, muddled. The episode he had witnessed at 
Cardiff station still obsessed him morbidly. He thought of Bramwell, foolishly 
devoted to a woman who deceived him sordidly, of Edward Page, bound 
to the shrewish Blodwen, of Denny, living unhappily, apart from his wife. 
His reason told him that all these marriages were dismal failures. It was a 
conclusion which, in his present state, made him wince. He wished to consider 
marriage as an idyllic state; yes, he could not otherwise consider it with the 
image of Christine before him. Her eyes, shining towards him, admitted no 
other conclusion. It was the conflict between his level, doubting mind and 
his overflowing heart which left him resentful and confused. He let his chin 
sink upon his chest, stretched out his legs, stared broodingly into the fire. 
He remained like this so long, and his thoughts were so filled with Christine, 
that he started when the old woman opposite suddenly addressed him. Her 
meditation had pursued a different course.
“Susan said not to give her the chloroform if it would harm the baby. She’s 
awful set upon this child, Doctor, bach.” Her old eyes warmed at a sudden 
thought. She added in a low tone: “Ay, we all are, I fancy.”
He collected himself with an effort.
“It won’t do any harm, the anaesthetic,” he said kindly. “They’ll be all right.”
Chap 4.indd   35 11/29/2024   2:26:15 PM
Reprint 2025-26
 Snapshots
36
Here the nurse’s voice was heard calling from the top landing. Andrew 
glanced at the clock, which now showed half-past three. He rose and went 
up to the bedroom. He perceived that he might now begin his work.
An hour elapsed. It was a long, harsh struggle. Then, as the first streaks of 
dawn strayed past the broken edges of the blind, the child was born, lifeless.
As he gazed at the still form a shiver of horror passed over Andrew. After 
all that he had promised! His face, heated with his own exertions, chilled 
suddenly. He hesitated, torn between his desire to attempt to resuscitate the 
child, and his obligation towards the mother, who was herself in a desperate 
state. The dilemma was so urgent he did not solve it consciously. Blindly, 
instinctively, he gave the child to the nurse and turned his attention to Susan 
Morgan who now lay collapsed, almost pulseless, and not yet out of the ether, 
upon her side. His haste was desperate, a frantic race against her ebbing 
strength. It took him only an instant to smash a glass ampule and inject the 
medicine. Then he flung down the hypodermic syringe and worked unsparingly 
to restore the flaccid woman. After a few minutes of feverish effort, her heart 
strengthened; he saw that he might safely leave her. He swung round, in his 
shirt sleeves, his hair sticking to his damp brow.
“Where’s the child?”
The midwife made a frightened gesture. She had placed it beneath the bed.
In a flash Andrew knelt down. Fishing amongst the sodden newspapers 
below the bed, he pulled out the child. A boy, perfectly formed. The limp, 
warm body was white and soft as tallow
1
. The cord, hastily slashed, lay like a 
broken stem. The skin was of a lovely texture, smooth and tender. The head 
lolled on the thin neck. The limbs seemed boneless.
Still kneeling, Andrew stared at the child with a haggard frown. The 
whiteness meant only one thing: asphyxia, pallida
2
, and his mind, unnaturally 
tense, raced back to a case he once had seen in the Samaritan, to the treatment 
that had been used. Instantly he was on his feet.
“Get me hot water and cold water,” he threw out to the nurse. “And basins 
too. Quick! Quick!”
“But, Doctor—” she faltered, her eyes on the pallid body of the child. 
“Quick!” he shouted.
Snatching a blanket, he laid the child upon it and began the special method 
of respiration. The basins arrived, the ewer, the big iron kettle. Frantically 
1
  the hard fat of animals melted and used to make soap, candles etc.
2
  suffocation or unconscious condition caused by lack of oxygen and excess of carbon dioxide 
in the blood, accompanied by paleness of the skin, weak pulse, and loss of reflexes
Chap 4.indd   36 11/29/2024   2:26:16 PM
Reprint 2025-26
Page 4


4
Birth
A.J. Cronin
 
In this excerpt from The Citadel, Andrew Manson, newly out of medical school, 
has just begun his medical practice as an assistant to Dr Edward Page in the 
small W elsh mining town of Blaenelly. As he is returning from a disappointing 
evening with Christine, the girl he loves, he is met by Joe Morgan. Joe and his 
wife, who have been married nearly twenty years, are expecting their first child.
Though it was nearly midnight when Andrew reached Bryngower, he found Joe 
Morgan waiting for him, walking up and down with short steps between the 
closed surgery and the entrance to the house. At the sight of him the burly 
driller’s face expressed relief.
“Eh, Doctor, I’m glad to see you. I been back and forward here this last 
hour. The missus wants ye — before time, too.”
 Andrew, abruptly recalled from the contemplation of his own affairs, told 
Morgan to wait. He went into the house for his bag, then together they set 
out for Number 12 Blaina Terrace. The night air was cool and deep with quiet 
mystery. Usually so perceptive, Andrew now felt dull and listless. He had no 
premonition that this night call would prove unusual, still less that it would 
influence his whole future in Blaenelly.
The two men walked in silence until they reached the door of Number 12, 
then Joe drew up short.
“I’ll not come in,” he said, and his voice showed signs of strain. “But, man, 
I know ye’ll do well for us.”
Chap 4.indd   34 11/29/2024   2:26:15 PM
Reprint 2025-26
Birth
35
Birth 35
Inside, a narrow stair led up to a small bedroom, clean but poorly furnished, 
and lit only by an oil lamp. Here Mrs Morgan’s mother, a tall, grey-haired 
woman of nearly seventy, and the stout, elderly midwife waited beside the 
patient, watching Andrew’s expression as he moved about the room.
“Let me make you a cup of tea, Doctor, bach,” said the former quickly, 
after a few moments.
Andrew smiled faintly. He saw that the old woman, wise in experience, 
realised there must be a period of waiting that, she was afraid he would leave 
the case, saying he would return later.
“Don’t fret, mother, I’ll not run away.”
Down in the kitchen he drank the tea which she gave him. Overwrought as 
he was, he knew he could not snatch even an hour’s sleep if he went home. He 
knew, too, that the case here would demand all his attention. A queer lethargy 
of spirit came upon him. He decided to remain until everything was over.
An hour later he went upstairs again, noted the progress made, came down 
once more, sat by the kitchen fire. It was still, except for the rustle of a cinder 
in the grate and the slow tick-tock of the wall clock. No, there was another 
sound—the beat of Morgan’s footsteps as he paced in the street outside. The 
old woman opposite him sat in her black dress, quite motionless, her eyes 
strangely alive and wise, probing, never leaving his face.
His thoughts were heavy, muddled. The episode he had witnessed at 
Cardiff station still obsessed him morbidly. He thought of Bramwell, foolishly 
devoted to a woman who deceived him sordidly, of Edward Page, bound 
to the shrewish Blodwen, of Denny, living unhappily, apart from his wife. 
His reason told him that all these marriages were dismal failures. It was a 
conclusion which, in his present state, made him wince. He wished to consider 
marriage as an idyllic state; yes, he could not otherwise consider it with the 
image of Christine before him. Her eyes, shining towards him, admitted no 
other conclusion. It was the conflict between his level, doubting mind and 
his overflowing heart which left him resentful and confused. He let his chin 
sink upon his chest, stretched out his legs, stared broodingly into the fire. 
He remained like this so long, and his thoughts were so filled with Christine, 
that he started when the old woman opposite suddenly addressed him. Her 
meditation had pursued a different course.
“Susan said not to give her the chloroform if it would harm the baby. She’s 
awful set upon this child, Doctor, bach.” Her old eyes warmed at a sudden 
thought. She added in a low tone: “Ay, we all are, I fancy.”
He collected himself with an effort.
“It won’t do any harm, the anaesthetic,” he said kindly. “They’ll be all right.”
Chap 4.indd   35 11/29/2024   2:26:15 PM
Reprint 2025-26
 Snapshots
36
Here the nurse’s voice was heard calling from the top landing. Andrew 
glanced at the clock, which now showed half-past three. He rose and went 
up to the bedroom. He perceived that he might now begin his work.
An hour elapsed. It was a long, harsh struggle. Then, as the first streaks of 
dawn strayed past the broken edges of the blind, the child was born, lifeless.
As he gazed at the still form a shiver of horror passed over Andrew. After 
all that he had promised! His face, heated with his own exertions, chilled 
suddenly. He hesitated, torn between his desire to attempt to resuscitate the 
child, and his obligation towards the mother, who was herself in a desperate 
state. The dilemma was so urgent he did not solve it consciously. Blindly, 
instinctively, he gave the child to the nurse and turned his attention to Susan 
Morgan who now lay collapsed, almost pulseless, and not yet out of the ether, 
upon her side. His haste was desperate, a frantic race against her ebbing 
strength. It took him only an instant to smash a glass ampule and inject the 
medicine. Then he flung down the hypodermic syringe and worked unsparingly 
to restore the flaccid woman. After a few minutes of feverish effort, her heart 
strengthened; he saw that he might safely leave her. He swung round, in his 
shirt sleeves, his hair sticking to his damp brow.
“Where’s the child?”
The midwife made a frightened gesture. She had placed it beneath the bed.
In a flash Andrew knelt down. Fishing amongst the sodden newspapers 
below the bed, he pulled out the child. A boy, perfectly formed. The limp, 
warm body was white and soft as tallow
1
. The cord, hastily slashed, lay like a 
broken stem. The skin was of a lovely texture, smooth and tender. The head 
lolled on the thin neck. The limbs seemed boneless.
Still kneeling, Andrew stared at the child with a haggard frown. The 
whiteness meant only one thing: asphyxia, pallida
2
, and his mind, unnaturally 
tense, raced back to a case he once had seen in the Samaritan, to the treatment 
that had been used. Instantly he was on his feet.
“Get me hot water and cold water,” he threw out to the nurse. “And basins 
too. Quick! Quick!”
“But, Doctor—” she faltered, her eyes on the pallid body of the child. 
“Quick!” he shouted.
Snatching a blanket, he laid the child upon it and began the special method 
of respiration. The basins arrived, the ewer, the big iron kettle. Frantically 
1
  the hard fat of animals melted and used to make soap, candles etc.
2
  suffocation or unconscious condition caused by lack of oxygen and excess of carbon dioxide 
in the blood, accompanied by paleness of the skin, weak pulse, and loss of reflexes
Chap 4.indd   36 11/29/2024   2:26:16 PM
Reprint 2025-26
Birth
37
Birth 37
he splashed cold water into one basin; into the other he mixed water as hot 
as his hand could bear. Then, like some crazy juggler, he hurried the child 
between the two, now plunging it into the icy, now into the steaming bath.
Fifteen minutes passed. Sweat was now running into Andrew’s eyes, 
blinding him. One of his sleeves hung down, dripping. His breath came 
pantingly. But no breath came from the lax body of the child.
A desperate sense of defeat pressed on him, a raging hopelessness. He felt 
the midwife watching him in stark consternation, while there, pressed back 
against the wall where she had all the time remained—her hand pressed 
to her throat, uttering no sound, her eyes burning upon him—was the old 
woman. He remembered her longing for a grandchild, as great as had been her 
daughter’s longing for this child. All dashed away now; futile, beyond remedy…
The floor was now a draggled mess. Stumbling over a sopping towel, Andrew 
almost dropped the child, which was now wet and slippery in his hands, like 
a strange, white fish.
“For mercy’s sake, Doctor,” whimpered the midwife. “It’s stillborn.”
Andrew did not heed her. Beaten, despairing, having laboured in vain 
for half an hour, he still persisted in one last effort, rubbing the child with 
a rough towel, crushing and releasing the little chest with both his hands, 
trying to get breath into that limp body.
And then, as by a miracle, the pigmy chest, which his hands enclosed, 
gave a short, convulsive heave, another… and another… Andrew turned 
giddy. The sense of life, springing beneath his fingers after all that unavailing 
striving, was so exquisite it almost made him faint. He redoubled his efforts 
feverishly. The child was gasping now, deeper and deeper. A bubble of mucus 
came from one tiny nostril, a joyful iridescent bubble. The limbs were no 
longer boneless. The head no longer lay back spinelessly. The blanched skin 
was slowly turning pink. Then, exquisitely, came the child’s cry.
“Dear Father in heaven,” the nurse sobbed hysterically. “It’s come—it’s 
come alive.”
Andrew handed her the child. He felt weak and dazed. About him the room 
lay in a shuddering litter: blankets, towels, basins, soiled instruments, the 
hypodermic syringe impaled by its point in the linoleum, the ewer knocked 
over, the kettle on its side in a puddle of water. Upon the huddled bed the 
mother still dreamed her way quietly through the anaesthetic. The old woman 
still stood against the wall. But her hands were together, her lips moved 
without sound. She was praying.
Mechanically Andrew wrung out his sleeve, pulled on his jacket.
“I’ll fetch my bag later, nurse.”
Chap 4.indd   37 11/29/2024   2:26:16 PM
Reprint 2025-26
Page 5


4
Birth
A.J. Cronin
 
In this excerpt from The Citadel, Andrew Manson, newly out of medical school, 
has just begun his medical practice as an assistant to Dr Edward Page in the 
small W elsh mining town of Blaenelly. As he is returning from a disappointing 
evening with Christine, the girl he loves, he is met by Joe Morgan. Joe and his 
wife, who have been married nearly twenty years, are expecting their first child.
Though it was nearly midnight when Andrew reached Bryngower, he found Joe 
Morgan waiting for him, walking up and down with short steps between the 
closed surgery and the entrance to the house. At the sight of him the burly 
driller’s face expressed relief.
“Eh, Doctor, I’m glad to see you. I been back and forward here this last 
hour. The missus wants ye — before time, too.”
 Andrew, abruptly recalled from the contemplation of his own affairs, told 
Morgan to wait. He went into the house for his bag, then together they set 
out for Number 12 Blaina Terrace. The night air was cool and deep with quiet 
mystery. Usually so perceptive, Andrew now felt dull and listless. He had no 
premonition that this night call would prove unusual, still less that it would 
influence his whole future in Blaenelly.
The two men walked in silence until they reached the door of Number 12, 
then Joe drew up short.
“I’ll not come in,” he said, and his voice showed signs of strain. “But, man, 
I know ye’ll do well for us.”
Chap 4.indd   34 11/29/2024   2:26:15 PM
Reprint 2025-26
Birth
35
Birth 35
Inside, a narrow stair led up to a small bedroom, clean but poorly furnished, 
and lit only by an oil lamp. Here Mrs Morgan’s mother, a tall, grey-haired 
woman of nearly seventy, and the stout, elderly midwife waited beside the 
patient, watching Andrew’s expression as he moved about the room.
“Let me make you a cup of tea, Doctor, bach,” said the former quickly, 
after a few moments.
Andrew smiled faintly. He saw that the old woman, wise in experience, 
realised there must be a period of waiting that, she was afraid he would leave 
the case, saying he would return later.
“Don’t fret, mother, I’ll not run away.”
Down in the kitchen he drank the tea which she gave him. Overwrought as 
he was, he knew he could not snatch even an hour’s sleep if he went home. He 
knew, too, that the case here would demand all his attention. A queer lethargy 
of spirit came upon him. He decided to remain until everything was over.
An hour later he went upstairs again, noted the progress made, came down 
once more, sat by the kitchen fire. It was still, except for the rustle of a cinder 
in the grate and the slow tick-tock of the wall clock. No, there was another 
sound—the beat of Morgan’s footsteps as he paced in the street outside. The 
old woman opposite him sat in her black dress, quite motionless, her eyes 
strangely alive and wise, probing, never leaving his face.
His thoughts were heavy, muddled. The episode he had witnessed at 
Cardiff station still obsessed him morbidly. He thought of Bramwell, foolishly 
devoted to a woman who deceived him sordidly, of Edward Page, bound 
to the shrewish Blodwen, of Denny, living unhappily, apart from his wife. 
His reason told him that all these marriages were dismal failures. It was a 
conclusion which, in his present state, made him wince. He wished to consider 
marriage as an idyllic state; yes, he could not otherwise consider it with the 
image of Christine before him. Her eyes, shining towards him, admitted no 
other conclusion. It was the conflict between his level, doubting mind and 
his overflowing heart which left him resentful and confused. He let his chin 
sink upon his chest, stretched out his legs, stared broodingly into the fire. 
He remained like this so long, and his thoughts were so filled with Christine, 
that he started when the old woman opposite suddenly addressed him. Her 
meditation had pursued a different course.
“Susan said not to give her the chloroform if it would harm the baby. She’s 
awful set upon this child, Doctor, bach.” Her old eyes warmed at a sudden 
thought. She added in a low tone: “Ay, we all are, I fancy.”
He collected himself with an effort.
“It won’t do any harm, the anaesthetic,” he said kindly. “They’ll be all right.”
Chap 4.indd   35 11/29/2024   2:26:15 PM
Reprint 2025-26
 Snapshots
36
Here the nurse’s voice was heard calling from the top landing. Andrew 
glanced at the clock, which now showed half-past three. He rose and went 
up to the bedroom. He perceived that he might now begin his work.
An hour elapsed. It was a long, harsh struggle. Then, as the first streaks of 
dawn strayed past the broken edges of the blind, the child was born, lifeless.
As he gazed at the still form a shiver of horror passed over Andrew. After 
all that he had promised! His face, heated with his own exertions, chilled 
suddenly. He hesitated, torn between his desire to attempt to resuscitate the 
child, and his obligation towards the mother, who was herself in a desperate 
state. The dilemma was so urgent he did not solve it consciously. Blindly, 
instinctively, he gave the child to the nurse and turned his attention to Susan 
Morgan who now lay collapsed, almost pulseless, and not yet out of the ether, 
upon her side. His haste was desperate, a frantic race against her ebbing 
strength. It took him only an instant to smash a glass ampule and inject the 
medicine. Then he flung down the hypodermic syringe and worked unsparingly 
to restore the flaccid woman. After a few minutes of feverish effort, her heart 
strengthened; he saw that he might safely leave her. He swung round, in his 
shirt sleeves, his hair sticking to his damp brow.
“Where’s the child?”
The midwife made a frightened gesture. She had placed it beneath the bed.
In a flash Andrew knelt down. Fishing amongst the sodden newspapers 
below the bed, he pulled out the child. A boy, perfectly formed. The limp, 
warm body was white and soft as tallow
1
. The cord, hastily slashed, lay like a 
broken stem. The skin was of a lovely texture, smooth and tender. The head 
lolled on the thin neck. The limbs seemed boneless.
Still kneeling, Andrew stared at the child with a haggard frown. The 
whiteness meant only one thing: asphyxia, pallida
2
, and his mind, unnaturally 
tense, raced back to a case he once had seen in the Samaritan, to the treatment 
that had been used. Instantly he was on his feet.
“Get me hot water and cold water,” he threw out to the nurse. “And basins 
too. Quick! Quick!”
“But, Doctor—” she faltered, her eyes on the pallid body of the child. 
“Quick!” he shouted.
Snatching a blanket, he laid the child upon it and began the special method 
of respiration. The basins arrived, the ewer, the big iron kettle. Frantically 
1
  the hard fat of animals melted and used to make soap, candles etc.
2
  suffocation or unconscious condition caused by lack of oxygen and excess of carbon dioxide 
in the blood, accompanied by paleness of the skin, weak pulse, and loss of reflexes
Chap 4.indd   36 11/29/2024   2:26:16 PM
Reprint 2025-26
Birth
37
Birth 37
he splashed cold water into one basin; into the other he mixed water as hot 
as his hand could bear. Then, like some crazy juggler, he hurried the child 
between the two, now plunging it into the icy, now into the steaming bath.
Fifteen minutes passed. Sweat was now running into Andrew’s eyes, 
blinding him. One of his sleeves hung down, dripping. His breath came 
pantingly. But no breath came from the lax body of the child.
A desperate sense of defeat pressed on him, a raging hopelessness. He felt 
the midwife watching him in stark consternation, while there, pressed back 
against the wall where she had all the time remained—her hand pressed 
to her throat, uttering no sound, her eyes burning upon him—was the old 
woman. He remembered her longing for a grandchild, as great as had been her 
daughter’s longing for this child. All dashed away now; futile, beyond remedy…
The floor was now a draggled mess. Stumbling over a sopping towel, Andrew 
almost dropped the child, which was now wet and slippery in his hands, like 
a strange, white fish.
“For mercy’s sake, Doctor,” whimpered the midwife. “It’s stillborn.”
Andrew did not heed her. Beaten, despairing, having laboured in vain 
for half an hour, he still persisted in one last effort, rubbing the child with 
a rough towel, crushing and releasing the little chest with both his hands, 
trying to get breath into that limp body.
And then, as by a miracle, the pigmy chest, which his hands enclosed, 
gave a short, convulsive heave, another… and another… Andrew turned 
giddy. The sense of life, springing beneath his fingers after all that unavailing 
striving, was so exquisite it almost made him faint. He redoubled his efforts 
feverishly. The child was gasping now, deeper and deeper. A bubble of mucus 
came from one tiny nostril, a joyful iridescent bubble. The limbs were no 
longer boneless. The head no longer lay back spinelessly. The blanched skin 
was slowly turning pink. Then, exquisitely, came the child’s cry.
“Dear Father in heaven,” the nurse sobbed hysterically. “It’s come—it’s 
come alive.”
Andrew handed her the child. He felt weak and dazed. About him the room 
lay in a shuddering litter: blankets, towels, basins, soiled instruments, the 
hypodermic syringe impaled by its point in the linoleum, the ewer knocked 
over, the kettle on its side in a puddle of water. Upon the huddled bed the 
mother still dreamed her way quietly through the anaesthetic. The old woman 
still stood against the wall. But her hands were together, her lips moved 
without sound. She was praying.
Mechanically Andrew wrung out his sleeve, pulled on his jacket.
“I’ll fetch my bag later, nurse.”
Chap 4.indd   37 11/29/2024   2:26:16 PM
Reprint 2025-26
 Snapshots
38
1. “I have done something; oh, God! I’ve done something real at last.” 
Why does Andrew say this? What does it mean?
2. There lies a great difference between textbook medicine and the world 
of a practising physician. Discuss.
3. Do you know of any incident when someone has been brought back 
to life from the brink of death through medical help. Discuss medical 
procedures such as organ transplant and organ regeneration that are 
used to save human life.
3
 a room for washing dishes and for similar work
He went downstairs, through the kitchen into the scullery
3
. His lips were 
dry. At the scullery he took a long drink of water. He reached for his hat 
and coat.
Outside he found Joe standing on the pavement with a tense, expectant 
face.
“All right, Joe,” he said thickly. “Both all right.”
It was quite light. Nearly five o’clock.
A few miners were already in the streets: the first of the night shift moving 
out. As Andrew walked with them, spent and slow, his footfalls echoing with 
the others under the morning sky, he kept thinking blindly, oblivious to all 
other work he had done in Blaenelly, “I’ve done something; oh, God! I’ve done 
something real at last.”
Chap 4.indd   38 11/29/2024   2:26:16 PM
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FAQs on NCERT Textbook - Birth - English Class 11

1. What is the process of birth?
Ans. During childbirth, the baby passes through the birth canal, with the head being the first part to come out. This process is known as labor and can be divided into three stages - the dilation of the cervix, the birth of the baby, and the delivery of the placenta.
2. What is the role of hormones in childbirth?
Ans. Hormones play a crucial role in childbirth. Oxytocin, known as the "love hormone," stimulates contractions and helps in the progression of labor. Another hormone called prostaglandins softens the cervix to facilitate its dilation. Additionally, adrenaline is released during labor to give the mother a surge of energy.
3. What are the different methods of pain relief during childbirth?
Ans. There are various methods of pain relief during childbirth. Some common options include natural techniques such as breathing exercises, relaxation techniques, and hydrotherapy. Medical pain relief options include epidural anesthesia, which numbs the lower body, and analgesics, which reduce pain perception.
4. What are the potential complications during childbirth?
Ans. While childbirth is a natural process, certain complications can arise. Some possible complications include fetal distress, umbilical cord problems, prolonged labor, postpartum hemorrhage, and infections. It is important for healthcare professionals to monitor the progress of labor and address any complications promptly.
5. How can one prepare for childbirth?
Ans. Preparing for childbirth involves various aspects. It is recommended to attend prenatal classes to learn about the stages of labor, pain management techniques, and newborn care. Additionally, maintaining a healthy lifestyle, practicing relaxation exercises, and creating a birth plan can help expectant parents feel more prepared for the birthing experience.
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