Buch lesen: «The Midwife's Child»

CHAPTER ONE

SHE was in big trouble.

Glancing at her watch with a mew of panic, Brooke careered through the pelting rain across the hospital car park, dodging puddles and pedestrians as she made a dash for the sanctuary of the hospital.

Why was her life always like this? Why? Her umbrella wavered threateningly in the strong wind and she flung a breathless apology at a pedestrian who gave her a nervous look and a wide berth. Why, for once, couldn’t things have gone smoothly? Just for one day, surely life could have been kind? What had she ever done to deserve the repeated obstacles that were delivered at her door?

First the heating, then the roof and now the car. What next?

Breathless and soaked, she shouldered her way through the revolving doors of the maternity unit, and the sudden warmth of the foyer made her pause and catch her breath.

Please, please, let the day improve, she pleaded to no one in particular as she took the lift to the third floor and attempted a first-aid job on her hair which fell in a damp, tangled mass halfway down her back. Twisting it firmly, she rummaged in her pocket for some pins and fastened it securely in a knot at the back of her head, hoping that it would hold until lunchtime.

In the sanctuary of the staffroom, she stripped off her wet clothes and changed into the comfortable blue cotton trousers and tunic top that everyone wore on the labour ward.

‘I’m really, really sorry, folks…’ Flustered and out of breath, she paused by the door of the office where everyone from the early shift was gathered. ‘I had some problems.’

‘You don’t need to explain.’ Sister Wilson’s voice was full of humour and sympathy. ‘We saw you getting off the bus and sprinting across the car park. I gather that joke of a contraption that you call a car failed you again.’

Brooke nodded and bit her lip. ‘It’s the rain, I think. It hates rain—’

‘And cold and heat,’ one of the midwives interrupted with a laugh. ‘Face it, Brooke, it’s on its last legs. You’d better ask Father Christmas for another one.’

It was only March and most of her problems were way beyond the touch of Father Christmas, Brooke thought gloomily, tucking a wayward strand of hair behind her ear.

‘I’ll get an earlier bus tomorrow.’ Dropping into a vacant chair, she glanced at the board to see how busy they were and her eyes widened in disbelief. ‘We’re full again?’

‘To the point of bursting.’ Gill Wilson stood up, suddenly businesslike. ‘And Antenatal have got two in early labour as well so we’re in for a good day. Brooke, I’ve allocated Paula the lady in Room 2, but as she’s still a student she obviously can’t take full responsibility so I’d like you to supervise. The lady’s name is Alison Neal and she’s a thirty-year-old primip and very anxious. Perhaps you should have five minutes with her on your own before Paula joins you. You’re normally very good with panickers.’

‘Of course.’ A primip—an abbreviation for primigravida, someone having their first baby—often needed more support and reassurance than a woman who’d been through it all before, and was usually in labour for much longer.

‘Suzie…’ Gill Wilson turned to another midwife. ‘Can you run between 4 and 5 for me and supervise the students? Diane can sort out the admissions and Helen can take the lady in room one. Oh, and by the way, things are looking up here. The new consultant started yesterday and the new senior reg starts in a few weeks so at least the medical staff won’t be so stretched.’

‘What’s the consultant like?’ Brooke draped her stethoscope round her neck and straightened her tunic.

‘First class.’ Gill Wilson nodded with satisfaction. ‘We’re very lucky to have him.’

One of the midwives gave a sigh. ‘Just tell us he isn’t a meddler. We don’t need another consultant like—’

‘Now, now,’ Gill interrupted briskly, a faint frown touching her forehead. ‘No need to name names. He’s left and it’s history and, no, Jed Matthews isn’t at all like that. He’s an incredibly talented obstetrician who thinks that women should do it by themselves whenever they can. I dare say you’ll meet him later but I think he’ll support our philosophy to the hilt.’

‘Well, that’s one bit of good news, then.’ Brooke stood up and tucked her pen and notebook into her pocket, falling into step beside her friend Suzie as they walked down the corridor.

Suzie gave her a sympathetic look. ‘You OK?’

‘Are you joking?’ Brooke rolled her eyes. ‘When was my life ever OK?’

‘What’s happening about the roof?’

‘I’ve got a man coming to see it on Saturday but at the moment I’m just using a bucket and lots of hope.’

Suzie pulled a face and looked worried. ‘This rain can’t last for ever.’

‘This is the Lake District so it can and, knowing my luck, it probably will,’ Brooke said dryly as they paused outside the door of Room 2. ‘But thanks for asking.’

Suzie nodded and hesitated. ‘Look, if you need a loan…’

‘No, thanks.’ Brooke stiffened and her small chin lifted slightly. ‘I’m fine.’

‘Brooke, for goodness’ sake!’ Suzie glanced along the corridor and lowered her voice ‘You’re not fine at all and you know it! You’re struggling like mad and it’s time you let someone help you.’

‘I don’t need help.’ Brooke’s tone was frosty and Suzie looked exasperated.

‘You’re so stubborn, do you know that? How will you pay for the roof?’

Brooke shrugged. ‘That’s my problem.’ One of the many. ‘I’ll do some agency work or something.’

‘Brooke—’

‘I’ll handle it.’ Brooke’s eyes glinted with determination and, without waiting for a reply, she shouldered her way into Room 2 and beamed at the woman sitting on the bed.

‘Hello, Mrs Neal. I’m Brooke Daniels, one of the midwives on the unit.’ She took one look at the wide, frightened eyes of the young woman in front of her and forced her own problems to the back of her mind, knowing that she had some serious work to do.

‘Could you call me Alison?’ The woman looked terrified. ‘It seems more…personal somehow. I hate anything medical.’

‘Try not to think of this as medical,’ Brooke advised gently. ‘Having a baby is perfectly natural and in this unit our policy is to intervene as little as possible.’

‘Is that why this room doesn’t look a bit like a hospital room?’ Alison glanced round at the pretty curtains and bedspread and the comfortable sofa and beanbags. ‘It’s more like being at home.’

‘Actually, it’s better than home,’ her husband pointed out dryly. ‘At home we haven’t got a king-size bed and a rocking chair.’

Brooke smiled. ‘The rooms are nice, aren’t they? The whole idea was to make people feel as though they were in the comfort of their own homes but with the advantages of hospital technology on hand if needed.’

Alison was still gripping her husband’s hand tightly. ‘Will you be with me all day?’

‘One of our student midwives, Paula, will be with you the whole time,’ Brooke told her. ‘I’ll be popping in and out all day and I’ll definitely be here when you deliver.’

‘I can’t bear to think about that bit.’ Alison managed a weak smile and bit her lip. ‘I’m terrified, I have to confess. I can’t relax at all.’

Brooke settled herself on the bed. Blow protocol. What this woman needed was the personal touch.

‘Well, helping you to relax is my job.’ She took Alison’s other hand in hers and gave it a quick squeeze. ‘Did you go to any of our antenatal classes?’

‘I went to the yoga class a few times but, to be honest, the roads were so bad in December and January that I stayed at home mostly.’ Alison looked anxious. ‘Should I have persevered? Would it have made a big difference?’

‘Well, the classes do teach you certain techniques for relaxation,’ Brooke told her, ‘but if you went a few times then you will have grasped the basics. We use lots of different methods to help you relax here—aromatherapy, the water pool and massage for starters.’

‘This place is more like a health farm than a hospital,’ Alison’s husband joked, and Brooke nodded seriously.

‘In some ways it is. The emphasis is all on keeping the woman as happy and relaxed as possible.’

Alison bit her lip, her dark eyes worried. ‘I’m just afraid that all the breathing and massage in the world won’t be enough for me. I know how much of a coward I am when it comes to pain! If I decide to have an epidural, will you think I’m awful?’

‘Not at all.’ Brooke gave her a reassuring smile. ‘We are totally committed to giving the mother the type of birth she wants. If someone is adamant that they want an epidural then we can arrange that. It’s nothing to do with bravery, Alison. The pain is different for each person and people cope in different ways, but we never, ever judge anyone, I can assure you of that! Do you have any strong views on the type of delivery you’d like?’

‘I did a birth plan.’ Alison reached for her bag and pulled out a piece of paper which she handed to Brooke a little hesitantly. ‘To be honest, I wasn’t sure that you’d want to see it. My midwife said that you don’t like them on this unit.’

‘Well, she’s right in a sense.’ Brooke took the birth plan and tried to explain as carefully as possible. ‘The reason is that we’ve found that some women have set themselves all sorts of goals and expectations and then, when things don’t go according to plan, they’re disappointed. For example, you might think you don’t want any pain relief but when you’re in the middle of things you might want to change your mind. We’ve had a few women who felt that they’d failed and let themselves down by not sticking to their plan, and that was awful. Everyone should be allowed to change their minds at any point.’

Alison nodded and gave a small smile. ‘I suppose you don’t really know how you’ll react to the pain until you experience it.’

‘That’s right.’ Brooke glanced between the couple, her expression serious. ‘It’s important not to think you have to stick rigidly to what you planned. We do look at birth plans if a woman has made one, but we really like to work with the mother and respond to what she’s feeling at the time.’

‘That sounds sensible—Ooh.’ Alison winced and screwed her fingers round the bedcover as a contraction started to build. ‘I never expected the pain to be this bad. Oo-ooh, Tim!’

Her husband stroked her shoulder awkwardly and cast a worried look at Brooke.

‘She’s fine,’ Brooke murmured, moving her palm over the woman’s swollen abdomen to feel the strength of the contraction. ‘Remember your breathing, Alison. In through your nose and out through your mouth. Perfect. Well done. There—it’s tailing off. Now, I just need to examine you. Has anyone explained to you about this machine?’

She moved it slightly closer and ripped off the trace that was hanging down. ‘This is called a CTG and it basically tells us about your contractions and your baby’s heart rate. At this stage we want you as mobile as possible, so we’ll only use it occasionally, just to get a picture of what’s happening.’

‘Does it look OK? It looks totally incomprehensible to me.’ Alison frowned down at the graph but Brooke nodded and filed it carefully in the notes.

‘It’s fine. Now, let’s take a quick look at this birth plan together.’ She read quickly and then glanced up at the couple. ‘You seem to be pretty open-minded about most things.’

‘I really didn’t want to have my membranes ruptured,’ Alison murmured, looking at her husband for support, and he nodded firmly.

‘That’s right. I gather a lot of hospitals do that, but we’d rather let nature take its course.’

‘So would we.’ Brooke slipped the birth plan into the notes and gave them both a warm smile. ‘You’re right that some units artificially rupture the membranes the minute the cervix is 4 cm dilated, but we never do that here. We don’t rupture membranes, we don’t monitor without a reason and we don’t do routine internal examinations either. We do them on admission and then when we feel they’re necessary.’

Alison’s husband frowned. ‘But if there’s a medical problem?’

‘Then we involve our medical team,’ Brooke told him promptly. ‘That’s the good thing about this unit. You get the nearest thing to a home birth without sacrificing the safety of a hospital. Now, then, I’d just like to feel the way the baby is lying, Alison, if that’s all right with you.’

She palpated the abdomen carefully, glancing up as Paula slid discreetly into the room and introduced herself to the couple.

‘Is it still the right way up?’ Alison looked anxious and Brooke nodded with a smile.

‘Absolutely. He’s coming out head first—what we call a cephalic presentation. And he’s nicely flexed so that’s good.’

Paula cleared her throat. ‘Sister wondered if you’d nip into 4, Brooke. They need some help.’

Brooke glanced at her and caught the urgency of her expression. Trouble, obviously. ‘Fine. Well, you’re staying with the Neals for the rest of your shift now, aren’t you? I’ll be back as soon as I can. Just help Alison with her breathing.’

She left the room calmly, and then speeded up as she made for the other delivery room.

‘Oh, Brooke—good.’ Gill Wilson glanced towards her and then back to her patient. ‘Mrs Fox is going to need a section. She’s bleeding a bit and we suspect a placental abruption. We’ve bleeped Mr Matthews, the consultant, and he’s meeting us in theatre. Fortunately she’s had an epidural so she shouldn’t need a general anaesthetic. Is Alison Neal all right for a while if you give me a hand? Suzie needs to go back to her student in 5 so I was hoping you could scrub and take the baby.’

‘No problem. Alison’s fine with Paula.’ Brooke could see from the debris around her that ‘bleeding a bit’ was something of an understatement, and she knew Gill well enough to know that she was concerned.

Suzie was checking Mrs Fox’s blood pressure again. ‘Eighty over fifty,’ she murmured, and Gill nodded briskly.

‘Right. Into theatre.’

Without waiting for a porter, they manipulated the trolley into Theatre where preparations were already under way for an emergency section.

Brooke scrubbed, preparing for her role which was to take the baby once it was delivered, leaving the surgeon to concentrate on the mother. Gill had said the new consultant was good. For the sake of Mrs Fox she hoped that was true. Things weren’t looking good.

‘How much blood has she lost?’ The deep male voice trickled through the doors and Brooke froze.

No. Dear God, no.

She listened again, her heart pounding in her chest. There was a low murmur of voices as Gill replied, and then his voice again. ‘OK—we need to get this baby out fast.’

It was him. It was definitely him.

She closed her eyes and struggled to breathe. Six years. It had been six years since she’d last heard that voice, but she’d have recognised it anywhere. Deep, tough and totally male. Smooth and confident like melted chocolate poured over solid steel. It was the sort of voice that made everyone stop and listen. The sort of voice that was used to issuing orders and commands. And it was the same voice that had once seduced her to within an inch of her life.

Brooke felt her knees shake as panic swamped her. What if he recognised her? No. She had to make sure he didn’t. If he ever found out…

Frantically searching for some way of concealing her identity, she noticed a box of masks and grabbed one, hooking it over her ears with shaking fingers. It wasn’t a long-term solution but at least it should buy her some time.

She slid into Theatre, her heart thumping, and quickly realised that she needn’t have worried. The new consultant wasn’t remotely interested in who was standing in his theatre. He was busy, saving two lives.

His hands as steady as a rock, he divided skin and muscle with a speed and skill that made Brooke blink with disbelief. Even in her state of panic she could see that he was good. Incredibly good.

‘Is there a paediatrician on the way?’ His sharp question was swiftly answered by Gill.

‘Dr Patel’s on her way down now, Mr Matthews.’

Brooke watched, transfixed, as he stroked through the layers until the uterus was exposed and then made a small transverse incision and passed his right hand into the uterus.

‘Out you come, little chap,’ he murmured, his eyes flicking up to his SHO who was assisting. ‘Press on the fundus.’

Sita Patel arrived just as the newly delivered baby let out an outraged yell, and suddenly Brooke was reaching for the wriggling child, her actions all automatic, her mind still paralysed with shock.

‘OK, what have we got here?’ The consultant had already turned his attention back to the job in hand. Stopping the bleeding. ‘Suction, please. And again… That’s better… Oh, yes, I see what’s happening…’

Brooke and Sita took charge of the baby, placing it gently on the resuscitaire which had been wheeled into Theatre, so named because it incorporated essential equipment for resuscitating a baby.

‘Apgar of 8 at one minute,’ Sita murmured, looping the paediatric stethoscope around her neck as Brooke carefully used suction to clear the baby’s mouth and nose of mucus. ‘He’s got good lungs!’

‘Is he OK? Is my baby OK?’ Mrs Fox was twisting her head anxiously and Jed Matthews gave her a smile, his eyes creasing above the mask.

‘He’s great—can’t you hear that yell? Dr Patel will bring him over just as soon as she’s checked him and made him warm. How are things over there, Sita?’

‘Fine, Mr Matthews,’ Sita replied, finishing her examination of the baby and hovering while Brooke wrapped him up warmly to prevent heat loss. ‘He’s ready to meet his mum.’

Brooke swallowed. Jed Matthews. She hadn’t known his name before today. She allowed herself a brief glance, her heart turning a somersault as she focused on the thick, dark lashes and the brilliant blue eyes visible above the mask. She’d never met a man with eyes like Jed’s. Just one look from those very male eyes and she’d drowned…

‘Good.’ His fingers were still working quickly within the uterine cavity, trying to stop the bleeding. ‘How much blood have we got cross-matched, Sister?’

‘Two units,’ Gill murmured, moving to his side and watching him work.

‘Let’s give her one unit now, please. Swab.’ He reached out a hand and took the sterile swab, frowning down at his handiwork. ‘OK, that looks fine. I’m ready to close. Part of your placenta had come away, Mrs Fox, and that was why you were bleeding, but it’s fine now. Nothing to worry about.’

Brooke stood immobile, her eyes moving down to those powerful shoulders, clearly outlined by the loose fabric of his theatre greens. How could it be him? How could he be here, of all places?

No longer under pressure, he glanced up and his eyes narrowed as he intercepted her look. For a long moment they stared at each other and Brooke swallowed hard, fighting an overwhelming impulse to turn and run. He hadn’t recognised her. He couldn’t possibly. Her hair was totally tucked away. Only her eyes were showing. He couldn’t have recognised her, could he?