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‘Right. This is Louise, our senior midwife. Known to everyone as Lulu.’
The woman she’d been chatting to. In her late thirties, dark-haired, little and plump with a friendly smile. And a knowing look in her eyes. No doubt a smile from Judith Powell melted the brain of just about every male she met, and it was obvious to everyone that he was no exception. ‘Pleased to meet you,’ he said.
‘And you.’
‘Catch you later, Lulu.’ Judith took a sheaf of files from the desk. ‘Right. Our first mum is Lisa Ford.’
Not ‘patient’, he noted. Good. So Judith took the modern approach rather than seeing pregnancy as a condition that needed to be treated.
‘It’s her first baby, she’s thirty-four and the baby’s breech presentation.’
Meaning that the baby was bottom down rather than head down in the womb. ‘So she’s in for a section?’ he asked.
Judith shook her head. ‘She wants a vaginal delivery, if possible.’
‘What sort of breech?’
‘Frank,’ Judith explained. This was the most common type of breech presentation, with the baby’s hips flexed and knees extended. ‘The ultrasound didn’t show anything conclusive but I’d like her to have another ultrasound after delivery—it’s possible that she has fibroids in her uterus.’
‘How are you planning to manage the delivery?’
‘I’m going to try ECV, when we finish the ward round.’ ECV, or external cephalic version, was a way of turning the breech baby to a normal presentation, through a kind of forward somersault.
‘You’re sure she’s a suitable candidate?’
‘The baby’s been breech since twenty-six weeks and I discussed it all with Rowan.’
His predecessor, who’d taken a sideways move to a consultant’s post in Birmingham, to be nearer his parents when their first grandchild was born in three months’ time.
Clearly Kieran’s doubts showed on his face, because she took him through Lisa’s case history. ‘She’s thirty-eight weeks now, it’s a singleton baby and not small for dates. Lisa has no uterine scars, no signs of hypertension or preeclampsia—so there’s a much smaller risk of placental abruption. Oh, and she’s rhesus positive, before you ask. And she’s had nothing by mouth since midnight. I’ve got the portable scanner on standby and the cardiotocograph ready. I thought we could do an ultrasound now to check the position of her placenta and the baby, whether the baby’s growth rate is satisfactory and whether the volume of amniotic fluid is normal. Then we’ll set the CTG running for half an hour so we can check the baby isn’t distressed.’
She was more thorough than he’d expected. Maybe he’d got it wrong and she wasn’t a makeweight. Maybe she’d been on her break when she’d been chatting to Louise, not simply wasting time. ‘And you’re experienced in ECV?’ he asked.
‘No. But I believe you are. So you can talk me through it.’
He frowned. ‘How do you know?’ Had his résumé been passed round the ward?
She looked embarrassed. ‘When we heard you were joining us from the Hampstead Free, I, um, asked Dad about you.’
‘Right.’ It was tempting—very tempting—to ask what Professor Powell had said about him. But Kieran had no intention of falling into that trap.
‘So will you work through it with me?’
He nodded.
‘Great. Thanks.’ She flashed him another of those knee-weakening smiles. He didn’t dare smile back. The safest place to look was at her hands.
Though even that was dangerous. There was no ring on the left hand, he noted. No white mark either, so it wasn’t that she removed a ring for her job. But the lack of a ring didn’t mean anything. Tess’s ex had never given her a ring, but she’d still been committed to him—and completely devastated when he’d dumped her three weeks ago.
Tess. Tess, who needed him right now. He should be thinking of his baby sister, not lusting after his colleague.
When Judith had introduced Kieran to the patients, written up their notes and introduced him to Margot and Daisy, the other two midwives on duty, they returned to Lisa Ford.
‘OK, Lisa,’ Judith said warmly. ‘The CTG results look fine—the baby’s happy. Your pulse and blood pressure are a little bit higher than normal, but I’d guess that’s because you’re nervous.’
‘A bit,’ Lisa admitted.
‘It’s your choice. You don’t have to do anything you don’t want to do,’ Judith reminded her.
Lisa bit her lip. ‘Is it going to hurt?’
‘It might be a bit uncomfortable, but it shouldn’t be painful,’ Kieran said.
‘I’ll be brave, then.’ She swallowed. ‘Because I really, really don’t want a section. I’d do anything to avoid it.’
‘We can’t guarantee this is going to work—and even if it does, your baby might be one of the stubborn ones who turns himself right back again,’ Judith warned gently. ‘But that’s why we’ve left trying the manoeuvre until after thirty-seven weeks, to give you a better chance of him not turning back again.’
‘Let’s do it,’ Lisa said.
‘You might be more comfortable if you empty your bladder first,’ Kieran said. ‘You’ll feel a bit of pressure on your tummy.’
When she’d left the room, he turned to Judith. ‘So I’ll tell her what you’re doing as you do it.’
Judith nodded. ‘Fine. I’ve read up on it—but it’s not the same as doing it yourself.’
‘If it doesn’t work, don’t think that you’re a failure or that it’s your fault,’ he said quietly.
Oh, no. Were her insecurities that obvious? She’d had to work hard to get this far. Really hard. Studying a lot longer than anyone else she knew. And if Zoe Hutton, her best friend, hadn’t coached her through some of her exams she would have failed.
Sometimes she wondered if she’d done the right thing. If she should have given up and gone for a career in music after all. But she hadn’t been able to stand the idea of disappointing her father. He’d wanted a son to follow in his footsteps. Judith was his only child. QED: she’d tried to make him forget that she was a girl, and had followed in his footsteps.
Except she didn’t have the natural brilliance of Zoe or the quickness of Holly Jones, her other best friend. She had to rely on reading up on things, and carrying obstetric handbooks in her pockets so she could double-check that she was managing complications properly. She’d only just been made a registrar; whereas Holly and Zoe had been promoted ages before. And Zoe was on the fast track to becoming one of the youngest consultants in the hospital.
A failure? Oh, he could say that again.
Then she made the mistake of looking at him. Lord, he had a beautiful mouth. A full, generous lower lip that made her want to lean forward and touch her own to it. And those dark, dark eyes—so deep she could drown in them.
She only just stopped herself raising a hand to touch his cheek, to find out if his skin was as soft as it looked. Kieran’s forebears must have some Mediterranean blood, she thought, because his hair was almost bluish-black and his skin had a faint olive tinge to it. Italian? Spanish?
Before she could make a fool of herself, Lisa returned, to Judith’s relief. She helped Lisa onto the bed. ‘I’m going to dust your tummy with talc,’ she said, ‘so I don’t pinch your skin.’
‘Thank you.’
Kieran took over. ‘With her right hand, Judith’s going to lift your little one’s bottom out of your pelvis. Her left hand’s going to be on the top of the baby’s head, and she’s going to push his head down so it follows his nose—as if he’s going to do a forward roll in your tummy. You’ll feel her left hand pushing his head down while her right hand pushes his bottom upwards at the same time.’
Judith tried it, then turned her head to mouth at Kieran, ‘It’s not working.’
‘But some babies like to be different,’ he said with a reassuring wink. ‘They’d rather do a backward roll than a forward roll, so Jude’s going to try that one next.’
Judith swallowed hard. It had looked so simple in the textbooks she’d pored over last night. She hadn’t bargained for a particularly stubborn baby.
‘Take your time, Jude. There’s no rush.’ Kieran smiled at her, then at Lisa. ‘Are you OK there, Lisa?’
‘Yes, Dr Bailey.’
‘Kieran,’ he corrected with a smile. ‘OK. Take some nice deep breaths for me. That’s it. Relax.’
He had a gorgeous voice. Judith could imagine lying face down on a bed, while his hands eased the knots out of her shoulders. Deep breaths…Relax…
She remembered where she was and could have kicked herself. Her mind needed to be on her patient, not her consultant! Even if he was the most attractive man she’d met in years.
‘Come on, little one,’ she coaxed, almost under her breath. ‘Turn for me. That’s it. Keep going. Keep going.’ She stared at Kieran. ‘Wow. I think he’s done it!’
Kieran quickly checked Lisa’s abdomen. ‘Yep. Well done, both of you.’
‘I didn’t do anything—I just lay here,’ Lisa protested.
‘You relaxed and let it happen. That’s important,’ Kieran said. ‘Now I’m going to check your baby’s heartbeat with the cardiotocograph again.’ He put the sensors back in place and looked at the trace. ‘His heart rate’s a bit slow, but this happens in around forty per cent of cases—it’s all down to compression around the head.’
Bradycardia or a slow heartbeat could also mean that the umbilical cord had been knotted, Judith knew, in which case she’d have to turn the baby back to a breech position and they’d have to admit Lisa for observation—maybe even for a Caesarean.
‘I’ll keep the CTG going for a bit longer, until I’m happy that the heart rate’s come back up again,’ Kieran said.
‘What happens then?’ Lisa asked.
‘It’s up to you. We can induce you, or you can go home to wait until labour starts naturally.’
‘If you wait, there’s a chance the baby might turn back again. But if you’re induced, there’s more chance that you’ll need us to help you deliver the baby. So it’s your choice,’ Judith said.
‘If the baby turns again, will I definitely have to have a section?’ Lisa asked.
‘Not necessarily,’ Kieran advised. ‘If you’d like to try for a vaginal delivery, and provided the baby isn’t distressed, that’s fine.’ He smiled at her. ‘Baby’s heart rate is coming back up again, and I’m happy with the trace. Everything seems fine. Do you have any pain anywhere?’
Lisa shook her head.
‘Good. If you feel any pain or experience any bleeding, you need to ring your midwife straight away, or come straight here,’ he advised.
‘So I can go home now?’
‘Rest for a little while first,’ he said. ‘But as soon as you feel ready to go, provided you’re not in any pain, let one of the nurses know and I’ll come and check you over before you go.’
‘Thank you. Both of you,’ she said, looking relieved.
Judith liked his bedside manner, the way he’d made Lisa feel at ease. Kieran Bailey was more than just a pretty face, she thought. And from the look on Lisa’s face, she thought so, too.
But as Judith left the room, she noticed a familiar scent. Baby sick. Kieran smelled faintly of baby sick. As she knew for a fact no babies had been sick on him on the ward that morning, it could only mean one thing.
His own baby had been sick on him that morning before work.
And that would explain why he’d been late on his first day.
She sighed inwardly. Just her bad luck. It was the first time she’d been attracted to someone in a long time—and he was married. Or at least involved with someone. The lack of a wedding ring didn’t mean anything.
And as for that flash of awareness she’d seen in his eyes, she’d make sure she kept him at arm’s length. She had no intention of smashing up someone else’s relationship. Hopefully the attraction would fade after a few weeks.
Or even less than that. Memories threatened to choke her.
‘Are you taking your lunch-break now, Jude?’ Louise asked.
Judith glanced at her watch. ‘If that’s OK with you, Mr Bai—Kieran?’ she corrected herself.
‘Fine.’
‘Why don’t you go, too?’ Louise suggested. ‘I can bleep you if you’re needed.’
Judith remembered her promise to Bella to look after Kieran. Damn. She needed some space right now to get her head straight. But it was his first day. It wasn’t fair to abandon him. ‘Um, would you like to come to the canteen with me?’ she asked. ‘I’m meeting a couple of friends, but they won’t mind if you join us.’
‘Thanks, but…’ Something that looked like guilt flickered over his face. ‘There are a couple of things I need to do. I’ll, um, see you later.’
‘Sure.’ She wasn’t sure if she was more disappointed or relieved that he wasn’t joining them. Relieved because she had a chance to put some distance between them. As for the disappointment, it was better this way. Besides, Zoe and Holly would have grilled the poor man until he’d given them his complete life history.
Her best friends were already waiting for her in the canteen. ‘Chicken salad wrap, orange juice and the last strawberry yoghurt,’ Zoe said, sliding the plates across to Judith’s place.
‘Angel.’ Judith hugged her and sank into her seat. ‘You’ve obviously had a good morning, Holls—you’re usually the last one here, not me.’
‘So what were you up to?’ Holly asked.
‘My first ECV, no less.’ Judith blew on her nails and polished them on her sleeve. ‘Well, with a bit of help from our new consultant.’
‘The one who worked with your dad,’ Zoe remembered. ‘What’s he like?’
‘OK.’
‘Oh,’ Zoe said meaningfully.
Judith pulled a face at her. ‘Don’t take that tone with me—just because you’re disgustingly happily married, it doesn’t mean everyone else has to be.’
‘No.’ Zoe flushed. ‘Sorry, Jude. No matchmaking attempts, I promise.’
Judith sighed. ‘Oh, hell. I’m sorry for snapping, Zo. And you know I’m pleased you and Brad are happy.’
‘So tell us about the new boy,’ Holly prompted.
Judith took a bite of her chicken salad wrap, making her friends wait. Then she smiled. ‘Kieran Bailey? OK. He’s taller than me, dark hair, eyes like black velvet.’ And a mouth I want to feel on mine. Except I can’t have him.
‘Are you sure you’re not smitten?’ asked Holly.
Her face must have given her away. Damn. ‘You know my track record with men,’ she said lightly. ‘I always pick the louses.’
