The Midwife's Special Delivery

‘The same,’ Ally sighed.

‘Still blaming me?’

‘She’s blaming everyone now—from the porter who wheeled her to Theatre, to the nurses, the consultant who came in and, yes, to you.’ Ally gave a sympathetic smile. ‘Rinska, you didn’t do anything wrong.’

‘I know that.’ Rinska gave a tired nod. ‘But try telling that to Kathy. Maybe she’s right,’ Rinska sighed. ‘Maybe I didn’t make myself clear enough, but I was honestly trying not to scare her too much. I thought she understood how serious the situation was.’

‘She didn’t want to understand,’ Ally said wisely, because even if Rinska was highly qualified, she still needed her colleagues’ support.

Kathy Evans was well known to everyone on the maternity ward. She had delivered a healthy baby boy three days earlier but, despite the fact that both mother and baby were doing well, Kathy was bitterly disappointed with how her labour had turned out and was making her feelings known to anyone who cared to listen—and extremely loudly!

Kathy had come in for an attempted VBAC—a vaginal birth after a Caesarean section. When she’d had her first child, the baby had been too large to negotiate the pelvis and an urgent C-section had been performed, much to Kathy’s disappointment. A staunch advocate of natural delivery, she had been disappointed that she hadn’t been able to achieve one and had been determined that her ‘mistake’ wouldn’t be repeated again. Previously it had been considered that ‘once a Caesarean always a Caesarean,’ but over the last few years, when appropriate, women had been offered a trial of labour. Things didn’t always work out as planned and often women still ended up requiring surgery to deliver their baby, but statistics were encouraging and the tide was starting to turn. Kathy had been determined that she would be successful in her quest to have a natural delivery, had done extensive research in her library and on the internet and was convinced that it was more a question of mind over matter than anything else. But even though her second baby was a much smaller one, Kathy’s uterus hadn’t contracted efficiently, and after a prolonged labour with minimal progress Rinska had become concerned by some rather ominous signs in Kathy’s and the baby’s observations and had called in Mr Davies, who had performed an emergency Caesarean section.

‘Rinska, you had no choice but to call in Mr Davies to perform a Caesarean section. And that’s coming from me—one of the strongest supporters in the unit for natural birth and minimal intervention. It would have been considered negligent if you hadn’t intervened when you did. You know that!’

‘I do know that.’ Rinska gave a small tired smile, obviously grateful for her colleague’s support. ‘I just guess I need to keep hearing it. Over and over in my mind I’ve gone through Kathy’s labour and I really cannot think of anything that I could have done differently, except perhaps explain things a little more clearly to her.’

Ally gave a dubious frown. Rinska, despite her heavy accent, despite the fact English wasn’t her first language, always spoke eloquently to the patients, always found the time, even in the most dire of circumstances, to keep her patients informed, and now here she was doubting herself.

Checking that no one was nearby, Rinska spoke in low tones. ‘I think she’s going to make a formal complaint.’

‘Then let her,’ Ally said with a confidence that belied how she really felt—even if Rinska was in the right, a formal complaint and the ensuing investigation was a horrible thing for anyone to go through. ‘Anyone who looks at her charts will know that you had no choice but to call in Mr Davies, and at the end of the day Mr Davies is the one who operated…’

‘I know,’ Rinska sighed. ‘But it’s me she’s really against. She was already in Theatre by the time Mr Davies arrived. She says that I panicked and overreacted, that I dramatised the situation just to get him to come in.’

‘That’s ridiculous.’

‘It’s also the last thing I need right now. Ally, please, don’t say anything, but I’m actually applying for a consultant’s position.’

‘Here?’ Ally beamed and Rinska nodded.

‘It’s early days, my paperwork isn’t quite through yet, but hopefully in a few weeks I can start doing the job I’ve trained so hard for. It’s not that I mind being a resident and having to double-check everything with a registrar who knows less than me…’ Rinska gave a low laugh at her own bitter voice. ‘Well, a little, perhaps, but it has helped me to learn about the hospital system from the bottom upwards, which can only be good. But it’s still been a tough year. And now just when there’s an end in sight I’m going to have this complaint to deal with. It’s not going to look good for me.’

‘You’ll be fine,’ Ally said firmly, and she meant it. ‘When does your shift end?’

‘Half an hour ago,’ Rinska said wryly. ‘I might head over to the social club afterwards. Do you want to come?’

Ally was about to shake her head. The hospital social club wasn’t really her scene but the prospect of a drink and a chat with Rinska was rather more inviting than sitting in the movies alone just so that she could avoid Rory, so instead she nodded. ‘Sounds good.’

Lucy Williams gripped Ally’s hand tightly as Ally rested her hand quietly on the young woman’s stomach.

‘They really hurt!’ Lucy gasped. ‘I mean really, and the doctor told me that I’ve got ages to go. Maybe I came in too soon. It’s just they were coming so regularly I thought I should be here, and now I find out that I haven’t progressed at all!’

‘Another one?’Ally checked as she felt Lucy’s uterus tighten beneath her fingers. ‘OK, don’t hold your breath, Lucy. Remember how we taught you to breathe in class…’ Her voice was calm and gentle, encouraging Lucy to take some slow deep breaths, talking her through the pain and waiting until the contraction had abated before offering her some much-needed encouragement.

‘You have progressed,’ Ally said firmly. ‘I saw you yesterday when you came in for monitoring and you’ve come a long way since then.’ Because Lucy’s baby was more than a week overdue, she had been coming into the unit for regular monitoring to ensure that the baby was still active and Ally was telling Lucy the truth—in twenty-four hours she had come a long way. ‘The baby is in a great position, and your cervix has thinned out beautifully. Now it’s just a matter of letting your body do its job. Remember how I told you that for the baby it’s like trying to push its head through a tight jumper?’

Lucy nodded.

‘Well, that’s what’s happening now. I know it can seem disappointing to hear that you’re only one centimetre dilated, but this isn’t a numbers game. You could dilate quite rapidly from here, or then again the contractions might abate for a while and give you some much-needed rest—but, whatever happens, you’re in labour, Lucy, and if you feel you needed to be here, then you’re in the right place.’

‘So what now?’

‘What do you want to do?’ Ally asked, not wanting to force her own opinions on her patient. But when Lucy just stared back helplessly Ally offered a couple of suggestions. ‘Why don’t you go for a gentle walk around the ward—let gravity help things along a bit?’

‘What about when I get a contraction?’

‘Lean on Dean.’ Ally smiled, looking over at the anxious husband.

‘People will think I’m mad! I’m not exactly dignified when I get a contraction.’

‘No one will turn a hair—we’re all completely used to that sort of thing here. This time tomorrow you’ll be watching some other woman doing exactly the same while you’re holding your very own baby and thinking, The poor thing. But walking around can help speed things along. After that it might be nice to have a deep bath, which can help relax you and take the edge off the pain.

‘Does that sound like a plan?’ she asked.

Lucy nodded, and as she heaved herself up out of bed, Ally helped her into a dressing-gown.

‘How long are you here for?’ Lucy asked.

‘I’m off duty soon, but I’ll be back at seven in the morning and by then I’m sure that you’ll either have your baby or you’ll be on the home run!’

‘God, I hope I’ve had it,’ Lucy sighed. ‘Did I really say I didn’t want any drugs?’

‘You really did.’ Ally grinned. ‘But nothing’s set in stone in the labour ward!’

Nothing in life was set in stone, Ally decided as two minutes after midnight her car pulled up in her driveway, her head still spinning from an evening in Rinska’s company. The house was in darkness. Fumbling in her bag for her keys, Ally opened her front door. The first thing to hit her was the smell of cold pizza, the second the deep vibrations of Rory snoring, the third the horrible sting of tears as she slumped on the bottom stair and put her head in her hands.

Rory didn’t often snore—but when he did, the house vibrated with each and every agonising breath. So much so that on occasions, when poking and pleading hadn’t helped, Ally had sat on this very step playing cards with his latest girlfriend, explaining that this wasn’t the norm. Rory only snored when he was seriously exhausted, perhaps after a full weekend on call or on the very rare occasion when he’d had too much too drink. Despite the fact Rory was very much a bloke’s bloke, he didn’t drink that much, too mindful of his patients to let loose. Rory invariably hit the diet cola, but every now and then he handed over his pager—when his rugby team won the final, which was almost never, and if he wasn’t rostered on for New Year and once or twice on his birthday.

She’d sat on these steps with Rory’s girlfriends for other reasons too—when Rory had decided to up stumps and move on! Box of tissues in hand, Ally had sat and shivered, listening as a pretty mascara-streaked face had begged Ally to tell her where she’d gone so wrong, attempting to explain that it wasn’t them that had the problem—that there wasn’t a thing they could change that would make him stay. Rory had told them from the very start that he didn’t want to settle down, that he was here for a good time, not a long time.

Her eyes caught on a duty-free bag on the hall table. Frowning, Ally picked it up and read Rory’s scruffy unmistakable writing that told her he’d given up and gone to bed, but thought she might like this. Peering into the bag, Ally started at the familiar purple packaging of what had once been her favourite perfume.

Once been, because the day Rory had left, she’d never worn it again.

Pulling open the lid, she aimed a squirt on her wrist, inhaling the heavy fragrance, closing her eyes and dragging it in, the husky, seductive tones evoking memories too dangerous to recall…Rory holding her, the strong, infinitely safe cradle of his arms wrapped around her slender body, the weight of his lips as he slowly explored every flickering pulse point, speaking to her for the first and last times in the intimate tones that were saved for the bedroom, telling her how her perfume drove him crazy, whispering dangerous words as he drove her to a higher place, telling her how the lingering scent of her long after she’d left a room could hold him there a moment longer…

And she couldn’t do it, couldn’t go there. Rubbing her wrists on her shirt as if she were contaminated, Ally tried to escape the heady smell, tried to slam shut the window of memories he had opened, but the blast was too strong, every recall painful, every memory tainted by his departure—multiplied by his re-emergence. Burying her head in her hands, Ally let out a tiny low moan, shook her head and willed it all to stop, but her mind was stuck in some vengeful replay, forcing her to remember the past, forcing her to gaze once again into those green eyes and recall his words.

‘You’d be so easy to stay for.’

‘Then stay.’ Two words uttered in the glowy dew of their first love-making, and even with his bags packed in the hall, the taxi booked to take him away, surely the love they had shared that night and the two words she had uttered should have revealed to him how much he meant to her.

But he hadn’t stayed.

Ally could still hear the sound of the shower in the en suite that horrible morning as he’d washed away every trace of her fragrance. She could still recall lying in bed and facing the curtains, pretending to be asleep as he awoke, sensing the regret that had drenched his body as he’d replayed the events of the previous night. Quickly, silently he’d dressed and an audible sigh of relief had come from him as the taxi had tooted in the driveway and he’d placed one final kiss on the swell of her shoulder.

Sitting on the stairs, head in hands now, it felt as if for three years she’d been playing some grown-up version of snakes and ladders. Elation at their closeness followed by devastation at his departure—and then the horrible process of regrouping, living in a world where he didn’t exist any more. The occasional postcard had been nowhere near enough to sustain her, so she’d focused instead on her work—climbing her career ladder in record time, placing a tentative toe into the murky single world she inhabited, dating even when she hadn’t felt like it, clawing her way to the top, where now it was Ally turning down dates, Ally who could pick and choose where she went on a Saturday night. Only for Rory to appear again, only to roll a six and find herself sliding down that appalling slippery slope and arrive back at the beginning.

And suddenly all the game looked was daunting—the thought of starting over incomprehensible.

Two weeks!

He could stay for two weeks and then he’d damn well have to find somewhere else. There was no way she could keep this up, no way he could expect to walk back in and take up their easy-going friendship, to stroll back into her life and take up where he’d left off.

An ironic smile twisted her mouth.

He’d left her naked in bed.

Showering in record time, Ally pulled on a T-shirt and for reasons she couldn’t quite fathom she bypassed the G-strings and pulled on the biggest, comfiest, ugliest pair of knickers she could find—knickers her great aunt had sent her one Christmas, knickers that she had meant to throw out, knickers she wouldn’t be seen dead cleaning the windows with! Sliding into her cold sheets, she pulled the blankets up to her chin, closing her eyes on this turbulent day, willing sleep to come so that she could function tomorrow. Pulling a pillow over her head, she tried to drown out the noise, then gave in and stared at the ceiling, admitting the truth: it wasn’t Rory’s exhausted snoring that was keeping her awake—the house could be in silence and she’d still be lying here awake.

It was the overwhelming fact that he was here.

CHAPTER TWO

WAKING up before her alarm, Ally washed and dressed in record-breaking time, layered her lashes with mascara and headed down to the kitchen. Berating the fact she’d flung all the sugar and milk down the sink, and loath to grind beans at this hour, Ally settled instead for a cup of black tea and a slug of honey as she stared at her ancient toaster and willed it to get a move on so that she could hopefully get out before Rory appeared.

The doctors normally started arriving on the ward around eight, an hour after Ally’s shift started, but, given it was his first day, no doubt Rory would be keen to make an early appearance. But Ally was determined to be in her car before Rory even hit the shower. Collecting up her pens and stethoscope and slinging her identity tag around her neck, Ally wondered if she shouldn’t give him a quick knock before she left. There were no signs of life coming from his bedroom. Normally, or at least a few years ago, Rory would have been up like a lark, noisily hogging the shower, breakfast radio blaring, and Ally wondered if he’d thought to set his alarm clock before he’d gone to sleep.

Of course he had, Ally assured herself. After all, he’d managed to work his way through two pizzas and had written her a note to go with her perfume before he’d gone to bed, It wasn’t as if he’d slept round the clock since she’d left him at lunchtime the previous day. And anyway, Ally decided, if he couldn’t remember to set his own alarm clock, it was hardly her problem. Closing the front door behind her at a quarter to seven, guilt caught up with her and she re-opened the door, this time slamming it with rather more force than she’d intended, causing her neighbour to frown as he picked up his newspaper from the nature strip and starting every dog in the vicinity yapping as if the postman was about to arrive.

Surely that would shift him!

‘I told you that you’d be on the home run!’ Walking into the delivery room after handover, Ally took a very agitated Lucy’s hand.

‘You told me I’d have had it by now!’ Lucy shouted, her face red from exertion. ‘I can’t do this! I want an epidural. Where the hell’s the anaesthetist?’

Ally had actually been rostered on for the postnatal ward this morning but, hearing how agitated and upset Lucy had become, it had been decided to do a hasty swap with the nursing allocations—continuity of care was always preferred and in some cases, such as this, essential. Lucy was starting to lose control, her high expectations of her labour—a quick natural birth—hadn’t apparently eventuated. Because Ally had seen Lucy on a number of occasions in Antenatal and on her arrival yesterday evening, it had been considered appropriate that she be present for Lucy’s delivery in the hope a familiar face might calm her.

‘It’s too late for an epidural, Lucy.’ Ally kept her voice firm, checking her patient’s observations and the latest CTG recording and noting that everything was progressing completely normally, though maybe not as quickly as Lucy would have liked. ‘You’ve already started pushing. Your baby’s going to be here very soon.’

‘It hurts,’ Lucy shrieked, fighting the contraction that overwhelmed her.

‘Lucy, take a deep breath and push.’ Ally’s voice overrode her patient’s scream. ‘Don’t waste your energy. Come on, push over the pain…’ For a second or two Lucy listened, pushing hard as Ally encouraged her. ‘That’s it. Come on, push down into your bottom.’

‘I can’t,’ Lucy gasped, lying back on the bed and shaking her head.

‘The harder you push, the sooner your baby will be here.’

‘It hurts.’

‘Because the contractions are working,’ Ally said. ‘Lucy, nothing we give you now for pain is going to have time to take effect. Your baby is nearly here, and if we give you drugs now it won’t help with your pain but it could make the baby drowsy at birth. What about trying the gas?’

‘I hate the gas!’ Lucy roared, but thankfully as another contraction came, this time she gritted her teeth and bore down as Dean, clearly thankful that things seemed a touch more in control, encouraged his wife to keep on pushing as Ally slowly counted to ten. ‘And again,’Ally said. ‘You’re doing marvelously. Take a big breath and push again!’

She was doing marvellously! In fact, just as Ally was debating whether to give the on-call a ring and let them know they’d be needed in the next hour or so, things started looking rather more imminent. Lucy’s shouts were getting louder and her language was getting more colourful as she struggled to get off the bed. The timid woman Ally had got to know was gone now as her baby prepared to make a rapid entrance.

‘Get me the bloody anaesthetist!’ Lucy roared. ‘Or I’m going home this very minute.’

‘Good morning!’

So calm and polite was Rory’s welcome, so huge his presence as he quietly made his way into the delivery room, that for a minute Lucy literally seemed to forget that she had a baby coming. Her angry face swung towards him, her bulging eyes struggling to focus as he walked over to the delivery bed.

‘Lucy Williams, I’m Rory Donovan.’

‘The anaesthetist?’ Lucy demanded. ‘About time!’

‘Afraid not.’ He gave an apologetic smile. ‘I’m an obstetrician. I thought about doing anaesthetics for a while, but I decided that I prefer my patients awake.’

‘Well, Lucy’s awake,’ a terrified Dean said, nervously shaking Rory’s hand. ‘No doubt the whole ward is now.’

‘From what I hear, she’s doing great.’ Rory gave Lucy a very nice smile and Ally could only blink in wonder as the roaring banshee that had been lying on her back suddenly sat up a touch and even managed a small smile back. ‘And if you carry on pushing the way you have been, you’ll have your baby in time for breakfast. I saw Win loading up her trolley as I walked past—I can’t believe she’s still here.’ The second part of his comment had been directed at Ally as she opened up a delivery pack but it was put on hold as Lucy bore down again, only this time it was with a rather more concentrated effort, and as she finished he easily resumed the conversation, this time including Lucy and Dean. ‘Win’s the domestic. She’s been here since they put the first coat of paint on and rumour has it that if you deliver before breakfast, she makes the lucky parents toast and eggs any way they want them. Sound good?’

‘Sounds great,’ Lucy gasped, gesturing for Dean to hand her some ice chips. In the momentary lull Ally headed over to the other side of the delivery room and started to pull up some drugs for the delivery and check the baby warmer.

‘Thanks for waking me.’ Rory’s sarcasm was delivered good-naturedly. ‘If your neighbour hadn’t had a dog barking the street down, I’d still be asleep.’

‘You should have set your alarm.’ Ally shrugged, refusing to take any responsibility. After all, she hadn’t seen him for three years—it was hardly fair for him to swan back into her life and expect her to suddenly start looking out for him! ‘I’m not your mother.’

And as quickly as that the light-hearted banter faded, Ally instantly regretted her words. Rory didn’t have a mother; in fact, Rory didn’t have any relatives. An only child, his mother had died when he’d been small and his father had lost his battle with cancer just before Rory had left to go to America. Ally had no idea of the circumstances of his mother’s death. Rory had only referred to it a couple of times and had always been horribly awkward with her afterwards, insisting that he was well over it, that it had all happened years ago. But, still, her thoughtless comment had clearly hurt and that had never been her intention.

Lord, how she wished somehow that she could take it back!

‘I’m sorry.’ Her apology was as embarrassed and as wooden as his response. ‘I should have known better—I just didn’t think…’

‘It’s no big deal.’ Rory shrugged those wide shoulders as if the words had barely registered, but his eyes told her otherwise. ‘I’ll go and see how Lucy’s doing.’

Gently he examined her, sitting down on the bed beside her and talking comfortingly as he performed the rather uncomfortable procedure. Ally watched as the rapport he had so easily created with his patient the moment he had walked into the room grew. Lucy was clearly comfortable with her doctor and that was incredibly important—Ally knew that more than most. In the public health system, rarely did patients get much of a say in what doctor would deliver them. Often, as the doctor arrived for the delivery, there wasn’t even time for more than the briefest of introductions. This matter had been addressed at Bay View by the midwifery team, a group of midwives allocated to each patient, looking after the mother during her pregnancy, so that in most cases a familiar face was present at the delivery. But even if Rory’s face wasn’t familiar, this morning it was very welcome. Dean was listening carefully as Rory explained his wife’s progress.

‘She’s almost there, Dean. Just encourage her to keep pushing. You’re both doing a great job.’

‘Don’t go too far.’ Ally smiled as Rory stood up, no doubt realising there was a good half-hour’s work before the baby came and ready for a bit of TLC and catching up with Win. ‘We might be needing you soon.’

‘I’m not going anywhere,’ Rory said easily, picking up a newspaper Dean had bought from the mobile trolley, sitting down on the two-seater sofa in the corner and turning directly to his horoscope. ‘Do you know what you’re having, Lucy?’

‘A baby,’ she gasped, ‘hopefully.’