Midwives On-Call

‘Is this what you wanted me to do? Adopt the kids the world’s abandoned?’

‘I don’t think I expected anything of you,’ she managed, and was inordinately proud of how calm she sounded. ‘At the end of our marriage all I could see was what I needed. I know that sounds selfish, and maybe it is, but it’s what I desperately wanted. Despite loving you I couldn’t stop that wanting. You always knew I wanted a family. I’m a midwife, and I’m a midwife because watching babies come into the world is what I love most. I’d dreamed we could have our own family …’

‘And when that didn’t happen you walked away.’

‘As I remember it, you walked.’

‘Because it’s not fair for me to adopt. These kids need their own parents.’

‘They don’t have them. Are you saying second best is worse than nothing?’

‘They’ll know … that they’re second best.’

‘Oliver, just because that happened to you …’

And she watched his face close, just like that.

He didn’t talk about it, she thought. He’d never talked about it but she’d guessed.

She thought, fleetingly, of her in-laws, of Oliver’s adoptive parents. But she had to think fleetingly because thinking any more made her so angry she could spit.

She only knew the bare bones but it was enough. She could infer the rest. They’d had trouble conceiving so they’d adopted Oliver. Then, five years later, they’d conceived naturally and their own son had been born.

Oliver never talked about it—never would talk about it—but she’d seen the family in action. Brett was five years younger than Oliver, a spoiled brat when Em had first met him and now an obnoxious, conceited young man who thought the world owed him a living.

But his parents thought the sun shone from him, and it seemed to Em that they’d spent their lives comparing their two sons, finding fault with Oliver and setting Brett on a pedestal.

Even at their wedding …

‘He’s done very well for himself,’ Em had overheard his adoptive mother tell an aunt. ‘Considering where he comes from. We’ve done what we could, but still … I know he’s managed to get himself qualified as a doctor but … His mother was a whore, you know, and we can never forget that. Thank God we have Brett.’

It had been as much as Em could do not to front the woman and slap her. It wouldn’t have been a good look on her wedding day—bride smacks mother-in-law—but she’d come awfully close. But Oliver had never talked of it.

It was only when the adoption thing had come up when Josh had died that the ghosts had come from nowhere. And she couldn’t fight them, for Oliver wouldn’t speak of them.

‘Oliver, we’re doing our best,’ she told him now, gentling, reminding herself that it was his ghosts talking, not him. She knew it was his ghosts, but she’d never been allowed close enough to fight them. ‘Mum and I are loving these kids to bits. We’re doing all we possibly can …’

‘It won’t be enough.’

‘Maybe it won’t.’ She was suddenly bone weary again. Understanding could only go so far. ‘But we’re trying the best that we can. We’ll give these kids our hearts, and if that’s not enough to let them thrive then we’ll be incredibly sad but we won’t be regretful. We have love to give and we’re giving it. We’re trying, whereas you … You lacked courage to even think about it. “No adoptions,” you said, end of story. I know your background. I know how hard it was for you to be raised with Brett but your parents were dumb and cruel. The whole world doesn’t have to be like that.’

‘And if you ever had a child of your own?’

‘You’re saying I shouldn’t go near Gretta or Toby because I might, conceivably, still have a child biologically?’

‘I didn’t mean that.’ He raked his hair again, in that gesture she’d known and loved. She had a sudden urge to rake it herself, settle it, touch his face, take away the pain.

Because there was pain. She could see it. This man was torn.

But she couldn’t help him if he wouldn’t talk about it. To be helped you had to admit you needed help. He’d simply closed off, shut her out, and there was nothing she could do about it.

She’d moved on, but he was still hurting. She couldn’t help him.

‘Go home,’ she said, gently again. ‘I’m sorry, Oliver, I have no right to bring up the past, but neither do you have a right to question what I’m doing. Our marriage is over and we need to remember it. We need to finalise our divorce. Meanwhile, thank you for tonight, for Adrianna’s birthday. I’m deeply appreciative, but if you want to pull out of Saturday’s childminding, I understand.’

‘I’ll be here.’

‘You don’t need to …’

‘I will be here.’

‘Fine, then,’ she said, and took a step back in the face of his sudden blaze of anger. ‘That’s good. That’s great. I’ll see you then.’

‘I’ll see you at the hospital tomorrow,’ he said. ‘With Ruby.’

And her heart sank. Of course. She was going to see this man, often. She needed to work with him.

She needed to ignore the pain she still saw in his eyes. She needed to tell herself, over and over, that it had nothing to do with her.

The problem was, that wasn’t Em’s skill. Ignoring pain.

But he didn’t want her interference. He never had.

He didn’t want her.

Moving on …

‘Goodnight, then,’ she managed, and she couldn’t help herself. She touched his face with her hand and then stood on tiptoe and lightly kissed him—a feather touch, the faintest brush of lips against lips. ‘Goodnight, Oliver. I’m sorry for your demons but your demons aren’t mine. I give my heart for always, non-negotiable, adoption, fostering, marriage … Ollie, I can no more change myself than fly. I’m just sorry you can’t share.’

And she couldn’t say another word. She was suddenly so close to tears that she pushed away and would have stumbled.

Oliver’s hand came out to catch her. She steadied and then brushed him off. She did it more roughly than she’d intended but she was out of her depth.

‘Thank you,’ she whispered, and turned away. ‘Goodnight.’ And she turned and fled into the house.

Oliver was left standing in the shadows, watching the lights inside the house, knowing he should leave, knowing he had to.

‘I give my heart for always.’

What sort of statement was that?

She’d been talking about the kids, he told himself, but still …

She’d included marriage in the statement, and it was a statement to give a man pause.

CHAPTER SIX

EM HARDLY SAW Oliver the next day. The maternity ward was busy, and when she wasn’t wanted in the birthing suites, she mostly stayed with Ruby.

The kid was so alone. Today was full of fill-in-the-blanks medical forms and last-minute checks, ready for surgery the next day. The ultrasounds, the visit and check by the anaesthetist, the constant checking and rechecking that the baby hadn’t moved, that the scans that had shown the problem a week ago were correct, that they had little choice but to operate … Everything was necessary but by the end of the day Ruby was ready to get up and run.

She needed her mum, a sister, a mate, anyone, Em thought. That she was so alone was frightening. Isla dropped in for a while. Ruby was part of Isla’s teen mums programme and Ruby relaxed with her, but she was Ruby’s only visitor.

‘Isn’t there anyone I can call?’ Em asked as the day wore on and Ruby grew more and more tense.

‘No one’ll come near me,’ Ruby said tersely. ‘Mum said if I didn’t have an abortion she’d wash her hands of me. She said if I stayed near her I’d expect her to keep the kid and she wasn’t having a thing to do with it. And she told my sisters they could stay away, too.’

‘And your baby’s father?’

‘I told you before, the minute I told him about it, he was off. Couldn’t see him for dust.’

‘Oh, Ruby, there must be someone.’

‘I’ll be okay,’ Ruby said with bravado that was patently false. ‘I’ll get this kid adopted and then I’ll get a job in a shop or something. I just wish it was over now.’

‘We all wish that.’

And it was Oliver again. He moved around the wards like a great prowling cat, Em thought crossly. He should wear a bell.

‘What?’ he demanded, as she turned towards him, and she thought she really had to learn to stop showing her feelings on her face.

‘Knock!’

‘Sorry. If I’m intruding I’ll go away.’

‘You might as well come in and poke me, too,’ Ruby sighed. ‘Everyone else has. I’m still here. Bub’s still here. Why is everyone acting like we’re about to go up in smoke before tomorrow? Why do I need to stay in bed?’

‘Because we need your baby to stay exactly where she is,’ Oliver told her, coming further into the room. He had a bag under his arm and Ruby eyed it with suspicion. ‘Right now she’s in the perfect position to operate on her spine, and, no, Ruby, there’s not a single thing in this bag that will prod, poke or pry. But I would like to feel your baby for myself.’

Ruby sighed with a theatrical flourish and tugged up her nightie.

‘Go ahead. Half the world already has.’

‘Has she moved?’

‘Nah.’ She gave a sheepish grin. ‘I feel her myself. I’m not stupid, you know.’ And she popped her hand on her tummy and cradled it.

There was that gesture again. Protective. ‘Mine.’

Oliver sat down on the bed and felt the rounded bump himself, and Em looked at the way he was examining the baby and thought this was a skill. Ruby had been poked and prodded until she was tired of it. Oliver was doing the same thing but very gently, as if he was cradling Ruby’s unborn child.

‘She’s perfect,’ he said at last, tugging Ruby’s nightie back down. ‘Like her mother.’

‘She’s not perfect. That’s why I’m here.’

‘She’s pretty much perfect. Would you like to see a slide show of what we’re about to do?’ He grinned at Ruby’s scared expression. ‘There’s not many gory bits and I can fast-forward through them.’

‘I’ll shut my eyes,’ Ruby said, but he’d caught her, Em thought. She wasn’t dissociated from this baby. Once again she saw Ruby’s hand move surreptitiously to her tummy.

He flicked open his laptop. Fascinated, Em perched on the far side of the bed and watched, too.

‘This is one we prepared earlier,’ Oliver said, in the tone TV cooks used as they pulled a perfect bake from the oven. ‘This is Rufus. He’s six months old now, a lovely, healthy baby, but at the start of this he was still inside his mum, a twenty-two-weeker. This is the procedure your little one will have.’

The screen opened to an operating theatre, the patient’s face hidden, the film obviously taken for teaching purposes as identities weren’t shown. But the sound was on, and Em could hear Oliver’s voice, calmly directive, and she knew that it was Oliver who was in charge.

She was fascinated—and so was Ruby. Squeamishness was forgotten. They watched in awe as the scalpel carefully, carefully negotiated the layers between the outside world and the baby within. It would be an intricate balance, Em knew, trying to give the baby minimal exposure to the outside world, keeping infection out, disturbing the baby as little as possible yet giving the surgeons space to work.

There were many doctors present—she could hear their voices. This was cutting-edge surgery.

‘I can see its back,’ Ruby breathed. ‘Oh … is that the same as my baby?’

‘They’re all different,’ Oliver said. ‘Your daughter is tilted at a better angle.’

‘Oh …’ Ruby’s eyes weren’t leaving the screen.

They could definitely see the baby now, and they could see how the baby was slightly tilted to the side. Carefully, carefully Oliver manoeuvred him within the uterus, making no sudden movements, making sure the move was no more dramatic than if the baby himself had wriggled.

And now they could see the spine exposed. The telltale bulge …

‘Is that the problem? The same as mine?’ Ruby whispered, and Oliver nodded.

‘Rufus’s problem was slightly lower, but it’s very similar.’

Silence again. They were totally focused, all of them. Oliver must have seen this many times before, Em thought—and he’d been there in person—but he was still watching it as if it was a miracle.

It was a miracle.

‘This is where I step back and let the neurosurgeon take over,’ Oliver said. ‘My job is to take care of the whole package, you and your baby, but Dr Zigler will be doing this bit. He’s the best, Ruby. You’re in the best of hands.’

They watched on. The surgery was painstaking. It was like microsurgery, Em thought, where fingers were reattached, where surgeons fought hard to save nerves. And in a way it was. They were carefully working around and then through the bulge. There’d be so many things to work around. The spinal cord was so fragile, so tiny. The task was to repair the damage already done, as far as possible, and then close, protecting the cord and peripheral nerves from the amniotic fluid until the baby was born.

‘Is … is it hurting?’ Ruby breathed, as the first incision was made into the tiny back.

‘Is he hurting? No. Rufus is anaesthetised, as well as his mum. Did you see the anaesthetist working as soon as we had exposure? The jury’s out on whether unborn babies can feel pain. There are those who say they’re in a state similar to an induced coma, but they certainly react to a painful touch. It makes the procedure a little more risky—balancing anaesthetic with what he’s receiving via his mum’s blood supply—but the last thing we want is to stress him. Luckily the Victoria has some of the best anaesthetists in the world. Vera Harty will be doing your anaesthetic and your daughter’s. I’d trust her with a baby of my own.’

Ruby was satisfied. She went back to watching the screen.

Em watched, too, but Oliver’s last statement kept reverberating.

I’d trust her with a baby of my own.

The sadness was flooding back. Oliver had been unable to have a baby of his own—because of her. She had fertility problems, not Oliver.

He’d left her years ago. He could have found someone by now.

Maybe he had. Maybe he just wasn’t saying.

But he hadn’t. She knew him well, this man.

There’d been an undercurrent of longing in the statement.

They’d both wanted children. She’d released him so he could have them. Why hadn’t he moved on?

Watch the screen, she told herself. Some things were none of her business. Oliver was none of her business—except he was the obstetrician treating her patient.

She went back to being professional—sort of. She went back to watching Rufus, as Oliver and Ruby were doing.

The procedure was delicate and it took time but it seemed Oliver was in no hurry to finish watching, and neither was Ruby. Em couldn’t be, either. Her job was to keep Ruby calm for tomorrow’s operation, and that’s what was happening now. The more familiar the girl was about what lay ahead, the more relaxed she’d be.

And not for the first time, Em blessed this place, this job. The Victoria considered its midwives some of the most important members of its staff. The mothers’ needs came first and if a mum needed her midwife then Isla would somehow juggle the rest of her staff to cover.

Unless there was major drama Em wouldn’t be interrupted now, she thought, and she wasn’t. They made an intimate trio, midwife and doctor, with Ruby sandwiched between. Protected? That’s what it felt like to Em, and she suspected that’s how Ruby felt. Had Oliver set this up with just this goal? She glanced at him and knew her suspicion was right.

The first time she’d met him she’d been awed by his medical skills. Right now, watching him operate on screen, feeling Ruby’s trust growing by the second, that awe was escalating into the stratosphere.

He might not make it as a husband, but he surely made it as a surgeon.

Back on screen, the neurosurgeon was suturing, using careful, painstakingly applied, tiny stitches, while Oliver was carefully monitoring the levels of amniotic fluid. This baby would be born already scarred, Em thought. He’d have a scar running down his lower back—but with luck that was all he’d have. Please …

‘It worked a treat,’ Oliver said, sounding as pleased as if the operation had happened yesterday, and on screen the neurosurgeon stood back and Oliver took over. The final stitches went in, closing the mum’s uterus, making the incision across the mum’s tummy as neat as the baby’s. ‘Rufus was born by Caesarean section at thirty-three weeks,’ Oliver told them. ‘He spent four weeks in hospital as a prem baby but would you like to see him now?’

‘I … Yes.’ Ruby sounded as if she could scarcely breathe.

‘We have his parents’ permission to show him to other parents facing the same procedure,’ Oliver told her. ‘Here goes.’

He fiddled with the computer and suddenly they were transported to a suburban backyard, to a rug thrown on a lawn, to a baby, about six months old, lying on his back in the sun, kicking his legs, admiring his toes.

There was a dog at the edge of the frame, a dopey-looking cocker spaniel. As they watched, the dog edged forward and licked the baby’s toes. Rufus crowed with laughter and his toes went wild.

‘He doesn’t … he doesn’t look like there’s anything wrong with him,’ Ruby breathed.

‘He still has some issues he needs help with.’ Oliver was matter-of-fact now, surgeon telling it like it was. ‘He’ll need physiotherapy to help him walk, and he might need professional help to learn how to control his bladder and bowels, but the early signs are that he’ll be able to lead a perfectly normal life.’

‘He looks … perfect already.’ Ruby was riveted and so was Em. She was watching Ruby’s face. She was watching Ruby’s hand, cradling her bump. ‘My little one … my little girl … she could be perfect, too?’

‘I think she already is.’ Oliver was smiling down at her. ‘She has a great mum who’s taking the best care of her. And you have the best midwife …’

Em flashed him a look of surprise. There was no need to make this personal.

But for Ruby, this was nothing but personal. ‘Em says she’ll stay with me,’ Ruby told him. ‘At the operation and again when my baby’s born. There’s a chance that she can’t—she says no one’s ever totally sure because babies are unpredictable—but she’s promised to try. I hope she can, but if she’s not then she’s introduced me to Sophia, or Isla will take over. But you’ll look after …’ Her hand cradled the bump again as she looked anxiously at Oliver. ‘You’ll look after us both?’

‘I will.’ And it was a vow.

‘Tell me again why I need a Caesarean later—when my baby’s born properly?’

He nodded, closed his laptop and sat back in a visitor’s chair, to all appearances prepared to chat for as long as Ruby wanted. He was busy, Em knew. As well as the promises he’d made her to childmind on Saturday, she knew he already had a full caseload of patients. But right now Ruby was being given the impression that he had all the time in the world, and that time was Ruby’s.

He was … gorgeous. She knew it, she’d always known it, but suddenly the thought almost blindsided her.

And it was more than him being gorgeous, she thought, feeling dazed. She was remembering why she’d loved this man.

And she was thinking—idiotically—that she loved him still.

Concentrate on medicine, on your patient, on anything other than Oliver, she told herself fiercely. Concentrating on Oliver was just too scary.

What had Ruby asked? Why she needed a Caesarean?

‘You see the incision we just cut in Rufus’s mum’s uterus?’ Oliver was saying, flicking back to the screen, where they could see the now closed incision in the abdomen. ‘I’ve stitched it with care, as I’ll stitch you with care, but when your bub comes out, she’ll push. You have no idea how hard a baby can push. She wants to get out to meet you, and nothing’s going to stop her. So maybe she’ll push against that scar, and if she pushes hard enough on very new scar tissue she might cause you to bleed. I have two people I care about, Ruby. I care about your daughter but my absolute priority is to keep you safe. That means a Caesarean birth, because, much as I want to meet your baby, we’ll need to deliver her before she even thinks about pushing.’

‘But if you wanted to keep me really safe you wouldn’t operate in the first place,’ Ruby muttered, a trace of the old resentment resurfacing. But it didn’t mess with Oliver’s composure.

‘That’s right,’ he agreed, his tone not changing. ‘I believe we will keep you safe but there are risks. They’re minor but they’re real. That’s why it’s your choice. You can still pull out. Right up to the time we give you the anaesthetic, you can pull out, and no one will think the worse of you. That’s your right.’

The room fell silent. It was such a hard decision to make, Em thought, and once again she thought, Where was this kid’s mum?

But, surprisingly, when Ruby spoke again it seemed that worry about the operation was being supplanted by something deeper.

‘If I had her …’ Ruby said, and then amended her statement. ‘When I have her … after she’s born, she’ll have a scar, too.’

‘She will,’ Oliver told her, as watchful as Em, waiting to know where Ruby was going with this.

‘And she’ll have it for ever?

‘Yes.’

‘She might hate it—as a teenager,’ Ruby whispered. ‘I know I would.’

‘I’ll do my best to make it as inconspicuous as possible—and cosmetic touch-ups when she’s older might help even more. It shouldn’t be obvious.’

‘But teenagers freak out about stuff like that. I know I would,’ Ruby whispered. ‘And she won’t have a mum to tell her it’s okay.’

‘If she’s adopted, she’ll have a mum,’ Em ventured. ‘Ruby, we’ve gone through what happens. Adoption is your choice all the way. You’ll get to meet the adoptive parents. You’ll know she goes to parents who’ll love her.’

‘But … Fil love her more. She’s my baby.’

And suddenly Ruby was crying, great fat tears slipping down her face, and Em shifted so she could take her into her arms. And as she did so, Oliver’s laptop slid off the bed and landed with a crash on the floor.

Uh-oh. But Em didn’t move. For now she couldn’t afford to think of computers. For now holding this girl was the most important thing in the world.

But still … A car and then a laptop …

She was starting to be an expensive ex-wife, she thought ruefully, and she almost smiled—but, of course, she didn’t. She simply held Ruby until the sobs receded, until Ruby tugged away and grabbed a handful of tissues. That was a bit late. Em’s shoulder was soaked, but who cared? How many times had Em ever finished a shift clean? She could count them on one hand. She always got her hands dirty, one way or another.

And it seemed, so did Oliver, for he was still there. Most consultants would have fled at the first sign of tears, Em thought. As a breed, surgeons weren’t known for their empathy.

He’d risen, but he was standing by the door, watching, and there was definitely sympathy. Definitely caring.

He was holding the two halves of his laptop. The screen had completely split from the keyboard. And the screen itself … smashed.

‘Whoops,’ she said, as Ruby blew her nose.

He glanced down at the ruined machine. ‘As you say, whoops.’

And as Ruby realised what he was holding, the teenager choked on something that was almost a laugh. ‘Em’s smashed your computer,’ she said, awed. ‘Do you mind?’

‘I can’t afford to mind.’

‘Why not?’ She was caught, pulled out of her misery by a smashed computer.

‘Priorities,’ he said. ‘You. Baby. Computer. In that order.’

‘What about Em?’ she asked, a touch of cheekiness emerging. ‘Is she a priority?’

‘Don’t you dare answer,’ Em told him. ‘Not until you’ve checked that your computer is covered by insurance. Ruby, if you’re rethinking your plans to adopt …’

‘I think … I might be.’

‘Then let’s not make any decisions yet,’ she said, hurriedly. Surely now wasn’t the time to make such an emotional decision? ‘Let’s get this operation over with first.’