Полная версия
Baby for the Midwife: The Midwife's Baby / Spanish Doctor, Pregnant Midwife / Countdown to Baby
ON GEORGIA’S third morning shift the day dawned cold and damp, with thick fog that engulfed the mountain and the road on the way to work. Georgia had left fifteen minutes early to be on the safe side and still only arrived as the clock hit seven.
Minutes after the night staff had departed a young woman hobbled miserably into the ward with her friend. She stood at the nurses’ desk with her hand cupped protectively around her small belly and her lips pressed tightly together.
Georgia came back from the medical end of the hospital at the sound of the buzzer and something about the young woman’s stance sent alarm bells ringing.
‘Can I help you?’ The young woman nodded but didn’t speak.
‘She’s having contractions,’ Her friend said, ‘and you need to stop them.’
Georgia blinked. OK. This was different. ‘I’m Georgia, the midwife. Would you both like to come through to the observation room and we’ll see what’s going on? Then I can ring the doctor.’
The spokeswoman nodded. ‘I’m Shannon and this is my friend, Del. She’s got eight weeks to go.’
Georgia glanced at the silent Del and her heart rate picked up. They’d have to fly her out if she was in labour—they couldn’t handle a baby that size here. Even the base hospital wouldn’t take her at that gestation.
Shannon went on. ‘She’s having twins.’
Georgia’s eyebrows rose. They’d have to fly her out urgently, which would be interesting with the fog. A twin pregnancy was even more likely to progress to a premature delivery.
Del froze as she went to sit on the bed and she grabbed Georgia’s hand and squeezed it as her contraction mounted. Georgia slid her other hand down to gently feel Del’s belly through her shirt, and it felt rock hard against her fingers.
Georgia reached for the buzzer and pressed for assistance. She glanced at Shannon and although Shannon looked scared, at least she could talk. Del certainly wouldn’t be talking for a minute. ‘How long has Del been having contractions?’
‘It took us an hour to get here and an hour before that.’
Two hours shouldn’t be too advanced in labour for a first baby, Georgia thought hopefully. ‘Is this your first pregnancy, Del?’
Shannon came to the rescue when all Del did was shake her head. ‘Her third. The last one took two hours.’
Georgia smiled at Shannon. ‘I’m glad you came with her.’ She looked at Del. ‘You’re not much of a talker, then, Del?’
Before Del could answer, if she was going to, a slightly breathless Flo arrived.
Georgia smiled at her. ‘Today we’re going to study the premature labour tray.’
Flo grinned and headed for the cupboard. She reached in and put the tray on the bench. ‘I hope it comes with instructions.’
‘You’d better ring Doctor, first, on his mobile. Tell him thirty-two-week twins in labour. He’ll come straight in.’
Flo’s mouth formed her favourite ‘O’ and she pulled the phone book across.
Georgia helped Del to lie on the bed and connected the monitors to her stomach. ‘These belts hold on the listeners that hear your babies’ heart rates and record your contractions at the same time. In your case we have two listeners for two babies’ hearts.’
Del nodded and winced as the next contraction started. Georgia could hear Flo’s brief conversation with Max.
She looked up. ‘Ask him if I can give the first dose of nifedipine as her contractions are three minutes apart.’
Flo nodded back. ‘He heard you and said give the first dose. He’ll be here before the next one is due.’ She hung up and came back across to Georgia. ‘You want some observations done?’
‘Please. I need to check Del’s antenatal records as well.’
Shannon was the only one with a shoulder-bag and Georgia directed her next enquiry to her.
‘Have you got Del’s antenatal card?’
‘She doesn’t have one. She’s only been the once because the doctor said she’d have to go to Brisbane to have her babies. She didn’t want to do that so she never went back to him.’
Georgia’s heart sank at the lack of antenatal care and information now available. ‘Where were you going to have your babies, Del?’
Del looked at Shannon. Shannon answered. ‘Here.’
Thirty-two-week twins here and no antenatal care. Meeandah was good but not that good.
Georgia rummaged through the tray and removed a strip of tablets and two spoons. ‘We want to stop your labour Del. I’ll crush this tablet between two teaspoons and you have to put it under your tongue until it dissolves. It’s actually a blood-pressure tablet that works on the muscles of the blood vessels but it relaxes uterine muscles as well.
‘The plan is that you have fewer contractions the more tablets you have.’And the doctor arrives soon after, Georgia thought hopefully. ‘Do you understand?’
Del nodded. Georgia looked at Shannon and lowered her voice. ‘Does Del talk at all?’
‘Sometimes if she has to, but she finds it hard.’
‘That’s OK, Del. As long as you understand and let me know if you need to know more—OK? And as long as Shannon stays.’ She grinned at Del’s friend.
Del nodded and opened her mouth and Georgia thought she was going to speak. She held her breath but Del only waited for the crushed tablet before closing her mouth again.
‘When the doctor comes, he’ll want to examine you to see if your cervix is opening. That makes a difference to what we do next. OK?’
Del nodded.
‘We’ll probably give you an injection to help your babies’ lungs mature in case they are born too soon.’
Del nodded and Georgia found herself nodding too. It all began to feel like a farce with all the headbobbing.
Georgia selected the cortisone injection from the tray and set it aside for Max to decide on. They’d need to liaise with whatever referral hospital had beds for premature twins but MIRA would set up the conference call between the parties as soon as Max rang them.
MIRA, standing for Mobile Infant Retrieval Australia, would fly mum and babies wherever they needed to go with expert personnel—as long as the mist lifted and they could land.
‘Can you give Del’s doctor’s name to Flo and she’ll get him to fax what info he has to us here?’ she asked Shannon. Shannon nodded and followed Flo out.
Max arrived sooner than was prudent, considering the road conditions, and Georgia was glad to see him safe as well as have access to his assistance.
‘This is Del.’
‘Hi, Del. I’m Max. I’m the doctor. Georgia says you’re in premature labour. You must be pretty scared at what’s going on.’
Del looked around for Shannon and Georgia held off answering for her to see if Del would speak.
She nodded.
Georgia did Shannon’s job. ‘Del’s not much of a talker. She’s having contractions three minutes apart, third pregnancy, quick labours. One antenatal visit, one ultrasound at eighteen weeks. They’re faxing it through as soon as they open the surgery, I guess.’
‘Good stuff.’ He held his hands up. ‘May I feel your tummy, please, Del?’
Georgia nodded along with Del and then realised what she’d done. She was going mad.
She left Max to jot down what she’d found so far and by the time she’d finished Max was ready to examine the patient.
Afterwards he pulled the chair up beside the bed to talk to Del. Georgia leaned out the door and called Shannon to come back in.
‘Shannon is spokesperson and she does a great job. It might be worthwhile waiting for her.’
Max raised his eyebrows and looked at Del. ‘Is that what you want, Del?’
Del nodded vehemently but she didn’t say anything.
Max sat back and Shannon hurried back in with Flo at her heels.
Georgia took Flo aside. ‘Can you switch both humidcribs on in the storeroom? Probably won’t need them but if it looks like we will then we’ll move them to the power points outside the door. Just leave them where they are for now as long as they are warming.’
Flo nodded and left.
Max had introduced himself to Shannon and then spoke to Del. ‘You’re four centimetres dilated and your babies need to be looked after by paediatricians when they are born.’ He paused to let his words sink in.
‘That means they’re too little to be looked after here at Meeandah. In fact, they’re too little to be looked after at the base hospital so they’ll have to go to Newcastle, if they have the neonatal beds free, or Sydney.’
Del’s eyes filled with tears and Max rubbed her wrist in sympathy. ‘I know it’s scary to think of going a long way away but you have to for your babies’ safety. When your babies are bigger, you will be able to come back here for them to finish growing up.’
Del nodded and looked at Shannon, who asked the question. ‘How long before she would come back?’
‘That depends how Del’s babies grow and the treatment they have when they are born.’
Max went on, ‘It is much better for babies to be transferred while they are still inside your tummy. It takes a lot of very sophisticated equipment to make an environment close to as good as your uterus is for your babies. We need to get you to a big hospital before your labour gets any further along. Do you understand?’
Shannon, Georgia and Del all nodded.
Max smiled at the three noddies. ‘I’ll be speaking to a doctor who will find where and when you’ll be going and when I know I’ll come back and tell you.
‘In the meantime, Georgia is going to give you two more tablets twenty minutes apart. Maybe later also an injection that will help the babies lungs mature for when they are born. Let Georgia know if you think your labour is getting stronger, OK?’
‘Than’ ’ou.’ Del’s quiet voice stopped Georgia as she turned away. So Del could speak. Trust Max to have elicited a response when she couldn’t. Were any women immune to the man?
‘You’re welcome, Del.’ He gave the young girl one of his special smiles and Del smiled mistily back.
Max stood up and examined the CTG tracing. ‘Your contractions have slowed a little to fiveminutely so the first dose of drug is working. Georgia will give you another tablet now.’
He looked up at Georgia. ‘I’ll be in the office on the phone if you need me.’
In the next twenty minutes Del’s contractions slowed to ten-minutely but they didn’t stop. Flo had been outside to see if the fog had lifted but the mountain still lay shrouded.
Georgia sought Max out as he finished the admission letter for whichever hospital would finally take her.
‘Del’s contractions are strong and very regular, sitting at ten minutes apart.’
He spread his hands. ‘There’s a chance one of the outlying Sydney hospitals may take her, otherwise she may have to go on to Canberra.’
‘If they don’t decide soon, she’ll get her wish and deliver here.’ Max seemed very calm considering they might have premature twins on their hands. ‘We’ll send her out by road ambulance to the base hospital until the fixed-wing aircraft can land.’
Georgia frowned. She’d tried that. ‘They refused her.’
‘With the airfields shut, they’ve OK’d it now. They said they’d even send the escort. But if she’s in strong labour they won’t take her on the plane either so she’ll have to go somewhere.’
Georgia smiled. Max had really done some ringing around. ‘You wanted the joys of rural obstetrics.’
He grinned at her. ‘Aren’t you having fun?’
‘The more the merrier.’
Max looked at her. ‘You may have spoken too soon.’ The screech of tyres could be heard coming hard round the bend into the hospital and they looked at each other as another screech heralded the arrival of someone in a great hurry.
A tall, bearded man rushed in, his eyes panicky with emotion. ‘Help us. My wife, Susie, is in the car, and she’s having the baby right now.’
Georgia tapped Max’s arm. ‘You go. I’ll get the emergency kit and a warm blanket and meet you there.’ Max nodded and jogged after the man.
Georgia hurried to collect the small tray, a warm blanket and infant rug from the hot box and a wheelchair in case they could move the woman to a more comfortable place for delivery.
By the time Georgia arrived they needed the warm blanket for the baby and the cord clamp and scissors.
The husband was calmer now that he wasn’t alone to cope and it was a very relieved family that moved into the ward to ensure all was well.
Susie clutched her baby to her as if she didn’t know where he’d come from.
‘It’s all a shock but you did beautifully,’ Max said with a smile. ‘Your son didn’t mind in the least being born in the car. He’ll probably grow up to be a rally driver.’
Flo stuck her head into the room. ‘There’s a phone call for you, Doctor.’ Max nodded to indicate he was returning to the other room, and Georgia had to smile at his mode of communication. Very appropriate for Del.
Susie shuddered. ‘Not if he drives like his father did on the way here. The fog made it a nightmare.’
‘Susie’s blood pressure is up,’ Gerry said mournfully.
‘Mine would be, too,’ Georgia said with a smile. ‘Perhaps you could just check it again in fifteen minutes, please. I’ll go back to Del if you settle everyone and maybe offer a cup of tea in here.’
‘Sure.’ Gerry was happy to have something to do with all the excitement. ‘Flo’s had all the fun this morning,’ she said.
Fifteen minutes later the ambulance arrived to take Del to the base hospital until the fog lifted, and Georgia only just finished all the transfer papers in time.
Max put the phone down. ‘They don’t want the steroids given or any more nifedipine.’
‘Do they want us to check her cervical dilatation before she leaves?’ Usually patients were assessed to ensure delivery wasn’t imminent or likely to occur during the transport period.
‘None of those things,’ Max said with a frown. ‘I queried it but the consultant was adamant.’
‘Things change all the time. Must be a new study out that I haven’t heard of,’ Georgia said, but it did seem strange to her as well.
Georgia signed and printed her name and packaged her letter and Max’s letter to the consultant stating what they’d done to go with Del.
A midwife from the base hospital had arrived as escort, which meant Georgia didn’t have to call anyone in to cover for her.
Suddenly the ward was quiet. All they had to do was clean up and prepare for the next person to come in.
After all the excitement it was a bit of an anticlimax and she wished Max could stay and have a coffee with her but she didn’t ask because it felt needy.
He waved and left and instead Flo and Gerry helped Georgia restock the trays.
‘This tray thing works pretty well.’ Flo repacked with satisfaction.
‘I wonder which one we get to use next,’ Gerry said gloomily, and Georgia laughed.
When Max walked in after work that night, Georgia had Elsa on a rug on the floor in the lounge. Elsa was stretched out on her tummy, kicking her legs with her nappy off as if trying to swim.
For Max, seeing mother and daughter so relaxed in his home, squeezed his heart so hard it was almost chest pain.
He despaired of ever being a part of their closeness. He should just enjoy this now because since the other night Georgia had created a distance between them he could feel growing every day.
At this moment she was laughing at the fierce expression on Elsa’s face as she tried to propel herself forward.
Georgia glanced up at him with her face alight as if to say, Will you look at her? This was what he wanted. She looked pleased to see him. It shouldn’t be this hard—they were legally married. It had to be a start.
He threw his briefcase on the lounge and gave in to the impulse to casually drop a kiss on the top of Georgia’s head as he passed.
‘What was that for?’ Georgia laughed up at him and he swore then he would fight for the right to be a part of their lives.
‘That is the new order of things. I’m home and I want to play, too.’ Then he knelt down in front of Elsa and tickled her. ‘Hey, young lady. Who said you could learn to crawl?’
He may have spoken to Elsa, who grimaced at him ferociously, but he listened for a response from Georgia to see how she had taken his welcome salute.
‘Right, then,’ she said. ‘You get to stay with the naked-bottomed one and I will change, because time has slipped away, and then you can shower after me.’
Georgia rose gracefully to her feet. She grinned at him and passed the disposable nappy she’d tucked under her arm before she sailed from the room.
Not too bad. At least she hadn’t banned him from head kisses. ‘Mummy thinks she can boss me around. What do you think of that?’ He bounced Elsa on his hip. ‘Though it is no hardship being left with you, young lady.’
That morning Max had shared his breakfast again with Elsa after her mother had gone to work. They’d had a fine old time and if Georgia worked the next few weeks, he planned on sharing his breakfast with his stepdaughter every day. ‘Let’s get this nappy on and we’ll have a walk out in the garden with the puppy.’
He carried a glaring Elsa out onto the veranda and the big dog moaned with pleasure when Max bounced the baby’s toes on his back for a moment. Elsa’s frown fell away and she chortled at the feel of rough doggy hair on her feet and then Max swooped her away to walk around the garden.
‘See the birdies? Birdies.’ On cue, the rainbow lorikeets screamed between themselves as they fought over the flowering bottlebrush bush, ripping the fine needles of flowers as they sought the nectar.
‘Noisy birdies,’ Max said, and Elsa crowed and opened and shut her hands in delight. The sun was heading behind the hills and the shadows were lengthening in the garden by the time Max took her back inside. The mosquitoes would be out soon and Elsa was tiring.
Dinner and bed for the baby. If only it was dinner and bed for Max, he mocked himself.
He knew who he wanted to bed, though even just holding Georgia through the long nights would be heaven. Nothing new there.
Georgia looked beautiful again tonight, Max thought soberly two hours later when they both sat down at the table. Her hair was loose and she had some flowing shirt with a deeper neckline than usual that highlighted the smoothness of her long throat.
They’d skipped pre-dinner drinks on the veranda because of Elsa’s late settling and now he was separated by the width of the table. He just wanted to touch her.
The sky grew inky outside, with clouds obscuring the stars, and Mrs White had retired for the night, leaving dinner in the kitchen.
Before he’d come home Max had rung through to see which receiving hospital Del had ended up in and how the babies were. Mother and the newborn twins were stable and settled. The one bad piece of news had been the consultant who had received them—Sol Winton.
Max still debated if Georgia should be told because he suspected the news would upset her. He knew her ex-husband had given Georgia an emotionally hard time as well as making her severely depressed.
During the last four months Max had seen no signs of paranoia or depression—and anyone with a colicky baby could easily plead depression—so Winton had obviously had some hidden agenda.
Still, she was away from him now and, theoretically, hearing about his hospital shouldn’t upset her too much.
He dragged his thoughts away from his quandary and caught Georgia in the middle of a half-hidden yawn. She even looked cute when she yawned.
‘You must be tired,’ he said. ‘It takes a while to get used to shifts again.’
She tucked her hand away from her mouth ruefully. ‘Not really. Do I look it?’ In fact, she looked a little crestfallen at his observation, and Max grinned.
‘You look positively haggard, darling,’ he drawled, and Georgia blinked before she realised he was joking.
‘Teaser.’ She shook her head at him and changed the subject. ‘How was the rest of your day?’
Max tilted his head. ‘Actually, you look stunning.’ He watched her frown at him but he was darned if he shouldn’t say it when he meant it.
He moved on when she grimaced at him. ‘Now, what was your question? My day? After our exciting morning?’
He ticked off his fingers. ‘Del’s twin girls were born at midday and all are well. They weighed over twelve hundred grams each so I don’t know where she was hiding that weight. The girls are breathing for themselves and may start tube feeds tomorrow.’
‘That’s wonderful.’
Before Georgia could ask more he went on hoping to change to another topic. ‘Even bigger news is that Tayla and my brother, Paul, have decided to get married. We’re invited to the wedding but guess who is not invited to be bridesmaid?’
‘Me?’ Georgia tried to look sad.
He shook his head sadly. ‘I know you must be dreadfully disappointed.’
Georgia put down her spoonful of pumpkin soup and looked up with a grin. ‘That’s wonderful. On both counts.’ Her eyes sparkled with laughter.
She stirred her soup with a smile. ‘You know, I think they will do very well together.’
She tilted her head. ‘Which hospital did you say had the neonatal beds? Del didn’t have to go to Canberra, did she?’
CHAPTER EIGHT
MAX should have known her empathy with her patients wouldn’t wane. She’d need to know Del was happy where she was.
‘No. I didn’t say.’
Max hesitated and then answered. ‘Lower Mountains Base Hospital.’ He wondered if they were both going to pretend the connection to her exhusband’s hospital didn’t exist.
Georgia’s spoon stilled and then she took another mouthful. The colour had left her face and he cursed himself for not withholding the information.
She swallowed slowly and then spoke to her spoon. ‘I’m glad all went well. I wonder how she’ll manage without Shannon to talk for her.’
She went on without pausing but at least she looked up at him. ‘I hear Susie has recovered from having her baby in the car and wants to go home tomorrow morning.’ Her voice was extra-bright and his chest tightened in sympathy for her.
‘I’m sure that will be fine.’ Max was in a differ-ent dilemma now. He didn’t want to upset Georgia by bringing the subject up again but she needed to know he was happy to talk about how she felt if she wished.
If she gave him the option. The silence lengthened and he guessed they were both going to pretend nothing was wrong.
Georgia felt gutted. She wasn’t even sure Max knew it was Sol’s hospital.
She tried to quell the pictures that rose unbidden into her mind. It’s OK, she told herself. The connection with Del wasn’t so bad. Was it?
Sol would have to be the receiving consultant on duty to have had any contact with Del. Even then the registrar would probably have been the one to read the nurse’s notes.
There really wasn’t much chance Sol would track them down, and she doubted Del would speak much about Meeandah except to nod.
Georgia just wished she hadn’t been the one to sign and print her name on the nurse’s transfer letter—along with Max’s. She still signed her maiden name because of the rigmarole of changing names through the nurse’s registration board so Sol would recognise it.
‘We have the weekend before us. What can we do to put a smile on your face?’
Georgia looked up at him blankly.
‘Would you like to go somewhere? For the weekend?’ This time it had been Max to change the subject and she was glad because her own brain still felt sluggish with shock.
The idea of hiding away from the world appealed to Georgia greatly. ‘Let’s go away. Drive bush roads for the weekend. Follow where the tracks take us.’
Nobody would find them and she would be able to push the thoughts of Sol far into the back of her mind again. She’d just begun to feel settled and happy but now the secure rock Max had built for her had crumbled away with only one obstetric transfer to Sol’s hospital. Her response in itself was disheartening.
‘Go camping, you mean?’ Max was looking at her as if to judge how serious she was.