The Midwife's Miracle Twins
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Caroline Anderson
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10
CHAPTER ONE
‘DO YOU NEED a man?’
Absolutely not, and particularly not the owner of the low, soft voice with a hint of laughter that came from behind her, but she’d exhausted all other options, so she stopped wrestling with the lid of the peanut butter and turned to face him.
He was propping up the door frame of the ward kitchen, arms folded and looking sexier than a man had any right to look in scrubs, and as she met his eyes a lazy smile tipped his mouth and tilted her heart sideways.
He had heartbreaker written all over him and under any other circumstances she would have run a mile, but right now she was too tired and hungry to refuse. She thrust the jar towards him.
‘Do you know what? I’ve tried everything else. Knock yourself out.’
The smile tilted a little more, and he shrugged away from the door frame and twisted the lid off with ridiculous ease.
‘It’s all in the wrist action,’ he said, that sexy mouth twitching, and she rolled her eyes and relieved him of the jar, stifling her smile.
‘I think you’ll find it’s brute force, but thank you anyway.’
His lips twitched again. ‘You’re welcome. My brute force was happy to oblige,’ he said, and she stuck a spoon in the jar and put it in her mouth before she could make another smart retort.
He gave a startled laugh and pulled a face. ‘Good grief, you must be desperate,’ he said, but she was past caring.
‘Hungry,’ she mumbled, her mouth all stuck up with the peanut butter, and he laughed again, this time with a hollow ring.
‘You’re not alone. If I didn’t loathe it, I’d grab a spoon and join you. Someone nicked my lunch out of the fridge. I’m Dan, by the way. Dan Blake.’
As in Daniel Blake, their new consultant? She nearly choked.
‘Georgia Seton, aka Georgie,’ she said, throwing the spoon into the washing up bowl and sticking out her hand. ‘I’m a midwife.’
‘I’ll look forward to working with you, then, Georgia Seton,’ he murmured as his hand grasped hers in a firm yet gentle grip that sent interesting tingles up her arm.
Well, that was one way of describing them. Dangerous was another. Their eyes met and locked, his a cool grey framed by dark lashes and the crinkle of laughter, and her heart hitched in her chest. She ignored it. She wasn’t ready for that kind of interesting. Not now, not ever.
He dropped her hand and she turned away from those mesmerising eyes, plunged herself wrist-deep into the washing up bowl in the sink and washed the spoon—and her hands, to get rid of the feel of his warm, firm grip as much as anything.
‘Back into the fray?’
His voice, like dark, melted chocolate, teased her nerve endings again. ‘Hopefully not,’ she said lightly. ‘Paperwork on my last delivery, then home for something proper to eat before I keel over. And with any luck I won’t be three hours late again today.’
He snorted. ‘Good luck with that. They broke me in gently with a nice simple elective list today, then chucked in a couple of emergencies just to mix it up, so I’m only running an hour late so far. I thought I’d come and introduce myself to whoever’s here on the labour ward on my way home, see if there’s anything useful I can do before I leave. Apart from opening jars.’
That made her smile. ‘Good idea. They’ll appreciate it. And thank you again for rescuing me.’
‘You’re welcome. Just don’t dream up a crisis before I get out of here.’
She gave a hollow laugh at that. A crisis was the last thing she needed tonight. She’d been running on empty for hours. ‘I’ll do my best.’
She flashed him a smile, squeezed past him in the narrow kitchen and caught the scent of his skin as her nose skimmed by his chest. No way. She was not interested.
Absolutely not...
‘Ah, Georgie, there you are. Can you do me a favour? Kat’s had to go home, she’s got a migraine, and we’ve got a primip who’s walked in with a slight bleed and everyone else is tied up. She’s just moved here, so we don’t have a hospital number for her yet but she’ll have her handheld notes with her. Room four. Her name’s Susie.’
Her heart sank at her team manager’s words. She’d only just finished writing up her last delivery, and she was about to go home. Or not, by the sound of it...
‘Is there really nobody else, Jan?’
‘No. I’m really sorry, but the night shift’ll be on soon and it’s probably nothing to worry about.’
Don’t say that!
She sighed and closed her eyes. ‘OK. I’ll go and see her.’ She shut the file and headed for what Jan seemed to think might be nothing to worry about. Which had probably jinxed it utterly.
She went into the room and found a young woman sitting cross-legged at the top of the bed with her eyes closed, a man, presumably her partner, sitting beside her stroking her hair back off her face.
They looked up as she closed the door, and she smiled at them. ‘Hi, my name’s Georgie, I’m a midwife and I’m going to be looking after you. You must be Susie?’
‘Yes, and this is Rob. He’s my partner.’
‘Hi, Rob. Good to meet you. Susie, I understand you’ve had a bit of bleeding. Is that right?’
She nodded, her hands stroking her abdomen in a gentle rhythm, her eyes a little worried. ‘Yes. I think I’ve just been overdoing it with the move, but I thought I should get it checked out. It was just a few spots, but my placenta’s low so I thought it was best.’
The shrill scream of alarm bells rang in her head. A low placenta. Fabulous. Jan had definitely jinxed it.
‘OK, well, let’s have a look at your handheld notes and see what they’ve got to offer.’
Susie shook her head, her eyes welling with tears. ‘I don’t know where they are. I put them down somewhere and I can’t find them because the house is in chaos—we’ve only just moved. My section was due next Friday and I was going to come in tomorrow to see someone but we didn’t know we were going to be moving so soon and it was such a rush and now I’m bleeding...’
Great. It just got even better.
‘Don’t worry, we’ll sort it out,’ she said calmly, handing Susie a tissue to blot up her tears. ‘We’ll need your name, date of birth, hospital number and so on so we can contact your old hospital and get the notes sent over. Rob, I wonder if you could go to the desk out on the ward and give all that information to the ward clerk while I look at Susie? And tell her I said it’s urgent. Is that OK with you both?’
‘Yeah, sure,’ he said, and dropped a kiss on Susie’s forehead. ‘I won’t be long.’
She smiled at him, and Georgie picked up her pen. ‘Right, Susie, as we don’t have any notes for you I need to take some details and then do a quick scan to see what’s going on. Did they give you a grade for your placenta previa?’
She gave a little shrug. ‘I don’t know. They never said.’
‘Has this happened before? Any spotting, pink discharge, anything like that?’
She shook her head. ‘No, nothing. I’ve been fine and I’ve felt OK till now, but...’
‘Do you know your due date?’
‘Yes. The twenty-fifth of August. I’m thirty-seven weeks and five days. I don’t know if it’s significant but I’ve been having a few—not contractions, really, I don’t think, but sort of tightenings?’
The alarm bells got louder. ‘Braxton Hicks contractions, probably. That’s quite normal. It’s your uterus toning up ready for the main event, but tell me if they get worse. Right, I need to do a scan so we can see what’s going on, but before I do that I just want to put this clip on your finger. It monitors your heart rate and your oxygen saturation, so it’ll give me an idea of how you’re doing. Have you had any blood pressure problems?’ she asked, strapping on the cuff.
‘Not as far as I know.’
Well within the normal range, and her sats were ninety-eight per cent. All good so far.
‘Right, let’s have a look at this baby. Have you felt it moving today?’
‘Oh, yeah. It wriggles all the time, and sometimes it jerks.’
‘That’s probably hiccups, it’s quite common. Could you pull your top up, please?’
Susie hitched up her top and wriggled her jeans down, and Georgie could see at a glance that the baby was sitting very high. She laid her hands on the taut swell of her pregnant belly, feeling the smooth curve of the baby’s back, the hard jut of its little bottom up under Susie’s ribs, the sharp point of a tiny heel on the other side as it stretched, but the baby’s head wasn’t engaged in her pelvis, even though it was head down. She pressed gently on the baby’s bottom, trying to coax it down, but it didn’t move at all.
Not good news. Her placenta must be very low.
‘OK, let’s have a listen to baby’s heart, shall we?’ she said, and moments later the steady swooshing sound filled the room.
One hundred and fifty-two beats a minute, which was spot on. Small mercies. ‘Well, that’s all good. Right, let’s do an ultrasound scan now, so we can find out a little bit more about what’s going on in there and get a look at this placenta.’
‘Do you think that’s caused it?’
She smiled reassuringly, trying not to stress her. ‘It might be, but you’re both doing well at the moment so I’m not worried for now.’
‘Oh, I’m having one of those things again. The Branston Whatevers.’
Georgie paused the scan. She could see the tightening of her uterus under the skin, the changing shape of Susie’s bump, and judging by the look on Susie’s face it wasn’t a Braxton Hicks.
‘Breathe, Susie. Nice and light, quick little pants and an outbreath, again and again until it eases. That’s lovely. Well done.’
By the time it had worn off Rob was back in the room, and he settled himself back beside Susie, holding her hand and looking worriedly at the screen as Georgie ran the transducer over her lower abdomen.
She felt her heart kick up a notch as the image appeared on her screen. The placenta was very low, spanning the area of the uterus that was starting to thin and stretch. Grade Three, and she was in the very early stages of labour, but the baby’s heartbeat was strong and steady, and so was Susie’s. For now.
She took a photo of the image on her phone, wiped away the gel and smiled at them both. ‘OK, Susie, your uterus is starting to pull up at the bottom where your placenta is, so we’re going to have to deliver the baby now. The first thing I’m going to do is take some blood and get that off to the lab, then book Theatre for you, OK?’
Her eyes widened and she reached for Rob’s hand. ‘Is my baby all right?’
‘Yes, it’s fine at the moment. Nice strong heartbeat, which is what we want to see, and you’re OK for now, but your placenta is very low, which is why you’ve had that bleed, so I’ll get a surgeon to have a look at it and get the ball rolling, OK?’
They nodded blankly, and she put a cannula in her hand, took all the necessary bloods and handed Susie a gown.
‘I won’t be long. Could you undress and put this on while I’m gone? I’ll only be a minute.’
She slipped out of the door and hurried to the work station. ‘Can you get these off to the lab now for urgent cross-match and group and save, and page the on-call registrar for me, Sally? I’ve got a mum with a placenta previa who needs an emergency section.’
‘She’s helping Samira with a breech—she’s only just gone in. Patrick’s here somewhere?’
The F2 who’d been with them a week. ‘Damn. No. I need someone more senior. She’s contracting. Is Mr Blake still around?’
‘I thought I told you not to dream up a crisis?’
She turned, and he took one look at her face and the smile faded from his eyes. ‘OK, what is it?’
‘Grade Three placenta previa, twenty-five-year-old primip. Thirty-seven plus five weeks. They’ve just moved and she’s lost her notes, so we have no records for her, but she’s had a slight bleed and she’s starting contractions. The move was a bit rushed, I gather. Here, I took a photo of the scan.’
He glanced at it, and his mouth tightened a fraction.
‘OK. She needs an emergency section. Have you told her?’
‘Yes, and she’s stable at the moment, but it won’t last. Do you want to check her now?’
‘No, I trust you and I’ve seen enough. Go and prep her for surgery and get her consented, I’ll kickstart this and come and join you.’
‘OK. I’ve done bloods for cross-match and group and save.’
‘Good. Thanks.’
She left them to it, his voice following her.
‘Can we get a crash section team on standby, please, and a Theatre ready asap? Theatre One should be free. They were cleaning it when I left. And activate major haemorrhage protocol.’
The door closed softly behind her, cutting out their voices, but she was relieved to hear him sound so controlled and in command. And he trusted her judgment.
Letting out a quiet sigh of relief, she went over to them and perched her hip on the bed and took Susie’s hand. ‘Right, I’ve had a chat to Mr Blake, one of our consultants, and he wants to do your Caesarean section now. He’s going to pop in and talk to you in a minute, but in the meantime I need to fill in the consent form and I’d like to put you and the baby on a monitor, just so we can keep an eye on things until Theatre’s ready.’
She shook her head. ‘I’m so sorry. This is my fault. The move was so difficult, it went on too long and I knew I should have contacted you but I didn’t have time, and now I’ve done too much and I can’t believe this is happening—’
Georgie squeezed her hand. ‘Susie, stop. This is not your fault, and you’re here now, you’re safe, and we’ll look after you. Don’t worry. It’ll soon be over, and you’ll make a quick recovery and your baby will be OK and you can all settle down in your new home.’
She put her on the monitor and everything looked fine. So far, so good. She rapidly filled in the notes, assembled all the things that would be needed, drew up the consent form, talked Susie through all the possible things that could go wrong, gave her a pen to sign the form and then handed her a tissue when she started to cry.
‘I really can’t believe this is happening. I thought I’d be OK.’
‘You are OK,’ Georgie said firmly. ‘We just want to make sure you and your baby stay that way.’
She printed off a host of labels for all the things that would need them, and then glanced up to scan the monitors for the hundredth time. Nothing drastic in the way of change for either mother or baby, but they were both subtly different, and she felt a flicker of unease.
‘How are you feeling, Susie?’
‘Not great. I’m having one of those Branston things again and I feel a bit woozy,’ she moaned, her face wincing, and Georgie checked the monitors again and felt the flicker of unease ramp up a notch. There’d been nothing to worry about a moment ago, but now the baby’s heart rate had dropped a little, and Susie’s blood pressure was down slightly while her heart rate was rising. Not much, but enough, and Georgie was reaching for the alarm button when she heard the door open behind her.
‘Hi. How are you doing?’
Dan Blake’s steady, reassuring voice came from behind her, and she turned and met his expressionless eyes.
‘Minor decels,’ she said quietly, knowing Susie wouldn’t understand that she was talking about the baby’s falling heart rate, and his eyes flicked to the monitors, an unreadable expression in them as he took in the non-reassuring trace.
‘Are we good to go?’ he asked.
‘Yes, all done, she’s consented. She’s ready.’
‘Good. Thanks.’ He looked beyond her and smiled, his face all calm reassurance now.
‘Hi, Susie. I’m Daniel Blake. I’m one of the consultants here, and I’m going to be looking after you.’ He stood at the foot of the bed, keeping the monitors in view as he spoke to them. ‘I understand Georgie’s told you that we need to deliver your baby now by Caesarean section?’
‘Yes. Please get it out safely.’
‘That’s what I’m here for,’ Dan said, and it sounded oddly like a vow.
Georgie took her hand and gave it a gentle squeeze.
‘It’s OK, Susie. You don’t need to be scared. We’re looking after you. I just need to get another line in, and we’ll take you straight up to Theatre as soon as they’re ready for you.’
‘I want my mum. Can we wait for her? She’s on her way.’
Dan shook his head, his voice gentle but implacable. ‘No. I’m sorry. We need to move fast, and I know it will all seem like a bit of a rush, but it isn’t, it’s all under control, we do this all the time. Trust us, Susie. You’re in the best place.’
Georgie saw Susie’s shoulders droop in resignation. Thank goodness.
‘OK, sharp scratch coming,’ she said, and as she finished inserting the port, Susie’s eyes widened.
‘Oh. I think I’ve wet myself,’ she said weakly, just as the alarms on the monitors started to beep. There was a dark, spreading stain on her gown, her blood pressure fell off a cliff, and the baby’s heart was racing.
‘Right, let’s go,’ Dan said crisply, and knocked the brakes off the bed as Georgie hit the alarm button again and it all kicked off.
Rob leapt to his feet, his eyes wide with fear, and Georgie unhooked all the leads and tried to reassure her terrified patient and her equally terrified partner as the team leapt into action and they ran for the lift.
Someone was holding the lift doors open, and when they opened again seconds later she was whisked into the waiting Theatre, Rob running with them to the doors, his hands knotted together in fear.
‘Don’t let her die. Please don’t let her die.’
‘It’s OK, Rob, we’ve got this, it’s what we do,’ Dan said quietly, giving his shoulder a quick squeeze, and they wheeled Susie through into the theatre suite and handed her over to the anaesthetist, the doors swinging shut behind them.
There was no time to scrub, just a massive dollop of hand sanitiser up to the elbows, then gowns and gloves and they were in there with the hastily assembled team, Susie already anaesthetised and draped, a nurse on each side of her squeezing in O negative blood, a TXA infusion going into another vein to stop the bleeding, oxytocin to contract her uterus, the neonatal team hurrying in around them as Dan picked up the scalpel and glanced at the anaesthetist.
‘Are we good to go?’
‘Yes, but don’t hang about.’
‘I won’t. Right, let’s get this baby out.’
It was the fastest section she’d ever witnessed, and it wasn’t subtle, but in moments he’d pulled out the floppy, grey baby boy and handed him to Georgie. She cut the cord and handed him straight to the waiting neonatal team and turned her eyes back to Dan’s hands.
He’d removed the placenta, but it wasn’t intact, and he was searching for the missing fragment while the inexperienced F2, Patrick, was trying his best with the suction.
‘BP’s falling. Fifty over thirty-five,’ the anaesthetist said.
Dan swore, clamped both hands around her uterus and held it firmly while they squeezed more blood into her.
‘OK. It’s picking up. Seventy-five over fifty.’
‘Right, I’m going to have one more go, and if I can’t find this bleed in the next few seconds she’ll lose her uterus,’ he said grimly. ‘Suction, please.’
He let go, but the suction failed to keep up and she could feel the tension in the room.
Jo, the registrar joined them, hurrying in to take the suction off Patrick, who was clearly panicking. Jo tried to clear the field for Dan to see.
‘Don’t you dare die on me,’ he said under his breath as he struggled to find and stem the bleed, but for a few seconds Georgie really thought she would. Either that, or lose her uterus and with it the chance of any further children. And there was still no sound from the direction of the neonatal team.
‘How’s the baby?’ Dan asked, as if he could read her mind.
‘Alive but unresponsive.’ The terse reply came from the other side of Theatre, and he swore again.
Then a tiny cough, so small they nearly missed it, and then the merest hint of a wail, and she saw the tension pour out of his shoulders.
He closed his eyes for a moment, sucked in a deep breath then started again, finding the last scrap of placenta and removing it, giving the oxytocin a chance to do its job. The flow stopped, her blood pressure picked up and once he was satisfied it was all right he nodded and started to close.
Georgie felt the tension drain out of her, and her eyes prickled with tears.
‘I thought we were going to lose them both,’ she said softly, her voice shaking.
‘So did I and we could have done. You should have called me sooner.’
He was blaming her? ‘This is not my fault, Mr Blake,’ she said quietly but firmly. ‘I’d only been in there a very few minutes, and as soon as I’d scanned her I came straight out to alert Theatre. It’s not my fault.’
‘No, of course it isn’t. Sorry. Bit of a sore point. I apologise.’ He met her eyes, his filled with an expression she didn’t really understand. Something to do with that sore point? She gave a tiny nod of acknowledgement.
‘Good. Accepted—but for the record, I don’t overlook things.’
‘I’m glad to hear it,’ he murmured, and carried on suturing, layer by layer, the concentration pouring off him in waves.
‘Right, that’s her uterus and muscle layers done. Jo, can I leave you to finish off, please? I want to go and talk to her partner.’
The registrar nodded, and they left her closing the skin and went out to give Rob the good news.
He wept with relief when he was told they’d both made it so far. Georgie could empathise with that, she was pretty close to it herself, and she didn’t think Dan looked too great, either.
‘Right, I need a shower and then I’m going home, and I think you ought to do the same,’ she told him after they’d checked on Susie in Recovery, and he nodded.
‘Good idea. Thank you for your help.’
‘You’re welcome.’
She spotted him in the ward kitchen ten minutes later, and she was shocked. His hands, rock steady while he’d been operating, were trembling so hard he could barely hold the glass of water in his hand, and his face was as white as his shirt.
‘Are you OK? You’re shaking.’
‘I’m fine. Just low blood sugar. I’ll be OK once I’ve eaten.’
‘Are you diabetic?’
‘No, I just haven’t eaten since breakfast, but I’ll be fine. I’m sorry I bit your head off,’ he added, and she decided to cut him some slack.
‘I’ll let you off this time. Want some peanut butter or will it choke you?’
He gave a short grunt of what might have been laughter. ‘I think I’ll pass. I’m going home. It’s only a twenty-minute walk and I’ve got food in the fridge. I’ll be fine.’
He didn’t look fine, far from it, and it didn’t sound as if he had anyone at home to feed him, either.
‘I’ve got a better idea,’ she said. ‘I’ve got a massive chilli in the slow cooker, a fresh loaf of tiger bread, and I live just round the corner. Literally five minutes and you can be eating it. What do you say?’
He hesitated, long enough that she knew just how bad he must be feeling, so she pushed harder.
‘I’ve got a sticky toffee pudding in the freezer. We could crack that out, too. Look on it as a welcome to your new job.’
She saw him buckle, and heaved a silent sigh of relief.
‘Sold,’ he said crisply. ‘Now let’s get out of here before anything else happens.’
He wouldn’t have made it home.
His whole body was shaking, he felt sick and lightheaded from low blood sugar and a massive adrenaline surge, and underlying it all was a tidal wave of emotion that was threatening to swamp him at any moment.
Of all the things to happen on his first day...
‘Right, we’re here. Come on in.’
As she opened the door, his nose was filled with the delicious smell of chilli, and he followed her through the hall into the little kitchen.
It was clean, tidy, unassuming—a bit like her, he thought. She’d been calm and unflappable throughout, but with a hint of iron. Like when he’d accused her of not calling him soon enough. She’d put him firmly in his place. He liked that. Less keen on the fact that he’d been so quick to accuse her of incompetence...
She handed him a knife, a board and the loaf of tiger bread. ‘Right, you slice the bread while I dish up. And don’t be coy with it, I’m ravenous.’
She opened the slow cooker—not massive, but certainly more than big enough for two—and spooned out two huge dollops into bowls while he sliced the bread into big fat chunks.
‘Cheese, yogurt?’
‘Anything. It smells amazing.’
His stomach growled audibly, and she laughed. ‘Here you go. Grab the bread and come on through.’
She led him into the living room at the back of the house and he followed her, his legs like wet spaghetti, and dropped into a chair at her dining table. The chilli was hot and fragrant, and he forked it down as if his life depended on it, mopping it up with chunks of soft, buttery bread until the bowl was wiped clean and the bread was all gone. Then he sat back and offered her a rueful smile.
‘That was delicious. Thank you.’
‘You’re welcome. Feeling better now?’
‘I’m getting there. I can’t believe someone nicked my sandwich.’
She laughed and got to her feet. ‘I can. Sticky toffee pudding?’
‘Absolutely. If you can spare it,’ he added as an afterthought, but she’d already walked out with their plates, so he stayed where he was and looked around him, taking in his surroundings for the first time.
It was a typical little modern town house, with the kitchen at the front and the living room behind it running the full width of the house, with French doors that led into the little garden. It was tiny, hardly more than a courtyard, and fully paved, but she’d made the best of it. It was stacked with pots overflowing with colour, and it looked fresh and inviting. His eyes tracked inside again, scanning the artwork on the walls, the choice of furniture, the soothing colour palette with little pops of vibrant colour that echoed the planting outside.
There was a crumpled throw over the back of a sofa, and a magazine lying open on the coffee table, as if she’d just got up and walked away. It was homely, welcoming, the house of someone who cared where they lived.
Unlike him. He didn’t really care about anything, not any more. So long as he had a bed to sleep in and a sofa and TV and a kitchen to hold body and soul together, he was OK. It was the garden he cared about, the only thing that mattered to him, because being outside surrounded by nature brought him a glimmer of the peace he yearned.
That and work, only not today. Today was the worst kind of day, the kind that pushed all his hot buttons.
He shut off that line of thought as she came back in with two steaming bowls of sticky toffee pudding topped with a scoop of vanilla ice cream.
‘That looks amazing.’
‘Don’t get too excited, it’s not home-made. I tried making it once and it was hopeless, so I buy it now. Comfort food, for the days when it all goes haywire.’
He grunted at that. Haywire was putting it politely.
‘I owe you dinner,’ he said, changing the subject, and she met his eyes.
‘I’ll hold you to that. Eat up,’ she said, and threw him a mischievous grin that stirred something deep inside him. Something vibrant and sweet and carefree that he’d lost long ago.
He picked up the spoon and turned his attention to something safer.
