Читать книгу Leaving Enchantment - C.J. Carmichael - Страница 7

THE SPACIOUS ROOM FELT tranquil and homey—with dim lighting, soothing classical music and the scent of lavender in the air. Steve Davidson rubbed massage oil through the back opening of his wife’s favorite flannel nightgown, while Mary crouched on her hands and knees panting softly.

She was ten centimeters dilated.

Lydia Kane, midwife and founder of The Birth Place, observed the young woman thoughtfully. Six years ago, Mary’s first delivery had been relatively quick. Lydia had predicted that this second one would be even faster. And yet the baby still hadn’t dropped into position in the birth canal.

Across the room, where she was folding the damp towels Mary had used to towel off from a soak in the whirlpool tub earlier, Gina Vaughn, the assisting midwife, was biting her bottom lip. Lydia caught her gaze and gave her a reassuring smile.

Gina was doing wonderfully. Newly certified, a mother of two herself, Gina’s passion for the calling reminded Lydia of herself decades ago. Oh, she’d been terribly idealistic at that age. A part of her, she knew, still was.

Even after all these years, every birth Lydia attended gave her the same deep sense of wonder and satisfaction. The belief that she was helping mothers savor the full meaning of their childbirth experience had motivated her to establish The Birth Place in the fairly isolated town of Enchantment, New Mexico, and to keep it running—sometimes overcoming incredible hurdles—for over forty years.

“Excuse me.” Steve approached, his eyes creased with concern. “How much longer, do you think? She’s really in a lot of pain.”

“Let’s see how she’s doing.” Lydia performed a quick examination. The baby hadn’t descended into the pelvis yet. Come on, little guy, she urged silently. She checked Mary’s temperature while Gina assessed the fetal heart rate with a handheld Doppler. Steve and Mary both seemed to relax slightly when they heard the steady rhythm.

“It’s 145 to 150 beats per minute,” Gina said.

Lydia nodded. “Temperature is normal.” She turned back to Steve. “It shouldn’t be much longer. Let’s wait for a few more contractions. Mary, do you want to try squatting at the side of the bed?”

Maybe a change in position would help bring the baby down.

Lydia knew the Davidson’s daughter, Sammy, hoped for a sister. But Lydia suspected Mary was carrying a boy, at least one pound heavier than Sammy had been.

“You’re doing beautifully,” she told Mary, stroking the petite woman’s back, containing her own growing unease.

“That last contraction was a killer.” Mary crawled awkwardly from the bed, leaning heavily on Steve for support. She grabbed one of the strong wooden posts, then squatted, pulling hard on the bed as another contraction swept over her.

“Oh, I need to push!” Mary cried.

Lydia understood the other woman’s overwhelming urge to bear down. In second-stage labor, Mary’s entire body was focused on expelling the child from her womb.

“Good work, Mary,” she encouraged.

Gina adjusted Mary’s gown so she could get yet another Doppler reading. Again, the sound of a strong heartbeat filled the room. Mary and Steve’s baby appeared to be coping well.

And yet…

Reserving judgment for a few more minutes, Lydia considered Steve’s worried face. These days, almost all of Lydia’s client’s husbands or partners chose to be present during the birthing experience—sometimes with siblings and other family members, too. Six years ago, Steve had been one of those keen father-to-be’s. But in the last, difficult hour of Sammy’s delivery, when Mary had been alternately crying and whimpering, he had left the room.

Lydia knew he’d been disappointed later, and so had Mary. This time Steve was determined to stick it out—for Mary and for himself. But he already appeared a little woozy.

“This is it!” Mary reached for Lydia’s hand as her body surged in one more powerful contraction. “Oh my God, the baby’s coming!”

But twenty minutes later, the baby still hadn’t descended very much. Lydia checked the time. Almost seven in the evening. More than five hours had passed since the Davidsons had arrived with Mary already in established labor. Lydia didn’t know what was wrong. Mary’s contractions certainly palpitated strong enough. Baby’s heart rate was stable. There was no apparent reason to be concerned and yet Lydia’s sixth sense warned that all was not well.

“Something doesn’t feel right,” she said quietly to Gina.

“Taking a little longer than we expected.”

Yes. But why? Lydia looked at the tiny woman who was now back on the bed, exhausted, disheartened. The disparity in size between Mary and her large-framed husband had caused Lydia concern when she’d first met the couple six years ago. But Mary had a proven pelvis. Sammy had weighed in at just over eight pounds.

However, this second child was bigger than the first. Perhaps even bigger than Lydia had estimated.

She made up her mind. “I’m moving them to the hospital.”

After a second Gina nodded. “Maybe that’s wise.”

“I’ve got the air mattress in the back of my van. Drive it right up to the back door, would you? My keys are in the top drawer of my desk. I’ll talk to the Davidsons.”

“Is there a problem?” Steve had noticed the two midwives conferring quietly.

“Probably not.” Lydia smiled at him, then his wife. “You’re doing wonderfully, Mary, and your baby is a real champ, too. But this delivery is taking longer than I expected, and I always play it safe in situations like this. I want to move you to the hospital.”

Arroyo County Hospital was just minutes away. Nevertheless, delivery in a bright, modern, bustling hospital was not what the Davidsons had wanted. It wasn’t what Lydia wanted for them, either, but she could not take any chances.

“I don’t want— Ohhh…” Another contraction hit Mary, sweeping away her objection. Lydia calmly coached her through the pain. When it was over, Lydia performed a quick reexamination to see if the baby’s head had dropped. Unfortunately, no progress had been made.

“I’m sorry, Mary, but we have to move you. I know it’s going to be uncomfortable, but Gina will ride with you in the back of my van. Steve, do you want to sit up front with me?”

“I’ll drive my own vehicle,” he decided, his voice taut with anxiety.

“Fine. We’ll meet you there. And don’t worry. Dr. Ochoa is on duty tonight. He’ll take good care of Mary.”

DR. OCHOA, AN OBSTETRICIAN at the Arroyo County Hospital, met them in the delivery room. Lydia referred all her high-risk patients to Dr. Ochoa and had unfaltering admiration for the man. His reciprocal respect explained their professional association for over twenty years.

“What’s the problem?” he asked, snapping on a new pair of gloves.

Already positioned on the delivery table, pale, exhausted Mary had no energy to speak. Steve, as well, was quiet and tense. Lydia hoped he wasn’t going to faint. Gina obviously had the same concern. She was at his side, watching him carefully.

Quickly Lydia filled the doctor in on the patient’s case history. “Mary’s been at ten centimeters for almost two hours now. The baby still hasn’t descended.”

The doctor nodded. “Well, let’s take a look. Maybe something happened on the drive over.” He ambled to the delivery bed. “Hello, Mary, Steve. I’m Dr. Ochoa. How are you doing?”

After a quick examination he noted that the baby was now in position. “But—” he gave Lydia a smile of approval “—I’m glad you brought her in. It’s always better to err on the side of caution.” He turned back to the anxious parents-to-be. “Shouldn’t be long now.”

Lydia noticed Steve’s shoulders relax a fraction. Did he feel better now that a real doctor was in charge? Mary, however, seemed stressed. Lydia took her hand.

Mary’s anxious gaze sought hers. “Will you stay until my baby’s born?”

“I will.”

“You won’t leave me?”

“No.” She patted Mary’s shoulder then glanced at the doctor, who nodded in acceptance.

“And my baby’s still okay?”

A nurse had hooked Mary up to an external fetal monitor now and had started an IV, as well. Lydia had only to glance at the machine to see the same fetal heart rate they’d tracked on the Doppler at The Birth Place.

“Your baby is fine, Mary.” She smiled across the room at Steve, who was leaning against a wall. “And you’re doing great, too, Dad.” Steve mustered a small smile in reply.

“Here comes another…” Mary pushed as best she could through the force of the contraction. With legs open and feet resting on the birthing bars, she sat at a fifty-five degree angle, grabbing her thighs.

“Oh-oh-oh…”

“Good work, sweetheart.” Steve spoke in an attempt to be reassuring. He couldn’t watch anymore, poor man. Lydia was about to suggest he take a breather, when suddenly the baby was crowning.

“The baby’s coming, Mary!” the doctor said.

The next contraction came only seconds after the previous. “Keep pushing, Mary,” Lydia urged.

Valiantly Mary bore down and the baby’s head delivered—large, pink and topped with matted black hair. Oh, he’s beautiful, but Lydia no sooner had that thought than the head receded partway into the birth canal.

She glanced sharply at the doctor, who frowned in return.

“One more time, Mary,” he instructed.

The next contraction should have done it. Mary’s face contorted with the effort of pushing. But nothing happened.

Fear, sharp and cold, froze Lydia. Something was terribly wrong here. The baby’s shoulders were trapped within the pelvis.

“Heart rate is one hundred,” the nurse reported. She put in a call for more help and a second nurse arrived a moment later.

Come on! Come on! Lydia chanted silently as another contraction proved as ineffective as the one before. Lydia slid in next to the doctor.

“Shoulder dystocia?”

Dr. Ochoa nodded.

Lydia had dealt with this complication before and delivered healthy babies every time. Still, she was very relieved that she’d made the decision to transfer the birth to the hospital.

“Why isn’t the baby coming?” Steve asked. “Is this normal?”

Far from it. In this position, the baby’s supply of oxygen was compromised. Every second counted. But Lydia was trained to project calm, even in moments of crisis. “We’re trying, Steve.”

“Let’s reposition the mother.” Dr. Ochoa’s tone was becoming more curt by the moment. Lydia did her best to reassure Mary as the bed was lowered to a flat position. Each of the nurses took one of Mary’s legs and lifted it up and back toward Mary’s ears. The doctor swept his fingers inside the stretched tissue of the perineum.

Seconds ticked by. A minute.

Lydia empathized with Dr. Ochoa as he tried desperately to angle the baby’s head down to the floor. But this baby simply would not move. Ochoa was sweating now, trying various maneuvers in increasingly desperate attempts to release one of the baby’s shoulders. If he had to, Lydia knew he would break the clavicle. They were running out of time.

“What are you doing?” Mary could barely utter the words through her exhaustion.

“Trying to get the baby out.” Lydia glanced at her watch, calculating the time that had already passed.

Come on! Come on!

“But we didn’t—” Another contraction knocked the words out of Mary’s mouth. She bore down and Lydia prayed.

“Come on, baby!” His face was turning blue. They had to get him out, his heart rate was continuing to drop. Eighty. Now sixty. Blue skin deepened to purple, and Lydia fought to keep calm.

“What’s happening?” Steve searched faces anxiously. He and Gina were standing too far back for him to actually see the action.

More personnel flooded into the room. Among them, Lydia recognized Dr. Joanna Weston, an excellent local pediatrician. No one bothered with the pleasantries of a greeting. All eyes focused on Dr. Ochoa and the baby he was trying desperately to bring into the world.

“Try a lateral push.” The doctor continued to work at delivering the shoulder, while one of the new nurses applied pressure across Mary’s abdomen hoping to dislodge that stubborn shoulder.

“Come on, honey,” Lydia urged. “This will be the one that does it.”

And it happened. With a grunt of effort, the doctor managed to pull out the anterior shoulder, then the posterior one. The baby was finally out.

Normally Lydia felt relief at this point. But not today. The baby’s face was bluish-purple, his body flaccid and blanched.

His. The baby was a boy. And big. Lydia’s estimate had been correct. He had at least a pound on his sister.

But he wasn’t breathing. Lydia watched the doctor check for a pulse. She could tell by Ochoa’s furrowed brow that he didn’t find one. He clamped and cut the cord, then passed the baby to Dr. Weston. She was the only one who could save this baby now.

Dr. Weston moved quickly and efficiently. She suctioned the baby before beginning to bag him with oxygen.

“Oh, my God. Is my baby okay?” Mary started to weep.

Turning from the resuscitation efforts, Lydia focused on Mary. She smoothed Mary’s damp hair and murmured softly. Gina, she noticed, was patting Steve’s shoulder.

As she repeated meaningless, comforting phrases, an internal dialogue ran through Lydia’s mind, a prayer for the baby lying lifeless under Dr. Weston’s care. Oh, Lord, please let this baby be all right. Please let him be strong and healthy like his sister. Mary and Steve are such good people, excellent parents. Please…

As Lydia prayed, Mary began to bleed. The flow was too heavy. The doctor inserted his hand into the vagina to see if the placenta was separating.

The next second Mary’s eyes rolled back and her body fell limp. She immediately turned blue.

God, no!

“We need oxygen! Fluids!” Dr. Ochoa ordered tersely. “And let’s get a second IV going.”

Lydia stepped back to give the nurses and doctor better access to Mary. The primary nurse began to bag her with one hundred percent oxygen.

“Code blue to room three-twelve stat.”

As the nurse summoned yet more help, Lydia guessed what had happened. Amniotic fluid embolism. She’d seen a few in her career. When the amniotic fluid was sucked into the mother’s circulation, the results were instantaneous and often dire.

This whole delivery was turning into the worst obstetrical nightmare anyone could imagine.

Lydia thought of little Sammy, probably sleeping at just this moment. That little girl needed her mother. They couldn’t lose Mary tonight. They just couldn’t.

While the nurses concentrated on their jobs, Dr. Ochoa delivered a complete placenta. Blood from Mary’s uterus flowed freely onto the doctor’s shoes, splattering onto the tile floor. The second nurse massaged the uterus frantically, but the bleeding continued.

“Pitocin!” the doctor ordered.

Another nurse, having anticipated this need, got the drug flowing through the second IV. At that moment the crash cart and team arrived and Mary was intubated. The team frantically tried other drugs to try to stop the bleeding.

Lydia stood back, watching the scene helplessly. The average pregnant woman carried about six liters of blood. At the rate Mary was hemorrhaging, she’d lose it all in a matter of minutes.

“We’ve lost her pulse! She’s in cardiac arrest!”

The doctor from the code team began chest compressions. Lydia stepped back to the wall, not wanting to get in anyone’s way. Still, her attention remained riveted on her lifeless patient. Mary was too young to die. She had so much to live for.

“Hang on, Mary. Please, please, hang on.” Mary couldn’t hear, not above the noise level in the room, but Lydia spoke anyway, her words like a prayer.

“How’s the baby?” she asked.

Dr. Weston threw her a frustrated look. “Still no respiration or heart rate. He isn’t responding…”

Were they going to lose them both? Oh, God, please no! “Come on, Mary. You can survive this. Your family needs you.”

Family. Steve. Lydia scanned the room anxiously but couldn’t see Mary’s husband. He wasn’t in the room anymore. Nor was Gina.

LYDIA HAD PROMISED Mary she wouldn’t leave her. And she didn’t. The team continued their resuscitation efforts for forty minutes, fifty…an hour. Dr. Weston eventually had to give up on the baby. She squeezed Lydia’s shoulder on her way out of the room. Lydia continued to pray for Mary.

But they couldn’t bring her back.

At just after nine, two hours after arriving at the hospital with the Davidsons, Lydia stepped out of the birthing room into the cold, wide corridor. A pregnant woman waddled by her, frowning at the blood splatters on Lydia’s thick socks and Birkenstock sandals.

“Lydia.” Gina approached from the far end of the corridor. Sorrow filled the air between them like a heavy cloud.

“You’re still here.” Lydia was unable to meet the other woman’s gaze.

“I’ve been with Steve.”

“Where is he?”

Gina pointed in the direction she’d come from. “The doctors are talking to him now.”

Lydia swallowed. She felt as though she should be the one to bear the awful news, but hospital protocol required that the attending physician announce a client’s demise.

“I’ll check on him,” she told Gina. “You go home now. You need to be with your husband and children.”

Gina brushed tears from her eyes. They clearly weren’t the first she’d shed that night. They would be far from the last.

Lydia hugged Gina, then forced herself to continue down the hall. She found Steve in a small waiting room, collapsed in one of a dozen poorly upholstered chairs clustered around a vending machine. Dr. Ochoa and Dr. Weston had just left.

“I’m so sorry, Steve.” Lydia felt a hundred years old.

He said nothing. Lydia wanted to cradle him in her arms, but he wouldn’t even look at her.

Lydia knew there were no words to soften his loss. “Steve, the hospital teams tried their best. They really did.”

He didn’t seem to hear. “I’ve lost both of them.”

The words tore at her heart.

“Yes.”

Finally Steve lifted his head. He stared at her with outrage, and she could hear what he didn’t say. We trusted you. You said everything would be okay.

“No.”

Lydia held out her arms.

“No!” He rose from his chair and turned, not to her, but to the soda machine. Raising his fists, the big, powerful man started to pound, one fist after another. “No! No! No!”

Each word conveyed crushing disbelief. How could she help him? Lydia was willing to do anything. If only she could take his pain and bear it for him.

She waited for his initial rage to subside, for him to be still. “Steve, let me call someone. How about your mother?”

His chest convulsed and he started to sob. “No!” he cried out once more, then bolted from the room like a panicked child. Once in the corridor he ran past the elevator to the stairs.

“Steve, come back! Let me help!” Lydia tried to follow, but in her sandals, she couldn’t keep up. Finally, she skidded to a stop, grasping at the handle of the door to the stairwell. As the door gave, she caught one glimpse of the top of Steve’s head.

And that was the last she saw of him.