Читать книгу A Promise...to a Proposal? - Kate Hardy - Страница 11

MRS HARRIS CAME in with her husband the next day for another attempt at the ECV. ‘I’ve been feeling a bit off, all day,’ she said. ‘I woke up in the middle of the night with a bit of a tummy-ache. Obviously I must’ve eaten something that didn’t agree with me last night.’

Or maybe, Ruby thought, it was something else causing that tummy-ache. She had a funny feeling about this—and her funny feelings were usually right.

‘Come and lie down, and I’ll examine you before we try the ECV again,’ she said.

Mrs Harris had just settled back against the bed when she grimaced. ‘Sorry. That was another twinge.’

Ruby examined her gently. ‘Has anyone mentioned Braxton-Hicks to you?’

‘The practice contractions, you mean?’

‘They’re the ones,’ Ruby said.

‘Yes—but I don’t think I’ve had any.’ Mrs Harris’s eyes widened. ‘Hang on—is that what the twinges mean? I’m having a practice contraction?’

‘Given that you’re three centimetres dilated,’ Ruby said, ‘then, actually, I think this is the real thing.’

‘But I’m only thirty-seven weeks! It’s too soon for the baby to be born.’ Mrs Harris bit her lip. ‘Do you think it was that ECV thing yesterday that’s caused this?’

‘Possibly. Or it could be that your baby’s just decided that his birthday’s going to be today,’ Ruby said with a smile. ‘Don’t worry about him being thirty-seven weeks. Not that many babies are born on their official due date—some are a couple of weeks before, and some are ten days or so late. By this stage your baby’s lungs are definitely mature enough to cope with being born.’

‘So will I have to have a section?’

‘Hopefully not,’ Ruby said cheerfully. ‘I’m just going to get someone to call Dr Webster for me. And I need to give you a scan to see exactly how the baby’s lying.’

‘Cold gel again?’ Mrs Harris asked ruefully.

‘I’m afraid so,’ Ruby said.

She came out of the cubicle and asked one of the auxiliary staff to find Ellis for her, then went back to see the Harrises and do the scan. She turned the screen so that the Harrises could see it. ‘And here we can see one baby getting ready to be born. His head’s tucked forward, just as I’d want it to be, and he’s in what we call the frank breech position—that’s the least complicated one, with his legs straight up in front of him.’

‘So I can try for a normal birth?’ Mrs Harris asked.

Ellis arrived in time to hear the question. ‘I examined you yesterday and I’m happy that your pelvis is big enough to cope with having the baby. He’s not too small, so there’s a lower risk of having problems with the cord; and he’s not too big, so he’s not going to get stuck. I’m happy with the position he’s in, with his head nicely tucked forward—so, yes, we can do this.’ He smiled. ‘As I said yesterday, I believe in keeping things natural as far as possible, so I’m not immediately going to say you’ll have to have an episiotomy and forceps to help you deliver. It might end up that way, but we’ll do our best to help you have the birth you want. Though I do want to remind you that if your labour doesn’t progress, any delays mean that the baby’s likely to be in distress and you’ll need to have a section. No heroics, OK?’

‘Agreed,’ Ian Harris said firmly.

‘Agreed,’ Mrs Harris said, though she didn’t sound quite so sure.

Ellis smiled at Ruby. ‘Dilation?’

‘Three centimetres.’

‘OK. It’s going to be a while yet before your baby arrives, so I’d suggest walking about a bit—the gravity will help him move down,’ Ellis said.

‘Would you mind very much if Coral—the trainee midwife you met yesterday—and one of the junior doctors came in to observe?’ Ruby asked.

‘No, that’s fine,’ Mrs Harris said. She squeezed her husband’s hand. ‘We’re going to have our baby today, Ian. I can’t believe it.’

It was a couple more hours before Mrs Harris was ready to start delivering the baby. Coral, the trainee midwife, and Lance, the new first-year doctor, came in to observe and Ruby introduced them both to the Harrises.

‘Being on your elbows and knees will be the most comfortable position for you, as well as being the most effective position for delivering the baby, because you can move about a bit,’ Ruby said. ‘And resting on your elbows rather than your hands will protect your wrists.’

‘Unless you really want an epidural, I’d recommend having either gas and air or pethidine as pain relief,’ Ellis added, ‘because an epidural will slow everything down.’

‘I don’t want a section,’ Mrs Harris said, ‘so I’ll manage with gas and air.’

‘Good on you,’ Ellis said.

‘The main thing to remember about a breech birth,’ Ruby explained to Coral and Lance, ‘is that you keep your hands off and be patient—you don’t want the mum clenching her muscles if you touch her.’

‘You intervene only if it’s clear that the baby needs help,’ Ellis said. ‘Which is why we’re using a foetal monitor to keep an eye on his heart rate.’

Ruby encouraged Mrs Harris to breathe through the contractions.

‘I can see the baby now,’ she said at last. ‘When you have the next contraction, I want you to give a nice big push for me.’

The baby’s buttocks arrived first, and then with the next contraction and the next push the back and shoulders were visible.

Ruby glanced at Ellis. As always when she delivered a baby with him, she noticed that he was almost misty-eyed. Ruby was, too; the moment a new life came into the world was so very special, and it was such a privilege to share it.

And Ellis was a particularly good doctor to work with; he was supportive, he listened to both the mum and the midwifery team, and he didn’t try to rush any of the mums straight to Theatre at the first sign of a complication.

At the next push, the baby’s legs came down.

‘Well done,’ Ruby said. ‘You’re doing just great. His legs are down, now. Keep breathing for me.’

The baby’s shoulders and arms came out next, and then Ruby glanced again at Ellis. At his nod, she moved into position, ready to catch the baby.

‘Almost here. Next contraction, give me the biggest push you can. Scream if you need to. Shout. Whatever you want to do, that’s fine. Just push,’ she said.

And finally, the baby’s head emerged.

‘The baby’s not crying,’ Mr Harris said, looking panicky.

And the baby was blue. At a first glance, Ruby would give him an Apgar score of four—very low.

‘It’s fine,’ Ellis reassured Mr Harris. ‘I know right now this looks very scary, but this is totally normal for a breech birth. Do you want to cut the umbilical cord, and then we can get this little one warmed up a bit and ready for a cuddle?’

Thankfully it was enough to distract Mr Harris; Ruby swiftly clamped the cord and Ellis gave the scissors to Mr Harris to cut the cord while Ruby wrapped the baby in a warm towel.

Ruby then took the baby over to the warming tray for warm air to be blown on him.

‘Do you want me to sort out the baby while you deliver the placenta?’ Ellis asked.

She smiled at him. ‘Yes, please.’

By the time she’d delivered the placenta, she was relieved to hear plenty of crying coming from Baby Harris, and she heard Ellis say, ‘I’m pleased to say your little boy’s pinked up very nicely indeed. He’s got an Apgar score of nine.’

Ruby knew that last bit was aimed for her, and she felt the strain between her shoulders disappear. Everything was fine. And, better still, Ellis also hadn’t mentioned anything about hip dysplasia, which could sometimes be a problem with breech babies.

Finally, Baby Harris was in his mum’s arms, skin to skin, and took all of three sucks for his first feed before falling asleep.

Ruby examined Mrs Harris. ‘I’m pleased to say that you don’t need any stitches,’ she said. ‘You did absolutely brilliantly. Congratulations to both of you.’

‘We could never have done it without you,’ Mrs Harris said. ‘I was so scared we’d have to just do what the doctor said.’

Ruby smiled. ‘They’re all pretty good here, actually.’ She lowered her voice to a stage whisper. ‘Though Ellis Webster is a bit special. But don’t tell him I said that, or his head will swell so much that he won’t be able to walk through the door for a week.’

Mrs Harris laughed.

‘Let’s get you settled down in the ward,’ Ruby said, ‘and you can get to know your baby.’ She stroked the baby’s cheek. ‘He’s beautiful.’

‘Do you have children?’ Mrs Harris asked.

‘No.’ She and Tom had thought very seriously about it, but then Tom had been diagnosed with leukaemia and it had never been the right time to discuss it again after that. ‘Maybe one day,’ she said wistfully.

And how odd that a picture flashed into her head. Of herself, tired yet glowing with happiness and holding a baby. And of Ellis sitting next to her, holding her hand and stroking the baby’s head.

Ridiculous. And totally inappropriate.

Ellis was her friend, and only her friend. And she had a date lined up on Saturday night with a completely different man, the new registrar on her best friend’s ward. She really shouldn’t be thinking about that kind of thing.

Ellis didn’t see Ruby over the weekend. He wanted to call her, but he knew she was going on a date with a colleague of Tina’s. So he needed to back off. To give her a chance to get to know the guy and enjoy dating again.

Even though what he really wanted to do was to scoop her over his shoulder and carry her off to his lair.

Ridiculous. He knew that Ruby saw him only as a friend. So he was going to have to ignore this stupid antsy feeling. She deserved to feel happy again. It was just a pity it meant she’d find that happiness with another man rather than with him.

So on Monday lunchtime, he summoned his brightest smile when he saw her. ‘Want to go grab a sandwich?’

‘That’d be nice.’

He waited until they’d sat down in the canteen before he asked, ‘So how was your date?’

‘Fine.’

Her smile was a little too bright. ‘But?’ he asked.

She wrinkled her nose. ‘He was a nice guy, but I don’t think he was ready to date again yet.’

Was that Ruby’s way of saying that she’d just discovered she wasn’t ready to date again yet, too?

He battened down the hopes as she continued, ‘I don’t think he’s quite over his divorce yet.’

‘Ah. Baggage.’

She gave him a rueful smile. ‘I guess we all have baggage when we get to this age.’

‘Mmm.’

‘Look at you,’ she said softly.

Oh, no. He really didn’t want to discuss that. He didn’t like talking about his feelings. And he definitely didn’t want to talk about his baggage. Ruby knew he was divorced, but he hadn’t told her the whole messy story.

‘Tom always said you’d never settle because you were trying to save people, to make up for the way they couldn’t save your sister.’

‘I guess that’s part of it,’ he said. ‘Though I always wanted to be a doctor, even when Sally was still alive.’ After Sally’s death, he’d vowed to work abroad rather than stay in an English hospital, and it had caused a rift with his brothers; they couldn’t understand why he risked himself the way he did, and they’d told him they didn’t want to lose him the way they’d lost Sally. But, however much he’d tried to talk them round, he hadn’t been able to make them see that he wanted to save all the other potential Sallys, and to do that it meant working abroad. ‘And it’s not why I became an obstetrician, either. I always planned to work in emergency medicine, like Tom. But then I did a rotation on the maternity ward and I fell in love with it—that special moment where you witness the miracle of a brand new life.’

‘That’s why I became a midwife, too,’ she said softly. ‘It never, ever gets old.’

‘And it’s even better in a world where things are sticky and you really feel that you need a miracle to happen and make things better. That first little cry…’ Every time, it made him misty-eyed and glad to be alive, all at the same time.

‘You still have itchy feet, don’t you?’ she asked. ‘I know you’re going back to the medical aid charity in a couple of months.’

‘It’s been arranged for a really long time,’ Ellis said. And he did want to go back. The trouble was, he also wanted to stay in London. But he wasn’t sure if he could—not if Ruby started dating someone else and it got serious. He’d promised Tom that he’d be there for Ruby, and he’d keep his promise; but he wasn’t sure that his promise could stretch to watching her date another man and being happy about it. ‘Anyway, we weren’t talking about me,’ he said, trying very hard to wriggle out of the subject. ‘We were talking about your date.’

‘I guess it was a case of nice guy, wrong time,’ she said with a shrug.

‘Would he be the right guy at a different time?’ It was a bit like prodding a bruise, but Ellis wanted to know.

‘Probably not,’ she said. ‘There wasn’t that spark between us. Whereas the first time I saw Tom…’

‘Yeah. I know.’ He reached across and squeezed her hand briefly.

Mistake. Because every nerve-end in his own hand tingled at the contact.

He knew about sparks, all right. Ruby most definitely made him feel that spark. His feelings for anyone he’d dated before just paled by comparison—including his ex-wife. But Ruby was vulnerable, she was still missing Tom, and she was still probably not quite ready to move on. Adding his job to the mix…In his book, it all made her very firmly off limits.

‘Hey. If you’re not busy with a date at the weekend, maybe we could do something together,’ he said lightly. ‘There’s that new action film.’

‘You want me to go and see a guy-flick with you?’ She laughed. ‘Ellis, much as I love you…’

As a friend, he reminded himself sharply.

‘….action flicks really aren’t my favourites.’

‘Hey, this one has a plot,’ he protested.

‘As if,’ she scoffed, still laughing. ‘All right, if you’re so desperate to see it, I’ll go with you. But it’s on the understanding that I want ice cream and popcorn.’

‘Deal,’ he said. It wasn’t a date date. But it would be enough. Because he didn’t have the right to ask for more.