‘I’ve not delivered a breech before,’ Jess murmured, following Sam’s lead and smiling broadly. ‘I hope you have.’
‘I’ve done my share,’ Sam assured her, washing her hands in the basin of water on the dresser. There was no point stating the obvious, that the breech deliveries she’d been involved with had been carried out in the safety of a highly equipped maternity unit. They didn’t have such luxuries on tap here so they would have to manage the best way they could.
‘I need a word with Khalid,’ she told Jess, refusing to dwell on the negatives. She had delivered several breech babies and every single one of them had survived. There was no reason to think that this baby wouldn’t survive too. ‘Our biggest problem is going to be the language barrier so we’ll need an interpreter.’
‘OK. Anything you want me to do?’ Jess asked, sponging Isra’s face.
‘Not really. I’ll only be a moment,’ Sam assured her.
She left the bedroom, frowning when she discovered that there was nobody about. After Khalid had woken her, he had led her to the servants’ quarters. Isra was the wife of one of the palace cooks and she and her husband lived in the grounds. Although their house was only small, much smaller than the one she and Jess were sharing, it was spotlessly clean and tidy.
Sam peered into a kitchen, which boasted a woodburning stove, and a tiny but well-equipped bathroom as she made her way along the passageway. From what she could see, the staff were well catered for and it was good to know that they were treated with respect. She came to the sitting room, which was also small but very attractive with brightly coloured rugs on the tiled floor and heaps of cushions on the low couches. It all looked very comfortable but decidedly empty. Where was everyone?
Sam stepped out of the door, waiting for her eyes to adjust to the darkness, and heard footsteps approaching. Just for a second her mind whizzed back to those moments in the bedroom when she had spotted the silhouette of a man highlighted against the window and she felt her heart race. If she’d known it was Khalid, would she have felt more afraid or less? Would it have been better to face an intruder than to face him and have to go through those seconds when she’d thought he had wanted her for a very different reason?
‘How is she doing?’
Khalid’s voice cut through her thoughts, cool and clear in the silence of the night, and Sam shivered. She turned towards him, taking care to maintain a neutral expression. There was no way that she was going to let him know how she had felt, definitely no way that she was prepared to admit that she had wanted him too, although not for his skills as a surgeon. It would be foolish to do that, foolish and dangerous as well. Giving Khalid licence to toy with her emotions again was a mistake she didn’t intend to make.
‘The baby’s breech,’ she informed him crisply. ‘It’s too late to perform a section so we’re going to have to deliver it vaginally but we’ll need an interpreter. The mother’s co-operation is vital in this situation.’
‘Of course,’ Khalid agreed, frowning.
Sam’s brows rose. ‘Is there a problem?’
‘Unfortunately, yes. The female interpreter I’ve hired isn’t joining us until tomorrow.’
‘Surely there must be someone else here who speaks English.’
‘Of course. However, they are all male.’
‘So?’
‘So it wouldn’t be right to allow them to be present at the birth.’
‘Why on earth not?’ Sam exclaimed.
‘Because men are not allowed to be present at the birth of a child, not even the father, let alone an outsider.’
‘That’s ridiculous,’ Sam declared hotly.
‘It may seem so to you but it’s a cultural issue.’ He shrugged, his face betraying little of what he was feeling. If he was annoyed by her outburst it didn’t show, Sam thought, but, then, why should he feel anything? Khalid was indifferent to her, as he had made clear. The thought stung so that it was an effort to focus when he continued.
‘Isra would lose the respect of her husband and her family if it were to happen. It’s out of the question, I’m afraid.’
‘How about if you did it? I mean, you’re a doctor, Khalid, so surely that makes a difference?’
‘I’m afraid not. Although views are changing in the city and there are even a few male obstetricians working in the hospital, the desert people still hold fast to the old ways.’
‘Then what do you suggest?’ Sam demanded, in no mood to compromise. Her feelings didn’t enter into this, she reminded herself. It was her patient who mattered, not how hurt she had been when Khalid had rejected her. ‘I need Isra to work with me, do what I tell her to do as and when it’s necessary. It’s vital if we hope to deliver this baby safely.’
‘The only thing I can suggest is that we erect a screen across the window. Then I can stand outside and relay your instructions to her without actually being in the same room.’
‘That sounds like a plan,’ Sam agreed slowly, then nodded. ‘Yes. It should work so long as you’re able to hear what I’m saying.’
‘Oh, that won’t be a problem.’ He smiled faintly, his beautiful mouth turning up at the corners. ‘You have a very clear and distinctive voice, Sam. I’ll have no difficulty hearing you.’
‘Oh. Right.’
Sam felt a rush of heat sweep up her face and was glad of the darkness because it hid her confusion. That had sounded almost like a compliment and it was something she hadn’t expected. She turned away, hurrying back into the house before the idea could take hold. Khalid could have meant anything by the comment or he could have meant nothing and she would be a fool to get hung up on the idea. She quickly explained to Jess what was going to happen, half expecting the other woman to find it as ridiculous as she had done. However, Jess merely shrugged.
‘I’ve come across it before. Some of the African tribes don’t allow men to be present at a birth.’
‘Really? I had no idea,’ Sam admitted. She glanced round when she heard noises outside the window. ‘It sounds as though Khalid is getting everything organised. We’d better get set up in here.’
She and Jess worked swiftly as they spread a sterile sheet under Isra and donned their gowns. Sam decided that she would need to perform an episiotomy to help ease the baby’s passage. As it was presenting bottom first, it was harder for it to make its way out into the world and a small incision in the perineum would help enormously. It would also prevent the perineum becoming badly torn.
‘Can you explain to Isra that I’m going to do an episiotomy?’ she said clearly, glancing towards the window. A wooden screen had been erected across it so she couldn’t see Khalid and could only assume he was there. ‘If you can tell her why it’s necessary, it should make it less scary for her.’
‘Will do.’
His voice floated back to her, soft and deep and strangely reassuring. Although she couldn’t understand what he was saying to Isra, Sam knew that his tone would have reassured her if she’d been in the young woman’s position. It obviously did the trick because Isra stopped looking quite so scared.
Sam worked swiftly, administering a local anaesthetic before making the incision. The girl lay quite still, bearing the discomfort with a stoicism that filled Sam with admiration. ‘Well done,’ she told her, patting her hand.
She jumped when from the window came the sound of Khalid’s voice repeating her comment. His voice sounded so warm that she shivered before she realised what she was doing and stopped herself. The warmth of his tone wasn’t a measure of his regard for her but for Isra, she