‘I’ll change the plan,’ Claire offered desperately, as Sophia ended the call. ‘I’ll have more pain relief than the gas. You can rupture the membranes. Whatever it takes …’ She was sobbing now. ‘We don’t want to have our baby in a hospital …’
‘I know.’ Sophia smoothed damp strands of hair back from Claire’s face. ‘But you know what the really important thing here is?’
She didn’t wait for a response. Greg was perched on the end of the bed, holding Claire in his arms as she lay back against him. She caught his gaze and then Claire’s.
‘My job is to keep both you and baby safe. At the end of the day, the only thing that matters is that you get to hold your healthy baby in your arms. I promise that where the delivery happens is not going to take away even the tiniest bit of joy that moment’s going to give you.’
A joy that Sophia might never be able to experience herself but that didn’t mean she couldn’t share it happening for others. It was precisely why she’d chosen this profession. Why she loved it so much. And why she was so passionate about doing whatever it took to ensure a happy outcome.
‘That’s all I want,’ Greg said, his voice cracking. ‘For you both to be okay. We always said that we’d go to the hospital the minute we were worried about anything.’
‘But I’m not worried. I’m just so tired … Oohhh …’ Claire’s face scrunched into lines of pain.
‘Another contraction?’ Sophia reached for the Entonox mouthpiece. ‘Here you go. Deep breaths …’
The loud rap on the door made her jump. Surely the ambulance hadn’t arrived this quickly?
‘Shall I go?’ Greg asked.
Claire spat out the mouthpiece. ‘No—don’t leave me … It’s…. Ahhh …’
Sophia wasn’t going anywhere either. The contraction had produced a rush of fluid. Claire’s membranes had finally broken. It was a sign that her labour was progressing again but Sophia wasn’t feeling relieved. Quite the opposite.
The fluid soaking into the pad beneath Claire’s hips had the stain of meconium that meant the baby could be in trouble. And …
Oh, dear Lord … yes … that was a loop of umbilical cord showing.
‘G’day …’ The rich, deep voice came from behind her. ‘I let myself in. Hope that’s okay.’
Sophia looked up. The man was wearing a high-vis heavy-duty jacket. He had a motorbike helmet on his head with the red, white and blue colours of Melbourne’s ambulance service and the title ‘Paramedic’ emblazoned across the front. The chin-guard and visor were flipped up so that she could see his face but she barely registered what he looked like. There was relief to be felt now—that she had professional help in what had just become an obstetric emergency.
‘Claire’s waters just broke,’ she said quietly. ‘We’ve got a cord prolapse.’
‘What’s that?’ Greg was leaning in, trying to see what was happening. ‘What’s going on? And who are you?’
The paramedic’s helmet was off by the time he’d taken two steps closer. ‘I’m Aiden Harrison,’ he told Greg. ‘Here to help.’ He was right beside Sophia now. ‘Modified Sims position?’
‘Knees to chest, I think. Claire? We’re going to get you to turn over, I want you on your knees with your bottom up in the air. Greg, can you help?’
‘What? Why?’ Claire was panting, recovering from the contraction. ‘I don’t want to move.’
‘We’ve got a small problem, guys.’ The paramedic had dropped his helmet and leather gloves, along with a rolled-up kit he’d been carrying. He didn’t sound stressed. Rather, he made it sound as if whatever the problem was, it was going to be easily remedied. ‘Your baby didn’t read the rule book and part of the umbilical cord has come out first. We need to take any pressure off it, which is why we’re going to let gravity give us a hand. Here … let me help.’
Somehow he managed to make it seem like nothing out of the ordinary to be getting a woman in labour to get into what seemed a very unnatural position, on her knees with her head lowered. Sophia was ready with the Doppler to check the baby’s heart rate again.
Aiden listened, his gaze on his watch. ‘Ninety-eight,’ he said. ‘What was the last recorded rate?’
‘One-forty.’ Sophia ripped open a packet of sterile gloves. In a blink of time, this had become a potential disaster. The baby’s oxygen supply was being cut off. ‘I’m going to try and ease the pressure.’
‘Oh, my God.’ Claire wailed. ‘What’s happening?’
‘You’re going to feel me inside,’ Sophia warned her. ‘I’m going to be pushing on baby’s head to take the pressure off the cord.’
Greg’s face was as white as a sheet. ‘How are you going to take her to hospital if she has to stay in that position?’ He glanced sideways to where the paramedic had discarded his bike helmet. ‘You’re not even driving an ambulance, are you?’
‘No, mate. I ride a bike. Gets me where I’m needed faster.’ Aiden reached for the radio clipped to his shoulder. ‘SPRINT One to Base. How far away is our back-up?’
They could all hear the woman’s voice on the other end. ‘Should be with you in less than ten minutes.’
‘Copy that. Make it a code one.’ He nodded at Greg. ‘Hang in there, mate. We’re under control.’
‘I’m getting another contraction,’ Claire groaned. ‘Ohhh … I want to push …’
‘Don’t push,’ Sophia warned. ‘Not yet.’
She looked up to find Aiden’s gaze on her face. A steady gaze but she could see he knew exactly what she was trying to decide and the almost crushing responsibility for making the right choice here.
‘The cord’s pulsatile,’ she told him. ‘And Claire’s fully dilated.’
Aiden nodded. If they were in hospital right now, an assisted delivery with forceps would be the fastest and safest way to get this baby out. With Sophia using two fingers to push on the baby’s head, the cord was being protected and the blood and oxygen supply was still adequate. She knew what she was doing, this midwife. Intelligent-looking woman, in fact, which probably explained the anxiety he could see in her eyes. She had to know exactly how dangerous this situation was for the baby.
Her hand was probably already aching, although Aiden couldn’t detect any signs of discomfort. Could she keep this up until they arrived at the hospital? The other option was not to slow down a natural delivery but to try and speed it up. To get the baby out fast enough to avoid potentially devastating complications from lack of oxygen. She was still looking at him and he got the feeling she was following his train of thought.
‘She’s also exhausted,’ she added. ‘Labour’s been a bit protracted. That was why I called for an ambulance in the first place. I’m not sure …’ Sophia bit her lip as her words trailed to an inaudible whisper. She hated feeling indecisive and it rarely happened, but a baby’s life was at stake here and there was another option. But if they encouraged Claire to push and she was too tired to be effective, they would have to wait for another contraction and they could end up in a much worse position, with the baby’s head cutting off any oxygen supply. The baby could end up with severe brain damage. Or it could die.
The weighing-up process was lightning fast but agonising. Sophia found she was holding the gaze of the paramedic. Light brown eyes, a part of her brain noted. Unusual. It was a calm gaze but it was intelligent. He knew what the issues