‘That sounds sensible—Ooh.’ Alison winced and screwed her fingers round the bedcover as a contraction started to build. ‘I never expected the pain to be this bad. Oo-ooh, Tim!’
Her husband stroked her shoulder awkwardly and cast a worried look at Brooke.
‘She’s fine,’ Brooke murmured, moving her palm over the woman’s swollen abdomen to feel the strength of the contraction. ‘Remember your breathing, Alison. In through your nose and out through your mouth. Perfect. Well done. There—it’s tailing off. Now, I just need to examine you. Has anyone explained to you about this machine?’
She moved it slightly closer and ripped off the trace that was hanging down. ‘This is called a CTG and it basically tells us about your contractions and your baby’s heart rate. At this stage we want you as mobile as possible, so we’ll only use it occasionally, just to get a picture of what’s happening.’
‘Does it look OK? It looks totally incomprehensible to me.’ Alison frowned down at the graph but Brooke nodded and filed it carefully in the notes.
‘It’s fine. Now, let’s take a quick look at this birth plan together.’ She read quickly and then glanced up at the couple. ‘You seem to be pretty open-minded about most things.’
‘I really didn’t want to have my membranes ruptured,’ Alison murmured, looking at her husband for support, and he nodded firmly.
‘That’s right. I gather a lot of hospitals do that, but we’d rather let nature take its course.’
‘So would we.’ Brooke slipped the birth plan into the notes and gave them both a warm smile. ‘You’re right that some units artificially rupture the membranes the minute the cervix is 4 cm dilated, but we never do that here. We don’t rupture membranes, we don’t monitor without a reason and we don’t do routine internal examinations either. We do them on admission and then when we feel they’re necessary.’
Alison’s husband frowned. ‘But if there’s a medical problem?’
‘Then we involve our medical team,’ Brooke told him promptly. ‘That’s the good thing about this unit. You get the nearest thing to a home birth without sacrificing the safety of a hospital. Now, then, I’d just like to feel the way the baby is lying, Alison, if that’s all right with you.’
She palpated the abdomen carefully, glancing up as Paula slid discreetly into the room and introduced herself to the couple.
‘Is it still the right way up?’ Alison looked anxious and Brooke nodded with a smile.
‘Absolutely. He’s coming out head first—what we call a cephalic presentation. And he’s nicely flexed so that’s good.’
Paula cleared her throat. ‘Sister wondered if you’d nip into 4, Brooke. They need some help.’
Brooke glanced at her and caught the urgency of her expression. Trouble, obviously. ‘Fine. Well, you’re staying with the Neals for the rest of your shift now, aren’t you? I’ll be back as soon as I can. Just help Alison with her breathing.’
She left the room calmly, and then speeded up as she made for the other delivery room.
‘Oh, Brooke—good.’ Gill Wilson glanced towards her and then back to her patient. ‘Mrs Fox is going to need a section. She’s bleeding a bit and we suspect a placental abruption. We’ve bleeped Mr Matthews, the consultant, and he’s meeting us in theatre. Fortunately she’s had an epidural so she shouldn’t need a general anaesthetic. Is Alison Neal all right for a while if you give me a hand? Suzie needs to go back to her student in 5 so I was hoping you could scrub and take the baby.’
‘No problem. Alison’s fine with Paula.’ Brooke could see from the debris around her that ‘bleeding a bit’ was something of an understatement, and she knew Gill well enough to know that she was concerned.
Suzie was checking Mrs Fox’s blood pressure again. ‘Eighty over fifty,’ she murmured, and Gill nodded briskly.
‘Right. Into theatre.’
Without waiting for a porter, they manipulated the trolley into Theatre where preparations were already under way for an emergency section.
Brooke scrubbed, preparing for her role which was to take the baby once it was delivered, leaving the surgeon to concentrate on the mother. Gill had said the new consultant was good. For the sake of Mrs Fox she hoped that was true. Things weren’t looking good.
‘How much blood has she lost?’ The deep male voice trickled through the doors and Brooke froze.
No. Dear God, no.
She listened again, her heart pounding in her chest. There was a low murmur of voices as Gill replied, and then his voice again. ‘OK—we need to get this baby out fast.’
It was him. It was definitely him.
She closed her eyes and struggled to breathe. Six years. It had been six years since she’d last heard that voice, but she’d have recognised it anywhere. Deep, tough and totally male. Smooth and confident like melted chocolate poured over solid steel. It was the sort of voice that made everyone stop and listen. The sort of voice that was used to issuing orders and commands. And it was the same voice that had once seduced her to within an inch of her life.
Brooke felt her knees shake as panic swamped her. What if he recognised her? No. She had to make sure he didn’t. If he ever found out…
Frantically searching for some way of concealing her identity, she noticed a box of masks and grabbed one, hooking it over her ears with shaking fingers. It wasn’t a long-term solution but at least it should buy her some time.
She slid into Theatre, her heart thumping, and quickly realised that she needn’t have worried. The new consultant wasn’t remotely interested in who was standing in his theatre. He was busy, saving two lives.
His hands as steady as a rock, he divided skin and muscle with a speed and skill that made Brooke blink with disbelief. Even in her state of panic she could see that he was good. Incredibly good.
‘Is there a paediatrician on the way?’ His sharp question was swiftly answered by Gill.
‘Dr Patel’s on her way down now, Mr Matthews.’
Brooke watched, transfixed, as he stroked through the layers until the uterus was exposed and then made a small transverse incision and passed his right hand into the uterus.
‘Out you come, little chap,’ he murmured, his eyes flicking up to his SHO who was assisting. ‘Press on the fundus.’
Sita Patel arrived just as the newly delivered baby let out an outraged yell, and suddenly Brooke was reaching for the wriggling child, her actions all automatic, her mind still paralysed with shock.
‘OK, what have we got here?’ The consultant had already turned his attention back to the job in hand. Stopping the bleeding. ‘Suction, please. And again… That’s better… Oh, yes, I see what’s happening…’
Brooke and Sita took charge of the baby, placing it gently on the resuscitaire which had been wheeled into Theatre, so named because it incorporated essential equipment for resuscitating a baby.
‘Apgar of 8 at one minute,’ Sita murmured, looping the paediatric stethoscope around her neck as Brooke carefully used suction to clear the baby’s mouth and nose of mucus. ‘He’s got good lungs!’
‘Is he OK? Is my baby OK?’ Mrs Fox was twisting her head anxiously and Jed Matthews gave her a smile, his eyes creasing above the mask.
‘He’s great—can’t you hear that yell? Dr Patel will bring him over just as soon as she’s checked