The Midwife's Secret Child

by Fiona McArthur

  ‘Of course,’ he said.

  Raimondo and Faith stood on each side of Cynthia, supporting her until she was comfortably sitting upright on the bed, the back raised and one pillow supporting her head.

  Faith turned to Raimondo as he stepped back. ‘Thank you. I’ll make a call and a nurse should be here soon. Will you stay by the desk in case I need you before anyone else arrives?’

  ‘Of course.’

  ‘Thank you. It’s a good place to find out about Cynthia’s husband. The ambulance control number is in red above the desk. They should be able to give you some information if you explain to them or they’ll call you back. Tell them we have Cynthia here and expect her to be transferred as well.’

  ‘Sì.’

  Faith crossed to the phone in the room and quickly dialled the hospital supervisor. She tucked the phone into her neck to free her hands and twitched the cover off the baby resuscitation trolley, then reached to turn the heater to warm just in case. She’d only checked the equipment half an hour ago, an early in the shift task everyone completed, so she knew everything was ready if they needed it.

  ‘Yes?’ the supervisor answered.

  ‘Hi, it’s Faith in Maternity. We have an admission, a lady in a car accident. She’s stable but contracting and could be in early labour. Can you send over a nurse as my second, please, and phone for Dr Southwell senior? There’s an out-of-town doctor here at the moment, so tell the nurse that’s who’s at the desk when she arrives. Too busy to explain just now.’

  She paused. Listened. Said ‘Thanks’ and put down the phone. ‘Right then, Cynthia. Let’s have a gentle feel of your tummy and listen to your baby. Raimondo will tell us as soon as he hears any news of your husband.’

  Cynthia nodded, her face shining pale against the white pillow, her dark eyes concerned as she held her stomach. ‘There’s another contraction.’

  Faith knitted her forehead. She needed obstetric history soon but the nurse could follow that up when she arrived. Faith crossed to the sink and washed her hands then went back to the bed, drying her fingers on the paper towel. She lowered the bed until Cynthia was lying flat with just the pillow under her head. Palpating a uterus in the upright position wouldn’t give the clear picture she needed from an unknown woman.

  ‘Is this your first baby?’ They’d have more time if it was, she thought; the contraction had finished as she lifted the pretty blue maternity shirt and gently began to palpate the woman’s stomach. Not her first baby, judging by the older silver stretch marks. She laid her fingers each side of the bulge and palpated in Leopold’s manoeuvre. ‘Nothing painful when I do this?’

  ‘No.’

  Good. Less chance of a quiet bleed from the accident then. The height of the uterus was consistent with thirty-six weeks, though the baby didn’t shift under her hands, which was a concerning indication of vigour.

  ‘She’s not my first baby. This is my fourth. Four in five years.’

  ‘Oh, my. Congratulations.’ Faith’s brows rose as she looked at the woman again. ‘You look too young for four young kids. I have one and look much more careworn.’

  Cynthia smiled wanly. ‘John and I have just been on a week’s holiday together. We were feeling relaxed.’ She clutched her stomach again. ‘I think this baby is wanting out.’

  Faith narrowed her eyes and glanced at the clock. Only two minutes since the last contraction. ‘Were there any complications in your previous births? Like a Caesarean or forceps. Or bleeding after the birth?’

  ‘No. Apparently I’m made to have babies.’

  Faith smiled. ‘Pleased to hear it.’ She listened to the clop of the baby’s heart rate, which made the mother’s mouth tilt up in relief at the comforting sound. Then Cynthia gasped, ‘Oops. I think I just had a show or my waters broke a little. Something feels wet.’

  By the time Faith had confirmed that there had been a small loss of blood and they’d sorted that development, Cynthia was returned to the sitting position. ‘Um.’ She fluttered her hands and her eyes darted around the room. ‘I need John. I think I want to push.’ Cynthia’s voice sounded tremulous, alarmed at the speed of change, and Faith frowned and looked at the phone across the room just as the nurse poked her head into the room.

  Faith blew out her breath in relief. ‘Perfect timing. Can I have a delivery set-up ASAP? And get the supervisor to find out how far away Dr Southwell is. We need him now.’ Faith didn’t often call the doctor but this was a post-accident baby and it could be born compromised.

  There was still that concern about abruption of the placenta from the sudden stop. ‘Can you also ask Dr Salvanelli to stand outside the door in case I need to call him in, please, until the doctor arrives?’

  The nurse nodded and hurried off after pulling the resus trolley closer to Faith.

  Cynthia sighed heavily on the bed and Faith pulled back the sheet she’d lain over her. ‘How about we just ditch the whole idea of underwear and check what’s going on so we know for sure?’

  By the time they’d done that Faith didn’t need to check anything more because there was an unmistakable bulge of baby’s crown inching into the world.

  ‘I need to move,’ Cynthia gasped. Already she was rolling onto her knees. Faith hurriedly stacked pillows so Cynthia could lean over a support. Things were progressing very quickly and the email of pre-birth papers would be moot until after baby’s arrival now.

  Faith leaned forward and pressed the call bell for the nurse to return. For now she needed an injection for after the birth so they didn’t have a haemorrhage. Fourth baby made the risk increased. They could find out the medical history later.

  Because the bag of waters was still intact, a large odd-shaped bag of fluid encased in membranes formed in front of the baby’s head and through that a dark-haired skull could be seen descending. ‘Looks like this baby wants to be born without breaking your waters first.’

  ‘One of my others did that,’ Cynthia panted. ‘Won’t drown, they said.’

  Faith did love old wives’ tales about midwifery, and even more she loved uncomplicated women like Cynthia who just went ahead and had their babies without any help from anyone.

  ‘Come on, you,’ Cynthia muttered as she bore down, because after progressing rapidly, with the birth of more of the head, now the speed of descent seemed to have stopped.

  Faith glanced towards the door; it was good knowing she did have backup help if needed, but she refrained from calling in Raimondo.

  The nurse came back in carrying an injection tray. Faith smiled at her. ‘Brownie points for you.’ She nodded at the injection. ‘Did you get onto Dr Southwell?’ Faith’s eyes returned to Cynthia, who had become more distressed.

  ‘They had to find him but he’s coming.’

  Without looking at the nurse, Faith nodded. ‘Great. Thanks.’

  ‘It feels stuck. I need to move.’ Faith wasn’t surprised. But with a sore ankle, squatting would be hard.

  ‘Would it be okay if I ask Dr Salvanelli to come in? He could take some of your weight as you try to get comfortable while the nurse sets up the rest of the equipment.’

  ‘Do it.’ Cynthia didn’t have words to waste.

  Faith raised her voice. ‘Raimondo?’

  Within seconds Raimondo stood beside her and between them they lowered the bed closer to the floor, helped Cynthia shift sideways on her knees until she was at the edge of the bed, and waited for the next contraction to ease before they moved further.

  A minute later she stretched her left leg down towards the floor, then moaned and they all froze.

  Cynthia sucked in a breath. ‘That shifted a little. Let’s go for a squat, which is how all my other babies were born.’ Except this time her right leg wouldn’t bear her weight.

  Faith and Raimondo’s eyes met across the woman’s head. ‘I always listen to the mother,’ Faith said quietly
and Raimondo nodded.

  ‘I have you.’ Raimondo’s hands were under Cynthia’s armpits. ‘Stand and then you can release the weight.’

  Cynthia shuffled sideways with Raimondo taking her full weight, not something Faith or the nurse could have done, and the woman sagged against him and bent her knees. She sighed with relief. ‘Better. Much better.’

  Faith took the warmed towel the nurse had handed her and wondered philosophically what would happen to Raimondo when the waters broke.

  A sudden whoosh delivered the answer as the membranes overextended their elasticity and a wave of amniotic fluid hit the floor and bounced backwards, covering his shoes behind the mother in a hot wave of sticky fluid. Faith bit her lip to stop the smile, safe behind the towel and concentrating on what she hoped would happen next.

  As expected, the baby’s impacted shoulder that had held up the birth suddenly freed with the extra room in the pelvis from the squatting position, and baby slid into the warm towel Faith caught her with. A slithery cord-wrapped bundle who lay still.

  ‘A girl,’ Faith murmured.

  The nurse, standing to the side of all the drama, reached over and clicked on the timer to begin recording time passed since birth.

  Cynthia swayed and her face paled. ‘I need to lie down.’ Almost before she’d finished the words Raimondo had scooped her up and put her back against the pillows. The nurse stepped forward with a warm blanket to cover her and Faith juggled the still attached baby onto the edge of the mattress and dried the infant, waiting for the mewling to start.

  At the end of the pulsating cord the silent baby didn’t cry. Or move.

  ‘Right then,’ Faith said quietly as she clamped and cut the cord. ‘I’m just going to take her to the trolley and check your baby out, Cynthia. I think she’s stunned by the quick trip through the birth canal.’

  The nurse took Faith’s place beside the bed and patted Cynthia’s shoulder. ‘I’ll take over here. We’ll ask if I need any help. Here’s a warm blanket as we wait for the afterbirth and your baby to come back. Let’s get you comfortable while we wait.’

  Raimondo followed Faith as she lifted the little towel-wrapped bundle onto the wheeled resuscitation bench and removed the damp cloth. She began to rub the baby with the new towel waiting under the overhead heater and Raimondo took the stethoscope that hung there and put it in his ears to listen to the baby’s chest as soon as Faith finished.

  With the lack of response she glanced at the ticking clock and reached for the little mask. ‘Positive pressure ventilation at thirty seconds after birth.’

  ‘Heart rate one-ten.’ Raimondo stepped back as Faith slid the tiny clear breathing mask over the baby’s mouth and nose. They watched the rise of the little chest as she began to puff small breaths of pressured air every second. Raimondo unwound the tiny pulse oximeter lead and strapped the sensor onto the pale baby hand. ‘I’ll get this running so we can tell how her oxygen levels are.’

  ‘Good. Still think she’s just stunned.’ Faith turned her head towards the bed. ‘Heart rate is good, Cynthia. She’s just figuring out this breathing game.’

  The nurse called out, ‘And we’ve finished third stage over here and no bleeding after the placenta.’

  That was a blessing. ‘Thanks, Nurse.’

  After thirty seconds of further inflations the tiny limbs began to move. Raimondo had calibrated the pulse oximeter and now the constant read-out of heart rate confirmed baby’s heart was chugging along as it should but baby’s breathing was still gasping and ineffectual, though Faith’s maintenance of air entry stopped deterioration.

  ‘I’ll do another thirty seconds of air.’ But Faith wasn’t happy. Baby should have recovered by now. ‘Can you have a look with a laryngoscope? Might be something that blocked the airway.’

  Raimondo nodded and the tension in her shoulders increased as he took over the hand-held intermittent positive pressure ventilation for the baby while she assembled the equipment needed. Her hands collected the necessary equipment swiftly as her mind searched for reasons. Simple obstruction was the most likely cause for baby not breathing when the heart rate was so good but she was getting worried.

  They didn’t have sick babies often but this baby had been in an accident and was slightly premature.

  Having Raimondo here beside her while she waited for the other doctor was surreal, wonderful in the circumstances, but probably not legal. Where was their backup?

  She took the ventilation mask off Raimondo and he took the laryngoscope gently—angling the curved beak with a light at the end and peering down the baby’s throat into the airways. She noted how skilfully he inserted the steel blade and narrowed his eyes at the now open and visible airway. ‘A small blood clot obscuring the trachea—it must flop back when you stop forcing the air in.’ He held out his hand, still focused on the airway. ‘Sucker?’

  Faith had the thin clear tubing ready and handed it to him to slide down the curve of the laryngoscope. His finger occluded the mechanism, they heard the gurgling sound of suction, then a dark clot slid up the tube and flashed past towards the vacuum bottle.

  Raimondo removed the tube and the laryngoscope from the baby’s throat in one smooth movement and Faith felt relief expand inside her. That skill was one she didn’t have.

  He smoothed the baby’s forehead. ‘Is this better?’ he asked her.

  The baby gasped and cried and Faith sagged a little with the rush of success and knew everything would be fine. Her eyes met Raimondo’s in a moment of pure relief and satisfaction. ‘Thank you,’ she mouthed, and when he smiled at her the connection between them flooded all the way down to her toes.

  CHAPTER SEVEN

  RAIMONDO FELT THE link between them as if it were a physical bond drawing them closer. How was this so? He watched as Faith, after a last glance at him, turned away and carried the now wriggling baby across to the mother, and knew that his life would always hold this so precious memory of working with Faith.

  A moment in time.

  The beginning of a child’s life.

  A moment such as this he had missed at his own child’s birth.

  He jerked himself back to the present. It had been a simple thing to find the airway obstruction, but Faith’s adeptness was also a reason for much satisfaction. He’d known she would be efficient and kind in her work but her calmness and competence during the rapid birth and the subsequent neonatal resuscitation made him feel a strange emotion he wasn’t familiar with.

  Was it pride? Approval that the mother of his daughter was so admirable? He thought about that. No. It was simple pleasure at helping Faith, at sharing a moment of release of tension, of mutual satisfaction and appreciation for the goodness of others. He was glad and thankful to be here for her. That was the emotion he felt. Gratitude.

  But standing here now was not needed and impacted on the privacy of the patient. ‘Congratulations, Cynthia. I will go out and try the ambulance control again for an update. Would you like me to pass the news on to your husband?’

  The woman looked up. ‘Yes. Please. I want to know how he is.’

  As Raimondo walked down the hallway an elderly gentleman with a stethoscope around his neck, and a decided limp, hobbled past him towards the birthing unit. The doctor had arrived.

  Raimondo didn’t slow him with introductions.

  By the time he had contacted ambulance control and ascertained the transport for Cynthia would be here soon, the nurse had returned to find out the results of his call. He passed them on and decided he would leave Faith to the no doubt mountain of paperwork she would have after such a rushed birth.

  He would see her tomorrow. Today he needed to find himself a base in Lighthouse Bay because already he could tell he would always want to spend time here.

  * * *

  The next morning, just before eight, Raimondo strode up the cliff path towards a small ho
use that sat to the left of the three crofts perched over Lighthouse Bay. He glanced back behind him to the soaring white stone lighthouse silhouetted against the sapphire-blue sky. The white tower seemed to watch him with guarded eyes from the big hill behind the hospital. Willing him to do this right.

  So much at stake.

  Perhaps even his whole future at stake.

  Not just for Chloe, the daughter he had not known he was blessed with, but for Faith. For their future. His and Faith’s future as parents together.

  A week ago he had only a throwaway comment from a colleague to suggest he had a child.

  Twenty-four hours ago he had not known that inside his chest lay a switch that would illuminate the dormant fascination and feelings he still held for Faith. This woman who had borne his child alone yet forgiven his absence so that Chloe would not be soured by a mother’s bitterness.

  How had he stumbled on this rainbow of hope that could change his life? How did he not destroy his chance here, as he had so many times by taking the wrong path?

  Faith had to see he could be trusted and would take as much care not to hurt their daughter as she would.

  A stone flew away from the side of his boot and he slowed. He could have driven to Faith’s house up the steeply inclined hill from the hospital but he’d preferred to walk to loosen the excited apprehension that had made him toss and turn for most of the night.

  He’d run over and over the episode at the hospital and marvelled at the opportunity to see Faith in her work. She’d been as wonderful as he’d expected and the privilege of sharing those moments stayed with him. Comforted him in his anxiety to do everything that was right by Faith.

  He shook his head ruefully and smiled at the ancient front gate he approached. The new padlock.

  There had been such a high from that shared medical emergency, and perhaps his soaring mood could have been partially responsible for his impulsive purchase of the building he was about to pass.

  He turned his head and studied his new acquisition in the morning light: the run-down almost-mansion next door to Faith’s home that he’d seen in the real estate window, walking home from the excitement at the hospital.