by Sarah Morgan
‘Yes.’ Mary nodded and gave him a wan smile. ‘Perhaps you ought to have a word with my employers.’
‘Willingly.’ Luca was totally serious and Mary gave a sigh.
‘Only joking. I’ll have to face the music myself and tell them I need some time off.’
Tia compared Mary’s story with Sharon’s reaction to her own pregnancy. She was lucky that the people she worked with were so sympathetic and supportive. Obviously it wasn’t the case for everyone.
Luca turned to Dr Ford and issued a stream of orders which left Tia’s head reeling. ‘Call the ward and admit her, please, and then get a line in and take blood for PCV, U and Es, TFTs. Make sure that the nurses know to chart all the losses and send a urine sample so that we can exclude a UTI.’
Dr Ford scribbled frantically on her pad. ‘And shall I arrange a scan?’
Luca nodded. ‘Please.’
He stood up and smiled at Mary. ‘I hope that a good rest might be enough to sort this problem out. I’ll pop and see you later tonight but stop worrying about work.’
Tia tried not to look at his broad shoulders or the powerful muscles of his thighs. Maybe if he’d never made love to her it wouldn’t be so bad, but knowing just exactly what Luca could make her feel was starting to drive her to distraction. They’d come so close to kissing the night before, and if she hadn’t made the silly no-touching rule she knew that they would have ended up in bed.
As far as she was concerned, the no-touching rule could finish at any time.
She was sure of her feelings and touching wasn’t going to change them.
She was totally, utterly, crazily in love with Luca.
But he still hadn’t told her about his past.
CHAPTER SEVEN
THE weeks leading up to Christmas were busy and Tia barely saw Luca at home. There was a nasty flu bug going round the hospital and consequently they were very short-staffed.
‘You look exhausted,’ she muttered one morning as she made them both a quick breakfast before they left for the hospital. ‘Can’t you take today off?’
‘Unless I catch flu, there’s no chance.’ Luca curved a lean brown hand around his coffee-mug and gave a mocking smile. ‘Dan’s away this morning and I’m covering his theatre list as well as my own workload. Still, tomorrow is Christmas Eve and we have two whole days to ourselves.’
Tia’s eyes widened and she shook her head, puzzled. ‘But I’m working.’
‘Not any more. Sharon and Dan put their heads together and decided that we need Christmas off,’ Luca told her with a smile. ‘So tomorrow we’re going to buy a tree and do some shopping. We’re having a proper family Christmas.’
A family Christmas?
Tia looked at him and swallowed hard. Normally she hated Christmas because she was either on her own or working.
‘I—I don’t usually bother with a tree,’ she confessed, and he gave her a slow smile that made her insides churn.
‘Well, this year you’re bothering. We’re buying the biggest tree in the forest.’
Caught up by his enthusiasm, Tia laughed. ‘The ceilings are too low.’
He gave a careless shrug. ‘So we cut the top off.’ He glanced at his watch and rolled his eyes. ‘Come on, or we’ll be late.’
Tia had to admit that his stamina was awesome. Despite the punishing hours he’d been working, he still looked relaxed and alert. If it had been her, she would have been in a coma!
‘I’m looking forward to having two whole days alone with you. I’m sorry I haven’t been home much lately.’ His dark eyes were watchful and she shifted slightly under his gaze.
‘It doesn’t matter. I’ve been pretty tired, to be honest. I’m usually in bed by nine o’clock anyway if the baby stops kicking for long enough to let me sleep.’
He gave a slight smile and his eyes flickered down to her now rounded stomach. ‘He is wearing his mama out and he hasn’t arrived yet.’
‘Yes.’ She blushed slightly. Since that night when they’d almost kissed, he hadn’t been near her.
They’d continued to talk and share confidences but he’d kept a distance from her and she didn’t know what to do about it.
She’d set the rules but she didn’t know how to tell him that she didn’t want to live by them any more.
No touching.
She must have been mad. She wanted him to touch her so badly it was a physical ache.
Maybe he didn’t want her any more.
Tia was spending more and more time on the antenatal ward where they were always desperate for staff. As it was Christmas, they discharged as many patients as they could, but they were still short-staffed which meant they had to close one ward and merge the antenatal patients with the postnatal patients.
‘Another brainchild of the powers that be,’ Sharon complained, after another argument with the hospital managers. ‘Just because it makes sense on paper, it doesn’t mean that it works in reality. Don’t these people ever think about the emotional side of things? I’ve got women with high-risk pregnancies forced to be side by side with women who have just had bouncing, healthy babies. Talk about cruel!’
Tia gave a rueful nod. It was cruel and she’d seen the yearning in some of the women’s eyes as they’d walked past the breastfeeding room.
Mary, the woman they’d admitted from clinic suffering from hyperemesis gravidarum, had spent several weeks in hospital being rehydrated before finally being discharged.
‘It’s such a wonderful relief to have stopped feeling sick,’ she confided in Tia with a wide smile. ‘I just hope it doesn’t start again.’
‘What happened with your job?’ Tia helped Mary zip up her holdall and get ready for her husband, who was collecting her. ‘Did they give you the time off?’
‘With a great deal of complaint,’ Mary said, with a sigh. ‘I can see now that I’m not going to be able to carry on in with my current job when I have the baby. I thought that I could do both—you know, the nanny and the high-powered career—but it doesn’t work, does it? Not if you want to see the child.’
‘No, I suppose not.’ Tia bit her lip as she looked at Mary, wondering what she was going to do herself. Luca had grudgingly accepted that she would work while she was pregnant but they hadn’t discussed what would happen once the baby was born.
‘It’s funny how you change,’ Mary said softly, slipping on her shoes and picking up her coat. ‘I used to think that I wouldn’t give up my job for anyone, but now I think that I wouldn’t give up being with my baby for anyone.’
Tia nodded slowly. ‘I suppose you just have to find an employer who is willing to be flexible.’
Mary laughed and smiled as she saw her husband walking onto the ward. ‘Yes, well, that certainly isn’t my lot! They’re about as flexible as an iron rod. Thanks, Tia. You’ve been really great this last few weeks. Thank Dr Zattoni for me, too, will you?’
Tia nodded and walked with her to the door. ‘Take care now.’
She watched Mary go and then returned to the ward. Her day was incredibly busy and at three o’clock a woman was admitted with premature rupture of membranes.
‘I felt this rush of water down my leg,’ she told Tia, ‘and at first I thought I’d wet myself—so embarrassing—but then I realised that it must be to do with the baby so I rang the labour ward. What happens now?’
Tia gave her a reassuring smile. ‘We need to examine you to see what’s going on.’
‘But it will be a dry birth, won’t it?’ The woman looked at her with scared eyes and Tia shook her head.
‘There’s no such thing as a dry birth, Chloe,’ she said calmly. ‘That’s an old wives’ tale. Women used to think that if their waters broke early the birth would be dry, but your waters will always break before the baby is born, even if it’s a last-minute thing. It doesn’t affect your labour in any way. What it can affect is the health of the baby if your waters break a long time before you go into labour.’
Chloe’s eyes widened as she stru
ggled into the unflattering hospital gown. ‘How?’
‘The fluid around the baby is held in place by a membrane and it means that the baby is totally enclosed in a little bag,’ Tia explained carefully. ‘If your membranes rupture, the baby is theoretically exposed to germs from the outside world. The most important aspect of looking after you is to check that you don’t develop an infection.’
She checked the notes and saw that Chloe was thirty-five weeks pregnant, but before she could examine her Luca arrived with Dr Ford and three students in tow.
‘Mrs Hunter, I’m Dr Zattoni.’ Luca shook Chloe’s hand and gave her a warm smile. ‘Could you tell me what happened?’
Chloe looked at him anxiously and repeated her story.
‘And you have no pain? Nothing that makes you think you could be in labour?’
Chloe shook her head. ‘Will you have to deliver the baby?’
‘Not necessarily. A pregnancy can sometimes continue for several weeks without problems. Our concern is to ensure that an infection does not develop.’
Chloe nodded. ‘Yes, that’s what Tia told me.’
Luca’s eyes flickered to Tia and she flushed under his warm gaze.
‘All the signs are that the baby is well at the moment. We will do some tests right away and then make some decisions on the best way to manage things.’
Chloe looked at him anxiously. ‘What sort of tests? Will I have to stay in over Christmas?’
Luca was noncommittal. ‘Possibly. I need to examine you internally to take a sterile sample of the liquor—that is the fluid that surrounds the baby,’ he explained. ‘That will give us an idea of lung maturity—how well your baby will be able to cope if it is born early. Then I want you to have another scan, just to check that everything is still looking good with the baby.’ He turned to Tia. ‘What’s her temperature?’
Tia nodded and gestured to the chart. ‘It’s normal. Thirty-six point eight. We’ll check it four-hourly.’
‘Good.’ Luca gave a brief nod and then turned to Dr Ford and gave her some instructions, breaking off as his bleeper sounded.
He lifted it out of his pocket and grimaced. ‘Labour ward. I’d better go.’ He glanced at Chloe with a smile. ‘Tia will arrange for you to have a scan and I will be back to examine you shortly.’
But he didn’t reappear. Tia was about to bleep him when Phil Warren, one of the registrars from the other obstetric team, arrived on the ward to examine Chloe.
‘Sorry about the delay. It’s a nightmare on the labour ward,’ Phil muttered in an undertone as he scrubbed and prepared to take the specimen. ‘A woman has ruptured her uterus. Luca’s trapped in Theatre.’
‘What?’ Tia stared at him in horror and disbelief. Rupture of the uterus was extremely uncommon in the UK. ‘Was it a previous Caesarean section scar?’
Phil nodded. ‘She’d already been admitted in labour but the doctor didn’t spot it. It was Luca who suspected it—he’s seen it before apparently. Anyway, he whipped her into Theatre just in time. She had a massive haemorrhage and it was touch and go with the baby.’
Tia stared at him in horror. ‘What did Luca do?’
‘Luca?’ Phil gave a dry laugh. ‘You know him. Mr Cool. He got the baby out so fast we didn’t see his fingers move. Funny, really. Every other surgeon I know would have been at least a little tense in that situation but not Luca. He doesn’t know the meaning of the word panic. The only slightly stressful moment was when he lapsed into Italian and no one had a clue what he was talking about.’
‘And is the mother all right?’
Phil nodded. ‘I think so. When I left, Luca had stopped the bleeding, but it looked as though he might have to do a hysterectomy.’
‘Poor woman,’ Tia said softly.
‘Yes, but she’s lucky that it was Luca,’ Phil said. ‘That was a tricky piece of surgery and he undoubtedly saved two lives. I don’t think I could have done what he did. He’s a bit of a hero on the labour ward today!’
Tia felt a glow of pride. The more she saw of him, the more she realised what a skilled obstetrician Luca was.
Later that afternoon she was moved to labour ward to help out and discovered that Sally Clarke, the woman with the breech presentation, had been admitted earlier in the day.
‘Luca is still promising to deliver her vaginally,’ Sharon muttered as she went through the notes with Tia. ‘If it was anyone but him I’d be protesting madly, but he’s adamant and he does seem to know what he’s doing. Can you go and assist? If things go wrong we’ll need some extra bodies and, anyway, you know her, don’t you? She was asking for you earlier.’
Tia hurried to the labour room and pushed open the door.
Sally was lying quietly, holding tightly to her husband’s hand as she listened to Luca.
‘You have an epidural in place,’ Luca told her, ‘because I don’t want you to push at the wrong time.’
Tia knew that it also meant that he could use forceps if he needed to.
‘I’m never, ever having another baby,’ Sally wailed, gripping her husband so hard that her knuckles turned white.
He looked at Luca in desperation and Luca gave him a reassuring smile.
‘Everything is fine, I promise you.’ He examined Sally carefully and then glanced at Dr Ford. ‘This is an extended breech—so that the presenting part is the buttocks. It is the most common type of breech presentation and much safer than a footling breech.’ He gave Sally a smile. ‘Sometimes they come out feet first and that gives us more of a headache.’
Sally gave him a wavering smile, her trust in him clear to see. ‘What if he gets stuck?’
Luca shook his head. ‘He won’t get stuck.’ He was totally sure of himself. ‘We know the size of the baby from the scan that you had, and we know the size of your pelvis from the X-rays.’
Dr Ford stepped closer, her arm brushing Luca’s. ‘Did she have lateral pelvimetry?’
Luca nodded. ‘It shows the shape of the sacrum and gives accurate measurements of the anteroposterior diameters of the pelvic brim, cavity and outlet.’ He looked at Sally and gave a sexy, lopsided smile. ‘This baby will fit, Sally. Trust me.’
He glanced at the CTG machine and placed a hand on Sally’s abdomen. ‘You have another contraction coming— I want you to push when I say.’ His eyes flickered to Tia. ‘Can you chase the paediatrician for me, please?’
Tia slipped out of the room and called Switchboard, knowing that the delivery wasn’t far away. She knew that lots of obstetricians chose to deliver all breech presentations by Caesarean section because they were afraid of litigation. It was typical of Luca that he’d allowed Sally to have the delivery that she wanted. His experience and instincts had told him that a vaginal delivery should be safe and he wasn’t going to let other people’s opinions dent his self-confidence.
She spoke quickly to the paediatrician who assured her that he was on his way, and then returned to the room to find that Luca had delivered the baby’s buttocks and legs.
Luca gently pulled down a loop of cord. ‘It’s important to avoid traction on the umbilicus or the cord might tear,’ he murmured to Dr Ford, ‘but it is also important not to manipulate or stretch the cord because it can cause spasm.’
Dr Ford leaned closer to Luca. ‘What happens now?’
‘The uterine contractions and the width of the buttocks will bring the shoulders down onto the pelvic floor,’ Luca told her, ‘and then they’ll rotate.’
He glanced up and smiled at Sally. ‘You’re doing brilliantly. Nearly there.’
Tia watched as he grasped the baby by the iliac crests and tilted it to free the shoulder.
‘I need a towel.’
Tia had warmed one in readiness and she handed it to him quickly.
Luca wrapped it around the baby’s hips, improving his grip and also helping to keep it warm.
As the anterior shoulder appeared he placed two fingers over the clavicle and swept them round to release the arm and then grasped the an
kles to free the posterior arm.
‘Just the head to go, Sally,’ Luca said quietly, infinitely patient as he waited, refusing to hurry nature. ‘I wait a couple of minutes and the weight of the body will bring the head onto the pelvic floor.’
Dr Ford looked at him with open admiration. ‘How will you deliver the head? Will you use forceps?’
‘No.’ Luca didn’t take his eyes off the patient. ‘It doesn’t really matter how you deliver the head as long as it’s slow and controlled. That’s the vital thing to remember. Tia, are you ready to clear the airway?’
‘Yes.’ Tia got ready with the suction and held her breath while he grasped the baby’s feet and, with gentle traction, swept them in an arc over Sally’s abdomen, allowing the lower half of the baby’s head to slip out.
She quickly aspirated the nose and mouth, making sure that the air passages were cleared.
‘All right, Sally,’ Luca’s voice was deep and controlled, ‘I want you to take regular breaths while I deliver the rest of the head.’
He took another three minutes to deliver the baby, allowing the slow release of pressures and tensions on the skull before finally placing the bawling child in the arms of his mother.
‘You have a beautiful son,’ Luca said huskily, a smile playing around his firm mouth. ‘Congratulations. And well done. You were very brave.’
Tears spilled down Sally’s cheeks and she reached out a hand to Luca. ‘Thank you,’ she said, the words choked as she battled with tears. ‘If it hadn’t been for you I know I would have had a section and I would have hated that. You made it special.’
Luca squeezed her hand. ‘You’re very welcome,’ he said quietly, stepping back as the paediatrician moved closer to take the baby.
It was way past the end of her shift but Tia didn’t want to leave until the placenta had been delivered and Luca had finished.
She wanted to go home with him.
As they made for the car park Dr Ford caught up with them and put a hand on Luca’s arm, her expression warm.
‘You were just amazing in there. There’s so much I want to ask you. Shall we go for a drink?’
