by Sarah Morgan
The concern on his face and his gentle endearment made her heart turn over.
‘I think so.’ She nodded and gasped as another pain tore through her. ‘Oh. Luca…’
He was beside her in an instant, sliding a lean, brown hand over her abdomen, feeling the strength of her contraction, murmuring encouragement to her as she tried to remember how she was supposed to breathe.
She sagged against the pillows as the contraction ended. ‘Can we stop the labour? I don’t want it to come early.’
Luca squeezed her hand and got to his feet in a fluid movement and looked at the trace on the CTG machine. ‘We need to examine you.’ He turned to Polly. ‘Have you called Dan?’
‘Yes.’ She nodded confirmation and Luca’s mouth tightened.
‘Well, call him again,’ he growled, moving back to Tia, his tension obvious.
Polly vanished and reappeared a moment later with Dan, who was the epitome of calm efficiency.
‘You’re determined to have this baby early aren’t you?’ he said lightly, smiling at Tia and taking the trace Luca handed him.
The next half-hour was a whirl of tests and discussions, and all the time Tia struggled to cope with the contractions, which were becoming more powerful by the minute.
Finally Luca raked a hand through his hair and sat down on the edge of the bed.
‘We have all talked about it and we are agreed that we need to get this baby out, Tia,’ he said quietly, his dark eyes holding hers. ‘I know you don’t want to have it early, but we don’t have any choice. Your labour is too advanced to stop it, and there is some evidence of mild foetal distress.’
Tia’s eyes widened anxiously. ‘How mild?’
‘Our baby is fine at the moment,’ Luca reassured her quickly, ‘but we are all agreed that we should deliver him or her as soon as possible. How do you feel about having a section?’
Tia swallowed. This wasn’t happening the way she’d expected. Naïvely she’d expected a perfectly normal delivery—the sort that she’d helped so many women with since she’d qualified as a midwife. She’d never thought that she’d be in the ‘complications’ category.
Suddenly she felt hideously frightened and it must have shown because Luca quickly turned to his colleagues.
‘Give us five minutes alone, please.’
They obeyed immediately and Luca moved closer to Tia and took her hands in his.
‘What is it that you’re afraid of?’
She shook her head, unable to articulate her feelings. ‘I don’t know—everything. I’m afraid of the baby coming early, I’m afraid of having surgery.’ Her heart thudded faster and she looked at him with scared eyes. ‘I didn’t want it to be like this. I thought it would all be normal.’
His grip on her hands tightened. ‘Not everyone is given the perfect delivery,’ he said softly, ‘but what matters in the end is that you are both fine. The rest of it we can deal with. Dan is one of the best surgeons I’ve ever seen and I’ll be there the whole time—’
‘Can’t you do it?’
His jaw tensed and for the first time in her pregnancy she thought she detected signs of strain in his face. Maybe he wasn’t quite as relaxed as he liked to pretend.
‘Tia, you know I wouldn’t be the best person for this.’ His eyes locked with hers and he smoothed her hair away from her face. ‘I cannot operate on the woman I—on my girlfriend,’ he amended quickly. ‘Dan is the best person.’
‘Can’t I have a normal delivery?’
Luca let out a long breath. ‘We could start that way and see how it goes, but you’re bleeding again and I’d rather we were in control of the situation from the start. My instincts are that we should get the baby out now.’
And he had the best instincts of any doctor she had ever met.
‘All right.’ Tia pulled herself together and gave a nod. ‘I just want the baby to be safe. Let’s get on with it, then.’
‘We’ll give you an epidural,’ Luca said, standing up and making for the door. ‘I’ll bleep the anaesthetist.’
The thought of having an epidural frightened her as well, but she knew that it was much safer for the baby than a general anaesthetic. But what would it be like to be awake as the baby was delivered?
She tried to be rational. At least if she had an epidural then she’d be able to be a part of the birth.
And Luca would be there.
Fighting down the panic, Tia gave Luca a smile, but she knew from the growing concern in Luca’s eyes that he understood exactly how she was feeling.
‘We’ll give you some gas and air until the anaesthetist arrives,’ Polly said briskly, pulling the machine closer to the bed. ‘Do you want me to remind you how to use it?’
Tia gave a weak smile. They were all shown how to use it in their training, of course, and she helped women use gas and air on an almost daily basis, but it was quite a different matter to be the patient!
‘I tried it once when I was training,’ she told Polly. ‘It made me feel dizzy.’
‘Yes, well, dizzy might be a pleasant change from the pain,’ Polly observed, her gaze sympathetic as Tia gave another groan as a contraction gripped her. ‘Let’s give this a try, and don’t breathe too quickly. That’s usually why people get dizzy, as you know.’
Polly handed her the mouthpiece and Tia breathed steadily, screwing up her face as the pain intensified.
‘Well done. Good girl.’ Polly encouraged her gently through the contraction and Luca slid an arm round her shoulders, hugging her against him as the contraction ended.
‘You need to start using the gas and air as soon as your uterus starts to harden,’ Polly reminded her, and Tia nodded, her face pale and drawn.
Luca stroked her hair and softly spoke to her in Italian.
‘What?’ Tia looked at him, pain making her uncharacteristically grumpy. ‘What did you say? I didn’t understand you.’
Something flickered in his dark eyes and he hesitated. ‘I said that it will soon be over,’ he muttered, and Dan shot him a strange look.
‘What? But I thought—’ He broke off as he caught Luca’s eye. ‘Well, I mean…my Italian never was any good, anyway.’ He cleared his throat and turned his attention back to the notes just as Duncan Fraser, the anaesthetist, hurried into the room.
‘I’m such a wimp,’ she gasped, clutching Luca and pushing away the gas and air. ‘Why do women ever want natural births?’
She’d never known such agony.
‘Labour is never the same for two people,’ Polly reminded her gently, rubbing her back to try and help relax her. ‘I’ve seen women deliver in hours and barely notice, and so have you. It isn’t a competition, Tia. You just have to do what’s right for you.’
Duncan made the necessary preparations and then moved closer to the bed. ‘When this contraction has passed I need you to sit on the edge of the bed for me. We’re going to need to work in between contractions, Tia, so if you feel another one coming, warn me.’
Tia did as he instructed, gripping Luca’s hand tightly.
‘All right, Tia.’ Duncan explained what he was doing in a calm voice and in no time at all the epidural was in place and the awful pain was fading to nothing.
‘Does that feel better?’ Luca’s eyes were clouded with concern and she nodded.
‘Much.’
‘We’re going to take you through to Theatre now, Tia.’ Dan issued some instructions and Tia closed her eyes as they wheeled her through the swing doors.
Why had this happened to her? Here she was, about to be operated on while she was awake. The thought terrified her!
Sensing her anxiety, Luca spoke quietly to Dan and then settled himself on a stool by Tia’s head and took her hand firmly in his.
‘It’s time we thought of some names,’ he said, his eyes warm as he held hers. ‘Something Italian, of course—Luigi, Leonardo, Gianfranco…’
Despite her nerves Tia smiled, grateful that he was trying to distract her. ‘What if it’s a gir
l?’
He gave a sexy grin. ‘I hope it is. I’m better with women.’
And didn’t she just know it!
Ignoring the flash of disquiet that his comment caused, Tia concentrated on thinking of girls’ names, only dimly aware that Dan had started operating. ‘Daisy?’
‘Daisy?’ Luca gave her a horrified look. ‘What sort of a name is Daisy? Is that the best you can come up with?’
‘I think it’s pretty,’ Tia muttered, her eyes rested on Luca’s thick, dark lashes and the hard angle of his cheekbones. ‘Or how about Lily?’
‘What is this preoccupation with flowers?’ For a brief second Luca’s gaze flickered over the green sterile towels to his colleague who gave him a reassuring nod.
‘I like Lily,’ Tia said huskily, starting to relax now that she realised she really couldn’t feel anything.
‘You are feeling all right?’ Luca’s voice was gruff and she gave a slow nod.
‘Yes, surprisingly enough. I can just feel some pulling, but it doesn’t hurt.’
‘I should think not!’ Duncan looked horrified at the mere suggestion that any anaesthetic he administered could be less than perfect. ‘How are you doing there, Dan? Any time in the next ten hours is fine by me.’
Despite the banter, Tia knew that Dan was working quickly and only seconds later there was a slight commotion and Luca straightened up, his features tense as Dan lifted the baby out.
‘Looks like you’ve got your flower, Tia,’ Dan said cheerfully as he handed the baby to Luca. ‘It’s a little girl.’
‘Oh!’ Tia stared, wide-eyed, as Luca held the bawling bundle close to her. ‘Oh, Luca…’
Tears slipped down her cheeks and she looked at the baby in amazement, thinking that she’d never seen anything so beautiful in her life.
‘Can we call her Lily? Please?’ Her voice was choked and for a moment Luca didn’t speak, his dark eyes unusually bright as he held his tiny daughter in his hands.
‘Lily sounds good to me,’ he said finally, his voice decidedly rough around the edges. ‘Lily Zattoni.’
CHAPTER TEN
LILY…
Tia stared anxiously at her daughter. ‘Is she OK? She seems tiny—’
‘Not that tiny for a thirty-four weeker,’ Julie, the paediatrician, took the baby away for a quick examination and Luca prowled over to her side, watching every move she made.
‘Are her lungs all right?’
His dark gaze was acute as he gazed down at his daughter, waiting impatiently while the paediatrician examined her.
‘Everything seems fine at the moment,’ Julie assured him, wrapping the baby carefully in warm blankets. ‘Obviously we’ll need to watch her carefully and see how she copes.’
‘I’ve found the problem,’ Dan said as he delivered the placenta. ‘A small section had started to peel away. It’s a good job we operated or this could have caused us a major problem later.’
Luca strode over to Dan’s side and the two men spoke softly together as they looked at the placenta.
Finally Luca turned and returned to his seat by Tia’s side, his eyes strained. ‘You are feeling all right, cara?’
Tia nodded, exhausted but relieved that it was all over. ‘Now what happens?’
‘You go into the recovery room and get to know Lily, and after a bit we’ll take you to the ward,’ Polly told her, finishing off the swab count with Dan.
Tia lay there, gazing at her daughter, oblivious to the action still going on around her.
Finally they finished and she was wheeled through to the recovery room.
‘We need to give her something to eat,’ Polly said, gathering the charts together. ‘Are you going to breastfeed her, Tia?’
Tia nodded. ‘I want to.’
‘OK, well, let’s see if we can get her to latch on.’ Polly positioned herself by the side of the trolley and together they tried to persuade Lily to feed. ‘Your milk might not come in for a few days, but I don’t need to tell you how good for her the colostrum is.’
Despite both their efforts, they had no success.
‘She’s not doing it.’ Tia’s voice was choked and Luca gave a frown.
‘Give her a chance, Tia,’ he said gently. ‘She’s tiny, cara mia. It takes a while to get the hang of it and she is only just thirty-four weeks. Her suck reflex may not have developed fully yet.’
They carried on trying and then Polly tested the baby’s blood sugar. ‘It’s very low, Tia,’ she said quietly. ‘We really do need to get something into her. Can I give her a bottle for now?’
Tia nodded reluctantly, disappointed that she hadn’t managed to breastfeed her daughter straight away but understanding that the important thing was that the baby had a feed of some kind because she was so tiny.
But Lily wouldn’t take the bottle either and there was something else that was disturbing Luca.
‘She’s grunting,’ he muttered, glancing across at Polly who nodded agreement.
Tia’s heart fluttered in her chest. She knew that grunting was often the first sign of respiratory distress.
‘But I thought her lungs were all right.’ She turned to Luca, visibly upset, and he gave her shoulder a squeeze.
‘She doesn’t seem to be as well as we first thought,’ he admitted, his voice rough with tension. ‘She obviously hasn’t developed her suck reflex yet and she’s going to need some help with her breathing. She needs to go to Special Care for the time being, Tia.’ He strode across to the phone and spoke to the paediatricians.
Tia looked at Polly with horror. ‘But I don’t want her to go to Special Care. I want her to stay here with me.’
Polly’s eyes were sympathetic. ‘I know that, Tia, but she needs some help. As soon as they’ve settled her you can go and visit her. We’ll push you in the wheelchair.’
‘Will you stay with her?’ Tia turned to Luca, upset that she couldn’t keep Lily with her.
‘Of course.’ Luca bent down and kissed her forehead. ‘Don’t worry.’
He scooped their daughter up gently and laid her carefully on his shoulder. ‘I’ll take her up myself, Polly. You stay with Tia.’
Polly frowned. ‘I ought to ask them to bring down an incubator.’
‘I would rather get her up there fast.’ Without further conversation, Luca left the room and Tia watched them, totally unaware that Polly was talking to her.
‘Tia?’ Polly finished checking her friend’s pulse and blood pressure and frowned down at her. ‘I asked if you were in any pain.’
Pain?
‘No.’ And anyway she didn’t care about pain. She just wanted her daughter to be OK.
By the time Luca reappeared Tia had been moved to the ward and settled in a bed.
After a conversation with Sharon, who was now back on duty, she’d persuaded the staff to remove her drip and her catheter.
‘I want to be mobile as soon as possible,’ she said stubbornly.
Dan popped up to see her and checked on the wound and her uterus and asked about her back.
‘It aches a bit,’ Tia admitted, ‘but I know that’s perfectly normal so you don’t need to reassure me.’
Dan grinned. ‘Having a well-informed patient is a mixed blessing. How’s Lily?’
Tia tried to hide her anxiety but failed dismally. ‘I don’t know. Luca’s been up there for ages…’
At that moment Luca walked quietly into the room, obviously expecting her to be asleep.
‘Is she all right?’ Tia winced as she struggled to sit upright and Luca frowned.
‘You are in pain?’
‘No,’ Tia lied. ‘How is Lily? What have they done? Is she ventilated?’
Luca sat down next to the bed and dealt with the questions one at a time. ‘Overall, she’s doing all right,’ he said carefully, and Tia’s breathing quickened.
‘But she’s got plenty wrong with her, hasn’t she? I can tell that you’re hiding something from me.’ Her eyes filled. ‘I want you to tell me the truth, Lu
ca.’
‘I’m not hiding anything.’ He took her hand and gave her a tired smile. ‘She’s just very small and 34 weeks is a bit borderline, as you know. Some 34-weekers are perfectly capable of managing on their own without help and they do fine. Others need help.’
‘How much help? Is she being ventilated?’
Tia knew from her own experience as a midwife that plenty of babies born prematurely needed ventilating to assist their breathing. Was this what had happened to little Lily?
Luca took a deep breath. ‘You know she was grunting and you know as well as I do that that can be a sign of respiratory distress. She’s also got a degree of intercostal recession and mild cyanosis. They’re giving her CPAP.’
Tia stared at him, aware that with CPAP—continuous positive airways pressure—the baby was able to breathe independently but a continuous distending pressure was exerted on the airway to prevent the tiny air sacs in the lungs collapsing at the end of each respiration.
‘Are they measuring her oxygen saturation?’
Luca nodded. ‘It’s variable, but they assure me that we can expect that with a 34-weeker. They’re giving her oxygen and they’ve passed a nasogastric tube so that they can feed her. Later on, if you have the energy, you could try and express some milk for her and they can put that down the tube. We don’t want to waste all those precious antibodies and we need to start stimulating your milk supply if she isn’t going to feed immediately.’
Tia nodded immediately. ‘Shall I do that now?’
‘No.’ He gave a gentle smile and gently squeezed her hand. ‘You need some rest. How are you feeling? I want an honest answer.’
‘I’m fine. I just want to get out of bed and go and see her.’ Tia looked longingly at the wheelchair. ‘Will you take me?’
‘Now?’ Luca glanced at Dan who shrugged.
‘I don’t see why not. She’s not going to get any rest while she’s worrying like this. Take her up there if she feels up to it.’
‘All right.’ Luca nodded slowly. ‘But you need to have some more pain relief first.’
‘Are you kidding?’ Tia managed a wry smile as she got ready to transfer herself into the wheelchair. ‘After labour pains, this is a piece of cake.’
