The Midwife's New-Found...

by Fiona McArthur

  With her obvious recoil Ben's hand drew back and froze in mid-air before he tucked it in his pocket out of sight as if ashamed of the contact.

  'I'm sorry.' He widened the gap between their bodies with a further step back and then glanced around as if seeing the room for the first time.

  The silence stretched between them and Misty couldn't remember a time when she'd felt more uncomfortable.

  Finally Ben spoke. 'So, no patients in here?' His comment hung, superfluous, in the empty ward but at least he'd tried to fill the gap in conversation and she gestured to the half-made bed.

  'I've just discharged the last, as you can see.' Great help with the dialogue, she mocked herself, but that was all she could manage right then. She was too busy trying to control the thudding in her chest.

  It had been a little over a month since she'd seen him but in that time she'd grown so accustomed to recalling his bare chest in her mind's eye that she was startled by his tailored clothes.

  The white of his shirt shone brightly against the tan of his neck, and his forearms looked strong and brown under the rolled-up sleeves. The fitted design of his buttoned shirt complemented the breadth of his chest far too effectively and she looked away and then down at his feet.

  Definitely not bare, they were encased in expensive Italian shoes and topped by tailored grey trousers that made her think of city specialists, not locum country doctors.

  She wondered suddenly how he'd find working in an environment so different from that of a city hospital.

  The silence lengthened and then his voice drifted softly across from where he stood. 'I'm sorry, Misty.'

  She tilted her chin and met his gaze. Finally she had control. 'For what, Ben?' Her tone was cool. 'I'm the one who left.'

  'For pressuring you when I shouldn't have.' He glanced around the empty room again. 'Can we talk about that?'

  She knew he could see the barriers she'd erected so it was a silly question, but still his asking shocked her. 'Not here or now, no!'

  Ben half laughed in frustration. 'When?' The woman would drive him mad with the way she looked at him as if she'd never felt any connection between them. But he could feel it shivering between them like a wall of nerve endings, waving in the breeze like the branches of a willow tree.

  Ignore it. Pretend it wasn't there. She could and so could he. He had to ignore it to because he'd really come here for his daughter. Not for Misty. He'd keep telling himself that and eventually it would be true.

  'When should we talk about it? Probably never, but I'll let you know,' she said, and looked away.

  That intrigued him. What didn't she want him to see in her face?

  She resumed the conversation as if whatever had bothered her had been mastered. Her eyes met his and now he couldn't look away.

  'At the moment I'm wondering why you're here.' She tilted her delightful chin at him. 'Why are you here, Ben?'

  'You're bristling,' he said conversationally. She wasn't as calm as she made out and that made him feel a little better. 'I think we should talk about that later as well.'

  The sound of a vehicle and the rattle of gravel outside heralded a new client and Misty looked away with what he considered disproportionate relief. 'In that case, I've work to do,' she said.

  'Work?' She wanted him gone. Well, he wasn't quite ready. 'Sounds interesting. After what you told me at the beach house. Could I see how it pans out? Then I'll slip away.'

  She didn't answer. 'I'll check out the admission CTG. See what the trace's like,' Ben murmured, and he drifted to the nurses' station and picked up a file as if to check for something.

  Misty looked at him strangely then shook her head. There was no doubt he'd exasperated her again. Now what had he said?

  'We don't have a foetal monitor here, Ben.'

  No CTG? 'What do you mean?'

  'It's a low-risk unit, remember,' she said. 'We only have low-risk women and hooking them up to a machine to electronically listen to a baby we can hear very well other ways is crazy. Our clinical skills give us all the information we need to know.'

  His hospital had always used them. They had been part of the protocol of every birth. He'd assumed Lyrebird Lake would have a machine somewhere, in a cupboard at least. He'd never even heard of a place delivering babies without one. The CTG machine allowed a baby's heart rate to be traced at the same time as the mother's contractions to indicate the baby's response to the stresses of labour.

  He breathed deeply. It would be OK. He supposed the trace didn't guarantee anything, and even when you could hold the results in your hand it didn't mean all was going to go well.

  He caught himself at that thought. These women and babies were healthy, she'd said. He was doing it again. Thinking negative thoughts.

  'Not even an admission trace.' He hoped she didn't hear the unhappy note in his voice that even he could hear. This place had to be good for his obstetric soul.

  'Don't have one, don't want one. We'll talk about this another time.'

  He couldn't imagine obstetrics without electronic screening tools for risk. 'What if you hear the baby's heart rate slow down after a contraction while you're listening?'

  'CHICKEN,' she said. Ben blinked. Surely she hadn't just called him a chicken?

  He felt as if he'd been slapped. He'd discovered Misty's feet of clay and his stomach plummeted. Unsafe practitioner? Surely not? He couldn't work here. Not in this environment. He stepped further away from her but she went on.

  'It's an emergency mnemonic, Ben. "C.H." stands for Change Her position. "I" stands for put an IV cannula in and Infuse or Increase her fluid load. "KE" stands for KEep listening after every contraction. "N" stands for Notify…' Her voice trailed off.

  Ben's head was spinning. C.H.I.C.K.E.N? He blinked.

  Misty sighed. She'd seen his horror when she'd given him the mnemonic. For her it had been a reflex answer from their emergency practices.

  He'd actually thought she'd dared him to play roulette with other people's lives.

  If she'd had more time she'd have been hurt but later she would mull over it. Why had he been so quick to damn her practice ethic? Did he honestly think looking after women at one of the most important times in their lives was a thrill ride?

  She shook her head to rid herself of the thoughts. Later. She'd sort him out.

  Misty frowned at him but then she heard the door open. 'I usually ring the nurse, but you can stay if you want, seeing as your paperwork came through.' She shrugged and tried to ignore him as she went forward to greet the woman and her anxious partner.

  'You're Montana's friend?' the man said, and when Misty nodded, he sighed with relief.

  'Cherry's waters have broken and she's been wanting to push for the last five minutes in the car. I was that scared she'd pop it out on my seat covers.'

  That would be Cherry Glover, Misty thought to herself as she mentally reviewed those 'at term' ladies the unit expected.

  'Looks like you made it just in time, then. You must be Ritchie.'

  She turned to the woman. 'Hello, Cherry. We'll have you all set in no time. Come through this way.'

  She paused at the desk and scooped up Cherry's file. 'This is Dr Moore. He's our new locum and will be staying as the second person because I don't have a nurse at the moment.'

  Ben waved and smiled, acknowledging his recruitment, even as Misty moved on to focus on the job at hand.

  She'd only read Cherry's notes that morning and her case was as uncomplicated as all the women booked to the unit were. No risk factors, healthy-sized baby, no blood-pressure problems prior to labour and this was her third healthy pregnancy.

  Ritchie was probably right. It was quite on the cards that Cherry was ready to 'pop' this one out. She smiled to herself as Cherry's next contraction was accompanied by a few grunty breaths on Cherry's part. No need to check if she was ready.

  Ben fiddled with the baby trolley while Misty helped Cherry climb awkwardly out of her damp clothes and wrapped her in a sar
ong.

  When her next contraction had eased Misty asked if she was up to climbing onto the bed for a quick abdominal examination and so Misty could listen to the baby's heartbeat.

  'Just to check baby's lie. We can use the Doppler with you standing after that.'

  'No problem, as long as you're quick,' Cherry said, and Misty saw Ben stiffen out of the corner of her eye. Now, what was up with him?

  When Cherry lay down Misty quickly palpated the woman's shiny round abdomen and easily identified the foetal back and the descent of the foetal head into the pelvis.

  Everything was great. 'OK, your baby's head is down and engaged nicely. He or she is facing the right way and I'll just have a quick listen.'

  Misty counted for a minute with the Pinard's, and as she turned her ear to Cherry's abdomen she found herself facing Ben. The expression on his face, though quickly hidden, had shown disbelief and even a tinge of sardonic amusement at her archaic instrument.

  'We use this first,' she said to Cherry, but really to Mr Modern Age in the corner, 'to confirm baby's position by the baby's heart rate. It sounds different using this to the mother's pulse. Sometimes the electronic equipment can hear the baby all over the place.' Sound principles, Ben, so get used to it! She hoped her eyes conveyed the message.

  He inclined his head so at least he was receptive to her rebuke, she thought grimly, and she straightened and concentrated on her client.

  Once she'd confirmed the baby's lie to her satisfaction she placed the hand-held Doppler on Cherry's stomach low down near her pubic bone so the parents could hear the clop, clop, clop of the baby's heartbeat as it filled the room.

  Ritchie smiled with relief and Misty grinned, too. 'Your little passenger is very happy in there, even though you've pulled the plug on them.'

  She helped Cherry stand up again and smiled at Cherry's sigh from the awkwardness of lying down during the serious end of labour.

  Even Ben should be able to see how much easier it was for Cherry in an upright position. 'Do you want to lean on the bed?'

  At Cherry's nod Misty raised the level of the bed so that Cherry could stand and lean against it without bending too much.

  Misty guided Ritchie behind his wife to massage her lower back in firm circular motions while Cherry breathed through the pains.

  When he was at his task, Misty turned to her own responsibilities. She connected the overhead heater and completed her own check of the baby's emergency trolley then readied her basic equipment for the birth.

  She was still aware of Ben as he leaned against the rear wall of the room, quietly watching.

  Concentrate, she chided herself as she began to mentally list her tasks. All she needed was two clamps for the cord and scissors for Ritchie to cut between the clamps, a dish to catch the placenta and a warm towel and blanket for baby.

  No drugs to hasten the placenta, she remembered. 'You've declined the injection after the birth, Cherry. Is that right?'

  Cherry sighed as the next pain started. 'I don't want it unless I have to.'

  'Have you explained the rationale for oxytocin, Sister?' Ben asked quietly.

  Misty froze and then glanced quickly at Cherry and Ritchie, but they didn't seem to have heard as the woman's breathing increased in tempo.

  'We discuss it at antenatal visits, yes,' Misty said, and then added, 'A woman's choice.' Then she ignored him and ran warm water into a bowl before she slipped her gloves on to dip a washcloth into the warm fluid and wait.

  Cherry moaned and Ritchie yelped as a small trickle of blood ran down his wife's leg. 'She's haemorrhaging,' he gasped, and Misty smiled.

  'That's the show. It's OK, Ritchie. That "shows" Cherry's cervix, or the opening at the bottom of the uterus, is opening and her time is near. After she's had the baby I'll get you to put the electric bed down to low level again so Cherry can lie back.'

  'You mean she's having it standing up?' Ritchie cast a horrified look in Misty's direction before his wife recalled his attention.

  'Fabulous,' Ben whispered with the tiniest hint of sarcasm, and Misty frowned. One more negative comment and she'd ask him to leave.

  'Keep rubbing!' Cherry's command was almost a growl and Misty bit her lip to stop her smile again. Cherry was running this show, not Ben Moore.

  'If Cherry didn't want to be in this position,' she said to Ritchie, and—without looking at him—to Ben, 'she'd move. Everything is fine. Now, do you see the controls for the bed, there, Ritchie?' Misty pointed. 'I'll tell you when to move it back down.'

  Ritchie gulped at that much responsibility and Cherry moaned loudly.

  Misty slipped in next to Ritchie. She placed her warm towel for the baby on the bed beside her client.

  'OK, Cherry,' she said. 'Nice and easy. I'm just going to put my hand down here with a warm washcloth to help that burning feeling as baby's head comes through.'

  She felt the baby's occiput bulge under her hand as Cherry pushed, and suddenly the head was out.

  'Whoops. That was quick.' Misty smiled. 'That's great, Cherry, your baby's head's born. Take some little breaths if the pain has gone or push again if you need to.'

  'Oh, my God,' Ritchie muttered distantly as his knees wobbled and he swayed limply against Misty as his legs gave way.

  'Just sit for a minute, mate.' Ben's calm voice came from behind Misty's shoulder as he nudged Ritchie into the chair beside the bed and the new father collapsed. Ben firmly placed Ritchie's head between his knees and bounced him twice.

  'Take a few breaths, mate.'

  At least Ben could do something constructive. Misty grinned without turning as she kept one hand on the baby's head. She flicked open the warm towel with the other and dried the little scalp as she waited.

  Cherry pushed again and baby rotated until a shoulder appeared, then the rest of baby unfolded into Misty's towel-wrapped hands in a flurry of limbs.

  Misty slipped the baby still joined by the umbilical cord through Cherry's legs to Ben, who had appeared usefully beside Cherry at the front. He gently wiped the little body before passing her naked baby up to Cherry.

  Cherry dropped her sarong unselfconsciously to bare her skin for baby, who mewled like a little kitten and then settled when she was snuggled against her mother's warm skin.

  'What is it?' Ritchie's voice was muffled from his position but cracked with emotion and Misty and Ben waited quietly for Cherry to look.

  'It's my girl,' Cherry sobbed as she hugged the squirming baby to her chest. 'Hello, Phoebe.'

  'Just push that button and lower the bed so Cherry can sit down, Ritchie.' She glanced at the man beside her but he'd returned his head between his knees.

  'I've got it,' Ben murmured from behind her left ear, and the whirr of the bed mechanism underlined his presence. She was glad he was there because with his scepticism he needed to see everything was normal. He'd even been a little handy.

  Cherry eased onto the bed with her baby against her chest and Ben draped a blanket over both of them.

  After a few minutes Misty lifted the edge of the blanket and offered Ritchie the scissors. 'Are you going to cut the cord, Ritchie?'

  'Can't.' Ritchie's voice was muffled from his hands over his face. 'Maybe in a minute.'

  'No rush.' Misty tucked the blanket back as they waited. After a further few minutes Ritchie reached across and Misty showed him where to cut.

  'I need to push again.' Cherry knew what came next as the placenta was delivered into the dish Misty held.

  Misty held up the bowl. 'Did you want to see this, Cherry? These are incredible things. I always think of placentas as amazing little heart-lung machines that incubate babies beautifully.'

  'I've never looked before,' Cherry said, and she craned her neck curiously when Misty held up the thin membranous bag.

  'This is where baby lived inside you,' Misty expanded the membrane so the pale balloon shaped bag hung as if baby was still inside.

  'The shiny side is inside the bag and you can see the place where
the umbilical cord is connected.'

  'Wow. Check this out, Ritchie.' Cherry was impressed but Ritchie kept his head averted now he'd lifted it enough to see his daughter.

  'No way.'

  Misty smiled at Cherry and took the placenta away.

  Ritchie shuddered. 'I'd much rather look at my daughter.' He stroked his baby's cheek. 'Phoebe. She's like you, honey.'

  He smiled tearily at Cherry. 'Gorgeous.' And he stood up carefully and leaned over and kissed his wife. 'Women are incredible.' He shook his head in disbelief that it was all over and his daughter was safely in front of him.

  Misty tucked the warmed blanket around Cherry's shoulders after ensuring her uterus had started contracting to control bleeding. She quickly checked Cherry's blood pressure and pulse while Ben listened to Phoebe's lungs, thankfully without disturbing her, as she nudged at her mother's breast.

  'We'll leave you three to get acquainted,' Misty said quietly. 'I'll just be outside if you need anything.'

  The new parents nodded as Misty and Ben left the room and the door shut quietly.

  CHAPTER SIX

  'AT THE lake we don't appreciate negative people in the birthing centre, Ben.'

  Misty was furious and Ben blinked because he hadn't seen it coming. The green sparks from her glare were no doubt burning holes in his forehead as he listened and he didn't see how he could have missed it in the room. 'Was I?' He hadn't realised it.

  Misty put the chart down carefully, though he had the impression she wanted to slam it through the desk. Amazing how much more powerful her restraint was. The woman was never boring.

  'There were a few sceptical comments I could have done without,' she said quietly. 'I'm hoping Cherry didn't hear them.'

  'I apologise.' He thought back. He may have muttered something about the patient standing up. It wasn't something he would choose as an optimum position for the person actually catching the baby. 'Did she choose vertical or did you?'