Maternal Instinct

by Caroline Anderson

Jenny closed her eyes and a tear trickled down her cheek. ‘I didn’t even know I was pregnant,’ she whispered. ‘I need to call my husband.’

  ‘By all means. We’ll get you moved up to the ward and prep you for Theatre, and then take you down as soon as possible. When did you last eat?’

  She shrugged. ‘I don’t know. Last night? Yesterday, anyway. I’ve been feeling too rough all day today to eat.’

  ‘OK. We’ll get you into Theatre as soon as we can.’

  They left her and walked back to the ward. Eve wondered if he’d say anything, but he just gave her a strained smile and said, ‘Well done. Want to do the op?’

  She didn’t, not really, because although it was inevitable, it was effectively a termination and she hadn’t done one yet, but this was at least utterly unavoidable and she had to start somewhere.

  ‘OK,’ she said, and he smiled again encouragingly.

  ‘I’ll see you up there with her in a while, then,’ he said, and disappeared into the theatre lift, leaving her to carry on alone to the ward.

  She managed the operation on Jenny, removing the swollen, distended tube with the beginnings of a tear and suturing the small incision without a hitch. Through it all Hugh was silent, but as she straightened up he said, ‘Well done. Thank you. Right, next I need you to do a section. It’s utterly straightforward, a breech presentation in a first baby, with a planned delivery date and no adverse indications except that the placenta’s right across the front of the uterus.’

  She felt her eyes widen. ‘Oh, cheers! Where will you be?’

  ‘Assisting you, silly,’ he said with a smile touching his eyes over the mask. ‘I wasn’t going to abandon you completely. But she’ll be conscious, so I won’t be telling you what to do. Just remember to ask if you need to.’

  She didn’t. It was, as he’d said, a textbook case, and he’d gone through it with her in the break while Theatre was being prepped for the next case, so she felt well prepared. And although it was technically more challenging, the satisfaction was huge, and she felt the still-new thrill of being the first person to touch the baby as she reached in and eased it out through the incision.

  ‘It’s a girl,’ she said, her voice choked, holding the baby up so the parents could see her. She knew her eyes would be bright with tears, as ever, but no one seemed to mind. ‘Congratulations.’

  ‘Oh, she’s beautiful,’ the mother whispered, starting to cry, and Eve had to blink hard to clear her own vision before she could complete the delivery.

  Hugh had clamped the cord and sucked out the baby’s nose and mouth, and he handed her, still wet and bloody and screaming, to her mother. The screams settled to a drizzling hiccup, and then stopped, calmed by the mother’s tender murmurings. Eve had to shut her ears and cut herself off from all that maternal bliss, reminding herself that she had a job to do.

  ‘Well done,’ Hugh murmured as she finished closing, and his eyes over the mask were warm with approval. He tugged it down and turned to the patient with a smile. ‘Right, let’s get you back to the ward and you can settle down with a cup of tea and feed the baby. Any names yet?’

  ‘I don’t know.’ The mother, Liz, looked at Eve over the top of the drapes. ‘What’s your name?’

  ‘Eve,’ she replied, and Liz smiled.

  ‘Eve. I like that. Can we call her Eve?’ she asked her husband, and he nodded, smiling thoughtfully.

  ‘Eve—yes. It’s lovely. If you don’t mind?’

  ‘Of course I don’t mind,’ Eve said, feeling herself tearing up again. Heavens, this was starting to be a habit!

  ‘Told you,’ Hugh murmured as they left the theatre. ‘It’s a good job you aren’t called Ermintrude.’

  ‘It’s a good job I’m not called Ermintrude anyway,’ she retorted. ‘My parents have got enough to answer for as it is.’

  He shot her a curious look, but she changed the subject quickly, quizzing him on her performance. ‘So, come on, what did I do wrong?’

  ‘Nothing.’

  ‘I must have done something. Too small or too large an incision? Too far round? Too high? Too low?’

  ‘No.’

  ‘Too slow? Pulled the baby out wrong?’

  He shook his head, a slow, lazy smile spreading over his face. ‘Nothing. You can’t get out of it. It was perfect. If she’d been my wife, I would have been happy for you to deliver her.’

  Wow. That was a compliment and a half, she thought, and felt the glow all the way to her toes.

  ‘So, what next?’

  He laughed. ‘You can do the rest of the list, if you like. I’ll just hold the retractors and doze quietly in the corner.’

  ‘Don’t you dare doze,’ she warned, feeling a touch of panic. What if she did something wrong?

  ‘Stop worrying. You’ll be fine, and of course I won’t doze.’ He gave her a thoughtful look. ‘You’ve got no confidence, have you? Lots of guts, and plenty of bravado, but no real confidence. It’s all show, and I think most of it’s put on for your own benefit, to convince yourself that you really can do it. Am I right?’

  Too right, and too close to the knuckle. ‘I just want to be sure,’ she said lightly, but she couldn’t meet his eyes again and stalled by fiddling with the drawstring on her trousers.

  He wasn’t having any, though, and, putting a finger under her chin, he tilted her head up to his. ‘You’re good,’ he told her seriously. ‘You spotted the ectopic when it was presenting like an appendix, and that takes skill. Believe it. Believe in yourself.’

  She swallowed, wanting to cry again, but there wasn’t time. ‘Our next patient will be here,’ she said, and headed for the sink to scrub. With a sigh Hugh followed her, saying nothing more for the rest of the day except to praise, encourage and inform when necessary.

  That evening he left her in charge of emergencies, and it was predictably busy. She coped, though, and didn’t need to call him in—mainly because nothing that drastic happened—but his words earlier about her self-confidence made her more determined than ever to cope alone.

  And she did, to her relief. At three in the morning, she shot downstairs to the canteen while the going was good, and grabbed a quick meal. While she was there she checked her phone, which was on silent, and realised she’d missed her alarm call reminder to take her pill.

  ‘Idiot,’ she muttered, fumbling for it in her bag, and taking it immediately. Nine hours late, and it wasn’t the first time, but even though she had to take it promptly because it was a progestogen-only pill, she should still be safe. She’d been told twelve hours, max, because this was a stronger one than some of the single-hormone pills which had to be taken extremely regularly. But it was just as well she’d opted for this one because of her hectic schedule, knowing it would be more likely to be safe if she was held up and took it late.

  It had to be. She wasn’t going to risk ending up in here having a termination, like some of their patients, although she didn’t think, if the crunch came, she could bring herself to do it. And she couldn’t take time off to have a baby, so she’d just have to make sure she didn’t get pregnant.

  Not that she’d be able to tell. Her system had been utterly confused by the introduction of the hormones, and she hadn’t had a period since she’d started taking the Pill weeks before.

  All the more reason to be careful, she told herself, and vowed to be more punctual with her pill-taking.

  Her bleep went, and she gulped down the rest of her coffee, grabbed the last bite of her sandwich and headed back to Maternity.

  ‘OK if I leave you?’

  ‘Fine,’ she said with a smile. She’d finished the operation, was just closing, and Hugh knew he could let her get on with it. The last few weeks had seen her ability and her confidence grow in leaps and bounds, and she was beginning to fulfill her great potential. She was going to be a fantastic surgeon, tackling everything she did with her trade-mark enthusiasm and dedication.

  And that was just at work. At home, with him and his children, she
was rapidly becoming an essential part of his life, although she stonewalled him every time he tried to bring up the subject of their relationship. Despite that, he knew that Eve was more and more comfortable with it and beginning to feel like part of the family.

  So long as he didn’t try and talk about it, or tell her that he loved her.

  Not that he had, not yet, because he’d sensed from the beginning that it would make her uncomfortable, and he didn’t want to frighten her off, but now he was finding it harder and harder. So many times a day he wanted to put his arms round her and hug her and tell her he loved her, like he did with the kids, like he had with Jo.

  He’d never thought he’d love like that again, and it scared him a little, but he wasn’t running away from it, and he wasn’t going to let Eve run away from it any longer either.

  It was just working out how to tell her.

  He headed to his office, intent on doing paperwork, and Maggie dutifully lined up a veritable rainforest requiring his attention.

  ‘This much?’ he said wretchedly, and she laughed.

  ‘You’ve been avoiding it,’ she pointed out, and he knew it was true. He’d spent too long with Eve, stolen time away from his responsibilities. With a sigh he settled down to work his way through it.

  ‘Coffee would be good,’ he murmured, and a cup appeared at his side in seconds. ‘Maggie, you’re a star.’

  ‘I know. Keep working.’

  ‘Yes, Mummy.’

  She slapped his hand and disappeared into her own office next door, leaving him chuckling. He was lucky to have her.

  She’d just done a quick ward round, checking on her post-ops, when Eve felt the first cramping pain. She rubbed her back absently. Too much time crouched on the stool doing gynae ops, she thought, but the next stab was lower and seemed deeper inside her, more abdominal.

  And then the next.

  The pains were coming in waves, she realised, evenly spaced. Like contractions.

  No. She must have a tummy bug, she thought, but they felt like period pains, and her heart sank. She’d only had a few odd days of bleeding here and there since she’d gone on the Pill. Obviously her body had decided that it was time for a full-on dysmenorrhoeic horror show, and it had chosen to today to start.

  Fabulous. They still had a clinic this afternoon, and she really didn’t need—

  ‘Ahhh!’

  ‘Eve?’

  She looked up, her mouth open, gasping with the pain, and found Sam frowning down at her in concern.

  ‘I’m fine,’ she said, trying to smile. ‘It’s just a period pain. I’ll be all right.’

  ‘Funny period pain,’ he said quietly. ‘Do you usually get them?’

  She shook her head, then felt a strange flooding sensation and glanced down, sucking in her breath at the spreading red stain on her pale blue theatre scrubs.

  ‘Right. In here,’ Sam said firmly, wheeling her through a door into an empty side ward that had just been vacated. ‘Lie down.’

  ‘Sam, I’m fine.’

  ‘Let me be the judge of that,’ he said, his warm, gentle hands exploring her abdomen thoroughly. ‘When was your last period?’

  She shrugged. ‘I don’t know. I haven’t had a proper one since I went on the Pill.’

  ‘Which was when?’

  ‘The middle of April,’ she said. It was now the middle of July, and she truly had no idea when her last period before then had been. Two weeks? Three? ‘That must be why this one’s so bad.’

  Sam grunted noncommittally and straightened up. ‘Let’s get some obs on you and find out what’s going on. When did you last pee?’

  ‘I have no idea.’

  ‘Good. I’ll do an ultrasound. Stay there.’

  He popped out, but he was only gone a moment, returning with a nurse, a portable obs unit and an ultrasound machine. ‘This isn’t as good as the one downstairs, but it’ll tell me what I want to know.’

  She didn’t ask. She didn’t want to know what he was looking for. She knew, anyway, but she said nothing, just lay there and let them all rush around her, obliging them with a urine sample, and then listening in a kind of shocked limbo to Sam’s gently delivered verdict.

  ‘You’ve almost certainly had a miscarriage,’ he told her, sitting beside her and wrapping her hand in his. ‘A better ultrasound will confirm it, and we’ll take you down for one shortly. Your pregnancy test was positive, but it would be for some days after the death of a foetus, and I wouldn’t want you to hold out any false hope. I don’t know yet if your uterus is going to empty itself spontaneously or if we’ll need to take you to Theatre to do a D and C, but your blood pressure’s stable and your pulse is nice and steady, so I don’t think anything untoward is about to happen. I take it you didn’t realise you were pregnant?’

  She shook her head numbly. ‘I had no idea.’

  He nodded. ‘How’s the pain?’

  ‘Receding a bit.’ Her fingers tightened on his and she met his eyes pleadingly. ‘Sam—don’t tell Hugh.’

  ‘I take it this is his baby?’

  She nodded, her heart aching. ‘Of course it is, and he’ll be devastated, but I just need time to think—to get used to the idea, before I see him.’

  ‘OK. I’ll try and stall him as long as possible.’

  But it wasn’t possible.

  Sam left the room, closing the door quietly behind him, and ran straight into Hugh at the first corner.

  ‘What the hell’s going on? Someone said Eve’s had a miscarriage. Where is she?’

  ‘My office, now,’ he said, and steered his friend away from the ward, sitting him down and telling him, as gently as he could, what had happened.

  Hugh was stunned. He stared at Sam, stared at his hands, scrubbed a hand round the back of his neck and stood up, pacing the floor for a moment before looking at Sam again, unable to believe what his friend had just told him. It couldn’t be…

  ‘How the hell did she get pregnant? When? She’s on the Pill.’

  ‘She doesn’t know. She had no idea she was pregnant. She asked me not to tell you, and I wasn’t going to if you hadn’t already heard, to give her time to think about it, let it sink in for a while before she spoke to you. I think you should give her some time.’

  Time to get her defences in order, he realised, but he wasn’t having it. This was his baby, too, and if they were losing it, they were doing it together.

  ‘Tough,’ he said, ripping open the door. ‘I need to be with her—and, before you say it, she needs to be with me. Can you get cover for us?’

  ‘Sure.’ Sam’s hand curled over his shoulder and squeezed. ‘For what it’s worth, I’m really sorry, Hugh.’

  He wrapped his fingers over Sam’s hand and squeezed back, swallowing the lump in his throat. ‘Thanks. And thanks for looking after her.’

  He headed back to the ward, tapping lightly on her door before pushing it open and going in. She was lying with her eyes closed, her head turned away, but he could see the tears on her cheeks and he knew she wasn’t asleep.

  ‘Eve?’ he murmured.

  She took a shaky breath. ‘I didn’t know,’ she said emptily. ‘I had our baby inside me and I didn’t know, and now it’s dead, and I didn’t even know I was having it.’

  He felt his eyes glaze with tears, and sitting on the bed he gathered her into his arms and rocked her as she wept.

  ‘Oh, darling, I’m so sorry,’ he whispered.

  ‘Sam wants to scan me later,’ she said unsteadily. ‘To see if there’s anything left.’ Her voice broke, and he wrapped her closer against his chest and shushed her.

  ‘Oh, sweetheart…’

  There was nothing he could say, nothing that would take away the awful realisation that her child—their child—had died. So he just held her, lying on the bed beside her and cradling her in his arms, not caring when the nurses who knew him so well came in to check her obs from time to time.

  After a while she slept, the boneless, exhausted sleep of so
meone in shock, and he found his own eyes closing. If only he could stay there with her, but he had the kids to see to, and patients needing his attention—No. Sam had sorted that out. Just the kids, then, and they didn’t really need him.

  He needed them, though, needed to know that two of his children were still alive. He shifted slightly, and Eve opened her eyes and looked up at him, puzzled for a moment before her memory returned and her eyes dropped shut again and the tears slid out from under her lids.

  ‘I didn’t even know,’ she said sadly. ‘That’s the worst bit. It seems so unkind that I had a child and I didn’t even know it was there, or acknowledge it. I never had time to love it, Hugh.’ He felt her stiffen, felt the thoughts tumbling in her head, and she struggled up into a sitting position. ‘Hugh, what if I did something wrong? What if the baby died because of something I did, because I was too stupid to realise I was pregnant?’

  ‘No!’ No, he couldn’t let her think that. He shook his head, reaching out to her. ‘You’ve done nothing wrong, Eve. You’ve had the occasional glass of wine, you eat a very sensible diet, you haven’t been exposed to X-rays or chemicals—there’s nothing to blame yourself for. It’s just one of those things that happens.’

  ‘I was still taking the Pill.’

  ‘That won’t have harmed it.’

  She sighed and scrubbed her hand over her nose. ‘Do you suppose there was something wrong with it?’

  He shrugged and sat up, shifting so she was back in his arms, propped against the pillows, cradled firmly against his heart where she belonged, if she only had the sense to realise it. ‘Probably. There is in a high proportion of miscarriages.’

  ‘Poor baby,’ she said, her eyes filling again, and she turned into his chest and hugged him tight. ‘Thank you for being here for me,’ she mumbled into his shirt, and he smoothed her hair and hugged her back.

  ‘Of course I’m here for you. I’m always here for you. I always will be. I love you, Eve. Where else would I be?’

  She tipped back her head and looked at him blankly for a moment, then turned away, moving out of his arms. ‘No. No, Hugh, you don’t. This is just a knee-jerk reaction.’

  He shook his head and sighed. ‘No, it isn’t, Eve. You know I love you. I’ve loved you for months. And I don’t know why you’re aren’t comfortable with it, and I know this isn’t the time to talk about it, but I can’t pretend it doesn’t matter any more, that you don’t matter, because you do. And we can get through this.’