by Sarah Morgan
‘I’ve read everything there is to read and watched everything there is to watch,’ Daisy told Miranda, and then gave a grin. ‘Don’t look like that. The one thing that the books warn you about is that labour rarely goes according to plan. Annie keeps telling me that I’ve got to stay relaxed and go with the flow. I’m glad she’s here because, to be perfectly honest, I find Mr Hardwick, the consultant, really scary. He always seems cross.’
Miranda put down the notes she’d been reading. ‘I haven’t actually met him, but I’m sure he isn’t cross. Perhaps just a bit serious. I see you’re hoping for a water birth?’
Daisy nodded. ‘I love the idea of being in the water. I swam every day in my pregnancy. One of my friends gave birth in water and she loved it. Do you think it’s possible?’
‘Absolutely, although we won’t want you to get into the water too soon or it might slow your labour down. And we might ask you to leave the water for the actual delivery.’ Miranda made a mental note to check on the hospital policy for water births.
‘That’s fine. I don’t care about that.’ Daisy screwed up her face and gritted her teeth. ‘Ouch. That’s really starting to hurt.’
‘Remember your breathing, Daisy.’ Annie put her arm round the younger woman’s shoulders. ‘Breathe through the contraction.’
Miranda slid a hand over Daisy’s abdomen to feel the strength of the contraction and talked quietly to her as she gave a little moan of pain and clenched her fists. Finally she relaxed. ‘It’s going off now…’ She breathed out heavily. ‘Why did it sound so easy during antenatal class? They made you feel as though you could cope with anything, but the truth is that the pain takes you over.’
‘Lots of women say that.’ Miranda stood up. ‘That was a pretty strong contraction. You might find the water comforting. Have you considered any other forms of pain relief?’
‘I just want to try the water to start with,’ Daisy said firmly, glancing at Annie for reassurance. ‘I know that I might need something more and if I do then that’s fine, but just for now I want to see how I go. I suppose I’m afraid that if I plan something else, I might grab it instead of managing.’
‘So…’ Miranda sat down on the chair next to the bed and gave a smile. ‘Have you painted the nursery?’
Daisy gave a dreamy smile. ‘It’s perfect. You should see it. Primrose yellow with such pretty curtains…’
They talked and Miranda monitored her, and halfway through the morning she slipped out to talk to Ruth about the hospital policy on water birth.
‘She’s five centimetres dilated and her contractions are strong and regular now. I think she could go into the water if that’s OK with you?’
‘No problem,’ Ruth said immediately. ‘Daisy is a perfect candidate, but none of our consultants like the mothers to deliver in the pool. To be honest, Mr Hardwick doesn’t like women to use water at all, but he’s had to agree to it because of the pressure from women.’
‘What about Mr Blackwell?’ Miranda couldn’t stop herself asking the question and then kicked herself when Ruth shot her a curious look.
‘Jake? Oh he’s perfectly relaxed about it. I’ve never met another doctor quite like him and I’ve worked with quite a few. He believes that women should labour in whatever way feels best for them. Such a contrast from a couple of his colleagues, who glance at their watches from the moment a woman walks through the door and then start reaching for the forceps.’ There was a weariness in Ruth’s tone that was hard to miss.
‘Because they want to get women out as soon as possible?’
‘Partly.’ Ruth shrugged. ‘And I suppose there’s an element of control there. They want the woman safely delivered in as short a time as possible. Some obstetricians are nervous of litigation and are less inclined to take risks than others.’
‘And Jake Blackwell isn’t?’
Ruth frowned. ‘I wouldn’t say he takes risks. He’s just very relaxed and confident and he puts the mother first. He tries to let women do what they were built to do. He has a very low rate of intervention. I’ll tell you this much…’ Ruth reached up and rubbed a name off the whiteboard with a scrap of tissue ‘… if I was having a baby, there’s no one I’d rather deliver it. Talking of which, where are you having yours?’
‘Oh…’ Miranda blushed and placed a hand on her abdomen in a self-conscious gesture. ‘I don’t know, to be honest. I’ve only just moved into the area. Here, I presume, given that it’s the only unit for miles around.’
‘You should register with someone.’
‘I know.’ Miranda pulled a face. ‘It’s on my list of things to do. And I wouldn’t know who to register with.’
Ruth dropped the tissue in the bin. ‘Why don’t you ask Jake? He’s brilliant. The best, in my opinion. Tom Hunter is good, too, although not quite so approachable. If I were you, I’d go for Jake.’
‘No, I couldn’t possibly do that!’ The words burst out before she could stop them and Ruth gave her a long, searching look.
‘All right.’ She spoke quietly. ‘But you ought to register with someone. Are you carrying your notes?’
Still struggling from the emotional turmoil of imagining the intimacy of Jake delivering her baby, Miranda stared at her. ‘What? Oh—yes. Yes, I am. But it’s been a very straightforward pregnancy. No problems at all.’
Except for the fact that her life was a total mess. But that probably didn’t count, she assured herself. Physically she was fine and that was all health professionals ever cared about.
Ruth was still looking at her. ‘Think about it,’ she urged. ‘As you say, if you’re living around here then this is the only unit in the area.’
Miranda nodded. ‘I’ll do something about it, I promise.’
She and Ruth prepared the water and Annie helped Daisy into the pool.
Instantly the frown on her face faded and her eyes closed. ‘Oh—that feels completely fantastic,’ she murmured, as she spread her arms out and slid further under the water.
At that moment her husband came into the room, clutching magazines and water. A tall man with glasses and a beard, his tension was obvious as he looked at his wife.
‘So how’s it going?’
Still with her eyes closed, Daisy smiled. ‘Perfect.’
Her husband breathed a sigh of relief and put the magazines down on the table. ‘Can I do anything?’ It was obvious from his tone that he was hoping that the answer was going to be no and Daisy chuckled.
‘Just sit and talk to me for a bit.’
Miranda stayed with Daisy for the whole day, monitoring the baby’s heart with the waterproof, handheld Doppler and generally offering support.
Towards the end of her shift she slipped out of the room to give Ruth an update and found her talking to an older man in a suit.
‘This is Mr Hardwick,’ Ruth said quickly. ‘Mr Hardwick, this is Miranda, one of our new midwives. She’s looking after Daisy.’
The consultant made a disapproving sound. ‘Is she nearing the end of the first stage? I’m going out to dinner tonight and I don’t want to be disturbed.’
Miranda bit back the sharp response that flew to the tip of her tongue. ‘She’s doing very well. She’s in the water now and—’
He frowned. ‘That will slow her labour down.’
Miranda took a deep breath. ‘On the contrary, I’ve often found that the relaxing effect of the water actually pushes labour forward, providing the mother isn’t put into the water too soon. Daisy didn’t go in until she was five centimetres dilated and now she’s—’
‘I want her out of the pool for delivery.’ Mr Hardwick’s mouth tightened. ‘It’s impossible to estimate blood loss in 600 litres of water.’
‘Of course.’ Miranda felt her hackles rise. ‘There’s nothing to suggest that this will be anything other than a routine, normal delivery. The foetal heart is—’
‘Obstetrics is nothing if not unpredictable, young lady,’ the consultant interrupted her again, his tone frosty. H
e then turned to Ruth. ‘I’ll be in my office for another hour and then I have a car picking me up.’
Without uttering another word, he strode off the labour ward and Ruth sighed.
‘Sorry about that. Communication skills aren’t his forte.’
‘Nice for the mothers,’ Miranda said dryly. ‘Now I see why Daisy finds him scary.’
‘Yes, well, Jake is on tonight so if there are any problems we’ll get him to sort her out, quietly and competently, while Mr H. is eating his starter,’ Ruth said quickly, picking up a set of notes and making for the door. ‘How’s she doing, anyway?’
‘Fine. I don’t anticipate any problems.’
She was to regret those words.
Daisy’s labour continued smoothly and as she reached the end of the first stage, Annie and Miranda helped her out of the pool.
Daisy groaned and slumped over a beanbag. ‘I’m going to kneel. It’s what we agreed would be best and it’s what I feel I want to do.’
‘Fine. Use any position that feels right.’ Opening a delivery pack and quickly snapping on a pair of gloves, Miranda examined the labouring woman. ‘I can see the baby’s head, Daisy. You’re doing so well. It won’t be long now.’
Daisy continued to push and the head was delivered but then immediately retracted.
It wasn’t something that Miranda had ever seen before but she knew exactly what it meant and felt cold fingers of panic slide down her spine. Without hesitation, she reached out and hit the emergency buzzer behind Daisy’s head.
‘Daisy, you’re doing really well,’ she said calmly, ‘but the baby’s shoulders don’t seem to want to be born so we just need a bit of help here.’
And she needed it quickly. There wasn’t going to be any time to disturb Mr Hardwick’s dinner. They had minutes to deliver the baby.
‘I want you to turn all the way over and back onto all fours—Annie and I are going to help you.’
She knew that such a manoeuvre might help dislodge the baby, but in this case nothing happened and seconds later Ruth hurried into the room, closely followed by Jake.
‘She’s had two contractions with no restitution—Turtle’s sign—and having her on all fours hasn’t worked,’ Miranda told them quickly.
Without any further questioning, Jake immediately took charge.
‘We’ll try the McRoberts manoeuvre. I need you on your back, Daisy, and I need you to stop pushing—can we get her onto the bed, please?’
Ruth and Miranda quickly helped Daisy onto the bed and flexed and abducted her legs while Jake washed his hands and pulled on a pair of gloves.
He applied supra-pubic pressure then did something magical with his hands and the baby slithered out, screaming and bawling.
‘Little girl, Daisy,’ Jake said calmly, clamping the cord and handing the baby to the mother, as relaxed as if it had been a perfectly normal delivery.
It was only then that Miranda realised that she’d been holding her breath. The tension left her in a rush and her knees suddenly felt weak.
As if sensing her state, Jake gave her a gentle smile. ‘Everything’s fine. Good job, Miranda.’
She swallowed, grateful for the praise but not at all sure that it was justified. He was the one who’d delivered the baby, and with a minimum of fuss and bother. He’d been so calm that it was quite possible that Daisy had no idea of just how serious the situation had been. Suddenly she was swamped by uncertainties and insecurities. What if he hadn’t been just down the corridor? What if they’d had to call Mr Hardwick away from his dinner? He never would have arrived on time.
‘She’s so beautiful,’ Daisy breathed, just as the paediatrician hurried into the room.
‘Did someone bleep me?’
Jake glanced up briefly. ‘Everything’s fine here, Howard, but, given that you’ve made the trip specially, perhaps you’d be good enough to take a look at the baby for us,’ he said easily, focusing his attention back on the delivery of the placenta.
Daisy released the baby reluctantly and the paediatrician checked her over and pronounced everything to be fine. An hour later mother and baby were transferred to the ward. It was three hours after Miranda’s shift should have ended.
Drained and exhausted and more than a little troubled by the events of the day, she walked slowly towards the changing room and dragged on her coat and scarf.
Wondering how on earth she was going to find the energy to cycle home, she pushed open the door that led to the stairs and then stopped. Jake was standing there, his broad shoulders leaning against the wall, blue eyes narrowed as he watched her.
‘I’ve been waiting for you—you’ve just worked a ridiculously long day. Again. Are you all right?’
She almost laughed. She was so far from all right that it wasn’t true, but she could hardly tell him that, could she? ‘I’m fine.’
‘You’re a liar.’
She lifted a hand and tried to rub away the nagging ache in her forehead. ‘If you want a rehash of last night’s conversation, I ought to warn you that this isn’t a good time. I know you’re mad with me, but—’
‘I’m not mad with you.’
‘Last night you—’
‘Last night I was angry, yes,’ he admitted, ‘but you have to admit that I had a lot to take in. I’ve had time to think about what you said and you’re right, of course. Your life is none of my business but, for some reason that I don’t entirely understand, I keep wanting to make it my business.’
‘Jake—’
‘I’m worried about you.’ His voice was firm and masculine and his gaze was disturbingly intent. ‘You shouldn’t be working these hours when you’re six months pregnant. I hope when you get home, he’s spoiling you and feeding you decent food.’
Miranda thought of the contents of her fridge and gave a wan smile. ‘Of course.’
Something flashed in Jake’s eyes and he straightened. ‘Come on, then. The least I can do is drop you home again.’
She glanced at him, startled. He hadn’t actually dropped her home the night before, but he didn’t know that, of course.
Too tired to argue with him, she followed him down to street level and watched in weary silence as he secured her bike to the back of his car.
Without speaking, he took the same route that she’d given him the day before and pulled up in the same street. Then he looked at her with a strange gleam in his eyes.
‘Are you going to tell me the truth now?’
‘About what?’
‘Well, about where you live, for a start.’ His tone was pleasant. ‘I know it isn’t here.’
Her spine straightened. ‘I don’t know what you mean.’
‘Oh, I think you do.’ He switched off the engine. ‘You don’t live here, do you, Miranda?’
She stared at him. ‘I—’
‘After I finished on the phone last night, I went looking for you. I knocked on every door in this street but no one had ever heard of a midwife called Miranda.’ His gaze didn’t shift from her face. ‘Funny, that, don’t you think?’
She swallowed hard. ‘Jake, I—’
‘So then I started to ask myself why you’d lie about where you lived.’ His voice was steady and calm. ‘It’s obvious that you’re involved with someone and that’s fine, but I would like to know why you’re lying to me. Why not just tell me the truth?’
‘I’m not lying. I haven’t lied once—’
‘We’re sitting outside a house where you don’t live. What’s that if it’s not a lie?’
She looked away from him. ‘I’m not used to confiding in people.’
‘Giving me your address counts as confiding?’ His tone was mild and she turned back to look at him.
‘All right, you can take me home. But then I want you to leave. I’m not prepared to answer questions and I don’t owe you any explanations.’
Jake pulled up outside the dimly lit block of flats and felt a shiver pass through him. In the darkness the whole area was threatening and unsav
oury, and he knew from experience that daylight didn’t improve it at all.
It was rough and dangerous and left him with one burning question that needed answering.
What on earth was Miranda doing, living in a place like this?
It seemed that the longer he spent with her, the less he knew about her life.
‘Thanks for the lift.’ She undid her seat belt but his hand closed over hers before she could open the door.
‘Not so fast.’ Her hand was slender and cold and he felt it tremble slightly under the pressure of his. Suddenly he knew she was hiding something. Something big. ‘I’ll see you to your door.’
‘There’s really no need. I can—’
‘I’ll see you to your door.’ His mouth set in a grim line, Jake released her hand, opened his own door and walked round the car to help her out. ‘Or are you afraid that your partner is going to give me a black eye?’
He was testing her reaction because he’d come to the conclusion the previous night that she didn’t have a partner, and his suspicions were proved correct as she hesitated fractionally and then her slim shoulders sagged.
‘I’m on my own.’ Her voice was so soft he could barely hear her. ‘No one is going to give you a black eye. But I still don’t need you to walk me to the door.’
‘Indulge me.’ In fact, she looked so exhausted he wondered whether he should carry her, but he managed to stand aside as she walked towards the steps and led him up two flights.
‘This is where I live.’ She took a key out of her pocket. ‘Thanks for bringing me home. I’ll see you tomorrow.’
She pushed open the door and he caught a brief glimpse of damp patches and threadbare carpet.
It was enough to make up his mind. There was no way he was leaving her here without at least understanding what was going on.
He followed her into the room, resisting her feeble attempts to close the door on him with a gentle push of his shoulders. Once inside, his gaze bordered on the incredulous as he glanced around the gloomy room. ‘What are you doing, living in a place like this?’ He winced suddenly, aware that his words were insulting, but then he decided that there was absolutely no way that she could possibly think that her living conditions were anything other than awful.
