‘Sure. Then check the placenta. Maybe there is a bit left behind that’s stopping her uterus from contracting properly.’ Max concentrated on finding Mel’s veins before she lost too much blood. Soon the lack of blood volume would make her veins collapse and it would be more difficult to find the blood vessel he needed.
Georgia explained to Tim, ‘I need to check the placenta to see there is none missing. Sometimes a small piece of placenta can stay behind and stop the uterus from fully clamping down on the rich blood vessel bed that it’s detached from.’
The nurses from the ward appeared and froze at the door, as if they didn’t want to come in. ‘I’m Flo,’ said one, and the other just stared worriedly at the blood.
Georgia smiled at them. ‘Come in, Flo. It’s OK. Maybe you could take over from Tim so he can help Mel hold the baby.’
Flo nodded and hurried to do as she’d been asked.
Georgia pointed at the tray and said to the second nurse, ‘Could you draw up four ampoules of the Syntocinon and put it into that flask for Doctor, please? That will help stop the bleeding. Then put another saline flask up to run as fast as it can through the other cannula to replace at least the volume of fluid Mel has lost.’
The nurse nodded and hastened to her tasks, obviously relieved that it was something she understood how to do.
Tim cradled his son and Georgia checked the placenta and then stripped off her gloves to check Mel’s observations. Max had the drip up as soon as it was loaded.
Still the haemorrhage continued and Max frowned as he looked across at Georgia. ‘Vital signs?’
Georgia didn’t like the persistence of this bleed and she was very glad Max had come when he had. ‘Her BP has fallen to eighty on forty and pulse rate is up to one thirty. I’ve some ergot here.’
‘Thanks. I’ll push it IV and see what we get.’
‘Mel?’ Tim’s voice startled them as he leaned over his wife. Mel’s face was ashen and her eyelids flickered but didn’t open when Tim called out.
Max had injected the drug and now he frowned as no immediate response was noted. ‘I’ll have to manually compress the uterus,’ Max said. Thankfully, when he did bunch Mel’s uterus between his hands the bleeding slowed, though as soon as he removed his hand it started again.
‘Oxygen,’ Max said at the same time as Georgia passed him to reach the flip-down cupboards with the resuscitation equipment. She slipped the mask over Mel’s face and tilted the whole bed so that Mel’s feet were higher than her head.
‘I may need the Prostin F2 alpha,’ Max said quietly, and Georgia nodded and moved to prepare the syringe.
Not often used, the last drug was injected straight into the muscle of the uterus, which meant Max compressed Mel’s uterus against one hand and injected the medication with the other.
Within less than a minute the gushing blood slowed to a trickle and Georgia and Max looked at each other with ill-concealed relief.
‘Tricky,’ Max said.
‘Very, but that’s done it.’ Georgia breathed out with the reprieve and after checking Mel’s blood pressure even allowed herself a small smile.
Mel moaned and her eyes flickered open as Tim sagged with relief.
Max checked Mel’s abdomen again and her uterus finally remained well contracted. Max nodded and looked at Georgia. ‘Better.’
‘Thank you,’ he said to Flo, and he smiled to include the other nurse, who blushed and backed away. Then Max looked at his wife. ‘Well done, Georgia.’
He leant down and spoke to Mel’s abdomen. ‘Now, why did you do that?’
The tension lightened in the room and Mel roused enough to say in a weak voice, ‘What happened?’
Tim sighed with relief and then suddenly paled further, sighed and sagged sideways.
‘Grab the baby,’ Max called to Flo, who scooped Tim’s son from his arms as Tim fell back in a dead faint. Max caught the new dad easily under the arms before he hit the floor, and dragged him into a chair.
Max looked down at the ashen Tim. ‘Just to top it off, poor guy.’
‘Never a dull moment,’ Georgia said, as she carried a damp facecloth across to Tim, who stirred groggily as the blood returned to his brain.
By the time a sheepish Tim was sitting upright, Mel had recovered some of the colour in her face as well.
Max jotted down the sequence of events with times and then crossed the room to speak to Tim and Mel. ‘Unfortunately we probably will never know why your uterus decided not to contract after birth.’
‘Mel’s BP is back to ninety on fifty and her pulse is one twenty,’ Georgia said.
Max nodded and spoke to Tim. ‘Mel’s compensating for the lower volume of blood she has circulating now, but childbearing women have extra safeguards for the risk of bleeding after birth. We’ll check what her actual red cell levels are and think about blood transfusion or not and discuss it later.’
He smiled that smile Georgia really did love. ‘Everyone in the room has a pulse of one twenty at the moment but it’s all settling now. Mel’s uterus is firm and behaving itself and the bleeding has stopped.’
He spoke to Georgia. ‘We’ll run the drip over four hours to make sure it stays that way and keep her in this room for a while so we can keep an eye on her to ensure it doesn’t start again. But it shouldn’t.’
Mel spoke faintly from the bed. ‘So much for not having a needle. That was a bad choice.’
Max shook his head. ‘Not so. Don’t lay blame on anything in particular. Lots of people decline the needle after birth and though it statistically increases risk, it didn’t cause what happened.’
Max paused to let the words sink in. ‘Unless you have a history of bleeding! Now you have that history…’ he shrugged ruefully ‘…I think your choice is limited for the future.’
Bravo, Max. Georgia wished she could clap because she knew a lot of medical officers who would have ground Mel down for her choice. She would tell him so tonight. In fact, she couldn’t wait until dinner tonight and the chance for their first real discussion about a specialty of medicine they both obviously loved.
Baby Billy nudged at his mother and Georgia smiled. ‘Would you like a hand to put your son to the breast? During breastfeeding more hormones are released, which will help prevent further bleeding as well.’
When Billy was settled at the breast, Georgia and Max left the new parents to enjoy their son in peace after the traumatic events following the birth.
Max slipped his arm briefly around Georgia’s shoulders and hugged her before he dropped his arm to his side again. ‘We’re a good team. That could have been much worse if the F2 alpha hadn’t worked or you hadn’t been prepared.’ Max smiled down at Georgia and she nodded.
‘I was glad you’d dropped in when the floodgates opened. It’s always tricky to do everything at once when things go only slightly unplanned, let alone a full-blown PPH. I wouldn’t have enjoyed the stress while I waited for you.’
Max’s eyes softened. ‘Is it still good to be back at work when you have occasions like that?’
Georgia looked at him and nodded without any doubt. ‘When it all turns out as well as that did then, yes, of course. And the birth was lovely.’
His face clouded again and she put her hand on his arm. ‘What’s wrong?’
He smiled and she wondered if it was forced. ‘Nothing. I was very proud of you, my wife, in there. But now I’ll have to go to work and crunch some numbers around until you call me again.’
He patted her shoulder and just before he moved off he said, ‘Do ring me. Any excuse to get out of the office is gratefully accepted.’
‘Perhaps you could come back at lunchtime and check on Mel and share my sandwiches.’
‘Sounds like a plan.’ He smiled and waved and she watched him go.
He’d been a pleasure to work with and as cool as ice in an emergency. But, then, she’d known that since Elsa’s birth.
She was trying to ignore the fact that her heart had given a jump
when she’d first heard his voice, and just watching him talk to Mel had made her so proud to think that for the moment, at least, he was her man.
She gave herself a little mental shake. She needed to think more about her work and less about Max.
That night at dinner it seemed the floodgates of work discussion opened. They’d never really discussed much about Max’s work but it was as if he’d finally decided he could talk to Georgia and she would not only understand but be deeply interested and have much to offer him in response.
‘I had no idea how much I missed the face-to-face obstetrics that I grew away from in administration.’
‘How could you not notice you’d left a clinical role?’ Georgia listened with her chin on her hands and watched the play of emotions cross Max’s handsome face. How had she come to be with this man? His kindness to her seemed to have no limits.
‘I started teaching.’ He shrugged. ‘And that always moves you back a pace as you encourage students to gain skills and be safe. The only way to impart that knowledge is to let them do it—which meant I didn’t.
‘That access to students meant people were always asking about change and why things were done in a certain way. Soon I was the person advocating change and fighting against the old school of habit.’
She smiled. He would be a good teacher. ‘That must have been satisfying.’
‘In its way it was,’ he said with a twitch of his lips, ‘but that pushed me further away from the births and into the boardrooms and medical committee meetings. Before I knew it, funding had become the big issue.’
She wouldn’t like that herself. ‘You must have been good at creating change?’
‘Maybe, but it is paradoxical that the more I see of grass-roots obstetrics the more I want to be part of it again.’
She could listen to him all night. She’d never had this. As an only child she’d never had a sister or brother she’d been able to really relate to and she’d never been close to Tayla.
Her loving parents had died together when she had just left her teens—too young to have really understood her mother yet old enough to see that true love was a worthwhile goal.
Her marriage, after the initial honeymoon period, had never included an equal partnership so any conversations had been dominated and directed by Sol.
With Max she felt she could dispute, digress or downright disagree, and her contribution would be appreciated. He must have felt the same because he stood up and held out his hand.
‘Come and sit with me for a while on the veranda. We’ll look over the ocean and check out the stars. It is a beautiful night.’
She took his hand and the feel of his fingers around hers as he helped her up made her realise she had never felt so relaxed and cared for by a man who had no expectations of her.
CHAPTER SIX
THEY rose and crossed the room and strolled out through the French doors to the veranda. A soft breeze blew tendrils of hair across Georgia’s cheek and she felt Max’s gaze on her as she sat down on the swing seat. He sat next to her and his strong thigh brushed hers as they swung.
Georgia took a sip from her glass and tried to retrieve the light mood they’d shared in the dining room.
The focus had shifted suddenly so that she was aware of Max’s weight against her and the subtle scent of his aftershave even with the breeze carrying scents from the garden her way.
She remembered those crazy fantasies she’d had on the mountaintop and shifted a little on the seat.
She cleared her throat. ‘Meeandah Hospital is certainly grass roots. You might change your mind when you’ve had ten nights’ broken sleep in a row from callouts.’
Max spread one arm to encompass the vista and the other he dropped around her shoulders. ‘A hospital like we have here has fewer than one hundred and fifty births a year. That leaves me two hundred nights with sleep at least—not counting the quick births in the night that I’m told about in the morning.’
What a dream life as far as she was concerned. Imagine living here, Elsa growing up in this wonderful environment, Max as a true companion and lover, plus the best of doctors to work with. They were damned attractive thoughts but Max could never settle here.
‘Somewhere like this is a big step down,’ Georgia said as she thought of the high-powered position he’d held in the city, and even the subtle state-wide ramifications of what he achieved now, along with his visits to the hospital. His position was important to the whole scheme of obstetrics in New South Wales.
Max looked across at her. ‘Could you be happy working in a facility like this?’
‘Of course.’ Couldn’t he tell? She glanced around them at the idyllic lushness of the garden and the endless sky, and thought of the birth she had already been privileged to share. ‘If the health system will sustain it, I’d stay here for ever.’
Georgia exhaled a long blissful sigh and looked across at him. ‘This is what I love to do. Before I worked at Lower Mountains Base, I had my own home-birth practice, but nowadays I couldn’t make that kind of availability commitment with Elsa.’
‘Why is that?’
She loved it that Max seemed so interested. ‘I need the framework of other midwives around me and this sort of situation is the nearest I can get to the ideal world.’
Max sat back. ‘I would never have imagined this sleepy town could be an ideal world.’
She sighed. ‘For you it wouldn’t be. You’d miss not having the city to call on for amusement.’ As she said the words, disappointment washed over her. Of course she was being unrealistic.
That was sad but true. Max would move on and she might even think about staying here when the time came for them to part, if she could be safe. Suddenly she didn’t want to think about the time when Max had moved on.
Max closed his eyes and felt her words slice into him. They hurt. When had he been bored in the last four months? When had he wanted to be anywhere but coming home to Georgia?
‘Do you know so little of me that you imagine that? Do you think me so needy of the bright lights?’ Sometimes he despaired he’d ever have a hope with this woman. She didn’t even try to understand him.
He sighed and watched her reflect back over what she’d said, but judging by her expression she still didn’t get it.
‘How could I know more about you?’ she said. ‘You don’t exactly talk about yourself. Apart from the last few weeks, I’d barely seen you except for night relief from Elsa.’
He supposed it was true, though to his mind she seemed to be everywhere. When they had rare time to talk his choice would be to hear about her, not himself.
If that was the price for her to really see him then maybe it was time he began to pay. ‘What do you want to know?’
She laughed and he wanted to kiss her—not talk about himself. Her infectious chuckle had been there since Elsa’s birth and he treasured these moments more each day.
She poked him gently with her elbow. ‘Do you realise how dangerous it is for a man to offer to tell all?’
He tilted his head. ‘I asked what you wanted to know—I didn’t promise I would tell you.’
‘Now you are being mysterious.’
And you are delicious. He swung the seat gently and she was carried with him back and forth. She wasn’t in his arms but it was better than nothing. ‘I’m not intentionally mysterious.’
‘So start with Tayla.’ Georgia folded her hands. ‘How did you meet her and what made you think you would be happy together?’
Max shook his head. ‘Why do women always start with another woman?’
‘Fine.’ She shrugged. ‘What do you want to tell me, then?’
His gaze locked with hers. ‘I’d rather tell you that I have enjoyed the last four months with you more than any I can remember.’
Georgia’s eyebrows rose in disbelief. ‘Sure,’ she said. ‘It must have been a hoot for you. You enjoyed being woken up by a colicky baby ten times a night and having a grumpy, sleep-deprived housemate to liv
e with.’ Why on earth would he?
‘Absolutely.’ The tilt of his lips confirmed that he had only pleasant memories and though he spoke quietly, his tone of voice indicated it was the truth. ‘I became acquainted with Elsa and she’s gorgeous, like her mother.’
Georgia tilted her head. ‘Same temperament, you mean?’
Max nodded. ‘She’s determined and independent, yes.’
‘Ah.’ She had him. ‘So living with me is like living with a baby with colic. I can see why you’d be attracted.’
They were teasing each other and she was beginning to enjoy it too much. This was far too dangerous for her peace of mind and she tried to steer the topic away into more general waters. Maybe he did have an agenda with her after all or he’d managed to beam in on one of her fantasies.
‘It is a glorious night,’ she said.
Max wouldn’t be diverted. ‘I appreciated each and every vision of you at night since Elsa was born.’
Georgia thought back over the range of short cotton nighties and men’s T-shirts and boxer shorts she’d worn, with her hair a mess. Not much to admire there.
He hadn’t finished and his voice brushed her skin with his breath as he turned to face her. ‘And I was privileged to see your hair wild and loose and the real you without the public face of composure that keeps me at arm’s length so very efficiently.’
This was serious stuff and she wasn’t sure where it had come from. The mood on the veranda had deepened to one of charged closeness and she couldn’t help softening against him. Georgia forced her arms to cross to block out the intimacy. To block it out because suddenly she wanted to reach across the seat and hug him for seeing a real person and not an object to own, like Sol had.
Obviously Max recognised the moment too and she must have given away more than she’d intended because she saw his surprise and the next thing he’d acted on the impulse she’d denied herself.
Very slowly but with intent his hand slid up her spine to the back of her head to hold her in place and then he leaned across and kissed her gently.
His lips savoured hers in a long slow exploration and his breath was warm as it mingled with hers.
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