A Summer Wedding For the Cornish Midwife

by Jo Bartlett

  ‘I’m losing the baby, aren’t I?’ Miranda’s eyes filled with tears again and this time they slid down her face. A few people had approached the stall, but luckily they seemed to have thought better of it and realised that now wasn’t a good time to shop for bouquets and buttonholes.

  ‘I can’t say for certain without a scan, but it sounds to me like you’ve got hyperemesis gravidarum.’ Anna squeezed her hand again. ‘Don’t look so worried, it’s just the medical term for severe morning sickness. Unlike normal morning sickness, it tends to come on earlier in the pregnancy and it’s not uncommon for it to start at three weeks, like it did for you.’

  ‘Will it hurt the baby?’

  ‘It’s you we need to look after. There’s some good news though. As horrible as it is, hyperemesis gravidarum is caused by higher than normal levels of the pregnancy hormone hCG. If you were losing the baby, those hormones would drop.’

  ‘Oh my God, really?’ Miranda leant forward in her seat, a tiny bit of colour coming back into her cheeks as she did. ‘Tom and I want this baby so much and after losing the first two, I was convinced it was going to happen all over again. If my body couldn’t even hold on to water, how could it hold on to the baby? I felt useless, when it’s what a woman’s body is supposed to be designed for. Does that make any sense at all, or am I as all over the place as I feel?’

  ‘It makes perfect sense.’ Anna stopped herself saying any more. It was her job to comfort her patients, not offload her problems on to them, but she understood exactly what Miranda meant; she knew how intoxicating hope could be. If things didn’t work out, she needed Miranda to know that she wasn’t to blame for that either. ‘And losing the babies wasn’t your fault.’

  ‘It’s just so hard to accept that there’s no reason for it. In a way it’d be easier if there was something I could do differently this time around.’ Miranda sighed. ‘Do they know what causes the extreme sickness, is it something I’ve done? Something I’m eating that I shouldn’t be?’

  ‘No one really knows for sure what causes it, but it’s definitely not something you can control. Sometimes it can have genetic links, and it’s more common in multiple pregnancies, but mostly it seems to just be bad luck.’

  ‘Would a scan this early be able to show if everything was okay?’

  ‘They should be able to see the sac and there’s quite a good chance they could see a heartbeat, even as early as this.’

  ‘I’ve never even got that far before. By the time I went for scans, it was already too late.’ Miranda wiped her eyes with the back of her hands. ‘If they pick up a heartbeat, does that mean I’m less likely to miscarry?’

  ‘It drops to about ten per cent if a heartbeat‘s picked up at this stage.’ Anna didn’t have to ask Miranda if she wanted a scan. ‘I think the best thing we can do is get you admitted to the hospital for some IV fluids and see if we can arrange a scan at the early pregnancy unit at the same time.’

  ‘I can’t go without Tom. If the worst happens and he’s not there… I just can’t go through it again without him.’

  ‘Of course not. Hopefully Brae will have managed to talk to him and we might even be able to get him to meet us there, to save time.’ Anna looked up to see Brae crossing the ballroom. ‘Talk of the devil.’

  ‘Did you manage to speak to Tom? Was he okay?’ Miranda attempted to get to her feet for a second time, but she started swaying again and Anna helped her back into the chair.

  ‘He’s fine and he’s on his way.’ Brae handed her the phone. ‘More importantly, how are you doing?’

  ‘Thanks to Anna, I’m not quite as panicky as I was.’

  ‘We can drive you to the hospital and get Tom to meet us there?’ The last thing Anna expected was for Miranda to shake her head.

  ‘If I leave the stall now, I’ll never get another pitch. It’s taken me three years on the waiting list to get a slot at this fair and, like I said, it’s probably the best one around.’

  ‘I’ll look after the stall while Anna takes you to the hospital.’ Brae smiled. ‘I’m not saying I know anything about floristry, but I’m used to dealing with customers and, if I know the prices of everything, I can at least take the money and write down the contact details of anyone who wants to place an order.’

  ‘Are you sure?’ Miranda widened her eyes as he nodded. ‘If I had the energy, I’d give you a hug.’

  ‘No thanks necessary. I can wait here until Tom gets back after the scan, or until the wedding fair finishes, if it takes that long.’ Brae caught Anna’s eye again. ‘I’d want someone to do the same if Anna was in your situation.’

  ‘You really are fantastic and the least I can do is make your wedding bouquet.’ Miranda gestured towards the table. ‘As well as the ones on display, there’s a book with lots of other styles I can do.’

  ‘Thank you so much, but I just want to get you to the hospital as soon as possible, so we can worry about everything else later.’ Anna helped Miranda to her feet, putting an arm around her waist.

  ‘I’ll ask the people next door to watch your stall for five minutes, so I can help Anna get you out to the car.’ Brae disappeared to speak to the couple running the neighbouring stall, who were selling personalised wedding favours. ‘Right, they’re going to watch it until I get back.’

  Brae all but carried Miranda out to the lobby of the hotel and ran down to get the car, pulling it up right outside the front door and helping Anna to get her in.

  ‘I really love you.’ Anna kissed him briefly as he opened the driver’s door for her.

  ‘You too.’ He tucked a stray strand of hair behind her ear as he spoke. ‘I hope it all works out okay, you know, with the baby.’

  ‘So do I.’ As Anna slipped into the driver’s seat, she couldn’t help wondering if Brae was talking about more than just Miranda’s baby. They hadn’t done anything about the prospect of adoption yet, but every time she spoke to Brae about it, or showed him some of the research she’d done, she was more at peace with the idea of letting go of her original dream. Creating a family so purposefully took someone really special; Brae fitted the bill perfectly and he’d balance out any inadequacies she had. After the wedding they could start making plans to take things forward and start the assessment process. She just hoped she wouldn’t experience the same doubts as Jess was having about fostering when the time came.

  The sonographer ran the scanner across Miranda’s stomach, as her husband Tom held on to her left hand. She was gripping the drip stand that was finally getting some fluid into her body with the other hand. Miranda had begged Anna to stay with them until after the scan and, positioned at the end of the bed, she saw what was on the screen before the sonographer even spoke.

  ‘Okay, well the good news is I can see a heartbeat.’ The sonographer turned the screen slightly, so Miranda and Tom could see the flickering heartbeat of their unborn baby. ‘There’s the first sac, with the heartbeat in it.’

  ‘The first sac?’ Miranda flashed Anna a look and she nodded, but the sonographer wasn’t finished.

  ‘Yes, there are two, but there’s no heartbeat visible in the second sac yet.’

  ‘Does that mean that one of the babies has died?’ Miranda’s voice caught on the last word. The poor woman had been through this twice before, and the pain of her previous losses was written all over her face.

  ‘It might just be because it’s too early to pick up the heartbeat yet.’ Anna didn’t want to give Miranda and Tom false hope, but she’d seen enough early pregnancy scans to know it was a strong possibility.

  ‘Your midwife’s right.’ The sonographer nodded. ‘It can mean that the embryo isn’t viable, but it’s more common at this stage for it to be because it’s just too early. You could definitely still be looking at a twin pregnancy.’

  ‘Twins!’ Tom’s face lit up with a mixture of excitement and terror, but Miranda shook her head.

  ‘Let’s not get too excited yet, it’ll just make it worse.’ She seemed to be gripping hi
s hand all the harder. ‘If the second baby doesn’t turn out to have a heartbeat, does that mean I’m going to lose the other one, too?’

  ‘Try not to worry about that.’ Anna spoke softly. ‘Like I said before, seeing a heartbeat cuts the risk of miscarriage down to ten per cent. It’s all really positive so far, so just try to hold on to that.’

  ‘That’s right.’ The sonographer smiled as Tom stood up and shook her hand. Anna could almost feel the love between him and Miranda filling the room, and their sheer joy at finally getting a step closer to the baby they’d been longing for was obvious. Miranda was probably ten years younger than her, and Anna couldn’t help wishing for the thousandth time that she’d found Brae earlier. There was nothing more pointless than wishing she could change the past, though. She had so much to be happy about and they had so many exciting plans for the future. The wedding was just around the corner and sharing his surname might seem like an old-fashioned gesture to a lot of people, but it would be another sign they belonged together. The Penroses, whether that was two, three, four, or a menagerie of ten – with dogs, cats and a tortoise – it would be their family name. And the only thing Anna would have changed was to have the wedding even sooner.

  12

  Anna set down the tray of hot drinks on the desk. Toni was in one of the delivery suites, assisted by Bobby, supporting a second-time mum-to-be whose labour appeared to be going perfectly to plan. Gwen was out doing home visits, which left Anna, Ella and Jess in the staffroom. Anna was running a clinic that was due to start in less than twenty minutes. It meant she had just enough time to grab a drink with the others, assuming no one came into the unit with an emergency, or because they’d gone into labour.

  ‘What’s on the menu for the wedding breakfast, then?’ Ella took the tea that Anna passed her.

  ‘We’re going for pan-fried hake, smoked hock of ham, or wild garlic mushrooms for the first course, then topside of beef, slow-roast pork belly, or spinach ravioli for the main course, and there are three or four dessert courses, all served with either Cornish ice cream or clotted cream, of course!’ Anna’s stomach grumbled as she reeled off the list. She’d burned the porridge she’d made for breakfast, too distracted by an email from the hotel to even notice the smell of scorched oats and milk until it was too late. She’d never have pictured herself as the sort of person who got so fixated by the small details, but planning the wedding was definitely taking over of late and it was just one more reminder of how much she missed her mum.

  ‘Were the choices all down to Brae, or did you get back to the hotel in time in the end?’ Ella broke a chocolate digestive in half, dunking it into her tea.

  ‘Once the sonographer at the Early Pregnancy Unit told Miranda everything looked okay, I dropped her home with her husband and went back to the hotel. Poor old Brae had been manning the stall all afternoon, and he’d almost filled the order book by the time I got there. So he’s got a backup plan if the fish and chip shop ever goes belly up!’

  ‘You know when someone says: “so and so is the salt of the earth, they’d do anything for anyone”, they really are talking about you and Brae.’ Jess smiled. ‘Dom probably wouldn’t have given up his Saturday afternoon rugby, even if I’d been the one having a pregnancy scan, let alone him doing it for a total stranger.’

  ‘Is he still messaging you?’ Jess had confided in Anna that there’d been a lot more messages from Dom since she’d decided to foster and she had a horrible feeling it was contributing to Jess’s wobbles about the whole thing.

  ‘I think he must have split up with that girl from work and he seems to think there’s still a chance for us.’

  ‘And is there?’ Ella took the words out of Anna’s mouth.

  ‘No…’ Jess hesitated for a moment. ‘I miss him sometimes, but I don’t know if that’s because I actually miss him, or whether it’s the whole package of his family that I miss. His mum and dad were always so lovely to me and I sometimes find myself driving in the direction of their house for a cup of tea after work, and for his mum to tell me it will all be okay however bad my day has been.’

  ‘You can come over to mine any time you have one of those days.’ Anna might have been less than a decade older than Jess, but she suddenly felt strangely maternal towards her.

  ‘You know I’m going to take you up on that, don’t you?’

  ‘The same offer goes for me.’ Ella smiled. ‘And sometimes I have leftover cakes from the bakery!’

  ‘Hey, that’s not fair, how am I supposed to compete with that?’ Anna rolled her eyes. ‘I’ll just have to come to yours for tea and cake with Jess, and we can all put the world to rights together.’

  ‘Now there’s an offer I can’t refuse.’ Jess looked resolute. ‘You can start by helping me find a good solicitor. I think the only way Dom and I are both going to move on, is if we make things official and I think it’ll help with the foster panel’s decision too.’

  ‘No more doubts about going through the assessment process then?’ Anna couldn’t help smiling at how vigorously Jess was shaking her head.

  ‘No, I’m definitely doing it. I know it’s going to be hard, reliving a lot of the stuff I went through, but nothing worth doing ever comes easy, does it?’

  ‘It really doesn’t and you’re going to make so much difference, Jess.’ Anna gave her a hug. ‘And we’re here for you whenever you need us, aren’t we, Ella?’

  ‘Absolutely and with as many cakes from Mehenicks’ bakery as you can face!’ The fact that Jess could make two such life-changing decisions all by herself couldn’t help but inspire Anna. The wedding plans might be in danger of taking over her life, but there was no excuse for her not to email a few adoption agencies, just to get some more information. The next meeting of the infertility support group, which was coming up soon, would be a chance to talk more about the option with Jess and other women who really understood. Suddenly she didn’t want to wait until the wedding was over to take the next step in her life with Brae.

  Tamara Scott’s cheekbones would have put a supermodel to shame. Even with her neat little baby bump, which looked nothing like the average full-term pregnancy, there wasn’t an ounce of spare flesh on her. Her hip bones might have all-but disappeared as she lay down on the examination table, but her ribs were still clearly visible and when she sat up again after Anna had run all the checks, even Tamara’s backbone pressed against the skin of her back.

  ‘Everything looks okay with the baby, although she might be a bit on the small side, but nothing you need to worry about.’ Anna gave Tamara what she hoped was a reassuring smile, but it didn’t stop the younger woman’s eyes looking so sad.

  ‘I’ve been trying to eat, I really have. I just find it so hard.’

  ‘You’re doing great. You’ve gained twenty-six pounds so far, that’s only two pounds off the target we set and you’ve still got two weeks to go.’ Anna had gone back through the notes before Tamara’s appointment. She’d spent the last twenty years, since turning thirteen, battling eating disorders of one type or another. She’d been hospitalised several times due to anorexia and it had left her with a number of problems, including a stark warning from her doctor that she’d never be able to have a baby unless she gained weight. As a result she’d put all her efforts into trying to get healthy to have a baby with her husband, Luke. The struggle with her body image had continued, though, and she’d been bulimic right up until the pregnancy was confirmed. The demons she was fighting didn’t disappear overnight just because she was pregnant.

  ‘My consultant said I should aim for closer to forty pounds, because I was so underweight to start with.’ Tamara wrung her hands in her lap. Sometimes Anna could happily swing for consultants who gave out such prescriptive advice, without really seeing the woman sitting in front of them. For Tamara, gaining twenty-six pounds was the equivalent of climbing Mount Everest. She’d had cognitive behavioural therapy for the body dysmorphia she’d suffered as a teenager, but she still battled with obsessive
behaviours and there was a risk that being pregnant could trigger a relapse.

  ‘Pushing yourself too hard, too fast, is only likely to have a negative effect in the end. You’re doing exactly the right thing, taking it slowly and trying to gradually increase the amount you’re eating.’

  ‘I’ll never forgive myself if the baby has any problems because of me. I want it all to be perfect for her, and for her childhood to be everything mine wasn’t.’

  Tamara’s anxiety seemed to stem from her problematic start in life. She’d told Anna enough about it for her to feel almost guilty that her childhood had been so idyllic. Jess was better placed to understand how much impact this could have. Even now Tamara’s past was blighting her present and Anna’s was pretty much perfect in comparison. She just wished she could do more to help her come to terms with it all, but sometimes it was a challenge to even get her to open up.

  ‘How are you finding being off your medication?’ Tamara had been taking anti-anxiety medication prior to falling pregnant and had stopped overnight when she’d got the positive test. It wasn’t what her doctors or Anna would have recommended, and there were other medications she could safely take during the pregnancy, but Tamara wouldn’t hear of it. She was working as hard as anyone Anna had ever met to turn her life around for the sake of her unborn baby, but she still seemed desperately fragile.

  ‘Some days are more difficult than others, I’m not going to lie.’ Tamara swallowed so hard it was audible. ‘But I don’t want to risk Belle’s health by pumping her body full of second-hand medication.’

  ‘It doesn’t have to be like that, there are—’ Anna barely got the chance to start the sentence before Tamara cut her off.

  ‘I know what you’re going to say; that there are some medications I could take. The thing is, I’ve always used them because they take the edge off life, you know? They dull things and blur it all, not just the tough bits. But when Belle comes, I don’t want that. I don’t want the edges to be blurred, or not to remember the details of those first few weeks and months. Some people can take medication and function perfectly normally, but it’s never been that way for me. Up until now, I didn’t want it to be.’