Читать книгу: «Pregnant With Her Best Friend's Baby»

CHAPTER ONE

‘DO YOU KNOW what the French word for a midwife is, Joe?’ Maggie Lewis jammed her helmet over her blonde curls but let the ends of her chinstrap dangle as they strode swiftly out to the helipad.

‘What’s that got to do with anything?’ Maggie’s crew partner, Joe Wallace, pulled open the side door of the helicopter, briefly obscuring the logo of Wellington’s Aratika Rescue Service emblazoned on the side of the aircraft.

‘We’re going to a woman in labour.’

‘Ah...is that what it is? Hasn’t come through on my pager yet.’

‘Prolonged first stage,’ Maggie added. ‘And the midwife has called for assistance because she’s now caught up with another patient who’s having a miscarriage and she can’t get back to check on this woman anytime soon.’

Joe stood back to let Maggie climb on board first. Their pilot, Andy, was already in the cockpit, well into an automatic pre-flight routine with the crewman and co-pilot Nick sitting beside him. The rotors were gathering speed and the downdraught was enough to make Joe push his sun-streaked brown hair back off his forehead and out of his eyes before he pulled his helmet on. How was it that he always managed to look as if he was overdue for a haircut?

Maggie fastened her chinstrap as she sat down and then pulled her harness over her shoulders. ‘Anyway... I’m sure you don’t know what a midwife is in French, so I’ll tell you. It’s a sage-femme. Direct translation is actually “wise woman”.’

‘Ah...’ Joe was grinning as he pulled the door shut behind him. ‘I see where this is going. You want to take the lead on this one, don’t you, even though it’s my turn? And even though you had all the fun of the post-cardiac arrest case we just finished?’

‘It was a good case, wasn’t it?’ Maggie smiled back as she pulled down her microphone, responding affirmatively to Andy’s query about whether they were good to go and then watching the ground recede as they lifted into the air. She was still thinking about their last mission, however. ‘It’s not often you get to bring someone back to life enough to have them cracking jokes with the ED staff when we get there.’

‘But you want this one, too.’

‘I was a midwife, once upon a time, you know. One of those wise women.’

‘Last century, you mean?’

‘Hey...you’re older than me, mate. I wouldn’t go making ageist jokes if I were you.’

‘At least I knew I wanted to be a paramedic from the get-go. You had to be a nurse and then a midwife before you saw the light and found your true calling.’

‘I must have been crazy,’ Maggie muttered. ‘I could be working in a nice, fully equipped maternity unit with colleagues who appreciate me and...whoa...watch out for those potholes, Andy.’

‘Sorry.’ But their pilot chuckled. ‘It might be a bit of a bumpy ride today. That’s Windy Wellington for you.’

‘I do appreciate you, Maggie,’ Joe said a few seconds later. He sounded perfectly sincere but Maggie could still hear a grin in his voice. ‘You know that, don’t you?’

She shrugged. Joe had been one of the first people she had worked with on the base when she’d joined the crew five years ago. ‘You’ve put up with me long enough, I guess.’

‘And there I was thinking it was you who was putting up with me.’

For a second, they caught each other’s gaze, with the ease and familiarity that only came after a friendship had had years to gather strength along with the kind of depth that could only come from shared experiences that often involved a life or death struggle. Their banter might push the limits occasionally but the trust and respect between Maggie and Joe was rock solid.

‘Actually...’ Andy’s voice coming through the in-built headphones in their helmets broke that moment of connection. ‘It’s me who’s had to put up with both of you for years now. Years and years of listening to you bicker about who gets to lead which job.’

‘We’re the dream team,’ Joe informed him. ‘As well you know.’

‘Yeah, yeah... I’m going to toss a coin when we land. Whoever gets heads gets to lead, okay?’

Maggie and Joe shared another swift glance. They both knew it wouldn’t actually make any difference. Neither of them had the kind of ego that interfered with clear communication or with deferring to someone who was more skilled in a particular area. They really were a ‘dream team’ and, while there were many medics on the Aratika Rescue Base that Maggie loved to work with, Joe was definitely her favourite.

‘It’s not as though we’re likely to have to deal with a delivery, anyway,’ Joe added. ‘If the mother’s had a prolonged first stage she’ll be exhausted and may not be anywhere near fully dilated. She might end up having a Caesarean. It’s the midwife’s call to get her into hospital instead of continuing with a home birth. I guess she’s requested a chopper because it’s an isolated property.’

‘Long, unsealed road to the nearest highway, too,’ the crewman, Nick, put in. ‘I don’t imagine a bumpy road like that would be very good for a woman in labour.’

Another pocket of turbulence made Maggie reach for a handhold. ‘At this rate, the ride with us into hospital might speed things up as much as a road trip could.’

‘We should be out of the worst of it when we get up north a bit,’ Andy told them. ‘ETA’s twenty minutes.’

Maggie peered down at the rugged, forest-covered hills and nearby coastline beneath them.

‘Isn’t that the Castle Cliffs resort down there?’

‘Where Cooper and Fizz are having their wedding?’ Joe leaned sideways to see where Maggie was pointing to a group of buildings half-hidden by forest on the edge of a cliff top. Cooper had started working at the base six months ago after emigrating from Scotland and Fizz was one of the emergency medicine specialists who were part of Aratika’s elite staff.

‘I think it must be.’ Joe nodded. ‘Certainly looks like the only way to get to it is by four-wheel drive or chopper.’

‘I might take my bike.’

‘What—you’re not going to wear a dress?’ Joe sounded shocked.

Maggie sighed. ‘I suppose I’d better. I hadn’t thought about it yet.’

‘The wedding’s next weekend. You’d better get on with it.’

‘I know. It’s just happened in a bit of a rush, you know? I really wasn’t expecting Fizz to suddenly get so formal. She told me not so long ago that she was never going to get married again.’

‘I guess finding out they’re going to have a baby changed things. Not that that’s the best reason to decide to tie the knot.’ There was an odd note in Joe’s voice.

‘It’s as good a reason as any,’ Maggie responded. ‘And I’ve never seen either of them looking so happy.’

Joe’s grunt was reluctant agreement. ‘Yeah... I would have thought Fizz would have been more upset having to give up her shifts at Aratika but I’ve not seen the smile drop from her face once.’

‘Mmm...’ Maggie closed her eyes for a moment. She could imagine how happy Fizz was feeling. Not just because she’d won that life lottery of finding the person she wanted to be with for ever—something Maggie had failed to find yet—but with the anticipation of holding their first baby in her arms in the near future. Maggie’s own arms were loosely folded in front of her and she could actually feel an emptiness there. An ache of longing...

It was getting stronger, that longing. The ticking of a biological clock. One of Mother Nature’s tricks to persuade women to reproduce before it became too late and, at nearly thirty-six, Maggie knew that her window of opportunity to become a mother easily was starting to close. She’d been envious of Fizz when she’d heard the news. Dead jealous, if she was really honest with herself.

‘That’s the road we’re looking for down there.’ Andy’s voice broke into Maggie’s thoughts a few minutes later. ‘We’ll follow it but keep an eye out for a farmhouse with a red ute parked in front of it. Apparently there’s an empty paddock by the road that we can land in.’

‘I’m getting an update.’ Joe was reading his pager. ‘Our patient is a thirty-one-year-old first-time mum. No problems with pregnancy and she’s full term. Name’s Kathy Price.’

It wasn’t Kathy who met them at the door of the house a few minutes later but her husband, Darren, who looked like he’d just come in from working on the farm. He had a checked shirt on over a pair of shorts and he dropped a pair of boots onto the veranda of the farmhouse before inviting the paramedic crew to come inside.

‘Dunno what all this fuss is about,’ he said, as he led them through to a bedroom. ‘I could have driven Kath in to the hospital. We don’t need all these bells and whistles.’

‘I think Kathy’s midwife was a bit concerned about how tired your wife was sounding,’ Joe said calmly. ‘And it is quite a drive.’

Maggie was slipping her arms out of her backpack straps. She crouched down beside the bed.

‘Hi, Kathy. My name’s Maggie and that’s Joe. We’ve come to take you into hospital to have your baby on your midwife’s advice. Are you happy with that decision?’

The exhausted-looking young woman nodded. ‘I’m just so tired,’ she whispered. ‘It’s been going on since the middle of last night.’

‘Your midwife checked you this morning, yes?’

‘Yeah...and I was two centimetres dilated at ten o’clock. She came back after lunch at one o’clock and I’d only got to four centimetres by then.’

‘So...’ Maggie checked her watch. ‘That’s about four hours ago now. How often are you having contractions?’

Kathy rolled her head from side to side. ‘I’m not sure. It feels like every couple of minutes and...and it hurts. I know I said I didn’t want any pain relief in my birth plan but I didn’t know it was going to hurt this much.’

‘We can give you something for the pain.’ Maggie glanced at where Joe was opening their packs and readying the equipment that they might need. A birthing pack that included neonatal resuscitation items like the miniature airways and bag mask. IV gear. Their small tanks of oxygen and Entonox. ‘We’ll start with some Entonox but we’ll put a line in your hand, if you’re happy with that, so we can give you something stronger if you need it.’

‘He’s a big baby.’ Darren sounded proud. ‘They said that at the last scan.’

‘Oh?’ An alarm bell sounded a warning for Maggie. ‘How big?’

‘Not too big,’ Kathy said. ‘My midwife said it was below the limit for it being a problem for a home birth and we both wanted that.’

‘Birth’s a natural process.’ Darren nodded. ‘Why go near a hospital if you don’t have to?’

‘You can’t just tie a rope around a hoof and pull it out,’ Kathy snapped at her husband. ‘I’m not one of your sheep. Ow...it’s starting again.’ She dropped her head back against the pillows and groaned. ‘It hurts...and...and I feel sick...’

Joe was right beside Maggie now. He raised an eyebrow. ‘Transition?’ he suggested quietly.

Kathy was shaking as the contraction subsided. ‘I need to go to the toilet,’ she moaned.

‘It’s okay, Kathy,’ Maggie said reassuringly. ‘I think that perhaps you’re a bit closer to having your baby than we thought. I’m going to get your clothes off and see what’s happening, okay? Joe’s going to take your blood pressure and things and...’ She caught Joe’s gaze. ‘Let’s get some oxygen on, shall we? And it would be great to get a foetal heart rate.’

‘What’s going on?’ Darren asked as they worked over Kathy. ‘I thought you were just going to take us in to the hospital.’

‘That was the initial plan,’ Maggie replied as she cut clothing clear. ‘But we can’t transport Kathy if a birth is imminent. We can manage things a lot better here than in the back of a helicopter.’

‘Crikey...’ Darren’s face became noticeably paler. ‘It’s happening now?’ He moved to the head of the bed to lean over his wife. ‘You okay, hon?’

‘No...’ Kathy grabbed at his hand. ‘Where’s that gas? I can’t do this... I need to push...’

‘Wow...you’re crowning, Kathy.’ Maggie could see the dark whorls of damp hair on the baby’s head. ‘Your baby’s almost here... Keep pushing—you’re doing great.’

Joe had the blood-pressure cuff wrapped around Kathy’s arm and the bulb in his hand but gave up trying to take a reading as he leaned to see what Maggie was watching.

They both saw the moment that it happened. The baby’s head was almost born and then it pulled back like a turtle retreating into its shell.

‘Turtle sign,’ Maggie said very quietly. She glanced up to catch Joe’s gaze. They both knew that this had the potential to become an obstetric emergency in a very short space of time.

‘Don’t push any more for the moment, Kathy,’ Maggie said calmly. ‘Try and pant for the rest of this contraction. Darren? Can you take Kathy’s pillows away? We need to get her lying as flat as possible.’

Maggie was going to hold the baby’s head and apply some gentle traction with the next contraction. Kathy was red-faced and gasping as she pushed. This time the baby’s head came a little further but then it stopped.

‘What’s going on?’ Darren looked fearful as he looked up from the baby to meet Maggie’s gaze. ‘Why isn’t it coming out?’

It was an effort to keep her voice this calm, especially as Kathy started sobbing. ‘Baby’s shoulders are just a bit caught behind the bones at the bottom of Kathy’s pelvis.’

Darren put his arms around his wife. ‘It’ll be okay, hon. These guys know what they’re doing.’

‘Why is this happening?’ Kathy cried. ‘After all this time and it’s been so hard...it’s not fair...’

‘It could be a positional thing,’ Maggie said. ‘Or maybe your baby’s a bit bigger than the scan suggested. Don’t worry, we have several ways we can help.’

And less than five minutes in which to do so.

Joe was right beside her and they were able to talk quietly for a few moments as Darren tried to comfort and reassure Kathy as she sobbed.

‘We can only spend about thirty seconds on each manoeuvre to deal with shoulder dystocia,’ Maggie said. ‘I know the protocol but I’d like to get some expert obstetric backup on the radio.’ She lowered her voice even further. ‘We need to be prepared for a neonatal resuscitation, too.’

Joe reached for the radio clipped to his belt but he was still listening to Maggie. ‘We’ll try the McRoberts manoeuvre first. If that doesn’t work, I’ll need you to provide traction while I put on some suprapubic pressure.’

Maggie turned to Darren. ‘Help me move Kathy down towards the end of the bed,’ she told him. ‘And, Kathy? I want you to pull your knees up to your chest and then push as hard as you can with your next contraction.’

Even as she was encouraging Kathy to push and telling her how well she was doing, Maggie’s brain was racing through the next steps, which would mean applying pressure to try and move the baby’s shoulders both externally and then internally. If that didn’t work she would have to follow guidance from one of the consultants in the maternity wing of Wellington’s Royal Hospital. She didn’t want to have to think about the more drastic measures that might need to be taken or the risks to both baby and mother.

Joe caught Maggie’s gaze as the sounds of the effort Kathy was putting into pushing began to fade into exhausted groans. Maggie nodded and they shifted positions, with Joe gently taking hold of the baby’s head and Maggie moving to the side of the bed where she could feel for the position of the baby’s shoulders.

‘You’re going to feel me pushing this time as well,’ she told Kathy. ‘We need the biggest push you’ve got this time.’

‘I can’t,’ Kathy moaned. ‘I can’t do it...’

‘Yes, you can.’ Darren was lying across the top of the bed, holding both of Kathy’s hands. ‘Hang on tight...you’ve got this...’

Maggie could feel the curve of the baby’s back beneath her fingers and then the lump of the tiny shoulder. She locked her hands by weaving her fingers together and then put the heel of one hand just above the shoulder. As Kathy’s next contraction gathered strength and she started to push, Maggie pressed down on the baby’s shoulder. Joe was applying traction. At one point during the tense thirty seconds of effort, Maggie and Joe held eye contact with each other. They co-ordinated a rocking motion as Kathy’s contraction began to recede and, finally, Maggie could feel the movement beneath her hands as one shoulder and then the other was freed.

‘Keep it going,’ she urged Kathy. ‘Just a little bit more... Baby’s coming... Push, Kathy...push...you can do it...’

And there was the baby, in Joe’s hands. Looking...alarmingly limp. Maggie reached for the clamps and sterile scissors from the birthing pack roll. They needed to cut the cord fast if resuscitation was needed.

‘Is he okay?’ Kathy was trying to push herself up onto her elbows. ‘What’s happening...?’

‘He’s breathing,’ Joe told her. ‘And starting to move. I’m just going to check his heart rate.’

The baby was moving and screwing up his little face as though he wanted to cry but couldn’t find the energy yet. They were both good signs but his colour wasn’t great, with his extremities a dark shade of blue, and Maggie wasn’t sure that his breathing was adequate. Joe wasn’t looking too worried, however. He was smiling down at the baby as he dried it off with a soft towel.

‘Hey there, little guy. You going to tell us what you think about all this?’

Maggie had the cord clamped and the scissors in her hand but, if an urgent resuscitation wasn’t needed, she didn’t have to rush.

‘Darren? Do you want to cut the cord?’

‘Apgar six at one minute,’ Joe told her. ‘Heart rate is over a hundred but the resp rate is on the slow side and he’s pretty blue.’

By the time Darren had cut through the cord, the baby was starting to make sounds. The first warbling cry came a few seconds later and Kathy burst into tears and held out her arms.

‘Can I hold him? Please?’

Again, Maggie and Joe shared a glance. And a smile this time. This situation was under control now with the emergency delivery successfully managed. Kathy still needed careful monitoring because she was at more risk of a postpartum haemorrhage after the complication with her baby’s delivery, and she needed to transfer to an obstetric unit as quickly as possible. But keeping the baby warm was also a priority and the best way to do that was to have him skin to skin with his mother and to cover them both with warm blankets.

It was Maggie who scooped up the infant to place him in Kathy’s arms and, as she felt the weight of the newborn in her own arms and against her own breast, she felt oddly close to tears. Because it was a reminder of that ache of emptiness she’d been so aware of earlier when she’d been thinking of the baby her friend Fizz was going to have?

No. These were more like tears of joy. How precious was this new life? Especially this one, after giving them all a fright on his way into the world, but all babies were just amazing and the joy of being part of a delivery was something that would never grow old.

This was more than a purely professional satisfaction, however. Maybe there was an echo of that ache of longing. Of the emptiness. Not in her arms that were still full of this new life but somewhere further down in Maggie’s body—in the space where a baby of her own might grow one day.

Her smile was definitely a bit wobbly as she helped Kathy move her clothing and gather her baby onto her chest.

‘He’s just gorgeous,’ Maggie murmured, stepping back to let Darren get close to his wife and baby for a few precious minutes of family bonding time as she and Joe got packed up and ready for the transfer to hospital.

Darren sounded a lot closer to tears than Maggie was. ‘Looks just like his daddy, I reckon,’ he said. ‘How ’bout that?’

Maggie checked her watch as she rapidly assessed the baby again before turning away to give this brand-new family just a moment of relative privacy. ‘Apgar score eight at five minutes,’ she told Joe.

He nodded, grinning, and then stripped off his gloves and unclipped his radio. ‘Andy? We’ll be ready to go inside ten minutes. Crank up the central heating in the cabin, we’ve got a baby to keep warm on the way home.’

Darren overheard him. ‘Will there be room for a dad in the helicopter as well?’

‘Sorry, mate.’ Joe shook his head. ‘It’s going to be a bit crowded. You’ll need to follow us by road.’

‘Don’t worry,’ Maggie added, to soften the blow. ‘We’re going to take very good care of both Kathy and the baby.’

* * *

A medical team, including Fizz Wilson, was waiting on one side of the Royal’s rooftop helipad to take over Kathy’s care as soon as they landed and lifted out the stretcher.

‘Third stage happened en route,’ Maggie told Fizz. ‘Oxytocin was administered on scene after the birth but I would estimate blood loss with the delivery of the placenta was still around three hundred mils with ongoing but slower loss now. She’s on her second litre of normal saline. Blood pressure’s one hundred and five over fifty.’

‘I feel fine,’ Kathy said. ‘Just a bit tired, that’s all.’

But Fizz took note of the low blood pressure and the urgent need to control any ongoing bleeding.

‘Let’s get moving,’ she instructed the ED staff with her. ‘Maggie, can you bring the baby, please? We’ve got a paediatric team waiting for him downstairs.’

Maggie followed Kathy’s stretcher with Joe walking beside her. ‘I could get used to this,’ she said.

‘What? Having full-on cases with successful outcomes? That’s two today.’ Joe was smiling. ‘I could get used to it, too.’

‘No... I mean this...’ Maggie looked down at the tiny sleeping face visible amongst the folds of blanket in her arms. ‘Carrying a baby around. I think I want one.’

Joe made a shuddering sound. ‘Rather you than me, mate. Hey...’ He increased his pace as the stretcher was slotted into the rooftop elevator. ‘Is there room for us in there, too?’

They squeezed in.

Fizz was right beside Maggie. She had her gaze fixed on monitor screen of the life pack, taking in as much information about Kathy’s condition as she could, but she slid a quick sideways glance at the baby a moment later.

‘Any problems?’

‘Not at all. He was a bit flat to start with but he picked up quickly. Apgar score was ten at ten minutes.’

Fizz was smiling as she turned back to her patient. ‘He’s so cute,’ she told Kathy. ‘Have you decided on a name yet?’

‘I like Aiden,’ Kathy said. ‘But Darren wants him to be Patrick, after his dad. We decided we’d wait and see what suited him more.’ She twisted her head, trying to see her baby’s face. ‘I think he looks like an Aiden, don’t you?’

Maggie smiled. ‘Aiden’s a great name.’ But so was Patrick, she thought. One of her favourite boy’s names, in fact. She wondered if Fizz and Cooper had already started discussing possible names for their baby or if they knew whether it was a girl or a boy.

The elevator doors opened again as they reached the ground floor and Fizz stayed by the head of the stretcher as it was swiftly rolled towards a resuscitation area in the emergency department. Kathy would have no idea that her doctor was pregnant, Maggie thought. And here she was, with baby Aiden or Patrick still in her arms. It was baby overload today, that was for sure.

Her head was still full of it when she and Joe finally got to take a break and sat down in the staffroom of the Aratika Rescue Base.

‘I haven’t finished the paperwork for the post-cardiac arrest case yet, let alone for the birth,’ Maggie sighed.

‘It won’t take too long,’ Joe said. ‘I’ll do the cardiac one.’

‘Because it’s half-done already?’

‘No. Because you’re the one who wants a baby. This way, you get to enjoy the case all over again.’

‘Hmm...’ Maggie shook her head. ‘It could have turned out to be not very enjoyable at all. I was so relieved the moment I felt that shoulder start to move.’

‘I’ll bet.’ Joe pulled the folder of paperwork towards him and took a pen from the pocket of his overalls. ‘Keep it in mind when you choose the father of your baby. You’re so short, it might be wise not to marry a solid, over six foot tall farmer like Kathy did.’

‘Five foot four is not short. I’m average,’ Maggie countered. ‘And I don’t even know any farmers. Or any potential baby daddies at all, in fact.’

‘They’re out there. In droves. You just haven’t been looking.’

‘That’s because I got fed up with relationships that were going nowhere fast.’

Including the one she’d been in with Richard, years ago, when Maggie had first started working at the rescue base. One that had had a promising start but had ebbed into being nothing more than flatmates. Friends. And it hadn’t been enough for either of them.

‘Maybe that’s because you go into them expecting them to be going somewhere. That can scare guys off, you know. It would scare the hell out of me, that’s for sure. In fact, it’s precisely why I’m currently single again.’

Maggie snorted. ‘It’s a baby I want. A partner would be a bonus, of course, but I’m running out of time to jump through all those hoops.’ She was only half joking. It really did feel like she was running out of time, given how many dead ends she had already come up against in the search to find someone to share her life with. ‘And who says you have to marry someone to have a baby, anyway? You might marry someone and end up being a single mother anyway—like Laura.’ Her flatmate had escaped what she suspected might have been an abusive relationship years ago when her son, Harrison, was only a tiny baby.