The Honourable Midwife. Lilian Darcy
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First things first, however. Pete was concerned about the extent of the bleeding, and about the ongoing health of an undernourished baby at thirty-three and a half weeks gestation.
If labour could be stopped or slowed, should he send Patsy to Sydney or Canberra? At thirty-three and a half weeks, the baby’s required level of care fell just days short of the scope of Glenfallon Hospital’s small level two special care facilities. On paper, a few days wasn’t much, but how significant was the compromised environment of the uterus?
The clock on the dashboard of his car read six forty-one when he pulled into a reserved space outside the two-storey building which housed Glenfallon Hospital’s maternity unit, including its special care facilities and an obstetric operating theatre opened just this year.
The hospital buildings in current use were all relatively new. They were pleasant but rather bland concrete and glass constructions dating from various times over the past twenty-five years when the town had been endowed with capital funds for expansion.
The original building, of gracious old stone with wide verandas, a slate roof and thick walls, was now used for outpatient clinics and support services. The change had been necessary. Apart from its inadequate size, you just couldn’t make the old building’s layout and facilities accommodate modern medical equipment and practice. Still, stubbornly, Pete liked the old building best. It was the same way he felt about Emma Burns’s cottage versus his own newly purchased dwelling.
The new place had a locked double garage with remote-controlled doors. It had two bathrooms, and a family room adjoining the state-of-the-art kitchen. It had a back yard that was currently a depressing expanse of arid soil and builders’ rubble but would eventually be a great place for the girls to play whenever they were in residence. He had a landscaping firm scheduled to start work on paths and retaining walls soon.
As with the new hospital buildings, however, he wasn’t convinced the house would ever have the right character.
Arriving in the unit, he discovered that, despite their head start, Patsy and Brian McNichol had got there just a few minutes earlier. The departing staff, Kit McConnell and Julie Wong, were both helping the new and nervous patient into a gown and checking her history. She was the delivery ward’s only patient at the moment, but the phone was ringing, heralding the possible arrival of someone else.
‘How are you feeling, Patsy?’ Pete asked at once.
‘The contractions are getting stronger. There’s one coming now…’
From Patsy’s reaction, the pain was quite intense. She couldn’t move or speak during its peak, and had to press a thick pad between her legs to deal with the blood. Pete wasn’t happy about how much was still flowing. He abandoned any thought of getting her moved to Canberra or Sydney.
This didn’t mean he was relaxed about the idea of delivering her here. They could be in for some problems after the birth, and dealing with a post-partum haemorrhage could be a nightmare. Thank goodness there were a couple of good doctors he could call on.
‘Let’s get you on your left side with your feet up on a pillow,’ he told his patient, masking the extent of his concern.
She looked pale and drawn. Tired, as if she hadn’t been sleeping well in weeks, which was probably the case. Bed rest wasn’t fun. No physical activity to promote a healthy fatigue at the end of the day, too much time to think and worry. And she was huge, the size due to her fibroids, not the baby.
Pete palpated the uterus, gave her an internal examination and found that the cervix was ripe, already fully effaced and dilated to six centimetres. The baby’s position wasn’t good. Feet and bottom down low, and head lying next to her mother’s heart. The heartbeat was fine, no sign of distress, and that was a plus. But he really didn’t like the bleeding, or his rough impression of the baby’s size. He’d been monitoring this for several weeks, and there’d been steady growth, but the baby was still smaller than it should be for this stage of pregnancy.
‘I’ll be back in a minute,’ he promised Patsy, when he’d finished.
Heading for the phone at the nurses’ station, he almost cannoned into Emma Burns, who had just arrived, and whom he hadn’t seen in the three months he’d been renting her house. She was like a breath of cool, fresh air, scented with spring. She was like her home—bright and pretty and calming.
They smiled at each other.
‘Hi,’ he said. ‘Welcome back.’
‘Thanks.’
A beat of uncomfortable silence hung in the air, and neither of them knew what to say. Pete felt there ought to be something better than what he’d come out with thus far. Something witty or meaningful. Something a little private and personal that encompassed all the complex flavours of the e-mails they’d exchanged.
As if he had time to think about it now!
She’d done something to herself while she’d been away, he noted vaguely. Something good. Hair was different. Eyes. Lips. How she’d done it, he didn’t know. He didn’t even know quite what she’d done, he only knew that it was good.
Straight, dark, glossy tresses, arched brows, glowing brown eyes, soft, happy mouth. And yet he didn’t even have time to say, Wow! You look great, Emma! Although he definitely wanted to.
‘Can you make sure the ob. theatre is fired up and ready to go?’ he said. ‘No one else in there, is there?’
‘No, we’re quiet.’
‘I’m phoning Gian Di Luzio and Nell Cassidy. I’ve a got a patient in there…’ he gestured at Room One with a backward jab of his thumb over his shoulder ‘…who’s making me nervous.’
‘Fill me in,’ she said. She had a lovely voice, clear and steady. ‘I’m not officially on yet, but I’m obviously going to be in on the surgery, right? I think we’ve got another labouring mum coming in, but Bronwyn’s going to handle her.’
‘Yes, I want you in Theatre,’ he answered. ‘And I expect you’ll be moving over to Special Care to look after this baby, if we keep her.’
Emma had spent two years in Sydney, a few years ago, acquiring specialised neonatal nursing qualifications, and staffing was usually juggled to enable her to care for any babies who needed extra attention and skills after birth. There were a couple of other well-qualified nurses to share the load as well.
‘Might we not keep her?’ she asked.
‘I hope we can.’ He hadn’t quite answered her question with the words, but went on to do so in his description of the patient’s history.
Emma’s appearance might have changed in three months—what was it? Her eyes glowed! But he doubted whether her capabilities had. She’d always been good. A team player and able to handle all the different types of people she had to deal with, from nervous new fathers to overworked GPs. She was level-headed, thorough and adept at anticipating problems. He sketched out what she needed to know, using a barrage of medical shorthand which had her nodding and frowning at once.
‘Yes, I see what you mean,’ she said. ‘I can see why you’d want Dr Di Luzio and Dr Cassidy.’
Gian Di Luzio was Glenfallon’s one obstetrician and gynaecologist, and a woman would have to go quite a distance to find another one. Like most parts of rural Australia, Glenfallon was chronically in need of specialists. As a result, there were several GPs in the area who’d obtained extra credentials in various fields to meet demand.
Pete was one of them. He’d returned to Glenfallon at the beginning of the year after two years spent in Sydney, and he was now better qualified than anyone but Gian in delivering babies and dealing with associated areas, but he was by no means too proud to reach out and grab a fully fledged specialist’s extra experience when he needed it. With the twin risks of post-partum haemorrhage and a delicate baby, this was one of those times.
Nell Cassidy was no slouch when it came