Midwives On Call: From Babies To Bride. Kate Hardy
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birth of their patient Kim’s second baby, but things hadn’t gone according to plan and, after transferring Kim to the MMU hours ago, a Caesarean section had been deemed the best option for an exhausted mother and a now distressed baby.
Kim and her husband, Peter, were in the theatre’s anteroom under the care of an anaesthetist as she received an epidural.
‘Put some theatre booties on over your shoes.’ Sophia pulled the disposable covers from the dispenser on the wall of the changing room. ‘And here’s a mask.’
‘Do we have to scrub in as well?’
‘No. We don’t go anywhere near the operating site. Our role is to support Kim in getting the best birth experience she can under the circumstances.’
‘Like making sure she gets the skin-to-skin contact?’
‘Exactly. But only if the baby’s well enough, of course. We have to be prepared, though. What’s the most important thing to make sure we’ve sorted?’
‘That her gown can be moved without disturbing the theatre drapes?’
‘Good.’ Sophia smiled at her student. ‘Now, let’s get moving. We’ve got a few things to organise. I’m going to liaise with the ward and check that a midwife is available to take transfer of care in the recovery room and I want you to ring the lab and order a bucket of iced water.’
‘For the cord blood gas samples?’
‘You’re onto it. We’ve also got to check that both the transport cot and the resuscitation cot are turned on and I want to make sure you know where all the equipment is. Follow me.’
There was a hum of activity in Theatre as the staff prepared for the surgery.
‘We’ll move the resuscitation cot over to here,’ Sophia decided.
‘Why?’
‘Hopefully, it’s not going to be needed, but if it is, we want a line of direct vision for both the parents so they can maintain visual contact with their baby at all times.’
Kim was wheeled in moments later. Lights were shifted and positioned and monitoring equipment attached. An ECG trace blipped into action on an overhead screen and numbers flashed and changed as they displayed heart rate, blood pressure and blood oxygen levels. Sophia showed Peter where he was allowed to stand, checked the function of the foetal monitor and then smiled at Kim.
‘All good?’
‘I’m scared.’
‘I know.’ Sophia squeezed her patient’s hand, careful not to dislodge the IV line. ‘You’ve got a fantastic team who are here to look after you and you’ll be amazed how fast it goes.’
‘I’m not sure any more … about … you know …’
‘Watching baby come out?’ Sophia glanced at the drape screen the theatre nurses were putting up at chest level. The plan had been to lower the screen after the incision to the uterus had been made but another glance showed how pale Peter was looking. A definite contender for fainting.
‘You don’t have to see that bit,’ she told Kim. ‘We can still put baby straight onto your chest.’ Her gaze caught Flick’s. ‘Let’s put a chair in for Peter. That way he can hold Kim’s hand and he doesn’t have to see anything he doesn’t want to either.’
The surgeon and her registrar came into Theatre and, for a while at least, Sophia could totally forget about her personal life as she got caught up in one of the more dramatic ways to bring a new life into the world.
She made sure Flick could stand close enough to see what was happening as the surgeon and her registrar stood on either side of Kim’s swollen abdomen. The only sounds were the beeping of the monitors and the calm requests for instruments as the initial incision was made and then the tissues quickly dissected with gloved fingers in use more often than a scalpel or scissors.
Sophia was sure that Flick was holding her breath—as she always did—when the careful incision into the uterus was made and they could see the dark whorls of wet hair on the baby’s head. Forceps were fitted to lift the head far enough for the surgeon to be able to hold it with her hands and then the baby was eased out, pausing long enough for the registrar to suction the infant’s airways.
The baby’s eyes were open and an arm waving slowly. Sophia breathed a sigh of relief. It started crying as its legs were lifted clear of the uterus and she heard a gasp that was more like a strangled sob of relief from both Peter and Kim. Flick was focused on the registrar clamping and cutting the cord but then her gaze caught Sophia’s and she gave a quick nod. She took the baby from the registrar as Flick helped a nurse to move the screen and she could place the newborn on her mother’s chest.
The longest part of the surgery came now, with the precise task of repairing all the layers of tissue, but, with the screen back in place, Kim was unaware of what was happening and time ceased to matter as she and Peter touched and marvelled at their new baby.
‘Did you note the time and sex of the baby?’
Flick nodded. ‘I’ve got the labels ready for the cord blood gas samples.’
‘Good. Now, double-check this with me. We have to make sure that the details on the maternal and neonatal wrist labels match.’
Thirty minutes later, Kim was ready to be transferred to a ward bed and taken into Recovery. The paediatrician had checked their daughter and she was wrapped and warm. Sophia put the small bundle into Peter’s arms to be carried into Recovery. The transfer of care to the ward midwife would happen there but Sophia wasn’t ready to leave yet. This was her favourite time after the tension of a Caesarean, to help with the first breastfeed and watch the bonding happening between the baby and her parents. Kim’s mother was waiting nearby, too, with their three-year-old son, who would be able to come and meet his new sister before they got transferred to the ward.
‘That was amazing,’ Flick said quietly, when they were finally heading home. ‘But I am so tired.’ She stepped into the lift and leaned against the wall.
‘Me too. This is when you really feel it, when the excitement’s all over.’ Sophia pushed the button to take them to the ground floor. It wasn’t just physical weariness either. With the prospect of heading home alone as soon as she stepped out of the Victoria’s front doors, she knew that she would end up feeling flatter than ever. ‘The café will still be open. Let’s go and get a coffee.’
Flick groaned. ‘Oh, no … not coffee. Even the thought of it makes me feel ill.’
‘Really?’ Sophia’s head swivelled to take a closer look at her student. ‘That’s not like you.’ She noted the pale skin and dark circles under Flick’s eyes. Something clicked into place. ‘Wait … you’re not pregnant, are you?’
‘I think it’s just something I ate.’
The lift stopped with a jerk as she spoke and then the doors slid open but was that enough to explain the way Flick was avoiding her gaze?
‘I’ve got to go. See you tomorrow, Soph.’
‘Hang on …’ She’d put her foot in it, even making the suggestion, hadn’t she? It certainly hadn’t been her intention to upset her student. ‘Hey … I’m sorry, Flick. I didn’t—’
Flick raised her hand, without turning. ‘It’s okay. I’m fine. Really.’
‘Sophia?’
The voice from behind made her spin round without thinking. It was so unexpected. So … welcome?
‘Aiden … What are you doing here?’
No. It wasn’t welcome. She didn’t want to talk to him right now. She needed to talk to Flick. Or maybe Flick needed to talk to her. Turning her head again, just as quickly, she could see Flick disappearing towards the front doors. She could hardly run away from Aiden.
She