Baby for the Midwife. Fiona McArthur
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for understanding.’
‘You’re welcome. Now let’s talk of something else. You didn’t miss any obstetrics at the hospital today so I hope you have someone to play midwife with tomorrow when you go in for your next shift.’
She followed his lead gratefully. ‘You did say your statistics pointed to one birth every two days.’
‘I’m infallible. I know you enjoyed your first day.’
Georgia thought back to her first shift and smiled. ‘They even paid me to have fun and brush up on my emergency obsterics. And it worked well because I was home by three in the afternoon and still had a few hours to feed and bath Elsa before you came home. Mrs White is looking forward to tomorrow with her.’
‘So you are happy to be back at work?’
‘As long as Elsa is fine, I love it. I should at least be able to do next week and if possible a short stint full time to allow Karissa her holidays, which would give me a good basis to refresh my skills for the future.’
He raised on eyebrow in disbelief. ‘I don’t think your skills need much refreshing, Georgia. I’m extremely comfortable that you would cope with anything.’
Max’s approval meant a lot. She had been surprised how at ease she’d felt at Meeandah, but Max’s presence had been that extra insurance she’d needed to make it easier. ‘Thank you, Max.’
She avoided looking at the swing again and decided she did feel a little easier already.
‘So tell me about your day at home,’ Max said. ‘What exciting things did I miss?’
He even looked interested. ‘Big news. Elsa opens and shuts her hands now.’ Georgia smiled reminiscently. ‘You wouldn’t think something so small would captivate both of us but she lay there for ages, watching her fingers open and shut, and I had to watch, too.’
Max smiled. ‘I’ll have to ask her to show me in the morning. When you go to work she shares her breakfast with me and I read the paper to her.’
‘She’d like that.’ Not many men would do that for a child that wasn’t even his own. Georgia fell more in love with him than ever and went back to eating her sawdust to avoid his eyes.
At Meeandah hospital Georgia had agreed to three staggered morning shifts in the first week.
The idea had been to see how Elsa and Mrs White got along and how Georgia coped with being away from her daughter for the first time since Elsa’s birth.
Her second shift was uneventful.
Max came in and discharged Mel to go home. He’d issued a prescription for double-strength iron tablets to increase Mel’s red blood cell count because she hadn’t wanted the blood transfusion Max had offered after her haemorrhage.
‘Don’t expect to do much except breastfeed Billy for the first two weeks to keep building up your milk supply,’ Georgia said.
Max stood beside her to wave them off with a few cautionary words for Mel. ‘Your low blood count will slow your lactation so Billy will be extrademanding and you will be tired.’
Mel shrugged. ‘I’m too excited to be going home to worry about that. Tim’s going to do everything except feed. He’s got three weeks off work.’
‘Good man,’ Georgia said, and she slanted a sideways glance at Max. ‘Max is excellent with Elsa, too.’ The two women smiled at each other as Tim looked proudly down at his son tucked under his arm.
Max shook his hand. ‘Good luck, mate. At least the men outnumber the women in your house.’
Tim grinned and carried Billy carefully to the car and strapped him into his new baby seat next to his brother, Andy.
Both Caesarean patients, Leanne and Tanya, had decided to go home too, and after Max left the ward Georgia worked in the medical end of the hospital.
She enjoyed the challenge to brush up on the medications and treatments she didn’t deal with in obstetrics. It also gave her a chance to get to know the other nurses she might have to call on in the future.
She gathered that Flo and her colleague didn’t feel as comfortable as they’d like at the obstetric end and Georgia could see why if they only went there for the last minutes of labour or in emergencies.
‘When it’s quiet, would you be interested in practising some obstetric emergency procedures, just so you would have more of an idea what we might want you to do?’
‘That sounds great.’ Flo was in her sixties, round and energetic with a host of grandchildren she loved to talk about. Georgia loved the way she and Gerry, the other nurse, were keen to update their skills and be as helpful as they could.
Gerry was tall and thin with a mournful face, but her wicked sense of humour appeared at the strangest times. Both women’s interest in learning about obstetric emergencies encouraged Georgia to go on. ‘If you find it helpful, we could do a different emergency each shift that I’m on.’
Later that day, when all the patients were resting, Georgia went through the postpartum haemorrhage tray with Flo and Gerry.
‘I thought we’d start with the emergency we’ve already had.’ She couldn’t help thinking of the way Max had so competently directed the emergency. No doubt it was still very fresh in the minds of Gerry and Flo as well. So she was pretty sure she’d have their attention.
‘With a postpartum haemorrhage the excessive blood loss can happen for different reasons. You can have a sudden heavy bleed, like we had with Mel the other day, where the woman bleeds quickly and things need to happen fast before she goes into shock from blood loss.’
Flo nodded. ‘Shock is when the body makes changes to ensure enough blood goes to the brain isn’t it?’
‘Yep. Like Mel’s pulse rate going up because her heart has to circulate fewer blood cells faster to get enough oxygen to her brain. That’s why the patient feels faint. If a person faints, they automati-cally lower their head and make gravity at least push blood to their brain. That’s why I raised the foot of the bed for Mel’s feet to be higher than her head.’
Georgia saw that they had the concept and moved on. ‘Or you can have a woman go back to her room and bleed quietly in a steady trickle until she is in just as much trouble. They’re usually the ones who buzz because they feel faint when they get up to go to the toilet.’
‘We had a lady do that…’ Gerry nodded soulfully ‘…at my training hospital back in the bad old days. When we went to make her bed she’d trickled steadily under the covers over a couple of hours and we nearly had a fit when we went to help her get up. She nearly died.’
Flo’s mouth formed an ‘O’ of surprise. ‘So that’s why we check postnatal women for the first four hours, just like a post-operative patient gets checked in Recovery.’
Georgia nodded. ‘But remember it’s not normal for a healthy woman to do that. The body has mechanisms to prevent it, but some women don’t know they are in trouble. Basic observation is very important. Rapid emergency treatment can save lives, and that’s where having everything ready to go is so important.’
Georgia removed the haemorrhage tray from the cupboard. ‘Let’s have a look at the tray we have here. You obviously need your IV fluids, a tourniquet, your cannulas to insert into the vein for access, and connection tubing for administering the fluids. You both remember Doctor connecting these to Mel. Then there are the drugs that can help with contracting the uterus.’
Georgia held up a sheet of paper in a plastic sleeve. ‘This is the order and dose of the drugs you would need, and that can be very helpful if no one has time to repeat what they asked for.’
Gerry snorted. ‘Typical. I wish I’d known that was there, even though I did manage to get them all in order.’
Gerry acknowledged she’d worried the previous day and Georgia was