Always the Midwife

CHAPTER NINE

CHAPTER TEN

CHAPTER ELEVEN

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CHAPTER ONE (#u6a0e9295-93dd-5f28-965a-c3f9257c3990)

THE BLIP OF the foetal heart monitor had definitely slowed down. Her decision might be a no-brainer but Sophia knew it wasn’t going to be popular.

‘I’m sorry,’ she told her patient, ‘but I’m not happy with the way things are going. We need to get you to hospital.’

‘No-o-o …’ First-time mother Claire Robinson had her heart set on a home birth. ‘You said I’m almost fully dilated. It can’t be much longer.’

‘You’re exhausted, sweetheart. Every contraction is harder for you and things are slowing down.’ She still had the hand-held Doppler against the distended abdomen of the pregnant woman. ‘Can you hear that the baby’s heartbeat has slowed down, too? It’s a sign that baby is getting distressed.’

‘What does that mean?’ Claire’s husband, Greg, was looking pale and anxious. ‘Is the baby in danger? Is Claire in danger?’

‘No.’ Sophia hastened to reassure them both. ‘But that’s what I want to make sure isn’t going to happen. The labour hasn’t progressed quite the way we wanted and …’ How could she tell these parents-to-be, without scaring them, that it was her instinct that something wasn’t right that was making the transfer seem urgent? ‘Let me make a call and see how far away an ambulance might be.’

The call was answered instantly.

‘My name is Sophia Toulson,’ Sophia said. ‘I’m a midwife with the Melbourne Maternity Unit at the Victoria. I’m at a planned home birth …’ She moved away from the young couple, lowering her voice as she gave the address details and then voiced her concerns.

‘An ambulance is probably fifteen minutes away,’ the dispatcher told her. ‘But we do have a SPRINT guy in your locality.’

‘SPRINT?’

‘Single Paramedic Response and Intervention. An intensive care paramedic on a motorbike.’

‘I think we just need the transport,’ Sophia said. ‘It’s not an emergency …’ But she could hear the note of doubt in her own voice. An exhausted first-time mother and a stalled labour. The potential for an emergency was there. Was that why alarm bells had started ringing?

‘I’ll change the plan,’ Claire offered desperately, as Sophia ended the call. ‘I’ll have more pain relief than the gas. You can rupture the membranes. Whatever it takes …’ She was sobbing now. ‘We don’t want to have our baby in a hospital …’

‘I know.’ Sophia smoothed damp strands of hair back from Claire’s face. ‘But you know what the really important thing here is?’

She didn’t wait for a response. Greg was perched on the end of the bed, holding Claire in his arms as she lay back against him. She caught his gaze and then Claire’s.

‘My job is to keep both you and baby safe. At the end of the day, the only thing that matters is that you get to hold your healthy baby in your arms. I promise that where the delivery happens is not going to take away even the tiniest bit of joy that moment’s going to give you.’

A joy that Sophia might never be able to experience herself but that didn’t mean she couldn’t share it happening for others. It was precisely why she’d chosen this profession. Why she loved it so much. And why she was so passionate about doing whatever it took to ensure a happy outcome.

‘That’s all I want,’ Greg said, his voice cracking. ‘For you both to be okay. We always said that we’d go to the hospital the minute we were worried about anything.’

‘But I’m not worried. I’m just so tired … Oohhh …’ Claire’s face scrunched into lines of pain.

‘Another contraction?’ Sophia reached for the Entonox mouthpiece. ‘Here you go. Deep breaths …’

The loud rap on the door made her jump. Surely the ambulance hadn’t arrived this quickly?

‘Shall I go?’ Greg asked.

Claire spat out the mouthpiece. ‘No—don’t leave me … It’s…. Ahhh …’

Sophia wasn’t going anywhere either. The contraction had produced a rush of fluid. Claire’s membranes had finally broken. It was a sign that her labour was progressing again but Sophia wasn’t feeling relieved. Quite the opposite.

The fluid soaking into the pad beneath Claire’s hips had the stain of meconium that meant the baby could be in trouble. And …

Oh, dear Lord … yes … that was a loop of umbilical cord showing.

‘G’day …’ The rich, deep voice came from behind her. ‘I let myself in. Hope that’s okay.’

Sophia looked up. The man was wearing a high-vis heavy-duty jacket. He had a motorbike helmet on his head with the red, white and blue colours of Melbourne’s ambulance service and the title ‘Paramedic’ emblazoned across the front. The chin-guard and visor were flipped up so that she could see his face but she barely registered what he looked like. There was relief to be felt now—that she had professional help in what had just become an obstetric emergency.

‘Claire’s waters just broke,’ she said quietly. ‘We’ve got a cord prolapse.’

‘What’s that?’ Greg was leaning in, trying to see what was happening. ‘What’s going on? And who are you?’

The paramedic’s helmet was off by the time he’d taken two steps closer. ‘I’m Aiden Harrison,’ he told Greg. ‘Here to help.’ He was right beside Sophia now. ‘Modified Sims position?’

‘Knees to chest, I think. Claire? We’re going to get you to turn over, I want you on your knees with your bottom up in the air. Greg, can you help?’

‘What? Why?’ Claire was panting, recovering from the contraction. ‘I don’t want to move.’

‘We’ve got a small problem, guys.’ The paramedic had dropped his helmet and leather gloves, along with a rolled-up kit he’d been carrying. He didn’t sound stressed. Rather, he made it sound as if whatever the problem was, it was going to be easily remedied. ‘Your baby didn’t read the rule book and part of the umbilical cord has come out first. We need to take any pressure off it, which is why we’re going to let gravity give us a hand. Here … let me help.’

Somehow he managed to make it seem like nothing out of the ordinary to be getting a woman in labour to get into what seemed a very unnatural position, on her knees with her head lowered. Sophia was ready with the Doppler to check the baby’s heart rate again.

Aiden listened, his gaze on his watch. ‘Ninety-eight,’ he said. ‘What was the last recorded rate?’

‘One-forty.’ Sophia ripped open a packet of sterile gloves. In a blink of time, this had become a potential disaster. The baby’s oxygen supply was being cut off. ‘I’m going to try and ease the pressure.’

‘Oh, my God.’ Claire wailed. ‘What’s happening?’

‘You’re going to feel me inside,’ Sophia warned her. ‘I’m going to be pushing on baby’s head to take the pressure off the cord.’

Greg’s face was as white as a sheet. ‘How are you going to take her to hospital if she has to stay in that position?’ He glanced sideways to where the paramedic had discarded his bike helmet. ‘You’re not even driving an ambulance, are you?’

‘No, mate. I ride a bike. Gets me where I’m needed faster.’ Aiden reached for the radio clipped to his shoulder. ‘SPRINT One to Base. How far away is our back-up?’

They could all hear the woman’s voice on the other end. ‘Should be with you in less than ten minutes.’

‘Copy that. Make it a code one.’ He nodded at Greg. ‘Hang in there, mate. We’re under control.’

‘I’m getting another contraction,’ Claire groaned. ‘Ohhh … I want to push …’