The Doctor's Runaway Bride

Tia stayed with Fiona until she was happy that the baby was feeding nicely and then moved on to help another new mother.

Before she’d even pulled the curtains around the bed, Sharon called her.

‘Sorry, Tia, would you mind going up to labour ward to give them a hand? They’ve had six admissions in the last two hours.’ Sharon rolled her eyes and walked up the corridor with Tia. ‘Chaos. And, of course, they’ll all end up down here.’

So Tia hurried to the labour ward and introduced herself to Nina, the midwife in charge.

‘Would you mind looking after Mrs Henson for the time being?’ Nina checked her notebook. ‘She’s only four centimetres and not coping well at all. We’ve bleeped the anaesthetist and he’s coming to do an epidural. And do you mind having one of the student midwives in with you? She needs to get a few more deliveries.’

Tia nodded. Student midwives had to deliver a certain number of babies under supervision before they were allowed to qualify.

Dawn Henson was a twenty-two-year-old woman, having her first baby, and one look at her face was enough for Tia to realise that she was terrified.

‘The pain is so much worse than I imagined,’ she gasped, her knuckles white as she grasped her husband’s hand. ‘I really, really wanted to have a natural birth but I don’t think I can stand it. I feel such a failure.’

‘You’re not a failure, Dawn,’ Tia said firmly. ‘Labour isn’t a competition. The pain is different for each individual and everyone copes in different ways. I think you’ve made a wise decision to have an epidural.’

Dawn bit her lip. ‘But I didn’t really want to have one. I’m terrified of having a needle in my spine. What if it goes wrong?’

‘It won’t go wrong.’ Tia looked up as Duncan Fraser, one of the anaesthetic consultants, walked into the room. ‘Here’s the person to talk to. Dr Fraser will explain everything to you.’

Signalling with her eyes that Dawn was more than a little anxious, Tia busied herself getting things ready for the anaesthetist.

Duncan talked quietly to the couple for a few minutes, explaining the procedure and the risks involved, pausing while Dawn had another contraction.

‘OK, I need to start by putting a drip in your arm.’

Tia handed him a wide-bore cannula and Kim, the student midwife, checked Dawn’s blood pressure.

‘All right, Dawn, I want you to sit on the edge of the trolley for me—that’s it.’ Tia helped her to adjust her position until she was as comfortable as possible and waited while Duncan scrubbed up.

He put on a sterile gown and gloves and positioned himself behind Dawn. ‘All right, I want you to tell me if you feel a contraction coming so that I can stop,’ he said quietly as he gave the local anaesthetic into the skin.

Duncan nicked the skin with the scalpel and introduced the Tuohy needle, advancing it cautiously towards the epidural space. He checked that the needle was in the right place and Tia watched Dawn carefully, knowing that even the slightest movement at this stage could result in a dural puncture with unpleasant consequences for the patient.

Fortunately Dawn remained still and Duncan quickly threaded the epidural catheter through the needle and withdrew the needle.

‘All right Dawn.’ Duncan glanced up briefly and then returned to his task. ‘I’m going to inject a small dose of anaesthetic now.’

He gave a test dose and then taped the epidural catheter in place and attached an antibacterial filter to the end. Tia timed five minutes and then checked the blood pressure.

Satisfied with the reading, Duncan gave the remainder of the anaesthetic dose.

‘All right, Dawn, Tia is going to need to check your blood pressure every five minutes for the first twenty minutes just to check that it doesn’t drop.’

Dawn gave him a grateful smile. ‘I can feel it working already—the pain is nowhere near as bad.’

‘Good.’ Duncan gave her a warm smile, talked to Tia about giving top-ups and then left the room.

Now that the pain had gone, Dawn’s face regained some of its colour and she was a great deal happier.

‘Will I still be able to push the baby out?’

‘We’ll certainly aim for that,’ Tia told her, checking her blood pressure again and recording it on the chart. ‘As you progress towards the end of the first stage of your labour, we’ll let the epidural wear off so that you can feel to push.’

It was towards the end of her shift when Dawn started pushing and the baby was delivered normally, with the minimum of fuss. Tia quietly praised Kim who had performed a textbook delivery.

‘I can’t believe it’s all over.’ Dawn collapsed, exhausted, her face pale. ‘I can’t believe we’ve got a little girl. We’ve only thought of boys’ names, haven’t we, Ken?’

Her husband gave a shaky laugh. ‘We’d better start thinking fast.’

Tia gave an absent smile, her eyes on the student midwife. The placenta wasn’t coming away as quickly as it should and Kim was obviously concerned. Tia knew that with the use of oxytocic drugs and controlled cord traction, the third stage of labour—the delivery of the placenta—was usually completed in ten minutes in the majority of labours.

In Dawn’s case they were well past ten minutes and Tia was well aware that there was a danger of bleeding if the placenta was retained.