The Midwife's Child

‘Is that why you encouraged her to go for the epidural?’

‘She wanted one,’ Brooke said simply, picking up the phone and dialling Switchboard. ‘She just needed reassurance that we wouldn’t disapprove of her choice.’

‘But generally you do try to encourage them to avoid medical intervention?’

‘What we really encourage is freedom of choice for the mother,’ Brooke told her, tucking the receiver under her ear. ‘We want them to have as much choice as possible in their labour and delivery. Alison is clearly not happy about using the pool and she’s in a lot of pain. An epidural is probably right for her. Switch? Can you bleep Dr Penny for me, please?’

‘I’ll need to do regular obs, won’t I?’ Paula scribbled in her notebook and Brooke nodded as she replaced the receiver.

‘Yes. An epidural can lower the blood pressure dramatically. I’ll leave you for now but give me a yell when Dr Penny arrives and I’ll give you a hand.’

The afternoon flew by and Brooke was rushed off her feet, helping students, admitting pregnant women in labour and arranging transfers to the ward.

‘You OK, Brooke?’ Gill caught up with her halfway through the afternoon.

Brooke rubbed her aching neck. ‘Yes, I suppose. I miss spending an entire shift with one woman.’ She exchanged a rueful glance with the senior sister.

‘Yes, well, that’s today’s NHS for you.’ Gill sighed and checked her watch. ‘I hate to ask you this, Brooke, and I suppose your circumstances will make it impossible, but—’

‘Will I work a double shift?’ Brooke chanted, rolling her eyes. ‘Yes, of course I will.’

Gill’s eyes narrowed. ‘You’re sure? I thought you might have to rush back.’

‘No. Not tonight.’

‘Well, that’s great. Thanks a lot. How’s Mrs Neal coming along?’

Brooke pulled a face. ‘Slowly. I’ve just bleeped the anaesthetist.’

‘Right. Let me know when she’s delivering.’

Alison Neal continued to make slow progress and by six o’clock she was fully dilated and had been pushing for an hour. As it was her first baby, in theory she could have been left to push for longer but Brooke was worried about the baby.

‘His heart rate is dipping slightly with each contraction, Alison, so I’m going to give the doctor a ring.’

Bother. She was going to have to ring Jed because his SHO didn’t have enough experience, the registrar was off sick and the senior reg wasn’t due to start for another six weeks.

He strode into the room five minutes later and Brooke immediately handed him the trace, dispensing with preliminaries.

‘We’re getting late decelerations.’ She knew that if the baby’s heart rate dropped after the peak of a contraction it could be a sign that the baby was short of oxygen. ‘I’ve tried changing her position but it’s made no difference.’

‘Right.’ Jed frowned down at the trace, and slipped the paper through his fingers, examining it in detail. ‘How many centimetres dilated is she now?’

‘She’s fully dilated and she’s been pushing for an hour, but the head’s still quite high.’

‘OK.’ Jed handed the trace back to her and smiled at the Neals. ‘I’m Jed Matthews, the consultant. How are you doing?’

‘I’ve been better.’ Alison was looking exhausted, her blonde hair hanging limply round her shoulders. ‘What happens now?’

‘I’d like to examine you,’ Jed said gently, ‘and then we’ll decide together what’s best.’

Alison nodded and Brooke gestured to Paula to help Jed as she settled herself on the bed and talked quietly to Alison.

Jed snapped on a pair of gloves and examined Alison carefully, his face a mask of concentration.

‘OK.’ His handsome face was thoughtful as he finished his examination and gave Alison a warm smile. ‘It’s hard to know who’s more tired, you or the baby.’

Alison’s grip tightened on Brooke’s hand and she and her husband exchanged anxious glances. ‘Is he in trouble?’

Jed hesitated, choosing his words carefully. ‘Not yet, but we need to deliver him as quickly as we can. Have you heard of a ventouse delivery?’

Alison took a deep breath. ‘That’s the suction thing, isn’t it?’

Jed nodded. ‘Basically, yes. I attach a flexible cap to the baby’s head and when you push, I give you a bit of extra help. You’re still doing most of the work, but I can give you a helping hand.’

Brooke blinked with admiration. Somehow he’d managed to make it seem as though Alison would still be doing it all herself. Clever man.

‘Will it hurt?’ Alison looked suddenly anxious and Jed shook his head, his eyes kind as he moved over to the sink and started to scrub.

‘Your epidural was topped up not long ago so, to be honest, it shouldn’t, and I’ll be as gentle as I possibly can.’

Seeing Alison’s expression, Brooke decided that Jed’s bedside manner was second to none but, then, she already knew that, didn’t she? Remembering just exactly how skilled Jed’s bedside manner was brought a blush to her cheeks and she dragged her mind back to work with an effort.

‘Paula, would you bleep the paediatrician and then assist Mr Matthews, please? I’ll sit with Alison.’

Alison grabbed her hand tightly. ‘Will you stay with me the whole time?’

‘The whole time,’ Brooke promised, hoping that Jed was as skilled at using the ventouse as he was at performing emergency Caesarean sections.

He was. As soon as she and Tim had manoeuvred Alison into the right position, Jed applied the cup to the baby’s head with enviable ease. He glanced over his shoulder at Paula.

‘Have you seen this before?’

She shook her head and he raised an eyebrow. ‘Well, stand a bit closer, then, and I’ll tell you what I’m doing.’

Paula blushed and did as she was told, sneaking a glance at the broad shoulders as she moved to where he’d indicated she should stand.

Noticing the look, Brooke felt a stab of jealousy which she quickly suppressed. What was the matter with her? Why should she be jealous?

Brooke watched as Jed applied traction, explaining quietly to Paula and talking occasionally to Alison who had Brooke’s hand in a vice-like grip.

‘It’s important not to use excessive traction,’ he murmured, using the force of the contraction to help his own efforts. ‘It’s descending nicely. Well done, Alison. We’ll soon have this baby out. What’s the heart rate doing, Brooke?’

Brooke glanced at the CTG machine and met his eyes. Frankly, it wasn’t good but she didn’t want to panic Alison.

‘Eighty,’ she said flatly, and Jed nodded, comprehension in his blue eyes.

‘Right. One big push for me, Alison. Come on, baby.’ He pulled gently and the head emerged, blue and mottled, just as Sita slid discreetly into the room with the necessary equipment.