The Baby They Longed For

by Marion Lennox

  No. She dropped the plastic and her hands went to her belly, instinctively, in the way of mothers the world over.

  Her baby.

  Please...

  She’d have to tell Noah. This decision had been his as well as hers.

  This was his baby.

  But...but...

  There was no reason to tell him. Not yet. She was literally days into her pregnancy. The problem with increasingly sophisticated pregnancy tests was that they confirmed pregnancy ridiculously early. She knew better than anyone the odds of miscarriage. Most miscarriages occurred almost before the mother suspected she was pregnant. If there was a problem, a woman’s body was wired to rid itself of a non-viable pregnancy, clearing the way to start again.

  But please... Not this time. Let there be no problem.

  She did have to tell Noah.

  Tell him what? She was talking to herself almost hysterically. Should she tell him that she was two minutes pregnant?

  She should wait and see.

  But she knew she couldn’t. It was his right to know.

  And that was doing her head in. She wanted this baby so much, and somehow she’d dragged him right in. Noah, with his overblown sense of obligation, his friendship. His...his...

  She couldn’t go there. There was so much about Noah she didn’t understand, so much that almost frightened her. She wasn’t in control when he was around.

  So many emotions...

  Daisy got bored and started pouncing on her knees from the steps above. Over and over. Every time she pounced, Addie picked her up and set her down, which suited Daisy fine.

  Babies liked repetition.

  Baby...

  Her mind seemed like it was caught in an out-of-control spin that left her feeling almost nauseous. She should be joyously happy, but there were so many unknowns. So much fear.

  And Noah.

  Noah’s baby.

  Where to go from here?

  Pretend things were normal? Wait and see? Decisions seemed impossible and when her phone rang she was almost grateful.

  What she needed until she had her head under control was work. A lovely birth, with no major complications but tricky enough to take her mind off what she could barely hope to think about. She had three mums due to give birth about now. Hopefully one was about to oblige.

  ‘Addie?’

  But it was Noah and simply by the way he said her name she knew this wasn’t a friendly chat. Neither was it a call about a normal delivery. There was urgency behind the two syllables.

  Medicine. Her world. She was already shoving her feet back into her shoes, heading indoors with the phone in her hand. ‘Give.’

  ‘Car accident,’ he told her. ‘Car clipped a lorry and rolled. They’re bringing them in now. Briana and Tom Danvers. Briana’s suffered multiple injuries and Morvena says she’s one of yours. The paramedics say she’s in final trimester.’

  Addie knew her. She’d seen her two days ago for her prenatal check. Bouncy and confident, Briana had been the picture of health, and the pregnancy was totally normal. ‘She’s thirty-four weeks,’ she said, grabbing her car keys.

  ‘They’re thinking foetal distress. They couldn’t get a heartbeat at first but it’s there now. It could be inexperience that had them not hearing, or stress, but we need you here.’

  ‘Of course. Where’s the ambulance? Can I meet it on the way?’ She didn’t say—she didn’t have to say—that the most common injury to a baby in a car crash was placental abruption. If the placenta completely separated from the uterus then death of the baby was inevitable, but if there was a heartbeat now, that hadn’t happened. A likely scenario was partial abruption, which meant a partial tear. If the oxygen supply was blocked for any length of time, or even intermittently...

  She had to reach her fast.

  ‘They’ll be here in five minutes.’

  Five minutes meant there was no advantage to meeting the ambulance for roadside intervention. ‘I’m on my way. Other injuries?’

  ‘Tom has lacerations, concussion, query broken collar bone. Briana has a broken wrist and chest injuries. Breathing issues. Query broken ribs. The pregnancy means they haven’t been able to give her anything.’

  ‘They can give her morphine if they need to. There’s crossover but it’s better than having her in agony. Airway stabilisation’s a priority but they know that. I’m there in three minutes. Or less.’

  And she was out the front door, leaving a bewildered Daisy looking sadly after her. Addie had been about to take her over to spend the afternoon with the oldies but there was no time to organise it now. ‘I’ll be with you before the ambulance.’

  * * *

  Morvena might be autocratic, dogmatic, even ruthless, but in a crisis there was no one doctors depended on more than a good nurse manager. She’d obviously mustered the troops. Addie reached the hospital before the ambulance arrived, and two other cars were screeching into the car park. Cliff, the anaesthetist, and Rob Holloway, the youngest of the town’s family physicians.

  Four doctors. Cliff and Rob for Tom, Noah and her for Briana? Swap Cliff when needed? If Tom’s brain injury was severe it’d have to be Noah and Cliff with Tom, and Rob with her. She was already playing out an emergency Caesar, planning resources.

  She headed straight for the trauma room. Noah was before her. Cliff and Rob had veered off to Emergency admissions. There was no greeting. There was no time for anything but what lay ahead.

  ‘Briana’s ours,’ Noah snapped. ‘The paramedics say she’s short of breath and they can feel broken ribs. There’s also blocked circulation to the arm, plus the foetal problems. I’m scrubbing for an immediate thoracostomy if that’s necessary. Our priorities are assessment, breathing, baby, wrist.’

  Her skill was babies. Delivering babies. Fast. Noah was the generalist and this was his call.

  She nodded her agreement. Noah was prioritising on the paramedic’s information but it was a reasonable call. They could change their minds after initial assessment but it settled them all to have an initial plan, to know what they were facing.

  Morvena was standing in the background, holding her phone, waiting for orders. Addie might have had puppy issues with this woman, but she had no issues now.

  ‘I need everything for a stressed premmie,’ she told her. ‘Incubator, the works. See if you can get one of the other GPs in, in case we need help with the baby. Warm everything. And ring the flying neonatal squad from Sydney. We can always call them off if we don’t need them.’

  ‘Already done,’ Morvena said.

  ‘Tell them to add another doctor to the flying squad,’ Noah told her. ‘A trauma specialist as well as a paediatrician. If we need to evacuate a distressed premmie and a mum with breathing problems, plus Tom with possible head injuries, we’ll need full medical support.’

  ‘If a thoracostomy tube’s needed, can we evacuate by air?’ Addie asked tentatively. This was not her specialty so she needed to ask. Did they need to organise a road ambulance as back-up? Noah gave her a swift nod of acknowledgement. Doctors questioning each other was never a problem—it made for far fewer mistakes.

  ‘It’s okay,’ he told her. ‘As long as the tube’s in situ and they fly at low altitude there’s no problem. Morvena...’

  ‘I’m onto it,’ Morvena said. ‘I’ll ring in more nurses.’

  She wheeled away. Addie headed for the sinks.

  Two minutes later the scream of the ambulance siren filled the silence of the valley and it was on.

  The paramedics’ assessment had been—was—totally accurate. They wheeled Briana in first and one look showed she was in deadly trouble. She was breathing fast. Her chest was heaving with effort, and her eyes were wide with panic. Noah was already in scrubs, gloved. While Noah watched, Addie pushed away the thermal blanket they’d used to keep her warm, then carefull
y removed the collar the paramedics had used in case of neck fracture. They both looked at her trachea and the shift was obvious. It was displaced, moved to the side.

  Tension pneumothorax.

  The paramedics had already slit her T-shirt. A light feel of her chest suggested the likelihood of rib fracture. Piercing of the lung. Air was obviously escaping, building up in the chest and causing the lungs to collapse.

  There was also the complication of her left wrist. Briana’s hand was pallid, cold and pulseless.

  Circulation?

  Breathing first.

  Addie was examining her ribs, gently feeling, focussing on the break. Briana was wild-eyed, terrified, frantic. To not be able to breathe...

  Addie took her good hand and held it, taking a sliver of a moment to give human contact, to make Briana feel like she was being held. That the fight was no longer hers.

  ‘You’re okay now, Briana. Safe. Try and relax while we ease your breathing.’

  ‘Briana, the reason you’re having trouble breathing is that you have air in your chest.’ Noah’s voice followed hers, deep, calm, steady. They were both in Briana’s line of vision, but her gaze locked on Noah. ‘It looks like you’ve broken a rib and it’s letting air in, squashing your lung. It feels terrifying but it’s easy to fix. The first thing we’ll do—what I’ll do now—is put a tube into your chest to let the air out.’

  ‘But Tom...’ It was a frantic gasp.

  ‘Tom’s okay.’ Once again his calm, deep voice got through. This wasn’t a voice that could be argued with. ‘He’s copped a few cuts and bruises and a broken collar bone but we think he’ll be fine. Dr Holloway and Dr Brooks are taking care of him but they’re not bringing him in here. He’s bleeding a bit and Morvena doesn’t like blood on her nice clean trauma room, do you, Morvena?’

  There was a snort from that lady behind them and Addie almost smiled. But...

  ‘My baby...’ Briana gasped.

  ‘Yep, we’ll check on her, too,’ Noah said calmly. ‘Her? Him? Do we know?’

  ‘H-her.’

  ‘Nice,’ Noah said, and smiled. ‘The ambulance officers have checked on your baby’s heartbeat, and it’s nice and loud.’ There was no point in telling her there could be a problem. ‘So our first priority is to get your breathing sorted. You have a broken wrist, too, Briana, and you need to let us sort it, but that comes second. I’m about to pop a needle in to get rid of the extra air in your lung. Then X-ray. Then we’ll look at your wrist. It must be hurting like hell. We can fix that. Okay with you, Briana?’

  He was gazing straight down at Briana, eyes locked on hers, and Addie saw the moment the panic eased.

  Trust...

  Briana trusted this man, and why wouldn’t she? There was no hesitation, only certainty that this was the way to go.

  He’d downplayed nothing. He’d told the exact truth. Too much air in your lung, let’s get rid of it. Your baby’s alive, we’ll check on her. Your wrist is broken, we’ll fix it.

  ‘We need to do a bit of undressing,’ Noah told Briana, and he summoned one of his gorgeous smiles. ‘It’s undignified, I know, but needs must. Addie needs to listen to that baby of yours and I need complete access to your chest. Sorry, but that very attractive T-shirt is about to become ribbons. Jeans, too.’

  ‘They’re my...they’re my gardening clothes,’ Briana wheezed. ‘We were going home...from helping my mother...spread chook poo on her roses.’

  ‘Well, I’m very sorry, but your chook-poo-spreading T-shirt and jeans are no more,’ Noah said gently. He couldn’t touch her as he was already gloved, but Addie was doing the touching for him. ‘But let’s mourn them later. First let’s get you safe.’

  * * *

  While Noah worked, Addie was fully occupied with her role, setting up a foetal monitor, trying to get a handle on the condition of the baby.

  She wasn’t liking what she was finding.

  The paramedics had mentioned when they’d first tried for a heartbeat that they hadn’t been able to find one. Given the roadside conditions, given the mother’s distress, given their own stress, they could well have missed it. The second time they’d tried they’d found it but it was erratic. Addie took blood for cross-matching straight away as a precaution and then set up a foetal heart monitor. She studied the cardiotocography and found no reassurance.

  There were dips in the baby’s heart rate.

  Briana had been hit, hard, and the placenta would have been slammed within the abdomen.

  There was also vaginal bleeding. Not much, but enough for deep concern.

  If this was partial abruption, it could turn to full at any moment. Or damage alone would be enough to cause foetal death. She needed to see this baby. She needed to be hands on.

  This was a thirty-four-week pregnancy. Totally viable. The risks on leaving her in situ were enormous.

  She wanted this baby born now.

  Her eyes met Noah’s and held for a fraction of a moment. It didn’t take longer. He read the message.

  He was working swiftly himself, with skill and precision, to establish a secure airway.

  A local anaesthetic came first, then prophylactic antibiotics to prevent complications like pneumonia later. Finally the chest tube was inserted carefully, and at last Addie heard the blessed hiss of released air, the instant relief of a compressed lung.

  Briana’s short, frantic gasps eased.

  Panic receded.

  Then Cliff was in the room, swinging in with the casual air of a doctor who was there for a social visit. He was good, too, Addie thought, and thanked her lucky stars for such colleagues. His presence meant they had three doctors. It must also mean that Tom was safe. Her stress level dropped a notch.

  ‘Greetings, all,’ the anaesthetist said, smiling down at Briana. ‘Mrs Danvers, you and your husband have interrupted my attendance at my son’s under-twelve footie match. We’re winning forty-seven to three and my Lucas has kicked seven goals. I need to get back for the riotous celebration of sausage rolls and soda. Meanwhile, I’ve been in to see your Tom. He’s bruised and bumped and he has a sore shoulder but he’s okay. I’ve given him a nice little something so he can be stitched up without pain and Dr Holloway has taken over. Now it’s your turn. What do you need me here for, guys?’

  ‘X-ray next.’ Noah was adjusting the thoracostomy tube, responding to Cliff but still talking to Briana. Including her in the conversation. Holding her to him in a way that surely must settle her in the midst of pain and fear. ‘Briana, your wrist is broken and needs to be reset. Dr Blair—Addie—also needs to run checks on your baby. What we plan to do is run you through X-ray, maybe do an ultrasound of your baby, and then make a decision.’

  He hesitated but only for a fraction of a moment, a fraction that Briana wouldn’t have picked up on but Addie heard it. It was a pause that meant he’d picked up on Addie’s concern. And it was best to be honest.

  ‘Briana, we’ll need to put you under in order to treat your wrist,’ he told her. ‘You have a blocked blood supply to your fingers and if we leave that for long you might end up with long-term stiffness.’ Paralysis, he meant, but that was a scary word to use. ‘But more.’ He nodded to Addie, an acknowledgement that she should take over the conversation if he got it wrong.

  ‘Briana, we’re also going to do a very careful assessment of your baby. She’s been given a fair shaking. She’s thirty-four weeks. If she’s born now then she’s hardly even classified as premature. She’s a fully formed baby, ready to be born. Ideally she’d probably choose to stay where she is for a few more weeks, but she’s had a bump and we’d like to see her, to make sure she’s okay. Dr Blair thinks the safest thing is to perform a Caesar. Would that be okay with you?’

  ‘You’ll take my baby...’ Briana quavered, and Addie stooped so her face was close to Briana’s. She touched her cheek, wiping away a frightened
tear.

  ‘No, Briana, we won’t take your baby,’ she told her. ‘We’ll give you your baby. I am a little worried,’ she conceded. ‘You have a bruise on your abdomen, which means you’ve been hit. I can hear your baby’s heartbeat so she’s okay but I don’t know if you have internal bleeding. For now, though, you and Tom and your baby are safe and we plan to keep it that way, even if it means we bring your little girl into the world a bit early. You need to trust us. Will you do that, Briana?’

  ‘I...’ Briana looked wildly around, at Addie, at the stern-faced Morvena in the background, at the now-serious Cliff, and then lastly at Noah. She looked at him for a long time.

  What was it with this man? Briana instinctively looked at him with trust.

  Whatever it was, she was taking it, Addie thought, because she saw the moment Briana relaxed. She saw the moment Briana decided she could abandon her flight-and-fight reflex and just...trust.

  ‘Okay,’ Briana whispered. ‘Just do it.’

  * * *

  And after that there was no time for introspection, no time for thoughts of anything other than doing.

  The X-rays showed a comminuted fracture of the wrist. There was an intermittent pulse. If there hadn’t been, in probability she’d be looking at the loss of her hand, but the paramedics had done their job well. They’d stabilised it, splinting it as well as they could, which had allowed a tiny amount of blood to get through.

  Not enough to stay viable for long, though, and the X-rays showed it wasn’t enough to depend on. The fracture meant she’d need specialist orthopaedic surgery to make sure the hand was fully functional but they needed to reduce the fracture now to make sure her hand was viable until they could get her to Sydney.

  Meanwhile, the information Addie was accumulating was growing increasingly worrying. The vaginal bleeding was sluggish but constant, and the baby’s heartbeat...