by Robin Gianna
Damn. Definitely dystocia, which had to be dealt with immediately, or the baby could be either seriously injured or die. And Aaron hadn’t dealt with one since his obstetrics training in the United States, and then only a few times.
“I thought the dad was going to faint, so he’s been taken to the waiting room,” Hope said.
“All right.” He quickly scrubbed, then snapped on gloves as Hope and the nurse got the patient set up in the room. The moaning, obviously terrified mother stared at him as he stood in front of her, Hope beside him.
“Is it okay? Oh, my God,” she cried, her moan morphing into a wail.
“Let’s see what’s going on,” Aaron said. Keeping his voice calm and soothing was an effort when he saw what he and Hope were dealing with here. Every muscle tensed and he took a deep breath, working to keep his calm and remember his training. “How long do you think it’s been since the baby’s head crowned?”
“Probably only a minute. I knew I had to get help immediately.” Hope pressed the microphone around her neck. “I’ll get Neonatal on the line now.”
“Good. Anesthesia, too, in case we have to C-section. Nurse, I need you to keep track of the time, and call out every thirty seconds that pass. Mom, what’s happening here is that the baby’s shoulder is stuck on your pelvis. I’m going to try to release it, okay?”
Her answer was another wail as he used the various maneuvers that sometimes worked in a situation like this. “Sorry. Hang in there. Big baby we’ve got here.”
Hope anticipated every action as they worked together to release the baby’s shoulder, but it was still jammed tight like a branch in a river rock.
“Thirty seconds,” the nurse said.
Sweat pricked Aaron’s skin as Hope’s intense eyes met his, and he knew she was thinking exactly what he was. That if they couldn’t get the baby out within moments, the chances of it being healthy and undamaged were damned unlikely.
“Is anesthesia on the way? No choice but to do the Zavanelli maneuver. Get her prepped for C-section. Make it a flash and dash to get the Betadine on in a hurry. Not low transverse, classical. You know time is critical. Then get scrubbed to assist.”
She gave him a quick nod. “Got it.”
Aaron sucked in another calming breath as he worked to maneuver the baby back to a position they could deliver it with a C-section. Hope quickly swabbed the woman’s belly with antiseptic. Anesthesia ran in, and Aaron sent up a silent prayer of thanks that the troops had arrived. Except they were far from out of the woods.
“Need general anesthesia, and some Versed too. Hang in there for us, Mom.”
“Oh, God,” the mother said again, gasping, her eyes already closing, her words slurred. “My baby. Is it going...to be...all right?”
“Doing the best we can.” He didn’t know the answer to her question, but he damned well was going to get the baby out as fast as possible to increase the odds of it surviving. Aaron tensely watched the anesthesia team get the patient intubated. “Is she ready?”
“She’s out. Good to go.”
“I’m ready, too, Doctor,” Hope said next to him.
“Good. Nurse, hand me the knife. Hope, I’m going to need you to help me from below.”
“I’m getting baby moved up a little more,” Hope said, her eyes fierce with concentration. “It’s...it’s fully back in her uterus now.”
“Good. I’m going to get started. Neonatal here yet?”
“Not yet,” Hope answered, her voice tense and worried.
“I need you to assist. Get ready to resuscitate baby and run it to the special care baby unit if Neonatal’s not here in time.”
“I’m ready.”
Aaron began the section and got the baby exposed as quickly as possible. He reached to lift the baby boy out, gritting his teeth at the infant’s dangerously deep purple color. If they didn’t get him breathing in short order, he either wouldn’t make it, or there’d be damage to his brain.
He quickly wiped the baby’s face, but knew Hope and the nurse would do a better job with cleaning the baby and getting it breathing than he would remember how to do.
As he passed the infant to Hope his eyes briefly met hers. Intense blue eyes that reflected back the same concern he had about the baby’s chances before she quickly focused with deep concentration on the infant.
“Is the Ambu bag ready?” Hope asked the nurse without looking up as she swiftly and efficiently suctioned the baby’s mouth and nose.
“Right here.”
Hope reached for it, placing the oxygen mask over the child’s nose and mouth as she instructed the nurse to rub the baby with a towel to dry and warm him. Just as Aaron was about to turn to the mother the rest of the cavalry ran into the room. He huffed out a giant breath of relief. Had to be the neonatal team, ready to assist Hope and take over. Then it was time to pray like hell for the little guy.
He watched for a second to see Hope pass the baby to the neonatal team. They wasted no time getting the baby resuscitated and stabilized as they checked his heart rate. Aaron sent up a silent prayer of thanks that the infant’s color already seemed a little better.
He refocused on the still-unconscious mother, who’d been through quite an ordeal, and got started repairing her incision. He could hear Hope briefing the neonatal team. Calm, composed information and questions, which was impressive, since he knew she had to be feeling the same adrenaline rush and stress he did.
“Baby’s in good hands, Dr. Cartwright,” Hope said from across the room. “I’ll scrub again, then I’ll help you close.”
“Good.” He wasn’t about to say, I can use all the help I can get and let everyone in the room know he was a little rusty at surgery, but had a feeling Hope already knew that.
Hope stood next to him, her arm pressing against his as they worked together. He glanced down at her and their eyes met again. This time, hers were smiling. “Impressive work, Dr. Cartwright. No one would ever guess you didn’t deliver babies every day, especially tough ones like this.”
“Doubt that’s true, but thanks. And you were pretty impressive yourself, diagnosing the problem instantly, getting her down to the OR and getting big baby pushed back up in time for me to get him out fast. We made a pretty good team, I think.”
“Yeah. We did.” Their eyes met again, held, and this time there was an odd, serious note in her eyes along with that smile and a clear admiration that made him feel pretty damned happy he’d been in the right place at the right time.
“Did Neonatal get cord blood to check baby’s gases?”
“Yes. They sent it to the lab stat, so we should know his PH soon. I’m praying he’s okay.”
So was Aaron. He’d almost forgotten how amazing it was to help bring a baby into the world and felt an attachment to the little guy. “How’s his anterior shoulder and arm?”
“Not moving it quite as well as he should, but the pediatrician said she thinks it’s going to be fine.”
“Good.”
They finished the repair in silence, Hope again working efficiently, anticipating everything he needed before he had to ask. “Okay.” He sat back and snapped off his gloves. “We can slow down her meds now and get Mom waking up,” he said to the anesthesiologist. “Nurse, can you take care of Mom and get her to Recovery while Hope and I go talk to the family?”
“Yes, Doctor.”
The two of them walked together toward the waiting room, and the same sense of connection he’d felt with Hope from the moment they’d first spent time together was there, but magnified times ten. He knew it was probably because they’d gone through such an intense procedure together with a baby’s life on the line, but it was a sensation he wasn’t familiar with. Didn’t know what to do with, either.
“Let’s see if we can get the PH test results before we talk to famil
y. If he’s healthy we can pass that good news on, but if we’re not sure yet it would make sense to gently prepare them for the possibility that he’d gone without oxygen a little too long and will have to be evaluated.”
“I agree.” She talked into the little microphone around her neck, then looked up at him, her blue eyes lit with joy. “PH was seven point four! Clearly no brain damage. He’s going to be just fine.”
“Thank God.” The relief that swept through him was surprisingly intense. Despite the stress of it all, he realized he was glad he’d had this experience today. Helping people conceive, being there for them for both success and failure, was what he did every day. Bringing that baby into the world was an entirely different kind of important. A reminder, really, that when he helped a couple get pregnant the end result was an incredible miracle. “You did it, Hope. You got him to the OR, then stabilized and bagged in the nick of time.”
“No, we did it. And Mum is all right, too, thanks to you.” Her elated and admiring gaze met his, and just as his chest began to fill with the same emotion she surprised him by practically launching herself at him, flinging her arms around his neck. A laugh bubbled from her lips as his arms wrapped around her, too. As if they belonged there. “Thank God you were in the hall when I came looking for help. You were amazing.”
“Like we said before, it was a team effort, Hope.” He couldn’t stop his hand from gently smoothing back strands of hair on her forehead that had escaped her ponytail. “You were more than amazing, and have a lot to be proud of today.”
“We do.” To his shock and utter pleasure, she gave him a big, smacking kiss on the lips, and he had to force himself to not go back for one less celebratory and a lot more sensual.
“I have to tell you though, for a minute there I was really worried,” she said. “When you couldn’t get him loose, even after you tried to turn him several different ways, and his color was so ghastly, I really thought it might be too late.”
“For the record, I was a little worried, too.” He pressed his mouth to her ear. “Don’t tell anybody, but I’ve never delivered a shoulder dystocia by myself before.”
“What? That makes it even more amazing!” Her eyes widened. “I guess I should have realized. You help people make babies, you don’t deliver them. When was the last time you did?”
“Obviously, during my obstetrics training I delivered a lot of babies, but not since then. And dystocia is pretty rare, as you know, though I hear it’s getting more common with bigger babies being born.”
“He was a big one, wasn’t he? I hope I don’t have to go through that again any time soon.” Unfortunately, she seemed to realize she was clinging to his neck and drew back. While Aaron liked her just where she was, her body pressed all warm and soft against his, he figured the hospital hallway didn’t provide the kind of privacy he found himself wishing for at that moment.
A man leaped up the second they stepped into the waiting room, and Hope approached him with a smile. “First, Mum and baby are doing fine, Mr. Smith. And second, it’s a boy! Congratulations.”
“Oh, thank God. Thank you. Thank you so much.”
The man’s voice was choked, and his eyes puddled up as he pumped Hope’s hand. Aaron felt relieved all over again that they were able to give him good news, when it had been too damned close to being the opposite.
“This is Dr. Cartwright, who delivered your son. I’ll let him explain what had to happen.”
“Hope probably told you the baby’s shoulder was lodged into your wife’s pubic bone. We did what we could to get him loose, but in the end had to do a Cesarean section. Being stuck in the birth canal like that is traumatizing to a baby, and we had to deliver him fast. But as Hope told you, your wife is fine and your son is fine. Quite a bruiser, too—I predict he’ll be a damn good rugby player someday.”
The man laughed and swiped at his eyes. “Can I see them?”
“Baby is in the SCBU, on the second floor,” Hope said. “I’ll meet you there in a few minutes, then take you, and baby, too, if I get the green light, to see your wife.”
The man again profusely thanked them and left, leaving Aaron to enjoy the smiling blue of Hope’s eyes for another minute. And he realized that, despite telling himself he needed to be, he wasn’t ready to accept her insistence that one evening together was all they could have.
Why he wanted to convince a woman to be with him if she didn’t want to be, he didn’t know, but he wasn’t going to waste time wondering. And with any luck, today’s events just might have provided him with a damned good bargaining tool.
“I think a celebration is in order, don’t you?” he asked, looking down into Hope’s glowing eyes. “How about we do that punting you’re dying to learn how to do, then have a drink in honor of Mom and big bruiser? I checked the weather just a little while ago, and it really is balmy right now. Honest.”
“I...I...”
He hated to see her joyous smile fade, her face turn away from him slightly to look over his shoulder at the wall. He grasped her chin in his fingers to bring her gaze back to him, and the troubled expression on her face made it difficult to keep his tone light. “Are you saying ‘Aye-aye, Captain,’ in anticipation of our boating expedition? What time are you off?”
“I’m working late, actually. Sorry.”
Well, damned if her voice and expression weren’t both equally stiff now. The part of him that knew he should go right back to what he’d decided earlier, which was to forget about her and whatever reason she had for not wanting to spend time with him, was overwhelmed by the chemistry between them. An attraction that sizzled every bit as much as it had the other night whether she liked it or not.
He dropped his hand from her chin and glanced around. The few people nearby were doing their jobs, and didn’t seem particularly interested in watching the two of them. “Is that true, or an excuse because you don’t want to go out with me?”
“Okay.” Her gaze met his squarely. “I’m not working late. It’s just that, like I said before, we can’t date.”
Those blue eyes might be trying to look decisive and firm, but he was pretty sure the little pucker between her brows showed confusion. And he knew damned well the heat sparking between them didn’t go just one way. Did it?
“That you would fib about that gouges right into my heart, you know.”
“Uh-huh. As though I could hurt Dr. Aaron Cartwright’s feelings.” The eye roll she gave didn’t completely conceal the flicker of worry on her face that maybe she actually had, and he had to smile at how sweet she was.
“You might be surprised.” He didn’t share his feelings easily, but he sure as hell had them. Especially around her. At the moment, those feelings were pushing him to coerce her into saying “yes” to a little more time together, good idea or not. “All I’m suggesting is a little celebration of our success, and for one of Cambridge’s lifelong citizens to learn punting so she doesn’t embarrass her hometown. But if you won’t join me, I’ll just go home and celebrate with a beer all by my lonesome, even though I did come to your rescue.”
“Not my rescue, the mum and baby’s rescue.” She folded her arms across her chest, but the amusement in her eyes that suddenly replaced the worry had him hopeful that she just might cave and forget whatever concerns she had. “Why I’m letting you twist my arm this way, I don’t know,” she said, shaking her head. “After I take Mr. Smith to see his wife and possibly bring baby to her as well, I’ll get cleaned up. I’ll meet you at the dock by that pub we went by the...the other night.”
Her face flushed as soon as she finished the sentence. The last thing he wanted was for memories of that night to make her change her mind, though how that could happen, he couldn’t imagine. Lord knew those memories were part of what made him determined to be with her again. “Listen, I rode my bike to work, but how about I ride it home now to get my c
ar and pick you up here in, say, an hour instead of meeting you there?”
“You rode your bike?” Those pretty pink lips of hers parted in surprise. “I rode my bike, too, since it was such a nice day.”
“See there? It was meant to be.” And it was. He’d felt that way the minute he’d met her, and this was more proof they were destined to spend some time together for a while. “We can enjoy the warm, late afternoon sun by riding along the river, have our punting lesson, then eat pub food. I’ll meet you at the north bike racks in an hour.”
He almost turned to walk away, not wanting to give her the chance to say no, but knew that would be rude. So he waited, his chest feeling a little tighter with each long beat that passed, wondering why her answer mattered so much. Why he felt nearly weak with relief when she finally nodded. “All right. An hour.”
“Good.” He headed back toward the nurses’ station where he’d left his briefcase, resisting the urge to look back at her. Wishing she’d been smiling when she’d answered, instead of so serious-looking, but he’d take what he could get.
With any luck, Hope really did want to be with him this evening and didn’t just feel obligated after he’d been so pushy about it. That kind of question had never entered his mind before on past dates, and he didn’t like it that he had to wonder about it now. But however their evening together went, for better or for worse, it was more than worth finding the answer.
CHAPTER SIX
THE EVENING SUN glowed low on the horizon, casting fingers of brilliant gold through the barren trees and across the landscape, turning the still green grass to a cheerful chartreuse. Hope breathed in the clear air, her chest somehow light and energized at the same time her tummy tightened with misgiving, wondering what in the world she was doing.
She dared to glance at the man riding beside her, the sun gleaming on his chestnut hair and movie-star-handsome face. Sunglasses covered his eyes, and he wore a fairly tight-fitting, long-sleeved athletic shirt that molded itself to the contours of his muscular arms and torso, and whoo, boy, were those contours very, very sexy.