by Sarah Morgan
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.
‘Stop using cord traction,’ she instructed Kim in a low voice. ‘There’s a risk that the cord might snap or the uterus might invert.’
Tia pressed the buzzer to call for help and then palpated Dawn’s abdomen. If the uterus was well contracted then it could mean that the placenta had separated but was trapped by the cervix.
Outwardly calm, still making small talk about the baby, Tia gently palpated the uterus with her fingertips. Instead of feeling firm and contracted, it felt soft and distended and her heart gave a little lurch.
She massaged the top of the uterus with a smooth, circular motion, careful not to apply too much pressure.
‘Is something wrong?’ Dawn looked at her with tired eyes and Tia gave her a reassuring smile, noting that she seemed very pale and restless.
‘Your placenta isn’t separating as quickly as it should do,’ she said carefully, ‘so we’ll just get the doctor to take a look at you. Nothing for you to worry about, Dawn.’
Sharon entered the room seconds later, her eyebrows lifted questioningly.
‘I think we may have a retained placenta here. Can you bleep the senior reg?’ Tia asked quickly, and Sharon nodded immediately.
‘Will do.’
‘Put the baby on the breast, Kim,’ Tia instructed quietly, and the student immediately did as requested, understanding that the action of breast feeding could help the uterus contract. Tia tried to rub up a contraction and just as she was starting to feel seriously worried the doors slammed open and Sharon hurried in, closely followed by—
Luca.
Tia’s heart kicked against her ribs and she turned incredulous eyes to Sharon who merely shrugged helplessly, indicating from her expression that she didn’t know what was going on.
Luca barely gave her a second glance, instead striding straight to the bed and introducing himself to Dawn. Tia immediately snapped back into professional mode, her personal feelings towards him temporarily forgotten. Now wasn’t the time to question his presence.
‘It seems as though she has a retained placenta,’ she told him quickly, ‘She delivered forty minutes ago. The uterus is atonic. I’ve tried to rub up a contraction, we’ve put the baby to the breast.’
Luca started scrubbing, firing questions at her over his shoulder. ‘Has she emptied her bladder?’
‘We’ve just catheterised her,’ Tia told him, ‘and we’ve got everything ready to set up an IV.’
‘She’s had an epidural?’
Tia nodded. ‘Yes, but it’s wearing off.’
‘Let’s top it up immediately and bleep the anaesthetist. I want her transferred to Theatre,’ Luca instructed, turning to his SHO who was hovering. ‘Can you sort out the epidural top-up and the IV, please, Dr Ford? Take blood for haemoglobin and cross-matching.’
Despite the emergency, the glamorous, dark-haired SHO couldn’t stop sneaking looks at Luca, and Tia found herself grinding her teeth as they moved Dawn into Theatre.
Luca walked quickly over to the head of the bed and gave the frightened woman a reassuring smile.
‘Dawn, your placenta does not want to come away by itself so I’m going to have to help it out,’ he said quietly, his Italian accent giving his words a warm and attractive quality. ‘You still have the anaesthetic in place so it shouldn’t be painful, but if I hurt you in any way I want you to tell me immediately. We will work as a team, I promise.’
Tia watched with awe as he calmed both Dawn and her husband with his quiet confidence and then prepared for a manual removal of the placenta.
Tia bit her lip. She’d actually never seen a placenta removed like this before. She’d read about it, of course, but she’d never actually seen it happen and she was heartily relieved that Luca was there to take charge. There were stories of exceptional circumstances when a doctor couldn’t be found and a midwife had had to undertake the procedure. Frankly, the thought made her shudder.
Sharon hovered at the back of the room, knowing that she could have a serious emergency on her hands.
‘She has a partial separation,’ Luca told the SHO as he examined Dawn. ‘The fundus is broad, whereas it should be contracted, and she is losing some blood.’
Actually, that was an understatement, Tia thought anxiously. Dawn was now bleeding steadily and she watched as Luca covered his hand in antiseptic cream and introduced it carefully into the vagina, following the line of the cord which he held tight with his other hand.
Then he released the cord and transferred his free hand to Dawn’s abdomen.
‘I can feel the separated edge…’ Luca’s handsome face was a mask of concentration as he worked his fingers between the placenta and the uterine wall.
Tia watched, fascinated despite her anxiety for Dawn, noting that he used his free hand to press on Dawn’s abdomen to prevent tearing of the lower segment of the uterus.
With a grunt of satisfaction, Luca rubbed up a contraction and gently removed his hand, dropping the placenta into a kidney dish. ‘There. OK, we need to check that this is intact.’
Tia adjusted the light and they examined the placenta thoroughly to check that none of it had been retained within the uterus.
When he was satisfied that the placenta was complete Luca turned his attention back to the mother.
‘Everything is fine, Dawn,’ he said quietly, examining her abdomen again. ‘Your uterus is well contracted now and the bleeding has stopped. We’ll check your haemoglobin level but I don’t think that the blood you have lost will cause you a problem.’ He turned back to his SHO. ‘Give her some more oxytocin and start antibiotics.’
‘Yes, Dr Zattoni.’ The SHO was gazing at Luca as if he was the answer to her prayers, and Tia was filled with a sudden insecurity.
It didn’t matter whether Luca was in love with Luisa or not—he would always have women throwing themselves at him. And would he be able to resist them? She knew better than most that plenty of men wouldn’t.
Men like her father.
Feeling sick at the thought she looked for an excuse to leave the room.
‘I’ll go and phone the ward,’ she mumbled, desperate to get away from the sight of Luca talking to the glamorous SHO. In fact, she could have used the phone in Theatre but she needed some space to calm herself down.
Sharon was hot on her heels as she made for the desk. ‘Look, I’m really sorry. Believe me, I had no idea—’
‘It doesn’t matter.’ Tia sat down on the nearest chair
and took several deep breaths.
Sharon looked at her anxiously. ‘Prof told me he had a new senior reg, but I didn’t bother asking the name and I didn’t even know he was due to start today. When I rang Switchboard they just told me that a Dr Zattoni was on call—I had no opportunity to warn you.’
‘It doesn’t matter,’ Tia repeated, feeling a rush of relief as her stomach calmed down.
Sharon looked totally confused. ‘But he couldn’t have arranged this overnight. Did he tell you last night that he’d applied for a job here?’
‘No, of course not.’ Tia’s voice was gruff and her eyes were slightly too bright. ‘He doesn’t tell me anything, remember?’
Sharon shifted slightly and glanced back along the corridor. ‘He’s a damn good doctor, Tia—that was an incredible performance back there.’
Tia nodded, a slight frown touching her brows. She’d never seen Luca in action before and he’d certainly been impressive.
Hoping that Sharon would drop the subject, she picked up the phone and called the postnatal ward just to warn them that Dawn would be on her way shortly and to brief them on what had happened so that they could monitor her condition.
‘Well, he’s obviously not thinking of returning to Italy any time soon,’ Sharon said quietly, and Tia looked at her.
‘No.’ She summoned up a smile for the sake of appearances, trying not to think about what it would do for her pulse rate to see Luca at such close quarters every day.
‘Which means that he can’t possibly be involved with Luisa.’
‘Does it?’ Tia closed her eyes and let out a sigh.
What a mess.
Sharon sat down on the chair next to her, her voice soft. ‘He wants you, Tia.’
Tia gave a crooked smile. ‘Or does he just want the baby. If it hadn’t been for the baby, he’d have patched things up with Luisa, remember?’
Sharon sighed. ‘Tia, you have to talk to him about it.’
‘No.’ Tia lifted her chin stubbornly. ‘He has to be the one to talk to me.’
Picking up the phone to end the conversation, she called a porter to come and help with Dawn and finished completing her section of the notes.
Luca strolled up to the desk, his shoulders looking broader than ever under the white coat.
‘Have you finished your shift?’
Tia stared at him defiantly, still furious that he hadn’t told her that he’d be working in the same hospital as her.
‘No.’
‘Yes.’ Sharon corrected her with a frown, glancing across at Kim. ‘Kim, would you mind taking Dawn up to the ward? Tia’s already spoken to them so they’re expecting her.’
Tia stood up. ‘I’ll—’
‘It’s already past the end of your shift and you’re exhausted,’ Sharon said firmly, avoiding Tia’s eyes. ‘Go home.’
Tia almost growled out loud. She was more than ready to go home but she didn’t want to go with Luca.
‘All right.’ She stood up. ‘But I’ll make my own way.’
Luca’s jaw tightened but he said nothing in front of her colleagues, instead choosing to follow her into the staffroom.
‘Luca, this is the female changing room,’ she pointed out, trying not to notice just how good he looked with his powerful body planted firmly in front of the door.
He shrugged dismissively. ‘I have something to say to you and I assumed you didn’t want me to say it in public.’
She yanked open the door of the locker, unable to keep the sarcasm out of her tone. ‘I’m amazed you want to talk to me at all. What’s the point of having a conversation when one misses out important details like, “By the way, Tia, I’ll be starting a new job in your hospital tomorrow.”’
And that was just for starters. She knew only too well what other important fact he was keeping from her.
‘I didn’t mention it because I didn’t know that I would be starting today,’ Luca said evenly. ‘In fact, I didn’t know that I would be starting at all. I have had several conversations with the hospital but it was only confirmed this morning. It seems that they are in a crisis. Someone is off with food poisoning and someone else has taken compassionate leave. So, instead of starting in a week’s time, I agreed to start immediately.’
‘But you could at least have mentioned it,’ Tia pointed out, her eyes blazing as she dragged her clothes out of her locker.
Luca frowned. ‘Nothing was confirmed and we had other, more important matters to discuss, as I recall.’
Tia stared at him in exasperation. ‘But you didn’t even tell me that you were applying for a job in England, and yet you must have applied months ago.’
There was a long silence and a strange look flickered across Luca’s handsome face.
‘Just after we met,’ he admitted finally, and Tia let out a disbelieving breath.
‘And it didn’t seem relevant to mention that either? Well, believe it or not, I like to know what’s going on,’ Tia said, stripping off her cotton bottoms and dragging on her jeans. She took hold of the hem of her top and then hesitated. ‘Look the other way.’
Their eyes clashed and a sharp stab of electricity shot through her body and weakened her knees.
He clearly thought it was crazy to look the other way when he’d seen her naked more times than he could count.
‘We don’t have that sort of relationship any more, Luca,’ she croaked, tightening her fingers on her tunic.
Muttering something under his breath, he turned his back, the tension visible in his broad shoulders.
She changed quickly and pushed her clothes into her bag. ‘You can look now.’
‘Thank you.’ His ironic glance was at odds with his courteous tone and she looked at him warily.
‘Now what?’
‘Now we go home and finish the conversation we were having when you passed out on me last night,’ he said softly. ‘My car is in the car park.’
She slung her bag over her shoulder. ‘Thanks, but I’ll make my own way home.’
His mouth tightened into a grim line. ‘On that contraption you call a bike? No way. You have been working all day and you are exhausted, Tia. I will give you a lift.’
She glared at him and then smiled sweetly. ‘Will my bike fit in the boot of your car?’
Luca winced visibly at the thought. ‘You can leave it here.’
‘Overnight?’ She shook her head. ‘No way. Someone might steal it.’
‘Steal it?’ His incredulous tone and the lift of his dark eyebrows told her clearly what he thought of that suggestion. ‘Tia, it is a heap of rusty metal. No one in their right mind would steal it.’
She opened her mouth to argue again and then closed it again. The truth was she was totally exhausted. She’d never felt so tired in her life and the thought of cycling the five miles home was almost laughable.
‘All right.’ She knew she sounded ungracious but she couldn’t help it. ‘We’ll go in your car.’
‘Good.’ For a moment she thought she saw humour gleam in his dark eyes but then it was gone and he held the door open for her. ‘Let’s go.’
They walked in silence out of the building. Just as they were crossing the car park, the glamorous Dr Ford dashed up to Luca, wanting him to check some trivial detail on a drug chart.
All Tia’s fears flooded back. Was Luca interested in the woman? She was certainly attractive and she was totally ignoring Tia.
On impulse she slipped an arm through his. ‘Hurry up, darling,’ she whispered in her sexiest voice. ‘I’ve been waiting to go home with you all day.’
Luca went still and she saw surprise flicker briefly in his eyes. And she could hardly blame him for that! She was pretty shocked herself. Whatever had possessed her? One minute she was keeping him at arm’s length and the next she was ready to claw Dr Ford’s eyes out…
Embarrassed and confused by her own behaviour, Tia gingerly released his arm and shrank quietly into the background as Luca turned back to the SHO, scribbled somethin
g on the chart and issued some brief instructions.
As Dr Ford walked back across the car park, Luca turned to her, his gaze uncomfortably penetrating.
‘Well?’
‘Well, what?’ Still feeling embarrassed, Tia yanked the car door open so hard that she nearly removed it from its hinges.
One eyebrow swooped upwards. ‘I need to spell it out?’
Tia glared at him. ‘She was drooling all over you, Luca.’
He turned his head to watch the retreating woman and then looked back at her, his eyes narrowing. ‘Dr Ford? You’re imagining things.’
‘Oh, come on.’ Had he really not noticed? ‘She’s crazy about you and she’s only just met you and she’s probably the first of many. I suppose the whole hospital will be drooling over you by the end of the week.’
‘Drooling?’ The expression in his dark eyes was stunned. ‘I’m a doctor, Tia, not some sort of sex symbol.’
Tia bit her lip. How had Sharon described him? Sex on legs.
Did he really have no idea how attractive he was to women?
‘Think about it, Luca,’ she mumbled. ‘Was that really an important question she asked you or was she finding reasons to speak to you?’
He opened his mouth and closed it again, staring at her thoughtfully. ‘She’s my SHO, Tia.’
‘You don’t need to tell me that.’ Tia gritted her teeth. ‘She’s been ogling you all afternoon.’
‘Ogling?’ His face was blank and suddenly he sounded very Italian. ‘What is ogling?’
Tia tipped her head back. ‘Staring at you, making eyes at you, flirting.’
‘You’re imagining things.’ His tone was calm but his gaze was speculative as it rested on her face. ‘She is my SHO. We have to speak to each other. We certainly weren’t flirting.’
Had he really not noticed? ‘She couldn’t take her eyes off you, Luca.’
‘And you were jealous.’ His quiet statement was more than a little smug and her chin lifted.
‘Jealous?’ She gave a short laugh that sounded false even to her ears. ‘Are all Italians as arrogant and self-confident as you? I wasn’t jealous, Luca.’
Being jealous would mean that she wanted him—and she didn’t, did she?