by Sarah Morgan
Lisa nodded, her eyes filling. ‘I can’t sit on my bottom at all. It’s agony. I know I’m being a wimp, but I can’t help it.’
‘You’re not being a wimp,’ Tia said immediately, her expression concerned. ‘Let me take a good look at you and then we can decide what to do.’
Tia started out by examining Lisa’s breasts, checking that they were soft and free from lumps, redness and soreness. ‘How’s the feeding going?’
‘All right,’ Lisa mumbled, ‘although I can’t sit up at all.’
‘Has anyone showed you how to feed lying down?’ Tia satisfied herself that everything looked healthy and then helped Lisa wriggle down the bed so that she could examine the uterus. ‘For a start, it’s so much easier at night just to feed the baby while you’re still lying down, and if you’re sore down below it will help you not to be on your bottom.’
Lisa shook her head. ‘They’ve been so busy up here since I arrived. Someone did help me latch her on the first time but I’ve been trying not to bother them since then.’
‘You don’t have to worry about that. It’s what we’re here for.’ Tia frowned as she palpated Lisa’s abdomen. She knew that, like most units, they were very stretched, but it made her uncomfortable to hear that Lisa had been reluctant to ask for help.
Satisfied that the uterus was well contracted and not painful, she asked Lisa various questions and then checked her perineum. What she saw made her wince. No wonder the poor woman was in pain. She had developed a severe haematoma of the vulva.
‘Lisa, I can see straight away what the problem is,’ she said quietly. ‘You’ve developed a blood clot down below. I’m going to call one of the doctors and ask them to take a look at you.’
Lisa’s eyes widened with anxiety. ‘Won’t it just go by itself?’
Tia hesitated. ‘It might,’ she said finally, ‘but I have a feeling that the doctors might want to sort it out for you. I’ll just give one of them a call.’
She bleeped Luca and explained what had happened over the phone, breaking off for a few seconds as the stabbing pain hit her again.
‘Tia?’ Luca’s deep voice was sharp and concerned down the phone. ‘Are you all right?’
She sucked in a breath and waited for the pain to pass. ‘I’m fine,’ she told him, changing the subject quickly. ‘So will you come and take a look at Lisa Burn for me?’
‘I’ll be five minutes,’ he said shortly, and she suspected that his haste was as much to check on her as the patient.
She was right.
He strode onto the ward in record time, his dark eyes cloudy with concern as he walked towards her.
‘She’s in Ward 4,’ Tia began, but he raised a hand and stopped her in mid-flow.
‘I’ll see Lisa in a minute. First I want you to tell me what’s wrong. And don’t say nothing because I know you well enough by now to know when you don’t feel right.’
It was true.
From being someone who didn’t understand her at all, he now seemed to be able to virtually mind-read.
‘I’ve felt a sharp pain a couple of times, that’s all,’ she mumbled, and his broad shoulders tensed slightly.
Maybe he was more anxious than he seemed to be.
He asked her some questions and then gave a sigh. ‘You’re probably right that it’s nothing,’ he said, his eyes scanning her pale face, ‘but I would prefer that you went home.’
Her eyes slid away from his. ‘I’m all right at the moment. If it comes back, maybe I will.’
‘Tia…’ His voice was a low, threatening growl and she looked at him pleadingly.
‘Luca, they’re so short-staffed here, it would put a terrible strain on them if I went home. I’m not doing anything strenuous and, anyway, this is the best place to be if something is going to happen.’
She didn’t voice her fear, but she was terrified of being at home on her own when the baby came. It didn’t matter whether Luca loved her or not—when it came to the baby she trusted him implicitly.
‘All right.’ He relented, stroking her cheek with lean brown fingers. ‘But try and rest as much as you can.’
‘I promise.’ Tia flushed slightly and her breathing quickened under his touch. ‘Are you ready to see Lisa now?’
Luca nodded, his eyes clinging to hers for a long, very unsettling moment. Then he seemed to pull himself together.
‘All right. Where is she?’
He examined Lisa and immediately agreed with Tia. ‘It’s a haematoma. We’ll observe it for a few hours and see if it contains itself.’ He glanced at Lisa. ‘I suspect we will need to take you to Theatre and evacuate the clot.’
True to her promise, Tia was careful not to do anything too energetic during the rest of her shift, and when Luca came back onto the ward to check on Lisa for the second time, she was sitting down, talking to one of the mothers who had just come back from Theatre.
She stood up instantly when she saw Luca and together they had another look at Lisa.
‘It’s spreading,’ Luca said immediately, his eyes quietly sympathetic as he looked at Lisa. ‘I’m going to pop you down to Theatre, give you a small anaesthetic and get rid of this blood clot.’
‘I’ll make the arrangements,’ Tia said at once, and busied herself doing just that.
Once she’d escorted Lisa down to Theatre it would be time to go home, but she wasn’t at all sure that she really wanted to go.
She hadn’t felt the pain for a few hours.
But what if it came back and she was on her own?
She lingered on the ward for another hour and then decided that she was being ridiculous. After all, she could hardly stay at the hospital all night, could she?
Gathering her belongings from her locker, she said goodbye to the rest of the staff and made her way to the car park.
Maybe a warm bath would relax her, and after that she could prepare some supper for Luca.
At eight o’clock Tia was pottering around the kitchen in her dressing-gown when the phone rang.
It was Luca, of course, telling her that he’d be late.
She replaced the receiver and looked sadly at the casserole which was bubbling temptingly on the top of the cooker.
Every time she tried to cook him a nice meal he missed it, but there was nothing that could be done. She turned the heat off with a resigned sigh, helped herself to a portion and then dropped the plate with a clatter as a sharp pain ripped through her abdomen.
Doubled over and gasping, she struggled over to the kitchen table and flopped into the nearest chair, trying hard not to panic.
It was the same pain she’d felt periodically earlier in the day, only this time it was a thousand times worse. It was as if someone was using knives on her insides. Surely this degree of pain wasn’t normal? She stroked a hand over her stomach, trying to relax herself, talking quietly to the baby. At least she was still feeling plenty of movements and she knew how important that was.
Suddenly she wished desperately that Luca was at home.
Should she phone him? She glanced at her watch, torn between the need for reassurance and guilt at disturbing him. The probability was that she’d be worrying him unnecessarily.
Maybe she’d just see how she felt in half an hour.
He’d promised not to be too late but he’d also mentioned that he had an emergency section to perform so she knew that he wouldn’t be home for a few hours at least.
Tia frowned ruefully at the mess on the kitchen floor. What a waste of casserole! She really ought to clean it up but she was afraid that if she moved the pain might come back.
A glance at the clock on the kitchen wall told her that it was only eight-fifteen. Just a quarter of an hour since Luca had called. Which meant that she needed to fill her time with something or she’d go mad.
Gingerly, still with one hand on her stomach, she stood up, waiting for the pain to tear through her again. Fortunately, it didn’t. It was still there, lurking menacingly in the background, but instead of
stabbing, it seemed to have settled down to a dull sawing that was more bearable.
She walked slowly through to the sitting room and lowered herself carefully onto the sofa, stretching out her legs and breathing steadily. She felt the baby kick against her hand and gave a soft smile. Whatever was happening, it was good to know that he was still all right.
She flicked on the television and became absorbed in a programme on dolphins, settling herself more comfortably on the sofa. Gradually her eyes closed and she drifted off, only dimly aware of the deep voice of the narrator in the background.
She awoke desperate for the bathroom and clumsily manoeuvred herself off the sofa and up the stairs.
The minute she opened the bathroom door she knew she was bleeding and icy rivers of panic trickled down her spine.
Dear God, no. Please, not that…
She needed Luca.
Even as she moaned his name she heard his key in the lock and she sagged with relief and called again, this time loud enough to be heard.
She heard the urgent pounding of his feet on the stairs and then he was beside her, his expression grim as he scanned her pale face.
‘Dio, Tia—you are in pain again?’
She nodded slowly and straightened, trying to catch her breath. ‘Yes, but that’s not all.’ She broke off and gazed up at him, her green eyes deep pools of fear. ‘Luca, I’m bleeding.’
He wrenched his coat off and slung it unceremoniously over the bannister and then steered her towards the chair in the bathroom. ‘Why didn’t you call me?’
She shook her head and bit down on her lower lip, trying not to cry out. ‘I fell asleep. Oh, Luca…’ Tears of panic and pain welled in her eyes and she looked up at him, desperate for reassurance. ‘What’s happening?’
‘I don’t know yet, but I soon will,’ he promised her, crouching next to her, his voice strong and reassuring. ‘Trust me, cara. We need to get you to hospital. It will be safer to examine you properly there. Will you be all right if I just go and call an ambulance?’
‘No.’ She grasped his arm and shook her head. ‘No ambulance. I don’t want you to leave me. Can you take me in the car? Please, Luca?’
He spoke rapidly in Italian and raked long fingers through his sleek, dark hair.
‘How much are you bleeding?’ He was virtually talking to himself as he checked quickly, his mind obviously working through the options. ‘It’s not too bad at the moment. All right, we’ll go in the car. Can you stand up?’
She hesitated and then nodded, sliding to the edge of the seat and standing gingerly, bracing herself as she waited for the pain to tear at her insides again.
He lifted her easily in his arms, ignoring her protest that she was too heavy, and carried her down the stairs and out to the car.
‘All right.’ He accelerated away smoothly, driving as quickly as he safely could. ‘I want you to describe the pain to me again. Where is it? How does it feel?’
‘It’s here…’ Tia winced and rubbed a hand low over her abdomen. ‘Quite low down and it comes and goes.’
‘Does it feel like labour?’ Luca broke off and shook his head impatiently. ‘Forgive me, that was a stupid question. You don’t know what labour feels like. Try and describe the pain, Tia.’
Tia looked at him helplessly. ‘I don’t know if I can. Stabbing, quite rhythmic—it feels as though something’s wrong.’
Luca stretched out one hand briefly and rested it on the top of her abdomen. ‘It doesn’t feel as though you’re having contractions. Everything will be fine, cara mia,’ he said softly, ‘but we do need to get to the bottom of the pain and I’d rather we did that in the hospital to be on the safe side. When did you last feel the baby move?’
‘Just before you arrived.’ She gave him a nervous smile. ‘He kicked me really hard.’
He nodded and put both hands back on the wheel. ‘Good.’
The trip to the hospital took less than half the usual time and in no time at all she was on the labour ward.
‘I want to examine your abdomen.’ Luca helped her move into the right position and adjusted her clothing to give him access. ‘OK, let’s see what’s going on here…’
His hands moved gently over her abdomen, a frown touching his handsome features as he examined her.
‘The consistency of your uterus is normal. Is there any tenderness?’
‘No—not really. It hurts but I don’t think it’s anything you’re doing.’
‘I want you strapped to a monitor and I want to scan you. Now.’ Luca straightened up in a lithe movement and glanced at Tia who was fighting back tears of panic.
Why, oh, why did this have to happen?
If anything happened to the baby…
She closed her eyes and tried to calm herself down. Luca didn’t need her to fall apart.
Scanning her tense features, he pulled her into his arms, talking soothingly in Italian before switching to English.
‘Calm down. It will be all right.’
She stared up at him, her eyes frightened. ‘If I lose the baby, Luca…’
He brushed her cheek with his knuckles. ‘You won’t lose the baby.’
‘What do you think is wrong?’ She shifted slightly on the bed, trying to find a comfortable position.
‘I suspect you have a mild separation of the placenta,’ he said quietly, walking towards the door. ‘We’ll have a better idea once we’ve scanned you.’
Tia felt as though she’d been showered with cold water and her palms suddenly felt sweaty. A separation of the placenta. She should know all about that, but suddenly everything she knew seemed to have vanished from her head. All she could think about was that she couldn’t bear the thought of losing the baby.
‘I’m only thirty-three weeks pregnant, Luca,’ she reminded him hoarsely, her words stopping him in his tracks. ‘It’s too early.’
‘The baby is a good size, and you’re only a day off thirty-four weeks,’ Luca said firmly, turning as Sharon appeared at the doorway. He spoke to her quietly and then turned back to Tia. ‘Let’s try not to panic until we know what we’re dealing with.’
Seconds later Sharon came in again with the relevant machines and Luca gave her a grateful nod.
‘I want to scan her and then I want her on a monitor. And could you call Dan Sutherland? I’d like his opinion.’
‘Well, he certainly owes you some time after all the clinics and Theatre lists you’ve covered for him this week,’ Sharon said immediately, her eyes on Tia. ‘Don’t you worry. You’re in the right place now and that baby of yours is going to be just fine.’
Tia forced back the tears that were threatening. She hoped they were right.
Luca scanned her carefully, checking the position of the placenta and looking for concealed bleeding.
‘There.’ He leaned forward and touched the screen with his finger to show Sharon what he’d noticed. ‘The placenta is in the upper segment and I can see just a small concealed bleed. I want her kept on a monitor, Sharon.’
Tia licked dry lips. ‘My placenta is coming away?’
Luca looked at her hesitantly. ‘Yes. But it’s only a small area—’
‘Luca, I’m a midwife,’ she reminded him in a croaky voice. ‘Small areas can become big areas.’
He sat down on the bed next to her, taking her hands in his. ‘Tia, now that we know what the problem is, we can deal with it. The baby is absolutely fine at the moment. He is still getting plenty of oxygen. We’re going to admit you to the ward here and you’re going to take it easy for a few days while we watch you.’
A lump grew in her throat at the thought of being on her own in a sterile hospital room.
She wanted to go home to their cottage.
‘This is all my fault,’ she whispered, placing a protective hand on her abdomen. ‘The baby must have known that I didn’t want it, but now I do, desperately, and—’
‘Hush.’ Luca’s voice was firm but kind. ‘Don’t torture yourself. The feelings you ha
d were perfectly normal. They certainly have no bearing on the fact that you’re bleeding. You need to try and relax, Tia. Please.’
Tia took a shuddering breath and tried to pull herself together. ‘I want to be at home—’ She almost said ‘with you’ but stopped herself just in time. The last thing he wanted was her all over him. They were good friends and they had an amazing sex life, but that was it.
‘Well, if you’re worried about not seeing Luca, don’t be,’ Sharon said briskly, helping Tia back into the wheelchair. ‘The man has a second home here in case you hadn’t noticed. He can sleep in the spare on-call room on the ward if he likes.’
‘Good idea.’ Luca nodded immediately. ‘I’ll pick up some stuff later and move in until you’re sorted out.’
The knowledge that he’d be close to her made her relax for the first time since she’d arrived at the hospital, and she gave him a grateful smile.
He might not love her but she certainly couldn’t fault the way he behaved towards her. He was very attentive and caring.
‘Right.’ He rubbed a hand over his face and took a deep breath, obviously marshalling his thoughts. ‘Let’s get you up to the ward and then I want to do a haemoglobin, a coagulation screen and a Kleihauer test.’
Dan Sutherland strolled into the room at that moment, his expression concerned as he looked at Tia.
‘What’s been happening to you, then?’
Luca filled him in and Dan nodded slowly. ‘Right. We really need to do a speculum examination as well. Would you rather I did that?’
Tia nodded, her cheeks flaming red. It shouldn’t have been embarrassing to be examined by Luca but she knew that it would be.
Sensitive to her feelings, Luca mentioned something about fetching some blood bottles and strode out of the room, leaving her with Dan and Sharon.
‘Poor chap.’ Dan glanced after him, a sympathetic expression in his eyes. ‘It’s never easy, having someone you love as the patient. He looks so stressed.’
Tia was hardly aware of what Dan was doing as he carried out his examination. It was true that Luca was stressed, but she knew that it was because of the baby, not her. She knew just how much the baby meant to him.
‘The bleeding is definitely from the uterine cavity,’ Dan said finally, tearing off his gloves and tossing them in the bin. ‘How far on are you? Thirty-three weeks—nearly thirty-four.’ He frowned down at her notes, lost in thought. ‘All right. Sharon, let’s give her some dexamethasone because I have a feeling that this baby might decide to make an appearance early.’