This time Annie couldn’t help herself. She got up and went to stand beside him, touching his arm. He flinched almost as if she had burnt him.
‘And Sebastian? What about him?’
His voice was raw when he spoke. ‘Whatever she says, he is my son. I was the one who looked after him in the night when he couldn’t sleep. The one who kissed his knee when he scraped it. Whatever the court says, he is still my son.’
‘Do you see him at all?’
‘No. That is why I am speaking to the lawyers about this baby.’ He smiled grimly, still looking into the distance. ‘I can’t lose this child too. You must see that.’
Annie could see it. Just by looking at him she could tell how badly he had been hurt. More than hurt, betrayed. It was the sadness she had seen inside him the night they had first met. And it was still there. But that didn’t mean she could risk losing control over her child’s future to appease a hurt Raphael had experienced at the hands of another woman. No matter how sympathetic she felt.
‘I wouldn’t stop you seeing your child. Not unless I thought it was harmful in some way. Can’t you trust me to do the right thing? After all, I needn’t have told you I was pregnant.’
‘I know. I misjudged you. And for that I am sorry. Can we start over again? Please?’ He smiled his killer smile which never failed to make Annie go weak at the knees.
She felt a shiver of excitement, and her heart beat faster. Did he mean start over from where they had left off in Spain? Did he still feel that same connection she did?
‘Can we be friends for the sake of our child? Work something out between us?’ Raphael continued.
Annie’s heart plummeted. Of course, she should have known. All he was interested in was the child. But he had a point—no matter how disappointed she felt that he didn’t want anything more than friendship from her, they needed to reach an agreement about what was going to happen once the baby was born.
‘You can come and see him any time you like,’ Annie said through stiff lips.
Raphael drew his brows together. ‘But I would also want him to come to Spain. He must get to know his family, what it is to be Spanish. I would want him to visit often.’
Instinctively, Annie placed her hands protectively on her belly. Could she trust him? This man she barely knew, yet was the father of her child? How was she going to bring herself to let this precious little one out her sight for a second, never mind to another country.
‘Don’t you trust me?’ he asked softly, as if he had guessed what she was thinking. ‘What can I do to make you believe me that I only want to do what is right for my child?’
Raphael raised a finger to her cheek, tracing a line down to her jaw. She couldn’t have felt his touch more keenly if he was drawing a knife across her skin. ‘What are you thinking? Please—tell me, cariño.’
This time it was Annie who drew away. She wrapped her arms around her body.
‘A year ago, I was going to get married, to Robert. We had known each other almost all our lives and planned to have a large family,’ Annie said slowly after a few moments. ‘But my periods had been irregular for years and somebody at the clinic I worked in, back in Edinburgh, suggested I have a fertility test.’ She looked into the distance, remembering. ‘I took it more out of curiosity than anything else. It never really occurred to me that there could be a problem.’
‘What was this test?’ Raphael asked.
‘It’s called an AMH. It’s fairly new but deemed to be very reliable.’
Raphael nodded. ‘I have read about it in the medical journals.’
‘Apparently my ovarian reserve was so low that even IVF would be out of the question.’
Raphael looked at her steadily.
‘Go on,’ he said.
‘It hadn’t even crossed my mind that there wasn’t plenty of time to think about having a child. You don’t think when you’re twenty-seven that it’s already too late do you? At least, I didn’t.’ She remembered only too well her feeling of shock and disbelief. ‘When I told Robert he was dismayed. And once he realised that even IVF was out of the question, he began to change. I told him that we could always adopt, but he said that he could never bring up another man’s child. After that we drifted apart. There was no more talk of weddings. I realised he couldn’t love me the way I thought he did, so I called the whole thing off. I think he was relieved. That’s when I decided to come to Penhally Bay. To start afresh. But the pain follows you, you know. It’s ironic, being a midwife. Every day you’re confronted with what you can’t have. Don’t get me wrong, I love my job and I love bringing happiness to all these couples, but it used to hurt.’
‘He couldn’t be much of a man, this Robert,’ Raphael said, frowning.
‘I can’t blame him. He wanted something I couldn’t give him. It was unfair to expect him to give up the chance of a family for me.’
‘If you were my woman, I wouldn’t have let you go. You should be with someone because you have to be. Not because you want children.’ His eyes were warm with sympathy. ‘But now I understand. Our baby will be very special for you. But for me, also.’
Annie nodded, relieved that he seemed to understand. ‘Raphael, this baby is like a miracle to me. I can’t believe how lucky I am. It’s unlikely, though, that I will ever fall pregnant again. This is my one chance to have a child.’ Annie struggled to keep her voice even. She knew there was no way that she could convey properly how devastated she had been when she had thought having a child of her own was an impossibility. And anyway, did she want to reveal anything more of herself to this man? She had already shown him too much of her soul. He was the father of her child, that was all, and she’d do well to remember that. Even if it almost broke her heart.
CHAPTER EIGHT
A FEW weeks later, Annie was back at work, feeling much more rested. She was surprised to find Claire and Roy waiting to see her. Claire wasn’t due to come in for another couple of weeks and Annie was immediately concerned to see her back so soon. She was even more worried when she saw the look of anxiety on the couple’s faces.
‘What is it Claire?’ Annie asked gently. ‘What’s bothering you? Is it the babies?’
‘I’ve had a little spotting,’ Claire said anxiously. ‘I know it can happen sometimes, but—’
‘We just wanted to make sure everything was all right,’ Roy finished for her.
Annie’s heart went out to the couple. She knew they’d be terrified. Claire had seemed so fragile the last time Annie had seen her that she was worried that if she lost the babies she would sink so far into depression that she might not come out the other side. Claire was already in her late thirties and the chance of another pregnancy was diminishing with every passing year.
‘I’m going to page Dr Castillo. His special interest is high-risk pregnancies and I’m sure he’ll want to scan you, Claire, to see what exactly is going on. I’ll ask him to come as soon as he’s free. In the meantime, could you try and drink as much as possible so your bladder is nice and full for the scan?’
Claire’s eyes filled with tears and she reached for Roy’s hand. ‘I’m so scared, Annie,’ she said shakily. ‘I don’t know if it’s better not knowing, if you see what I mean? As long as I don’t know I—we—still have hope.’
Annie stood up and went over to Claire and wrapped her in her arms. ‘You’re way ahead of yourself. I know how scary all this can be. Believe me. Let’s just take one step at a time, okay?’
When Claire nodded, Annie picked up the phone and asked switchboard to page Dr Castillo. While she waited for him to answer she filled a glass of water from the jug on her desk and handed it to Claire.
‘Dr Castillo.’ Annie heard his deep voice on the other end of the phone. ‘You were paging me?’
‘Dr Castillo,’ she said formally. ‘It’s Annie. I have someone I’d like you to scan. Could you come down to the antenatal clinic?’
‘I’m due in theatre in fifteen minutes. Can it wait until later?’
Annie looked over at Claire, who was drinking the water as if her life depended on it. ‘No,’ she said, ‘it can’t.’
‘Are you all right?’ Immediately the concern was back in his voice.
‘Of course,’ Annie said. ‘It’s a couple with a twin IVF pregnancy. She’s had some bleeding and is feeling anxious.’
‘I’ll be right there,’ Raphael said, and disconnected.
Annie only had enough time to prepare Claire for the scan before Raphael arrived. He was wearing his theatre scrubs, which framed his muscular body perfectly. Once more, despite herself, Annie felt a thrill when he came into the room. Must be the pregnancy sending her hormones into overdrive, she told herself.
Raphael introduced himself to the worried couple and his easy and relaxed manner soon put them at ease.
While he set up the scanning machine Annie gave him an overview of Claire’s history to date. ‘This is their third attempt at IVF. Neither of the first two goes resulted in a pregnancy, but this time both the embryos put back implanted successfully. Claire had a scan around seven weeks and two heartbeats were clearly visible at that stage. She’s been well up until now, but had some spotting last night. They thought it best to have it checked out.’
Raphael caught Annie’s eye. It was obvious from the sympathetic look in his eyes that he knew how close to the bone seeing Claire was for her.
‘How many weeks into the pregnancy are you?’ he asked Claire, bringing her into the conversation.
‘Twenty-four,’ Claire replied.
Roy held his wife’s hand as Annie covered her stomach in ultrasound gel. They all watched the screen as Raphael scanned. As the image came up on the monitor, Annie could immediately make out two heartbeats. She felt a surge of relief, but almost as quickly it was replaced with concern. While two babies were clearly visible, neither of the babies were the size they should be for the dates. To make matters worse, one was significantly bigger than the other. As Raphael turned to look at her, she could see he shared her concern.
‘I have some good news for you and some not-so-good news,’ he said gently. ‘As you can see from the monitor—’ he indicated the two beating hearts with his finger ‘—there are two heart beats—there and there.’ Claire and Roy craned their heads to see what he was showing them. ‘The problem, however, is that one baby—’ he pointed to one of the tiny forms ‘—is significantly smaller than the other. This suggests that the bigger baby is taking more than its fair share of the nutrients from the placenta, meaning that the smaller baby is struggling to get enough to grow.’
‘What does it mean?’ Roy asked.
‘It means,’ Raphael said, ‘that both your babies are still alive. That’s the good news. However, we will have to monitor both of them carefully over the next couple of weeks. If it looks like the second baby isn’t getting enough nutrients, we will have to think about what to do.’
‘What might those options be?’ Although Roy’s voice was calm, Annie knew he was only keeping it together for Claire’s sake.
Raphael looked at him sympathetically.
‘It’s too soon to know. As I said, we will monitor your babies very closely over the next couple of weeks. Keep an eye on their growth.’
‘And if the second baby doesn’t grow? What then?’ Roy insisted. ‘Look—’ he turned to his wife and gripped her hand tightly ‘—we’d both prefer to know, so please tell us. What is the worst that can happen?’
‘We might have to deliver the twins much earlier than we would like. I know this a lot for you to take in, and I believe it is important for patients to have all the facts so they can be fully involved in the decision making process, but I am not ready to make that decision yet. As I say, we should wait and see how they get on.’
Claire turned terrified eyes to Annie.
‘I don’t understand,’ she said. ‘Annie, is there a chance my babies could die?’
Annie put her arms around the distraught woman’s shoulders. ‘;There’s nothing to suggest that right now, Claire. I know all this is difficult for you to take in. But you are lucky to have Dr Castillo to look after you. He is one of the leading experts in his field. We have to trust him.’
Raphael looked at Annie, seeming surprised at her warm endorsement, but then he turned to the couple.
‘I want you to go home and try not to worry, even though I know that will be difficult. I will scan you again in two weeks’ time. We will have another look at your babies then, and think about what to do. In the meantime, all we can do is wait.’
And pray, Annie thought. Pray that this couple weren’t going to have their dreams dashed. But Raphael was right, there was nothing more that could be done right now.
She made another appointment for Claire and Roy to come back to see her and Raphael before seeing them out of the department. When she returned to the room, Raphael was still there, writing in Claire’s notes.
‘What do you really think?’ she asked him.
He looked up at her, surprised. ‘Exactly what I told them. We’ll know more in a couple of weeks. In the meantime, all we can do is wait.’
‘Couldn’t we have waited until the next scan? Now they’ll have days of worry to live through when it might not be necessary.’
Raphael narrowed his eyes at her. ‘I believe that parents have the right to know all the details. The days when doctors decided to hold back information from their patients for their own good are gone. No?’
‘But if it means putting them through unnecessary worry? Can’t you see how terrified they are?’
Raphael leaned back in his chair and looked at Annie thoughtfully. ‘Tell me,’ he said softly, ‘if you were in her shoes, would you want to know the truth?’
Annie knew she was being unreasonable but she couldn’t help herself. Having experienced the terror of thinking she was about to lose a desperately wanted child, she knew exactly what Claire was going through. Raphael leaned across the desk and touched her arm gently.
‘They asked me for the truth, Annie. I couldn’t do anything else but tell them. Can’t you see that?’ He dropped his hand. ‘Maybe you are getting too close to your patients. We need to keep some professional distance, otherwise we can’t help them.’
Suddenly all the anger went out of Annie. Raphael was right. Roy had asked and he had deserved an honest answer. And Raphael was right too about her letting her personal feelings get in the way. If she were to help the couple, she needed to keep her perspective.
Later that day Annie saw Mrs Duncan, a smiling mother of four young children.
‘Nurse Kate sent me here for a scan,’ she said, settling herself into the chair. ‘I’m pregnant again. Number five! I know it’s a bit unexpected—for me, too—but the more the merrier, I say.’
Annie looked at Mrs Duncan’s notes. Her last pregnancies had been straightforward and Kate had looked after her at the surgery. The first two had been born at St Piran’s and the last two at home, with Kate in attendance.
Instantly she was concerned. Mrs Duncan had been in her mid-thirties when her first child had been conceived and almost forty when her youngest, now four and a half, had been born. At almost forty-five Annie knew that the chances of the baby having some sort of abnormality were significantly raised. No doubt the same thought had occurred to Kate and that was why she had sent the woman to Annie’s clinic for a nuchal scan. But it seemed as if the reason for the scan hadn’t really sunk in with the happy woman in front of her.
‘It’s not the best timing,’ Mrs Duncan continued. ‘Not with the six of us still living in the caravan while our house is being rebuilt. Although we should be back in our own house by the time this one is ready to be born.’
Annie shivered as she remembered the storm that had devasted a large part of Penhally Bay months earlier. The buildings that had been damaged were almost repaired but two people had lost their lives and no amount of rebuilding would ever completely undo the trauma of that day in people’s minds. She couldn’
t help but admire her patient’s cheerfulness in the face of what must be very demanding circumstances.
‘I’m sure Kate told you why she was sending you here for a scan, Mrs Duncan?’ Annie asked. Of course, the senior midwife at Penhally Bay Surgery would have explained it all to her patient, but from Mrs Duncan’s cheerful attitude, Annie sensed that she didn’t seem to realise that she had a significantly higher chance of a chromosomal abnormality in this pregnancy.
‘Oh, please call me Mary,’ the older woman said. ‘And, yes, Nurse Kate said that everyone was offered a scan when they were twelve weeks now. So that’s why I’m here. I’ll have my scan and then if you could give me the picture, I’ll be on my way.’
Annie suppressed a smile, before inviting Mary up onto the couch. News of the brand-new scanner they had at St Piran’s had spread quickly. The 3D images were clear enough to see even minute details and patients loved taking home photographs of the images. But almost as soon as she started to scan Mary, she could see that her instincts had been right. The nuchal fold, indicating an increased chance of Down’s syndrome, was obviously thicker than normal. Her heart sank.
Mary quickly sensed that something was wrong. She squinted at the screen and then turned to look at Annie.
‘What is it?’ she asked. ‘There’s something wrong, isn’t there? I can tell from the look on your face.’
‘I’ll need to do a blood test to confirm it, but I have to tell you that there are signs that your baby has a higher risk of Down’s syndrome. If the blood test comes back positive, you may wish to think about amniocentesis.’
‘What’s that when it’s at home? Anyway, I thought that was why I was having this scan.’
Caroline Anderson, Anne Fraser, Kate Hardy, Margaret McDonagh Page 24