Josie also predicted he would not plan on coming for another hour or more. He hated having to wait around for “his part”. She was in no mood to deal with him tonight.
Josie’s predictions rang true when Dr. Curtis responded to her page some ten minutes later.
“She went from a four to an eight in an hour,” Josie said. “With the intense contractions she’s having now, I’m sure it won’t take much longer.”
“This is her first baby, though. Bet you ten to one she’ll be pushing for at least an hour.”
Josie didn’t respond. Sometimes she wondered if he had a script on his night stand that he always read verbatim. Too tired to deal with him right now, she hung up the phone somewhat rudely and returned to her patient to begin preparing for the baby’s arrival and help Pamela stay focused and relaxed during her strong contractions.
“Oooohhh!” Pamela’s loud moan greeted her when she stepped through the door.
“Short, shallow breaths now, Pamela,” she said, putting her own fatigue aside and shifting into high gear. “He-he-he.”
Pamela tried breathing the way Josie instructed then replied in a strained voice, “I feel...like I need...to push.”
“I know,” Josie said, moving to the bedside. “You’re going to have to wait a little longer though. Relax and keep breathing. I promise it will help.”
“I don’t know...if I can wait...” Pamela said, gasping for breath and groaning even louder than before.
“Almost through with this one,” Josie said, looking at the black line beginning to decline on the graph and taking note of how long it had lasted. She began to feel concerned at Pamela’s sudden sense of desperation. She had been so calm all night.
Josie waited until Pamela took some deep breaths to recover before revealing Dr. Curtis’ views on epidurals. “But it’s up to you,” she said. “If you want one, then I’ll call him back and get him to change his mind.”
Pamela didn’t have time to respond as another contraction began, less than thirty seconds after the previous one. Josie could see the sharp rise on the printout. Fearing for the baby’s well-being with such an intense contraction, she checked the monitor but saw the baby’s heart rate remain well within safe limits.
“I think I better check you again with the next one,” Josie said after Pamela kept saying she wanted to push throughout the intense contraction.
She asked Pamela to lie back. Removing the blankets from her patient’s legs, she felt her heart leap into her throat. The head was coming.
“Well, your body isn’t wasting any more time,” Josie said, paging the desk for assistance.
Gina answered. Explaining her patient’s situation, Josie asked her to page the resident on duty.
“She’s assisting in an emergency c-section,” Gina replied.
“Any other doctors here?”
“Not that I know of.”
“Midwives? Sue?”
“Sue’s not at the desk. I’m not sure about midwives. I’ll check around and let you know,” she said.
Josie flipped on the light to the warmer, tossed some blankets on the pad, and hurried to pull out the delivery cart from a large bottom cupboard.
Stepping back to check on Pamela, she watched as another contraction began. Josie pulled a stool to the end of the bed and tried to stay calm. Panicking would not do her patient any good.
Sue stepped into the room. “What have we got, Josie?”
Josie felt relieved to see her. “This baby is coming--now!”
Sue stepped over to have a look for herself. “You can say that again.”
Josie kept her eyes on the head as it began to crown. Pamela moaned even louder than before as another contraction seized her. “Don’t hold your breath, Pamela. Push when you need to.”
Josie began to move aside and let Sue take over, knowing she had delivered many babies in her fifteen years of experience, but Sue stopped her.
“You can do this, Josie,” she said. “She’s your patient. I will assist.”
On the inside Josie trembled with fear, but on the outside she felt as steady as a rock. Her patient needed her to be.
Pamela pushed and the baby kept coming, not seeming to care that a nurse instead of a doctor was waiting to catch him. The head came through without struggle and the body came soon after.
Grasping the warm baby in her hands as it emerged, Josie let out the breath she’d been holding and smiled with relief. The baby began to wail, and she laid the newborn on Pamela’s chest.
“It’s a boy,” she announced.
Sue had a warm blanket waiting and dried the newborn’s skin.
“Good job, Pamela,” Sue said to the new mother. Lifting her eyes to Josie, she smiled at her and winked. “Good job, Nurse Matthews.”
Watching babies be born was one thing, being the first one to hold a brand new life was quite another. The experience left Josie flying high. She remained in good spirits for the remainder of her shift. Nothing could permeate her light heart.
“Hey, there’s the doctor now,” Dr. Jacobs greeted her a few hours later when she stopped at the nurses’ station. Apparently he had heard about the eager baby.
She waved him off. “Nothing to it.”
“Have you ever considered becoming a midwife, Josie?”
He sounded serious, and Josie stared at him. The thought had crossed her mind a few times. Certified nurse-midwives were in high demand. The hospital employed two who were always on call, and many clinics had one or more to take the low-risk patient load off the doctors’ crowded appointment schedules.
“I suppose I have. Maybe somewhere down the road,” she said. “At one time I wanted to be a doctor, you know.”
“Yes, I remember you telling me that.”
Dr. Jacobs had gotten to know her on a more personal level than most of the other doctors she worked alongside regularly. He always took the time to ask her about Tommy and life in general, and she tried to ask about his wife and three kids. She had learned so much from him about labor and delivery and had a great deal of respect for him both as a mentor and a friend. She did not take his next words lightly.
“I have no doubt you would make an excellent one.”
She didn’t know if he meant as a doctor or a midwife, but his words remained with her the rest of the morning. Deep down she knew she would love to be either, but she didn’t see it as a possibility. At least not yet.
Before she had discovered her pregnancy during her final month of college, she had been accepted to one of the top medical schools in the country. Her plans had been put on hold, however, and she had decided to pursue nursing instead. Becoming a midwife did not take as much training as a doctor, but she knew she didn’t have the time or the money for either right now.
Josie pushed the thought aside and returned to Pamela’s room one more time. The baby slept in his bassinet, and Josie stroked his fuzzy cheek. Looking at the name tag above his head, she saw they had named him Tyler.
“I will think of you often, Tyler,” she said, recalling the absolute thrill it had been to guide him into the world. A baby’s first breath had never been sweeter.
***
The smell of fresh rain came on Thursday afternoon as Josie waited for Tommy’s bus to arrive. The air felt warm, but fat drops of moisture cooled Josie’s bare arms. The sun had been out when she had returned home from the hospital that morning, and she had not anticipated the sudden change. Seeing others around her in the same predicament, she knew the storm clouds had moved in over the city in the last few minutes.
Tommy had not worn his coat either, and they hurried back to their building with the rain spattering them with a good shower. Josie always enjoyed the dry summer months, but she welcomed the rain back too. Growing up in Oregon, she had become used to the wet climate, and even though it could be an inconvenience at times, the rain brought a sense of comfort also. Something she could always count on.
Josie stopped to get her mail, and they walked to t
he elevator. They only waited a brief moment before the doors opened. Josie smiled at the familiar faces stepping from the cubicle.
“Hi,” she said to Angela and Rick, then dropped her eyes to Baby Nathan awake in his carrier.
She knelt down to his level. “Hello, sweetie. How are you?”
The baby stared back at her with wide gray eyes. “We’re on our way to the doctor for his four month checkup,” Angela said.
“Four months. Wow! You’re sure getting big,” she said to the wide-eyed baby. He began sucking on two fingers.
Josie returned to her full height. “Time for shots?” she asked.
“Yes,” Angela sighed. “I hope they don’t keep him up all night this time.”
“I remember those days,” she said, corralling Tommy in front of her. “You were a very fussy boy for two days straight every time.”
Tommy wiggled out of her arms, and they all laughed.
Rick and Angela needed to get going and said good-bye. Josie and Tommy took the elevator to the top floor and spent the afternoon indoors. Josie wished she didn’t have to go to work but comforted herself with the knowledge she only had one more night to go and then could enjoy three full days off.
By the middle of her shift that night she felt drained and didn’t know how she would make it through the remaining hours. The exuberance of her exciting night two days before had worn off, although she continued to hold the memory of Baby Tyler close to her heart.
She had been with one woman most of the night, through seven hours of labor and an hour of pushing before the baby had made its way into the world.
“You should get some rest now,” she said, hanging her stethoscope around her neck. “Would you like me to take the baby to the nursery?”
Her patient nodded. “Bring him back when he wakes up, okay?”
“Sure thing,” Josie said.
The new mother’s eyes were closed again by the time she left the room. Josie wheeled the bassinet with the sleeping baby aboard to the nursery, left him in the care of the nurse there, and went to the nurses’ station to see if she had any new assignments. Fortunately she did not.
Having neglected her two postpartum patients longer than she liked, Josie decided to check on them before taking her break. The first one she found sleeping. The second needed some help with breast-feeding. Josie stayed until the newborn had eaten successfully on both sides.
She took a late lunch and then returned, taking on another patient who had come in. The young woman delivered at six-thirty, under the care of a certified nurse-midwife. Josie always liked working with Joy. She lived up to her name and continued to show the same level of excitement over each birth, no matter how many she had done. Unlike the doctors who were generally only present for the final minutes of labor, Joy was there from beginning to end, and she usually stayed for an hour or more afterwards.
Josie decided to ask Joy some questions before she left. Dr. Jacobs’ words had lingered with her for the last two days.
“How long have you been doing this, Joy?”
“I’ve been at the clinic with Dr. Watt and Dr. Kirkwood for about three years, but I also worked at a hospital in Washington before that for two years as an on-call midwife.”
“Which do you like better?”
“This,” she replied without hesitation. “As an on-call midwife I only delivered babies for women I had never met before. But now I see my patients throughout their pregnancy. It’s much better this way.”
“What made you decide to become a midwife?”
“I was an L&D nurse for ten years. I’d seen it all and was getting a little bored and restless. I loved it, but I worked in a hospital where the patients were being treated like they had a disease instead of giving birth. It wasn’t like it is here. The patients didn’t have any choices about their childbirth, and I got tired of telling patients to do things I didn’t believe in.”
Josie understood what she meant. “I know some doctors and nurses around here who still treat their patients that way. A couple of days ago I had a woman who hadn’t made much progress after being here for most of the day and when I asked if she had been out of bed at all, she didn’t even know that was allowed. It’s very frustrating.”
“A lot of people are afraid of change,” Joy said. “Their motives are sincere, but they don’t trust birth and forget that women’s bodies are designed to do this. Sure, things go wrong sometimes and interventions are necessary, but most of the time the babies would come with or without us.”
Josie wanted to know more. “How exactly does it work between you and the doctors at your clinic?”
“I work mostly with low-risk patients. All of them are seen by me on their first visit, and I determine whether or not they have any risk factors that are beyond my training. If not and they don’t develop any problems during the pregnancy, I continue seeing those who agree to having me as their primary caregiver, and I am the one who delivers the baby too. I can always call one of the docs during labor if I have any concerns or a complication arises. We discuss the situation and they come in if I or they feel it’s necessary.”
“I take it you enjoy your job?”
Joy laughed. “Definitely. I have found my calling.”
Josie pondered Joy’s words on her way home. Becoming a midwife did appeal to her, but Joy said she’d been a nurse for ten years before getting her midwife training. Maybe she wasn’t ready for that yet. Still, it was something to consider.
CHAPTER FOURTEEN
Josie changed into her cotton pajamas after getting Tommy off to school and welcomed the comfort of her bed. Pulling the blankets up to her chin, she fell asleep without effort.
But anxious thoughts concerning the coming evening kept her from escaping reality completely. She had a dream where she sat at a table in the restaurant with Brandon. He held her hand across the table and smiled. Suddenly Allison burst into the room, shoving her to the floor and throwing a glass of ice-cold water in her face.
Josie awoke, her hand wiping at the imaginary liquid. The digital clock on her night stand read 2:07. She decided to get up. Her busy week had kept her from thinking about her dinner plans with Brandon, but her nervousness returned in full force as she showered. She hadn’t seen him since Monday night when he had gone to the movie with her and Tommy. Her resolve to put her feelings for him aside and be happy for him and Allison faltered a bit. Once again she began to wonder if spending an evening with him was such a good idea.
She and Tommy went for a walk later in the afternoon after he’d had his snack. A few autumn leaves had fallen along the sunny path. Tommy said he needed to gather some to take to class on Monday. He chose a brown maple leaf first but then discarded it when he saw another.
“Look, Mommy. This one is lots bigger.”
“It is prettier too. Look at all the different colors.”
Tommy nodded. “It has some green, but a lot of yellow and orange.”
“There is some red too, see?” Josie said, pointing to a small section along an edge.
They continued walking. Tommy twirled the leaf by its stem and held it up to blow in the gentle breeze. By the time they returned to the sidewalk leading to their building, Tommy had three more leaves and Josie held two, one in each hand. Riding the elevator to the top floor, Josie reminded Tommy of her plans for the evening.
“Can’t I come?” he whined.
“Not this time.”
“Why not?”
“Because.”
“Because why?”
Josie sighed. I’m not sure what this is all about. How can I explain it to Tommy?
“Sometimes grownups need time alone so they can talk without being interrupted.”
“What are you going to talk about?”
I wish I knew.
“I don’t know.”
“I’d be good,” Tommy pleaded.
“I know you would, but we might be there for awhile and you would get tired.”
They reached t
he apartment and stepped inside. “Here, set your leaves on the table,” Josie said. “We should put them between newspaper and lay books on top of them to keep them from curling up.”
Tommy ran to the stack of old newspapers in the recycling bin. Once they had all the leaves pressed, Josie put some fish sticks and Tater Tots in the oven for Tommy’s dinner and went to get herself ready. Scanning her closet for something suitable for the evening, she debated between several different outfits. They were going to Newport Bay, a restaurant at RiverPlace Marina two minutes away. Any attire would be acceptable there, from jeans to formal wear. She wanted to look nice, but not too dressy.
She narrowed it down to her best jeans with her favorite sweater, or with a long-sleeved white western-style blouse she had bought from a mail-order catalog last year. She had always liked the shirt but had never worn it, seeming to never be the right occasion. It had silver buttons all the way down the front and lace insets on the sleeves and collar.
She tried it on, liking the way the crisp white fabric contrasted with the jeans and her dark hair. Reaching for her favorite belt, she strung it through the loops of her pants and fastened the silver buckle that matched the buttons on the shirt. She decided to go with it.
Scolding herself for fussing over her attire, Josie vowed to stick with the basics from now on. Brushing her hair into place and using a few squirts of fruity-scented hair spray, she surveyed herself in the mirror and decided a bit of make-up would do. A light dusting of ivory powder, a few strokes of soft pink blush, and some mascara to enhance her long lashes. Her simple silver hoop earrings were the finishing touch.
The timer on the oven dinged, and Josie returned to the kitchen to take out Tommy’s dinner. She set out a plate for him before returning to the bathroom to brush her teeth and select the right shoes. She chose her black loafers.
Baby's Breath (Garden of Love 2) Page 12