Midwife's Baby Wish

by Gill Sanderson

  There was one small thing. Before she set off on her afternoon rounds she scribbled a quick note and put it through his letter box. ‘Help! There was so much food left last night that Jane gave me a great box of it. Please come and help me get through some of it. A meal of leftovers after you’ve finished evening surgery? Love, Lyn.’ That should do it.

  ‘Not a date or an assignation or anything like that,’ she said when Adam presented himself at her door in the evening. ‘Just a couple of friends eating up some scraps and then enjoying each other’s company.’

  ‘Sounds good to me. And just in case, I brought a bottle of wine.’ He followed her into her kitchen and stared at the vast number of plates. ‘Did you say eating up some scraps?’

  ‘That was Jane’s phrase. I didn’t think it was a particularly accurate one. Now, let’s sit down and start.’

  He seemed to recognize her mood and reacted to it. For the moment they forgot themselves and talked about their work. He was getting very interested in the outreach clinic and told her how useful it was to some of the outlying farms.

  ‘You’re getting to sound like one of the locals,’ she said playfully.

  He took her seriously ‘I’d like to be one.’

  They washed up together and then sat together on her couch. Since Lyn was technically on call, she refused a glass of wine but insisted that he have one.

  Adam put his arm round her shoulders and she nestled into his chest. ‘Right now I’m happy,’ she told him. ‘I don’t want to think, I don’t want to talk, I don’t want to plan. I just want to be here with you. The future doesn’t exist. There’s only now.’

  He kissed her forehead. ‘I’m happy, too, Lyn,’ he said. And there they stayed, quiet, contented. And at eight o’clock Lyn’s mobile rang.

  The voice on the other end was sheepish. ‘I’m sorry to bother you, Lyn. I thought this was a false alarm, but the contractions got more and more frequent, and now the waters have broken. I’m properly in labour.’

  Lyn had known Frances Lane for years. She was a calm, capable farmer’s wife with two sons already. Frances had had a scan, and knew that her third child was to be a girl. She was looking forward to having a daughter.

  The baby was due in a fortnight. Frances had done everything correctly, had been to all the classes Lyn had run, was in all ways prepared. Her previous two children had been born at exactly the predicted time. She had discussed it with Lyn and had decided to have this baby at home.

  ‘You’re early,’ Lyn said. This was the last thing she had expected – in fact, the last thing she needed. Years of experience should have told her that babies had minds of their own.

  ‘I know I’m early, and you’ve probably got things you have to do. Do you want me to phone an ambulance? Or is there another district midwife?’

  Lyn glanced at her watch. To her amazement it was only eight o’clock. She’d had a full day. ‘I’m on my way, Frances,’ she said firmly. ‘I should be there in about half an hour. Just try to relax. You know the exercises we practiced.’

  Then she turned to Adam. ‘This has happened before,’ she said. ‘Just like it did with Hetty Summers.’

  ‘Then your patient can have a midwife and a doctor. Just as Hetty did.’

  ‘There’s no need. You must be tired and this could take hours. Why don’t you …?’

  ‘And I remember what happened when we came back from helping Hetty Summers.’

  ‘Adam!’

  He held up his hands. ‘I’m only joking. We have work to do now, let’s do it. I’ll fetch my bag from next door and we’ll be off. Want to let the surgery know where we are?’

  ‘As always, I’ll leave a message. Now, I’ve got five minutes to get into a clean uniform.’

  They took her car as it was her call-out. The farm wasn’t too far away and they were met by Alan, Frances’s husband, who was as calm as she was.

  ‘Frances’s ma had taken the kids,’ he said. ‘We’re all prepared, but if you want Frances to go to hospital then we’ll go along with that.’

  ‘Let’s see how things are progressing first,’ Lyn said. ‘This is Dr Fletcher. He’s here as …’

  ‘I’m here as a makeweight,’ Adam said. ‘Lyn will do the delivery.’

  Lyn went up to see Frances, looked at the carefully set-out room, the cot waiting in readiness. Next door was the bathroom, very handy.

  First a quick examination and then the inevitable paperwork. Lyn chatted to the relaxed and confident Frances as the labour took its natural course. This was how home births ought to be, Lyn thought. Frances had worked hard on her relaxation exercises and said that she needed no pain relief. All was going well. As always, Lyn felt involved in the process, her previous fatigue now forgotten. Adam came in, was introduced to Frances and then said he would wait outside. He was there if needed.

  The baby would be born soon. Frances’s face took on that expression of excitement and fear that Lyn knew so well. The head had crowned. ‘All right, you can push now,’ Lyn urged. Frances grimaced, and pushed.

  She pushed well, but after fifteen minutes there was no further progress, and after twenty minutes Lyn was slightly worried. Frances was now showing signs of weariness. Something wasn’t quite right.

  Cautiously, Lyn felt past the baby’s head and knew instantly what the trouble was. The baby was stuck, the shoulders not rotating into the position for an easy birth.

  ‘I think we’ll ask Dr Fletcher in,’ she said to Frances, ‘just to have his opinion on things.’ She kept her voice calm, there was no need to frighten the patient.

  She went into the next room and shut the door behind her … ‘Adam, we have a case of shoulder distochia.’

  Adam was instantly alert. ‘Has she had an episiotomy?’

  ‘No. So far it hasn’t seemed necessary.’

  ‘I’ll go and scrub up. Make sure Frances had plenty of gas and air, get her into the McRoberts position and perform an episiotomy. Then we’ll see how things are going. Send Alan out. I’ll tell him to phone for an ambulance. We might need hospital help.’

  ‘Right.’ Lyn returned to her patient. ‘Just a little problem, Frances,’ she said, ‘Dr Fletcher is coming in to give me a hand. And we think we’d like you to go to hospital to be checked over.’

  ‘I’ll have my baby here first?’ Frances was anxious.

  ‘I’m sure you will. Now, I want you to lie on your back and pull your thighs up and outwards. You need an episiotomy so I’m going to give you an injection, which might sting a little. And I want you to start using the gas and air.’

  It was a straightforward procedure but she was glad when Adam appeared by her side and smiled down at the troubled Frances. ‘Your baby won’t turn round,’ he explained gently, ‘and she needs to, in order to be born. I’m going to push down here to try and dislodge the shoulder and ease her round. It’s called applying suprapubic pressure. Now, I don’t want you to worry.’

  Somehow Frances managed to smile. ‘I’ve seen Alan pull a calf out with a rope round its neck,’ she said, ‘and both calf and cow were fine. So I guess I can take a bit of pressure.’

  He pressed – but the baby didn’t move. Lyn looked at him, still apparently calm and smiling, but could sense the urgency he was feeling. From being an ordinary birth, this was turning into a nightmare.

  Without saying anything, he moved away from the side of Frances, positioned himself between her legs and reached into the birth canal, trying to rotate the shoulders though 180 degrees so that the posterior shoulder was anterior. He didn’t succeed. And now the baby’s life was in danger.

  There was one last thing to try. ‘I’m going to see if I can deliver the posterior arm,’ he said. ‘I need to get my hand into the sacrum, get hold of the arm, pull it over the chest and get the hand out. Then there should be no difficulty in delivering the arms and then the baby.’

  ‘Of course,’ she said. It was something she had never done, a manoeuvre usually performed by a gynaecologist in Th
eatre with a team of assistants. A farmhouse bedroom wasn’t the right place.

  She looked at Adam. He was maintaining the usual medical calm, but she could tell by the slight dampness on his upper lip, the slightly deeper tone of his voice that he was nervous. He knew what a risk he was taking, what the possible consequences were.

  ‘This shouldn’t take a minute,’ he said to Frances. And behind her patient, Lyn squeezed her eyes shut in a moment’s silent prayer. She knew what failure would mean to Frances – and to Adam.

  She watched Adam’s intent face as he reached for the tiny arms and tried to manoeuvre the now distressed baby. And then, slowly, he smiled. He had done it. He stepped back and said, ‘All should be as normal now. You deliver the baby, I’ll stay here and take it.’

  He leaned over Frances and smiled. ‘Panic over now, Frances. We’ll have the baby out very soon now.’

  ‘I knew I didn’t have to worry,’ Frances muttered. Lyn wondered if she could see the expression of joy and relief on Adam’s face.

  After that, all went according to plan. Adam was hardly needed. Soon they had a fine, yelling baby girl. Lyn weighed her, cleaned her, went through the usual necessary tests, wrote up the Apgar score and placed her on her mother’s breast. The placenta was delivered normally.

  Shortly after that the ambulance arrived, and they decided to send mother and child to hospital just in case. ‘But it was a home birth,’ Frances said. ‘Thank you so much, both of you.’

  ‘We both enjoyed it,’ Adam said.

  Past midnight again when they got back to her house, Lyn didn’t even need to ask Adam if he was coming in. He flopped onto her couch.

  ‘You’ve been through more than me this evening,’ she said flatly. ‘You were worried in case you failed.’

  ‘It was a nightmare. Just one of those things that happen. But we managed, Lyn, didn’t we? We managed. And she was a lovely baby.’

  ‘You managed. I think it was one of the bravest things I’ve ever seen anyone do. Now I’ll fetch us a drink.’

  They sat side by side, her head on his shoulder, his arm loosely round her. Perhaps later they would go to bed, but now they were content just to be together.

  ‘Just having you here makes me feel calm and cosy.’ The words came out before Lyn could stop herself.

  He didn’t reply and after a moment she started to worry. His body had been relaxed but now it tensed. He turned his head from side to side and she had the feeling that he was searching for words, trying to say something that was precisely right.

  Eventually he said, ‘This evening we went through something together. We were a team, each knew what the other needed. Now we need to be a team again. Lyn, tell my why you won’t let me say I love you.’

  She jerked upright. ‘Please, Adam, not now. I’m tired and I …’

  ‘If not now, then when? We’ll never be more together than we are at this minute! Lyn, this is … this is a barrier between us and it’s driving me mad! I know you love me. And I can’t imagine anything so terrible that you can’t tell me.’

  ‘You can’t imagine,’ she said desolately. ‘And you think you want to know?’

  A tiny part of her mind protested that this wasn’t fair, he had asked her when she was weak, vulnerable. Another part of her desperately wanted to tell him, to share her secret.

  ‘I need to know,’ he said. He looked at her assessingly. ‘You’re going to tell me. And I’ll love you just as much when you have told me as I do now. That I know, and that I promise you.’

  ‘I know you will,’ she said. ‘But it’s not enough.’

  She forced herself to move a little away from him, to stare stony-eyed at the wall opposite. ‘Just tell me what you see as our ideal life together. How you might see us in ten years – if we were still together.’

  She could tell he was picking his words with infinite care.

  ‘First, there’s no rush. We need time to get to know each other better, to see into each other’s lives. And that should be fun. But then I see me staying, working up here, having a home together, being with friends, having children.’

  ‘How many children?’

  ‘We’d both decide after you’ve had the first. But three … I’d like four children.’

  ‘How about no children?’

  He laughed. ‘Lyn, you love children! I’ve seen you with the newborns, with Helen, with lots of others. You were born to be a mother.’

  ‘It’s a pity, then, that I can’t have them.’

  ‘What?’

  Never had she heard such disbelief, such horror in a voice. She turned to look at him. ‘I checked with the consultant. After I had that miscarriage there was so much scarring, there’s no chance of my conceiving. Adam, I can’t have children.’

  ‘Oh, my love!’ He took her to him, kissed the tears now running down her face. ‘Look, it doesn’t matter. We have each other and we can …’

  She stopped him. ‘I know what you’re going to say and I believe you mean it. But, please, Adam, I want you to be honest with me. Two choices – one, living with me and our children; two, living with me and no children. Which would make you happier?’

  ‘That’s not fair! I love you and. we can sort things…’

  ‘I want an answer, Adam! Adam, tell me! And be honest, I deserve that.’

  It took an age before he replied. His face was haunted, there was even the steely glitter of a tear in his eye. She could tell the struggle he was having. And eventually he muttered, ‘I’ve always wanted children. But, Lyn…’

  ‘If I can’t give you children,’ she said, ‘I’ll never marry you. And no argument will make me change my mind. Now, I dearly want you to stay the night, but I think you’d better go.’

  Chapter Nine

  Normally Adam slept from the moment his head hit the pillow to five minutes before he was due to rise. This time he thought that he’d stay awake for ever when he got into bed. But his overtaxed brain had had enough and he slept at once.

  In the morning he woke an hour early, and he knew that he wouldn’t go back to sleep. What could he do about Lyn? His first reaction was the same as it had been the night before – he didn’t care whether she could have children or not. He loved her. But then his native honesty took over. He did love children.

  And then his phone rang. He looked at it gloomily. For a doctor an unexpected early morning call was usually bad news. He knew it wouldn’t be Lyn, she’d just ring his doorbell. Not that there was much chance of it. He picked up the phone.

  ‘I’m ringing you early because I just have to talk to you,’ a voice said. ‘And this is important.’

  ‘Ros? I thought we’d got things settled for a while, put the programmes on hold. I’m supposed to be taking it easy for six months – being a country doctor.’

  ‘So you are and so you can be for the rest of the six months. But something has come up. We’ve had a query from America. A company out there has seen your work and wants to know if we’re interested in running a series together. We’d be selling to the British and the American markets. This would be fantastic – and mean a tremendous increase in the amount you earn.’

  ‘I like the idea of working and making a programme at the same time. But it’s in America.’

  ‘Adam,’ Ros pleaded, ‘this could be the big chance for both of us. Will you at least come and talk to these people?’

  He thought. Ros had been good to him, perhaps he owed her this chance. But was he sure himself?

  ‘It’s early and it’s a bit of a shock, Ros,’ he said. ‘Let me think about it for a couple of days.’

  Her voice was plaintive. ‘Think about it, Adam. You’d be so good at it.’ Then she rang off. She knew that pushing him too hard usually wasn’t successful.

  He lay in bed, wondering. Since he’d come to Keldale, he’d hardly missed working in television. Now he had other interests. And after last night’s revelation it seemed supremely unimportant.

  He went downstairs, made him
self a drink and sat holding it in his living room. He was conscious that not ten feet away, on the other side of the wall, Lyn might be doing the same as he was. She had told him that sometimes she thought of him in this way. It seemed odd to him.

  Last night had been traumatic – for both of them. Now he just didn’t know what to do. His first reaction was still to storm next door and tell her that having children didn’t matter. He loved her. But he knew that there was a strength of mind in her that wouldn’t be easily swayed. Reluctantly, he realized that they both needed time. And then perhaps he could approach her again.

  Adam had a good morning at the surgery and then a list of home visits to make in the afternoon. He didn’t see Lyn, who was out herself, making home visits.

  It was yet another glorious day. The sun had that deep orange tint that only comes with autumn, the leaves were turning russet brown. This year the change had come early.

  He was calling on Albert Dent, a fifty-five-year-old farmer who owned a prosperous farm in the river valley. A few weeks ago Albert had slipped from the top of a hayrick, suffering a compound fracture of both tibia and fibula. Complications had set in, the leg had taken time to mend and now Adam knew he wasn’t bringing good news.

  He spread the X-rays he had brought on the table. ‘I wanted to show you exactly what the trouble is, Albert,’ he said. ‘Your leg was fractured here and here. The orthopaedic surgeon pinned it, did the best he could. I know you’ve been having physiotherapy for the past few weeks, and the therapist says you’ve done your exercises religiously. You’ve even lost a few pounds, which can’t be bad. But …’

  ‘But I’ll never be as good as I was,’ Albert said sadly. ‘I’ll never be able to walk all day without some pain, never be able to carry the loads I carried before.’

  ‘It’s not all bad news. If you take care of yourself you should be fine. But before you were working harder than a twenty-year-old should have to work. Now you can carry on working – but you must take it easier.’

  ‘And if I don’t?’

  ‘The pain will make sure that you do,’ Adam told him bluntly. ‘And if you don’t listen to your body you could end up in a wheelchair.’