friend and her colleague. Asking for more was just greedy.
She tapped on the open door and leaned against the jamb. ‘Hey, Ellis. Can I borrow you for a second?’
He looked up and smiled at her, and her heart skipped another beat.
‘Sure. Problem?’ he asked.
‘Complication,’ she said. ‘I have a first-time mum who’s thirty-seven weeks. Her baby’s quite happily settled in the breech position. I know her birth plan is firmly centred round a natural birth with no intervention.’ And she also knew that a lot of doctors would take one look at Mrs Harris’s situation and immediately insist on a caesarean section. Given Ellis’s experience outside the hospital, Ruby really hoped that he’d take a different tack and give Mrs Harris a chance to have the birth she really wanted. ‘So I wondered if you’d mind coming and chatting through her options for the birth,’ she finished.
‘Of course I will. You did warn her that babies never respect their mum’s birth plans, didn’t you?’
She smiled back. ‘I always do.’
‘So what are you thinking?’
‘We’ll start with an ECV to see if we can get the baby to turn,’ Ruby said. ‘But, if it doesn’t work, I’m hoping that I can talk one of the obstetricians—’ she gave him a pointed look so he’d know she meant him ‘—into agreeing to a trial of labour for a vaginal breech delivery.’
‘I think we’ve only had a couple on the ward since I’ve been here, and I wasn’t on duty at the time,’ Ellis said. ‘Are the doctors here not supportive of vaginal breech births?’
‘Theo’s wonderful,’ Ruby said. Theo Petrakis, the director of the maternity ward at the London Victoria, believed in supporting his midwives and keeping intervention to a minimum. ‘But, as you say, it’s not that common—and I need someone who’s had a reasonable amount of experience in delivering breech babies.’
‘Which is why you’re talking to me?’
She gave him her sweetest smile. ‘Got it in one.’
‘She’s a first-time mum, so we have no guarantee that her pelvis is big enough to cope.’ Ellis looked thoughtful. ‘OK. If ECV doesn’t work then—on condition the baby’s not too big or small, the baby’s head isn’t tilted back and I’m happy that the mum’s pelvis is going to cope—I’ll support you and you can call me in, even if I’m not on duty when she goes into labour. But in return I need a favour from you.’
Ruby’s heart skipped yet another beat. What was he going to ask for?
A kiss?
She shook herself mentally. How ridiculous. She really had to stop fantasising about Ellis. This was totally inappropriate. They were at work, and she needed to keep her professionalism to the forefront. ‘Sure. What do you want?’
‘I’d like you to talk your mum into letting a couple of the junior staff observe their first ever breech birth. One midwife, one doctor.’
‘Great minds think alike. I was going to ask you if there was anyone you wanted to come and observe.’ And she really liked the fact that he’d thought of the midwifery team, too, not just the obstetricians. She smiled. ‘I want to reassure Mrs Harris that we’ll try our best to help give her the birth experience she really wants, but I’ll make it clear that if the baby’s in distress at any point then we might need to give her a section, so she needs to be prepared for that to happen.’
‘Which is again where I’d come in,’ Ellis said.
‘Just flutter those disgustingly long eyelashes at her. Actually, on second thoughts, perhaps you’d better not,’ she said. ‘You already look more like a movie star than a doctor.’
‘Very funny, Rubes,’ Ellis said, but he didn’t look the slightest bit offended.
Which was another reason why she should put this whole thing out of her head. If she made an approach to Ellis and he turned her down…Even though she knew he’d be kind about it, it would still put a strain on their friendship. On their working relationship. And Ruby didn’t want to take the risk of wrecking either of them.
Maybe it was just loneliness making her feel this way, and she should take Tina up on her offer of setting her up with the new registrar on the Neurology ward.
‘Penny for them?’ Ellis asked.
No way was she going to tell Ellis what she was thinking about. ‘Just my first-time mum,’ she said with a smile. It was true; it just wasn’t the whole truth.
Back in the examination room, she introduced Ellis. ‘Mrs Harris, this is Dr Ellis Webster, one of our registrars. Ellis, this is Mrs Harris. She’s a first-time mum, the baby’s thirty-seven weeks, and the baby’s quite happy in the breech position.’
‘Nice to meet you, Mrs Harris.’ Ellis shook her hand and smiled at her. ‘Ruby tells me that you’d like as natural a birth as possible.’
‘I definitely don’t want an epidural. I want to manage with gas and air,’ Mrs Harris said. ‘And I really didn’t want to have a section.’ She bit her lip. ‘But, because the baby’s lying the wrong way, does that mean I have to have a section?’
‘It’s a possibility,’ Ellis said, ‘but it might be possible for you to have a vaginal delivery. With the baby being breech, it means that the head—which is the biggest part of the baby—is the last bit to be delivered, so it’s a little bit more complicated. May I examine you?’
At her nod, he examined her gently.
‘As Ruby said, your baby’s definitely bottom-down. But we can try to persuade the baby to move. There’s a procedure called an ECV, which stands for external cephalic version. Ruby here’s very experienced.’
‘What happens is that I’ll press down on your abdomen and encourage the baby to turn a somersault—a bit like him doing a forward roll inside your stomach,’ Ruby explained.
‘And it always works?’ Mrs Harris asked.
‘It works about for about fifty per cent of babies,’ Ellis said. ‘And if it doesn’t work today, then we can always try again tomorrow. Though I should warn you that even if the baby does turn, sometimes the baby then decides to roll back again.’
‘So if you do this ECV thing, what about the baby?’ Mrs Harris asked. ‘Will he be OK? It’s not going to hurt him?’
‘He’ll be fine,’ Ruby reassured her. ‘Plus we’ll monitor him before, during and after the ECV to keep an eye on him. There is a tiny risk that you might start having contractions, and also the baby’s heart rate might go up a bit—usually it settles again pretty quickly, but I do want you to be aware that sometimes the baby’s heart rate doesn’t settle again, and in that case you’ll need to have a section.’
‘But it’s a tiny risk?’ Mrs Harris checked.
‘Tiny,’ Ruby confirmed.
‘All right, then.’ Mrs Harris paused. ‘Will it hurt me?’
‘It
