time. Well, certainly not the latter. So much on his plate right now.
Claire’s behaviour was like a nightmare. Her ultimatums to him didn’t make sense. He suspected she was sleeping around, but perhaps that wasn’t fair. Perhaps he was simply displacing the real sources of his anger onto a safer issue. How well was she looking after the girls? He wasn’t happy with their informal custody arrangement as it stood. He wanted more involvement in his daughters’ lives.
And now Patsy McNichol had apparently gone into premature labour, with bleeding that didn’t surprise him but definitely wasn’t good. She’d done well so far with the pregnancy, and they’d all been crossing their fingers that this wouldn’t happen.
There was no time to eat, or to gulp the coffee he craved. He left a message on the answering-machine at his practice, asking his staff to reschedule the first hour of his morning appointments, and he reversed out of the garage and pressed his finger to the button on his remote control garage door opener at six thirty-three.
He couldn’t help reviewing Patsy McNichol’s history as he drove. She was thirty-five years old, by no means too old for a first baby but old enough to have developed the uterine fibroid tumours in the muscle layer of the uterine wall which had clouded the safety of this pregnancy from the beginning.
Unfortunately, the fibroids had been small enough to have sent out no warning signals before she’d conceived. If he’d known about them before the McNichols had started trying for a baby, Pete would have recommended surgery—the procedure was called a myomectomy—which would in all likelihood have cleared the way for a normal, healthy pregnancy.
As soon as Patsy had conceived, however, it had been too late. Pregnancy produced hormones—high levels of oestrogen and progesterone which stimulated rapid growth of the fibroids. With the relative positions of the fibroids and the placenta that he’d seen on more than one ultrasound scan over the past three months, Mrs McNichol had been lucky to have had so few problems thus far.
There’d been signs on the most recent ultrasound, however, that the baby was no longer getting its optimum amount of nourishment. Although, thanks to the growth of the fibroids, the uterus itself was now very large, the baby wasn’t.
Patsy was desperate to keep the pregnancy going in safety. She’d given up work around the family farm months earlier than she and her husband had originally planned, and had gone on bed rest as soon as Pete had mentioned the idea. She’d had two or three episodes of moderate bleeding which they’d managed to control through medication, but now there was cramping as well.
A few months from now, when the uterus had returned to its pre-pregnancy size and her hormone levels had dropped, Patsy would go under the knife again, so that the fibroids could be safely removed. A future pregnancy would almost certainly be a much safer proposition for her.
First things first, however. Pete was concerned about the extent of the bleeding, and about the ongoing health of an undernourished baby at thirty-three and a half weeks gestation.
If labour could be stopped or slowed, should he send Patsy to Sydney or Canberra? At thirty-three and a half weeks, the baby’s required level of care fell just days short of the scope of Glenfallon Hospital’s small level two special care facilities. On paper, a few days wasn’t much, but how significant was the compromised environment of the uterus?
The clock on the dashboard of his car read six forty-one when he pulled into a reserved space outside the two-storey building which housed Glenfallon Hospital’s maternity unit, including its special care facilities and an obstetric operating theatre opened just this year.
The hospital buildings in current use were all relatively new. They were pleasant but rather bland concrete and glass constructions dating from various times over the past twenty-five years when the town had been endowed with capital funds for expansion.
The original building, of gracious old stone with wide verandas, a slate roof and thick walls, was now used for outpatient clinics and support services. The change had been necessary. Apart from its inadequate size, you just couldn’t make the old building’s layout and facilities accommodate modern medical equipment and practice. Still, stubbornly, Pete liked the old building best. It was the same way he felt about Emma Burns’s cottage versus his own newly purchased dwelling.
The new place had a locked double garage with remote-controlled doors. It had two bathrooms, and a family room adjoining the state-of-the-art kitchen. It had a back yard that was currently a depressing expanse of arid soil and builders’ rubble but would eventually be a great place for the girls to play whenever they were in residence. He had a landscaping firm scheduled to start work on paths and retaining walls soon.
As with the new hospital buildings, however, he wasn’t convinced the house would ever have the right character.
Arriving in the unit, he discovered that, despite their head start, Patsy and Brian McNichol had got there just a few minutes earlier. The departing staff, Kit McConnell and Julie Wong, were both helping the new and nervous patient into a gown and checking her history. She was the delivery ward’s only patient at the moment, but the phone was ringing, heralding the possible arrival of someone else.
‘How are you feeling, Patsy?’ Pete asked at once.
‘The contractions are getting stronger. There’s one coming now…’
From Patsy’s reaction, the pain was quite intense. She couldn’t move or speak during its peak, and had to press a thick pad between her legs to deal with the blood. Pete wasn’t happy about how much was still flowing. He abandoned any thought of getting her moved to Canberra or Sydney.
This didn’t mean he was relaxed about the idea of delivering her here. They could be in for some problems after the birth, and dealing with a post-partum haemorrhage could be a nightmare. Thank goodness there were a couple of good doctors he could call on.
‘Let’s get you on your left side with your feet up on a pillow,’ he told his patient, masking the extent of his concern.
She looked pale and drawn. Tired, as if she hadn’t been sleeping well in weeks, which was probably the case. Bed rest wasn’t fun. No physical activity to promote a healthy fatigue at the end of the day, too much time to think and worry. And she was huge, the size due to her fibroids, not the baby.
Pete palpated the uterus, gave her an internal examination and found that the cervix was ripe, already fully effaced and dilated to six centimetres. The baby’s position wasn’t good. Feet and bottom down low, and head lying next to her mother’s heart. The heartbeat was fine, no sign of distress, and that was a plus. But he really didn’t like the bleeding, or his rough impression of the baby’s size. He’d been monitoring this for several weeks, and there’d been steady growth, but the baby was still smaller than it should be for this stage of pregnancy.
‘I’ll be back in a minute,’ he promised Patsy, when he’d finished.
Heading for the phone at the nurses’ station, he almost cannoned into Emma Burns, who had just arrived, and whom he hadn’t seen in the three months he’d been renting her house. She was like a breath of cool, fresh air, scented with spring. She was like her home—bright and pretty and calming.
They smiled at each other.
‘Hi,’ he said. ‘Welcome back.’
‘Thanks.’
A beat of uncomfortable silence hung in the air, and neither of them knew what to say. Pete felt there
