stethoscope at the same time. Nothing was happening.
‘One more try, then I’m going to intubate,’ she announced. ‘Heart rate’s a little slow and thready, and there’s a bit of a murmur. It may clear up on its own. They often do. Still, we have to get moving on this.’
Already, nearly two minutes had passed since the clamping of the cord, and every second without oxygen was critical. Thank goodness Patsy was unaware of all this!
‘Emma?’ Nell prompted.
‘Yes.’ She had the intubation equipment ready, and the oxygen.
The tube was pitifully small, and it would be an extremely delicate procedure, with the risk of tubing into the stomach instead, creating yet another delay. Nell had her naturally pale face set like a mask as she made her final attempt to squeeze oxygen into the baby’s lungs manually.
‘Come on, darling,’ she repeated, tapping the tiny feet, chafing the chest, looking for the right stimulation.
Normally, her skin complemented her dark blonde hair, but that was all tucked beneath her royal blue disposable cap. She looked as efficient and as cool as a machine, but Emma knew she had a strong, passionate heart beating away underneath.
‘OK, we’ve got her,’ Nell announced at last. ‘No tube, thank goodness. She’s breathing on her own. Yes.’ She watched and listened. ‘Yes! Heart rate is better already. Colour’s improving. She’s picking up quickly now.’
The five-minute Apgar score was the crucial one as a predictor of long-term health and development. Emma added the figures again. One for tone, one for colour, two for respiration…Seven. Eight would have been nice, but if she’d added that extra point, she would have been cheating.
‘Good. Go for it. Got our own problems over here,’ Gian said, in answer to Nell.
‘Houston, we have a—’ Dr Ang began.
‘Shut the hell up, Harry,’ Pete sang at him.
‘Sure. Sure.’
‘Can we tie off this vessel?’ the obstetrician asked.
‘Got it,’ Pete murmured. ‘How’s the placenta looking?’
Emma didn’t have time to look over at the table to see what was happening. She heard Pete’s voice, muttering something else, and Dr Ang confirming that everything looked fine at his end, although the patient’s blood pressure was beginning to drop.
‘OK, placenta’s coming away,’ Gian said. ‘Most of it. Getting a big bleed now.’ His voice was calm, almost lazy, but no one was fooled. ‘Cautery, Mary Ellen. Good. Thanks. Let’s get this closed off.’
There was a hiss, and the acrid smell of burning.
‘Good girl, what a lovely pink colour now! What great breathing!’ Nell said, as if it was the baby’s own success, not hers, and perhaps she was right. She leaned closer, listened once more just to check. ‘You good, darling girl! Now we’ve got it all happening,’ she crooned at the tiny baby, still working quickly as she spoke.
She taped a pulse oximeter to the baby’s hand, checked the fluctuating numbers that appeared on the screen. Climbing. Pink had now begun to radiate outwards from torso to extremities. Emma blinked back tears of relief. Blue was just the wrong colour for a baby, frightening and wrong. Pink was like the sun coming out on a cold, cloudy day, lifting spirits at once.
‘Thank God!’ she whispered.
She saw Pete’s glance cut across in her direction from the table. His face looked frozen for a moment, stark. He was thirty-six, she knew, but he looked forty today. A very masculine, competent, good-looking but stressed-out forty. Her fingers suddenly itched to smooth the lines on his face, to trace the shape of his mouth until it softened beneath her touch.
Then he blinked those tired brown eyes with their creased lids, grinned at her and nodded, wordlessly sharing her prayer of relief. She grinned back, and felt a rush of warmth and happiness. Gian’s running commentary suggested he had the bleeding in hand. Most importantly, the baby girl was breathing.
Emma wasn’t, as she smiled at Pete.
She seemed to be floating a good three inches above the ground, and she wasn’t breathing at all.
But at the moment breathing didn’t seem remotely important.
‘DR CROFT, we’ve got Rebecca in transition and almost ready to push,’ said Bronwyn. She was an efficient, thin and rather cool brunette, married with a school-aged son and daughter.
‘Right.’
Pete took a deep breath, switched his focus quickly. Little Lucy McNichol was looking good now, better than he’d dared to hope. She was small, just over three pounds on the old scale, but after that initial, frightening hitch with her breathing, she seemed reasonably strong, and she’d even taken the breast.
Nell had said she thought the gestational age might be closer to thirty-five or thirty-six weeks, not the thirty-three he’d been working on. Patsy might have mistaken bleeding at the beginning of the pregnancy for a period, and he’d dated the baby on that basis. With the spread and position of the fibroids retarding growth, the ultrasound scan at seventeen weeks hadn’t contradicted those dates.
But now here was Rebecca Childer about to give birth, and Bronwyn thought her dates might be wrong in the other direction. With no accurate date of LMP—last menstrual period—and no ultrasound measurements, they were working purely on the measurement from pelvic bone to top of uterus.
‘Don’t be surprised if you get called back up here,’ he told Nell, as she stripped off gloves and mask and prepared to head back down to A and E. ‘We have another iffy pregnancy on hand.’
‘I’ll be back up here anyway as soon as I can, just to make sure Lucy’s doing as well as we think,’ she said. ‘I did hear a faint murmur over her heart, did I tell you? But, of course, that’s very common. I’ll let it go as long as her stats are good.’
‘It’s your call. She looked good to me, too.’
‘See you in a while.’ Nell went towards the lift.
‘Rebecca, how are you doing here?’ Pete asked his new patient, as he entered Delivery Room Two.
She didn’t answer, just gave him a hostile look which he shrugged off. If he hadn’t asked about her state, the look would have been just as grim. In the grip of a powerful contraction, she wasn’t enjoying herself at the moment.
As soon as the contraction was over, he gave her a manual exam. It wasn’t routine policy to do so in this department, but Rebecca wanted a progress report. He listened to the baby. Heartbeat was fine. Dilatation was almost complete. The head was nice and low, but small. He agreed with Bronwyn. This wasn’t a thirty-seven-weeker.
‘Have we got extra staff?’ he muttered to her.
‘Vanessa Gunn is
