‘Get him on the line and keep him there. Then phone St Piran’s and bring them up to speed. Could you make sure we have an incubator for the baby on board, too? C’mon, Abby. I guess you’re on. Let’s go and get kitted up.’
As Abby raced after him down the steps and into the cloakroom where their gear was kept, she ran through what she knew about placenta praevia. And what she did know didn’t make her feel any better.
‘Not good news, is it?’ she said as Mac passed her a jacket.
‘Tell me what you know about the condition.’
‘Placenta praevia is where the placenta is lying in front of the baby, blocking the birth canal. I know it can cause massive, even fatal bleeding if left untreated. If she’s already in labour, we don’t have much time.’ Although they had covered complications of childbirth in their training, until Sara it hadn’t crossed Abby’s mind that it could really happen. Now she knew better. Please, God, don’t let this first call end in disaster.
‘Do we have an obstetrician on call?’ she asked.
‘At St Piran’s. Kirsten will patch us through as soon as we’re airborne. There’s no time to wait, though.’ Mac stopped for a moment and rested his hands on her shoulders. He looked directly into her eyes. ‘Are you going to be okay?’ His look was calm, reassuring. Everything about him radiated confidence and Abby relaxed a little.
‘Sure.’ She kept her voice light. ‘All in a day’s work.’
They piled into the helicopter and lifted off, heading towards the coast.
‘ETA twenty minutes,’ Greg’s voice came over the radio. ‘It’s a bit breezy where we’re heading so it might get a little bumpy.’
‘Do you think we’ll be able to put down?’ Mac asked.
‘There’s a good-sized field behind the farmhouse, but I guess it depends on how soggy the ground is. We won’t know until we get there.’
Abby and Mac shared a look.
‘Have you ever done an emergency section before?’ Abby asked. If they couldn’t get mother and baby to hospital, it would be their only chance. But such a procedure would be tricky even for a qualified obstetrician in a fully equipped theatre. Her heart started pounding again. Confidence was one thing, but did Mac have the skill needed to back it up?
‘I have.’ He leaned across and flashed Abby another wicked grin. ‘But don’t worry, I have every intention of letting the obstetricians do it.’ He held up a finger and listened intently.
A quiet voice came over the radio. ‘Hello, Mac. Dr Gibson here. What do we have?’
‘A thirty-four-weeker with placenta praevia who has gone into early labour. Control has her son on the phone. Mum tells him she thinks her contractions are coming about five minutes apart. The mother’s name is Jenny Hargreaves. She tells us she was due to be delivered by section at St Piran’s so you should have her case notes there.’
There was a short silence. Abby guessed Dr Gibson was bringing up Jenny’s record on her computer screen.
‘I’ll make sure neonatal intensive care is standing by and that we have a theatre ready. How long d’you think before you’ll have her here for us?’
‘Another ten minutes until we land. If we can. Say another ten to examine our lady and get her loaded and twenty back. Do you think we’ll make it?’ Again there was that easy smile as if this was just another everyday callout.
‘If anyone can, you can,’ came back the reply. ‘But if she’s gone into active labour she could be bleeding massively and you may have to section her there and then. It won’t be easy.’
‘Hell, whoever said anything is easy in this job? But trust me.’ He turned and winked at Abby. ‘If I can get her to you without having to section her, I will.’ He flexed long fingers. ‘Been a long time since I did one of those.’
‘Good luck,’ Dr Gibson said calmly.
A short while later they reached the farm. To Abby’s relief the pilot had been able to find a spot to land. The helicopter rotors had barely slowed when Mac hefted the large medical bag over his shoulder.
‘Okay, we’re on. Remember to keep your head down.’ Abby took a deep breath, sent a silent prayer towards heaven, and followed him out of the helicopter.
Mac sprinted towards the farmhouse, carrying the medical case that weighed at least ten kilos as if it were nothing. Abby ran after him, doing her best to keep up.
A child with wide, frightened eyes was waiting for them by the doorway.
‘Please hurry, my mum is bleeding,’ the boy said.
This was the worst possible news. Jenny being in labour was one thing, but they had banked on having enough time to get her to hospital. If she had started bleeding it meant that the placenta was beginning to detach. As it did, the baby’s life support system became compromised and the life of the mother was in jeopardy. It would have been dangerous enough in hospital, but all Abby and Mac had was some morphine and basic equipment. It wasn’t good. Abby’s heart jumped to her throat.
Mac paused by the doorway and hunkered down so that he was at eye level with the boy. He placed a hand on the child’s shoulder.
‘What’s your name, son?’
‘Tim.’
‘It’s going to be all right, Tim, I promise. Now, if you could take us to your mum, we’ll look after her.’
Whatever Tim saw in Mac’s eyes seemed to reassure him. He nodded and led them inside the farmhouse and into a bedroom. On the bed, a woman lay writhing with pain. She was pale and her eyes were stretched wide with fear.
Abby and Mac rushed to her side.
‘Jenny, isn’t it?’ Mac said as he laid the medical case on the floor. ‘I’m Dr MacNeil and this is Abby Stevens. We’re going to do everything we can to look after you and your baby.’
Abby felt Jenny’s pulse.
‘Over one hundred and thready,’ she told Mac as she unwrapped the stethoscope from around her neck.
‘How long have you been bleeding? And when did the contractions start? ‘ Mac asked.
‘I just started bleeding a few minutes ago. The contractions started about an hour ago. I phoned the hospital and they said they would get an ambulance.’ Jenny reached out a hand and squeezed Abby’s fingers hard. ‘You have to save my baby. Please. You’ve got to help us.’
‘We are going to do everything possible,’ Abby replied with what she hoped was a confident smile.
She checked Jenny’s blood pressure. As expected, it was low. Jenny was already bleeding heavily.
‘I’m just going to give you some fluids through a needle in your vein,’ Mac explained as he swabbed a patch of skin near Jenny’s elbow. ‘Then we’re going to get you onto a stretcher and into the air ambulance,
