system makes your body produce antibodies. This won’t affect you at all, but it might affect your baby in any future pregnancies, because if any future baby is rhesus positive, the tiniest leak of blood will make your body produce antibodies, which can cross the placenta and attack the baby’s red blood cells. The baby’s red blood cells change in shape and don’t last for as long as they should do, so the baby can become very anaemic and jaundiced. If the baby’s really badly affected, it might turn into a condition known as hydrops fetalis—meaning that the baby’s tissues are very swollen—and there’s a much greater risk of stillbirth. So that’s why, if we knew you’re rhesus negative, we’d give you an injection of something called anti-D, which stops your body producing these antibodies.’
Estée bit her lip. ‘Right.’
‘It doesn’t usually affect first babies,’ Claire said, ‘unless you’ve had a bit of bleeding during your pregnancy, or a threatened miscarriage, or a test such as an amniocentesis. And your midwife really should have tested your blood when she booked you in, plus twice more in later pregnancy.’
‘I’m not good with needles,’ Estée said. She wrinkled her nose. ‘It’s my fault. She said she needed to do it but I kept saying I’d do it next time.’
Claire sat next to Estée and held her hand. ‘Except then you missed your appointments,’ she said gently. ‘Estée, you took a risk with yourself as well as your baby. Antenatal appointments are a way of letting your midwife check that you’re OK during your pregnancy and not developing any conditions such as pre-eclampsia, which could make you or your baby very ill.’
‘But I was really well—I was hardly even sick! I didn’t show until nearly six months...’ Estée chewed her lip again. ‘He will be all right, won’t he?’
‘We’ll do our best. If it is rhesus haemolytic disease, we can give him a transfusion which will take some of the bilirubin out of his blood—that’s the chemical that’s turning him yellow—and help increase his red blood cells, which will get rid of the anaemia. We can also give him light treatment. That just means putting him under a bank of lights which will help with the jaundice.’
‘So he’s not going to die?’
‘Not if I can help it.’ Claire squeezed her hand. ‘But I do need to know a couple of things, Estée. Things that will stay totally confidential, but that will help us to help Miles.’
Estée thought for a moment. ‘All right.’
‘But before we talk, I need a blood sample. I promise you, you’re not going to feel a thing.’
‘She’s brilliant,’ Eliot said. ‘If she can take blood from tiny, fragile premature babies without hurting them, just think how easy it’ll be for you.’
‘I hate needles,’ Estée said.
‘Then turn and talk to Eliot,’ Claire suggested. ‘Tell him all about the nursery you’ve got planned for Miles.’
Eliot came to sit by the other side of Estée’s bed. ‘This is the bit I like. Holding the hand of the prettiest mums,’ he said. ‘It’s nearly as good as cuddling a new baby.’
‘Oh, men!’ Estée said.
Claire gave Eliot the thumbs-up sign.
‘So, what colours are you using?’
‘Yellow,’ Estée said. ‘With teddy bears. I didn’t know if it was a boy or a girl, so I wimped out and played safe.’
‘Sounds great. Babies love teddies.’ He almost swapped confidences and told her that he’d stencilled Ryan’s room with teddies, but he managed to bite the words back at the last moment.
‘All done,’ Claire said, capping the sample.
Estée stared at her in amazement. ‘But—I didn’t even feel it.’
‘I told you so.’ Eliot winked at her. ‘Claire’s the best.’
‘Can you sort the tests, please, Eliot?’ Claire asked.
He nodded and left the room.
‘OK, Estée. Well done for being brave. I hate needles, too,’ Claire said. ‘So, can you tell me, is Miles your first baby?’
‘Yes.’
‘You haven’t had a miscarriage before?’
‘No.’
‘Any bleeding in this pregnancy?’
‘Just a bit of spotting. My friend said it wasn’t anything to worry about so I didn’t bother telling my midwife.’
‘Right.’ The tiny haemorrhage had probably been enough to start the antibodies; in subsequent pregnancies it could take as little as 0.03 ml of the baby’s blood to make Estée’s body produce the antibodies. ‘Do you know your husband’s blood group?’
‘He’s A negative, like me.’
‘Right.’ Claire took a deep breath. Now for the crunch question. ‘I’m sorry to ask you this, Estée, but is there any chance that your husband isn’t your baby’s father?’
‘Oh, God.’ Estée’s face crumpled and she sobbed. ‘Roger mustn’t know.’ She closed her eyes. ‘I found out he’d had an affair with his secretary. I wanted to pay him back, so I had a fling with his best mate one night. Mickey and I were drunk...The worst thing is, it didn’t even make me feel better. Then I found out I was pregnant. I was so sure it was Roger’s. I mean, me and Mickey...it was only once.’
‘Once is all it takes,’ Claire said drily. ‘If you and Roger are both A negative, Miles should be A negative, too. So Mickey’s blood group must be rhesus positive, and Miles must be his baby.’
‘What am I going to do? If Roger dumps me because of this...I don’t want to be a single mum. I’d never cope. He doesn’t even really want kids—so I didn’t tell him for weeks and weeks, until it was almost too late to do anything and...Oh, God. What am I going to do?’ Estée wailed.
‘It’ll sort itself out. The first thing to concentrate on is making Miles better,’ Claire said. ‘Try not to worry. We have people you can talk to here—counsellors who can help you through the problems you might face with your husband. But right now your son needs you on his side. He needs cuddles and for you to talk to him, sing to him, let him know you’re here. And as soon as we get the test results back, we’ll be able to start treatment.’
‘Thank you. I’m sorry for being so wet. It’s...’
‘You’ve just had a baby. Your hormones are all over the place, you’re worried about your son, and it’s perfectly natural.’ Claire squeezed her hand again. ‘I’ll come back and see you as soon as I’ve got the results. In the meantime, if you need anything, the nurses are here to help.’
‘Thank you,’ Estée said again.
Ten minutes later, Eliot rapped on her open office door. At her nod, he walked in and closed the door behind him. ‘Well?’
‘You
