go. And her blood pressure wasn’t dangerously high, just enough to bear watching. Not that deliveries made him nervous—he’d done his fair share over the past ten years—but he wasn’t real excited about doing an out-of-hospital birth with an underweight woman, three weeks early—she thought—whose case he didn’t know.
“You can go ahead and push now,” he said, leaving the sheet up and peeling off the gloves.
“Like you’ve got any say in it,” she got out, just before her face contorted again. But not with pain this time. With determination.
Ryan wriggled into a fresh pair of gloves, deciding against asking her if she wanted to get the kids up. They were zonked, nobody needed the distraction right now, and if she’d wanted them up, he had no doubt she would have made her wishes known.
Three pushes later, the baby’s head crowned. No surprise there.
“Pant, Maddie, pant! Don’t push, you hear me? Pant the baby out…yeah, like that, good. Baby’s real small…the idea is to birth it, not launch it into orbit.”
For a split second, her startled gaze met his and she looked as though she might laugh…only another surge diverted her attention.
“Pant, honey! That’s right, that’s a girl… Good, good…okay…here we go…!”
He steeled himself for her screams…but they never came. One of his patients had likened giving birth to squeezing a cannonball through the eye of a needle, an image which had pretty much burned itself into his mind. Maddie Kincaid, however, either had the highest pain threshold known to womankind or was possessed of a will Ryan decided he did not ever want to tangle with.
Two blinks later, a tiny, perfectly shaped head slid out, the cord loosely wrapped around the baby’s neck. Ryan easily untwisted it, helping the little thing to rotate before easing first one shoulder, then the other, out from underneath the pubic bone, then presented Maddie Kincaid with her new daughter—five and half pounds, tops, of flailing determination, red and wrinkled and bald, but with a set of lungs capable of waking the dead in three counties.
With a sound that was equal parts laugh and sob, Maddie thrust out her arms. “Give her to me! Is she okay? She must be okay if she’s cryin’ like that, right?”
“She’s fine,” Ryan said, trying to ignore the strange, burning tightness in the back of his throat that assailed him every time he delivered a baby. He quickly suctioned the perfect little nose and mouth, wrapped little missy in a clean towel and laid her on Maddie’s stomach. He should probably get to the Apgar scoring, but God knows millions of healthy babies had been born over the years without being graded like eggs the minute they were born.
“You’re a peanut, but you’re a real perky little peanut,” he said softly, rubbing the tiny thing’s back through the towel. Then he looked at the skinny, scrappy woman who’d just produced the now-quieter infant squirming in her arms, and something inside just melted, like when your muscles get all tense but you don’t even realize it until someone tells you to relax. “You done good, Mama. Shoot, you didn’t even work up a good sweat.”
Silver eyes, full of delight and mischief, briefly tangled with his. “Widest pelvis in the lower forty-eight,” she said, her grin eclipsing the entire lower half of her face.
And the thought came, This is no ordinary woman.
A moment later, in a flutter of skirts and long salt-and-pepper hair, Ivy Gardner burst into the room, took one look at the situation and said, “Figured you’d get the fun part, leave the cleanin’ up to me!” Except then the two-hundred-pound woman, her hair barely caught up in a couple of silver clips, swept over to the bed. “I’m Ivy, honey,” she said to Maddie, her expression softening at the sight of the baby. “Oh…wouldja look at this cutie-pie?” She let out a loud cackle. “Boy or girl?”
“A girl. Amy Rose.”
Ivy grinned. “Amy. Beloved.”
“That’s right.”
But Ivy had already turned her attention to other matters, massaging Maddie’s abdomen to facilitate the expulsion of the placenta, all the while cooing to the new baby and praising her mama.
Ryan left them to it. Ivy Gardner had delivered more than five hundred babies in the last twenty-five years, had never lost a one. Or a mother, either. And right now, he figured his patient could use some mothering herself.
His heart did a slow, painful turn in his chest as he peeled off his gloves, staring out the window. The rain had stopped, he realized, the sky pinking up some in the east.
And Ryan found himself beset with the strangest feeling that his life had just changed somehow.
He glanced over at the two children, stirring from sleep on the chair. It plumb tore him up, seeing those three—now four—in the condition they were in. What had brought Maddie here, with two small children and as pregnant as she was? She didn’t look like she was much more than a kid herself, although he supposed she was at least twenty or so. Except for the mud on the bottoms of their jeans, the kids’ clothes had been clean enough, but they were worn, probably secondhand, the little girl wearing her brother’s hand-me-downs, he guessed.
His gaze drifted back to Maddie. Scraps of light brown hair, the color unremarkable, grazed her cheeks and neck, the shoulders of her faded nightgown. Paper-thin, freckled skin stretched across prominent cheekbones, a high forehead, a straight nose. When she spoke or laughed, her voice was rusty. When she gave a person one of her direct looks, it was like staring into a bank of storm clouds.
And those storm-cloud eyes clearly said, “I’m more than life has ever given me a chance to be.”
Right now, those eyes were fastened on her newborn child, the harsh angles of her too-thin face aglow with the rush of new-mother love. Born too soon, the infant wasn’t quite “done” yet, but he was sure Maddie didn’t see the wrinkled, ruddy skin, the bit of hair plastered to the head with vernix, the little face all smushed up like a dried apple. The infant yawned, and Maddie giggled.
“You’re a funny-looking little thing,” she whispered, and Ryan almost laughed out loud.
“Mama?”
Ryan turned in time to catch another sleepy yawn. Noah’s hair had pretty much dried by now, sticking up all over his head in a mass of little horns. Ryan could relate.
“Hey, grasshopper,” he said, scooping the child off the chair, blanket and all. “Come meet your new sister.”
For an instant, the child cuddled against his chest. Too sleepy to protest, probably. He smelled sweet. Clean. Whatever was going on in Maddie Kincaid’s life, she’d given her children baths last night. An effort which had probably brought on the premature labor.
Ryan set the child, still huddled under his blanket, on the bed at Maddie’s knees. The boy rubbed his eyes, yawned again. Then frowned. “Another girl?”
“Oh, now, hush up,” Maddie said over a weary, but relieved, laugh, as Ryan deposited an owl-eyed, silent Katie next to her brother. “There’s nothing wrong with girls, silly billy—”
“Good Lord!” Ivy peeled the back of the blanket from the boy’s shoulder. “What on earth do you have on?”
“Their
