her own family would be under the spotlight of a case conference and she wanted her sister and brother’s case worker to be as passionate and as informed as she usually was. Still, even if Nina hadn’t prepared as meticulously as usual, she was still well informed and, given Sienna was only two weeks old, most of the details of the case were fresh in her mind.
She knew that most of the medical staff were opposed to Sienna being discharged home to the parents. Their concerns had been well voiced and they were repeated again now.
First she heard from Brad Davis, head of the prenatal unit. Brad had seen Hannah for her very brief prenatal care and had also delivered Sienna, but thankfully he was very matter-of-fact in his summing up.
‘Hannah presented to us at thirty-four weeks gestation,’ Brad explained. ‘She had recently resumed her relationship with Sienna’s father, Andy. He was seemingly the one who insisted that Hannah attend Angel’s. Andy was concerned about Hannah’s drug habit and the effect it would have on their unborn child—Hannah’s only concern was feeding her habit.’
‘At that time,’ Nina responded, and Brad nodded. ‘She complied with the methadone programme?’ Nina asked, and again Brad nodded, and so on they went.
Nina heard from the midwives and nursing staff and also the addiction counsellors who had been in regular contact with Hannah.
Eleanor Aston, though, was particularly difficult. Always a huge advocate for her patients, Eleanor was perhaps the most insistent that Sienna be removed from her mother’s care.
‘I looked after her son last year.’ Eleanor’s voice shook with emotion. ‘And I can remember—’
‘We’re not discussing Sienna’s half-brother this morning,’ Nina interrupted. She knew that it was terribly difficult to separate the two cases, especially as Eleanor had dealt with Hannah at her very worst and had looked after what had indeed been a very sick little baby boy with a very cold and unfeeling mother, but this was a crucial part of Nina’s job and one that made her less than popular at times with the medical staff.
‘The difference this time around is that Hannah is doing her best to get straight and she is also in a very different relationship with this baby’s father. As soon as Andy found out that Hannah was pregnant he brought her straight to Angel’s and has been rigorously making sure that she keeps up with the programme, and Hannah herself has made a huge effort—’
‘When?’ They were half an hour into the meeting and it was the first time that Jack had actually spoken. He looked across the table at Nina as he did so. ‘When exactly did Hannah make this huge effort that you keep talking about?’
‘Since she came to Angel’s.’ Nina’s voice was very calm. She had been expecting Jack to step in at any moment and she hadn’t been proved wrong.
‘She had nine months to dry out,’ Jack said, and then corrected himself. Nina was quite sure Jack’s mistake was deliberate. ‘Oh, sorry, make that eight months, because it was considered vital that we induce her early due to the baby’s failure to thrive in the womb.’ Still he stared at Nina, perhaps waiting for her to interrupt, or to speak over him, but she met his cool gaze without words of her own and Jack carried on.
‘So, all in all, she actually managed two weeks of antenatal care, mainly because of her boyfriend’s efforts, and then two weeks of huge effort postnatally, but only with every system and resource available in place.’
‘Your point being?’ Nina asked, and Jack didn’t answer. ‘Why wouldn’t we offer every resource that we have to this family?’ She watched his jaw tighten as she scored a point.
‘Hannah has been attending addiction counselling twice daily. For the first time she actually wants all the help and support that we can provide and there is also an extremely devoted father who, I am quite sure, will put the baby’s welfare first. Hannah has broken down with me on two separate occasions and told me that she doesn’t want another child taken off her and that she is prepared to do whatever it takes. Now, I know that this is early days—’
‘My doctors have been up with that baby night after night,’ Jack interrupted. ‘I personally have been called in when Sienna has become agitated and distressed.’ His eyes held Nina’s and she didn’t blush or blink but simply met his gaze. ‘The baby had severe withdrawal, she was small for her dates due to maternal malnourishment, just like her older brother, and it is my opinion that the last person the baby—’
‘Sienna,’ Nina interrupted. ‘The baby is called Sienna and to date there is nothing that I have seen, from my many observations, to indicate that any of the traits that were a cause for concern with her other children are present now, and the nursing observations verify that….’
Jack drew a long breath as Nina spoke on. Her holistic approach irked him, and he sat, turning his heavy pen over and over as he listened to Nina drone on about how damaging it would be to both Sienna and Hannah if they were separated now, especially as a strong bond had been established. Jack said nothing, though he wanted to point out that a bond surely took longer than a couple of weeks, but he knew he’d be shot down, not just by Nina but by everyone in the room.
Jack really didn’t get the maternal bond argument.
His pen turned in his fingers as he thought for a moment of his own mother—she certainly hadn’t had one. Instead, Jack had been assigned to two nannies and had only been brought down for dinner and social events.
But instead of dwelling on his own messed-up family, he listened how, from Nina’s findings, there was nothing to indicate at this stage that Sienna was at risk and that with full back-up and aftercare, the department had determined that the child should be discharged to the care of the parents.
‘So what am I here for, then?’ Jack challenged. ‘From a medical point of view the baby has put on sufficient weight to be discharged, she is stable, her withdrawal from methadone is manageable now and you’ve clearly already determined the outcome. You’re really not interested in hearing our concerns—’
‘Don’t!’ For the first time this meeting Jack heard the shake of anger in Nina’s voice. ‘Don’t you dare insinuate that I am dismissing the medical staff’s concerns.’
Jack rolled his tongue in his cheek. He certainly wasn’t about to apologise, but inwardly he conceded that perhaps he had gone a bit too far. At the end of the day the social services department did one hell of a job. They dealt with the most vulnerable children and handled the most difficult cases and had to make decisions that few would relish, so he sat silent as Nina spoke on.
‘Every one of your concerns has been listened to and addressed. Every point you have made has been noted.’ Nina looked around the table. ‘I have to take each case on its own merits and in this case I see the mother making a huge effort. She is racked with guilt, witnessing all that Sienna is going through, and—’ Nina looked over at Eleanor ‘—while I accept that she had none of those feelings with the other two children, in this instance it is very different.
‘There is a father who is stepping up and a couple who are desperate to keep their child but, yes, there is also a baby who, thanks to her mother’s poor choices, has had an appalling start to life. Now, I could arrange temporary placement for Sienna, but I can assure you the foster-care system is not a fairy-tale alternative, especially when we believe that, with support, this family does have a chance.’
‘Well,’ came Jack’s terse response, ‘I’ve voiced my concerns.’
‘They’ve
