done the chest-beating Tarzan-type thing. What was it about this woman that made him feel like that?
‘Right. This is Louise, our senior midwife. Known to everyone as Lulu.’
The woman she’d been chatting to. In her late thirties, dark-haired, little and plump with a friendly smile. And a knowing look in her eyes. No doubt a smile from Judith Powell melted the brain of just about every male she met, and it was obvious to everyone that he was no exception. ‘Pleased to meet you,’ he said.
‘And you.’
‘Catch you later, Lulu.’ Judith took a sheaf of files from the desk. ‘Right. Our first mum is Lisa Ford.’
Not ‘patient’, he noted. Good. So Judith took the modern approach rather than seeing pregnancy as a condition that needed to be treated.
‘It’s her first baby, she’s thirty-four and the baby’s breech presentation.’
Meaning that the baby was bottom down rather than head down in the womb. ‘So she’s in for a section?’ he asked.
Judith shook her head. ‘She wants a vaginal delivery, if possible.’
‘What sort of breech?’
‘Frank,’ Judith explained. This was the most common type of breech presentation, with the baby’s hips flexed and knees extended. ‘The ultrasound didn’t show anything conclusive but I’d like her to have another ultrasound after delivery—it’s possible that she has fibroids in her uterus.’
‘How are you planning to manage the delivery?’
‘I’m going to try ECV, when we finish the ward round.’ ECV, or external cephalic version, was a way of turning the breech baby to a normal presentation, through a kind of forward somersault.
‘You’re sure she’s a suitable candidate?’
‘The baby’s been breech since twenty-six weeks and I discussed it all with Rowan.’
His predecessor, who’d taken a sideways move to a consultant’s post in Birmingham, to be nearer his parents when their first grandchild was born in three months’ time.
Clearly Kieran’s doubts showed on his face, because she took him through Lisa’s case history. ‘She’s thirty-eight weeks now, it’s a singleton baby and not small for dates. Lisa has no uterine scars, no signs of hypertension or preeclampsia—so there’s a much smaller risk of placental abruption. Oh, and she’s rhesus positive, before you ask. And she’s had nothing by mouth since midnight. I’ve got the portable scanner on standby and the cardiotocograph ready. I thought we could do an ultrasound now to check the position of her placenta and the baby, whether the baby’s growth rate is satisfactory and whether the volume of amniotic fluid is normal. Then we’ll set the CTG running for half an hour so we can check the baby isn’t distressed.’
She was more thorough than he’d expected. Maybe he’d got it wrong and she wasn’t a makeweight. Maybe she’d been on her break when she’d been chatting to Louise, not simply wasting time. ‘And you’re experienced in ECV?’ he asked.
‘No. But I believe you are. So you can talk me through it.’
He frowned. ‘How do you know?’ Had his résumé been passed round the ward?
She looked embarrassed. ‘When we heard you were joining us from the Hampstead Free, I, um, asked Dad about you.’
‘Right.’ It was tempting—very tempting—to ask what Professor Powell had said about him. But Kieran had no intention of falling into that trap.
‘So will you work through it with me?’
He nodded.
‘Great. Thanks.’ She flashed him another of those knee-weakening smiles. He didn’t dare smile back. The safest place to look was at her hands.
Though even that was dangerous. There was no ring on the left hand, he noted. No white mark either, so it wasn’t that she removed a ring for her job. But the lack of a ring didn’t mean anything. Tess’s ex had never given her a ring, but she’d still been committed to him—and completely devastated when he’d dumped her three weeks ago.
Tess. Tess, who needed him right now. He should be thinking of his baby sister, not lusting after his colleague.
When Judith had introduced Kieran to the patients, written up their notes and introduced him to Margot and Daisy, the other two midwives on duty, they returned to Lisa Ford.
‘OK, Lisa,’ Judith said warmly. ‘The CTG results look fine—the baby’s happy. Your pulse and blood pressure are a little bit higher than normal, but I’d guess that’s because you’re nervous.’
‘A bit,’ Lisa admitted.
‘It’s your choice. You don’t have to do anything you don’t want to do,’ Judith reminded her.
Lisa bit her lip. ‘Is it going to hurt?’
‘It might be a bit uncomfortable, but it shouldn’t be painful,’ Kieran said.
‘I’ll be brave, then.’ She swallowed. ‘Because I really, really don’t want a section. I’d do anything to avoid it.’
‘We can’t guarantee this is going to work—and even if it does, your baby might be one of the stubborn ones who turns himself right back again,’ Judith warned gently. ‘But that’s why we’ve left trying the manoeuvre until after thirty-seven weeks, to give you a better chance of him not turning back again.’
‘Let’s do it,’ Lisa said.
‘You might be more comfortable if you empty your bladder first,’ Kieran said. ‘You’ll feel a bit of pressure on your tummy.’
When she’d left the room, he turned to Judith. ‘So I’ll tell her what you’re doing as you do it.’
Judith nodded. ‘Fine. I’ve read up on it—but it’s not the same as doing it yourself.’
‘If it doesn’t work, don’t think that you’re a failure or that it’s your fault,’ he said quietly.
Oh, no. Were her insecurities that obvious? She’d had to work hard to get this far. Really hard. Studying a lot longer than anyone else she knew. And if Zoe Hutton, her best friend, hadn’t coached her through some of her exams she would have failed.
Sometimes she wondered if she’d done the right thing. If she should have given up and gone for a career in music after all. But she hadn’t been able to stand the idea of disappointing her father. He’d wanted a son to follow in his footsteps. Judith was his only child. QED: she’d tried to make him forget that she was a girl, and had followed in his footsteps.
Except she didn’t have the natural brilliance of Zoe or the quickness of Holly Jones, her other best friend. She had to rely on reading up on things, and carrying obstetric handbooks in her pockets so she could double-check that she was managing complications properly. She’d only just been made a registrar; whereas Holly and Zoe had been promoted ages before. And Zoe was on the fast track to becoming one of the youngest consultants in the hospital.
