extremely loudly!
Kathy had come in for an attempted VBAC—a vaginal birth after a Caesarean section. When she’d had her first child, the baby had been too large to negotiate the pelvis and an urgent C-section had been performed, much to Kathy’s disappointment. A staunch advocate of natural delivery, she had been disappointed that she hadn’t been able to achieve one and had been determined that her ‘mistake’ wouldn’t be repeated again. Previously it had been considered that ‘once a Caesarean always a Caesarean,’ but over the last few years, when appropriate, women had been offered a trial of labour. Things didn’t always work out as planned and often women still ended up requiring surgery to deliver their baby, but statistics were encouraging and the tide was starting to turn. Kathy had been determined that she would be successful in her quest to have a natural delivery, had done extensive research in her library and on the internet and was convinced that it was more a question of mind over matter than anything else. But even though her second baby was a much smaller one, Kathy’s uterus hadn’t contracted efficiently, and after a prolonged labour with minimal progress Rinska had become concerned by some rather ominous signs in Kathy’s and the baby’s observations and had called in Mr Davies, who had performed an emergency Caesarean section.
‘Rinska, you had no choice but to call in Mr Davies to perform a Caesarean section. And that’s coming from me—one of the strongest supporters in the unit for natural birth and minimal intervention. It would have been considered negligent if you hadn’t intervened when you did. You know that!’
‘I do know that.’ Rinska gave a small tired smile, obviously grateful for her colleague’s support. ‘I just guess I need to keep hearing it. Over and over in my mind I’ve gone through Kathy’s labour and I really cannot think of anything that I could have done differently, except perhaps explain things a little more clearly to her.’
Ally gave a dubious frown. Rinska, despite her heavy accent, despite the fact English wasn’t her first language, always spoke eloquently to the patients, always found the time, even in the most dire of circumstances, to keep her patients informed, and now here she was doubting herself.
Checking that no one was nearby, Rinska spoke in low tones. ‘I think she’s going to make a formal complaint.’
‘Then let her,’ Ally said with a confidence that belied how she really felt—even if Rinska was in the right, a formal complaint and the ensuing investigation was a horrible thing for anyone to go through. ‘Anyone who looks at her charts will know that you had no choice but to call in Mr Davies, and at the end of the day Mr Davies is the one who operated…’
‘I know,’ Rinska sighed. ‘But it’s me she’s really against. She was already in Theatre by the time Mr Davies arrived. She says that I panicked and overreacted, that I dramatised the situation just to get him to come in.’
‘That’s ridiculous.’
‘It’s also the last thing I need right now. Ally, please, don’t say anything, but I’m actually applying for a consultant’s position.’
‘Here?’ Ally beamed and Rinska nodded.
‘It’s early days, my paperwork isn’t quite through yet, but hopefully in a few weeks I can start doing the job I’ve trained so hard for. It’s not that I mind being a resident and having to double-check everything with a registrar who knows less than me…’ Rinska gave a low laugh at her own bitter voice. ‘Well, a little, perhaps, but it has helped me to learn about the hospital system from the bottom upwards, which can only be good. But it’s still been a tough year. And now just when there’s an end in sight I’m going to have this complaint to deal with. It’s not going to look good for me.’
‘You’ll be fine,’ Ally said firmly, and she meant it. ‘When does your shift end?’
‘Half an hour ago,’ Rinska said wryly. ‘I might head over to the social club afterwards. Do you want to come?’
Ally was about to shake her head. The hospital social club wasn’t really her scene but the prospect of a drink and a chat with Rinska was rather more inviting than sitting in the movies alone just so that she could avoid Rory, so instead she nodded. ‘Sounds good.’
Lucy Williams gripped Ally’s hand tightly as Ally rested her hand quietly on the young woman’s stomach.
‘They really hurt!’ Lucy gasped. ‘I mean really, and the doctor told me that I’ve got ages to go. Maybe I came in too soon. It’s just they were coming so regularly I thought I should be here, and now I find out that I haven’t progressed at all!’
‘Another one?’Ally checked as she felt Lucy’s uterus tighten beneath her fingers. ‘OK, don’t hold your breath, Lucy. Remember how we taught you to breathe in class…’ Her voice was calm and gentle, encouraging Lucy to take some slow deep breaths, talking her through the pain and waiting until the contraction had abated before offering her some much-needed encouragement.
‘You have progressed,’ Ally said firmly. ‘I saw you yesterday when you came in for monitoring and you’ve come a long way since then.’ Because Lucy’s baby was more than a week overdue, she had been coming into the unit for regular monitoring to ensure that the baby was still active and Ally was telling Lucy the truth—in twenty-four hours she had come a long way. ‘The baby is in a great position, and your cervix has thinned out beautifully. Now it’s just a matter of letting your body do its job. Remember how I told you that for the baby it’s like trying to push its head through a tight jumper?’
Lucy nodded.
‘Well, that’s what’s happening now. I know it can seem disappointing to hear that you’re only one centimetre dilated, but this isn’t a numbers game. You could dilate quite rapidly from here, or then again the contractions might abate for a while and give you some much-needed rest—but, whatever happens, you’re in labour, Lucy, and if you feel you needed to be here, then you’re in the right place.’
‘So what now?’
‘What do you want to do?’ Ally asked, not wanting to force her own opinions on her patient. But when Lucy just stared back helplessly Ally offered a couple of suggestions. ‘Why don’t you go for a gentle walk around the ward—let gravity help things along a bit?’
‘What about when I get a contraction?’
‘Lean on Dean.’ Ally smiled, looking over at the anxious husband.
‘People will think I’m mad! I’m not exactly dignified when I get a contraction.’
‘No one will turn a hair—we’re all completely used to that sort of thing here. This time tomorrow you’ll be watching some other woman doing exactly the same while you’re holding your very own baby and thinking, The poor thing. But walking around can help speed things along. After that it might be nice to have a deep bath, which can help relax you and take the edge off the pain.
‘Does that sound like a plan?’ she asked.
Lucy nodded, and as she heaved herself up out of bed, Ally helped her into a dressing-gown.
‘How long are you here for?’ Lucy asked.
‘I’m off duty soon, but I’ll be back at seven in the morning and by then I’m sure that you’ll either have your baby or you’ll be on the home run!’
‘God, I hope I’ve had it,’ Lucy sighed. ‘Did I really say I didn’t want any
