Midwife in a Million (5 page)

Lucy nodded, so Kate went on. ‘Go with it, ride the waves and relax, and think of your little baby waiting to meet you.’

Lucy searched Kate’s face and must have seen the conviction there because she finally nodded. ‘Okay. I can do that.’

Kate sat back and smiled, proud of her young patient’s willingness to trust her own instincts—and Kate. ‘I’m here and so is Rory. In a while we’re going to ring the hospital in Derby and see if they can meet us somewhere if you get into strong labour. We’ll look after you and your baby, no matter what.’ Her eyes drifted to Rory’s in the mirror. He was watching.

‘Do you want me to stop so you can check her out?’ he said.

Kate shook her head. ‘How long to the next stop?’

He glanced at his watch. ‘Half an hour to the general store. You could use the landline there too, talk to Derby; might be easier to hear if the satellite reception is playing up.’

Past the point of no return, then. At least Kate knew there was no turning back. ‘We’ll be fine till then, thanks. I’m just glad the real rain held off for this long.’

She smiled down at Lucy. ‘You’ll be able to get out, go to the Ladies and stretch your legs.’

Not long later a flash of lightning ahead and the almost immediate crack of thunder warned them they were heading into the thick of a storm.

Suddenly the heavens opened and the road ahead turned the previously smooth dirt into a sucking quagmire. As the heavy sheets of rain flooded the mud it made visibility and stability tough. Rory cursed silently under his breath and he glared skywards. If it had held off a little bit longer it would have been good.

His hands tightened on the wheel as he felt the truck slew sideways and he accelerated briefly until the off-road tyres caught and he had traction back. ‘Might take a little longer,’ he called over his shoulder and slowed down until the truck was barely making a brisk walking speed and they ground their way towards the hills through the middle of the storm.

‘I’m glad I’m not flying in this,’ he heard Kate say to Lucy.

‘Me, too.’ Lucy’s voice wobbled and Rory looked out of the side window and winced as a flash of light illuminated the sparse scrub. He could agree with that but it wasn’t much fun driving either. He was just glad that he was the one carrying such precious cargo because the retired Charlie had been night blind ten years ago and Bob was even worse.

A little over three-quarters of an hour later they pulled up at the rustic roadside store that marked the half-way point of their journey and Rory was able to pull up under cover to let them out.

They stayed just long enough to achieve what they had to. Kate rang Derby to update them and promised to phone at the next stop, if not before. Rory topped up the diesel and bought takeaway coffee for all of them to go with the sandwiches they’d brought, while Lucy slipped off to the Ladies.

He had a few minutes to quiz Kate, at least. She looked strained and he didn’t doubt she was feeling the weight of her decision. ‘So how do you think she’ll go?’

Kate chewed her lip at him over the rim of her paper cup and for once there wasn’t any of that reserve he’d felt between them since he’d come back. Somehow, that was even harder to bear.

She seemed to shake off her preoccupation while he waited and he wondered for a second if he was making this easier or harder for her by being the one to drive them to Derby. Then he mocked himself for even dreaming his presence made a difference.

Kate seemed to have come to peace with her decision. ‘If Lucy labours and progresses to birth then we’ll just do the best we can. I think she’ll be fine. We’ll be fine. If that’s the way it goes, then we’ll concentrate on the quickest way to get the baby to the special care nursery in Derby.’

So there was a chance they’d have the baby in the truck. Rory’s brain froze for a second. Lord help them. That was definitely not what he’d expected her to say.

‘Do you think that’s going to happen?’

Babies. He knew next to nothing, really. Give him a ten car pile-up any day. He knew what to do with massive trauma and advanced life support. He knew how to coordinate disasters, reallocate staff, vehicles and modes of transport. But the idea of a premature baby—he remembered those pink and shiny, almost see-though miniature babes from air ambulance trips—relying even a little bit on him was more scary than he’d bargained for.

Kate looked serene now and Rory felt like shaking his head. She continued with, ‘I’d say there’s at least a fifty-fifty chance of her progressing to birth, especially now she’s in early labour; it just depends.’ He closed his eyes.

Oblivious, Kate went on, ‘Of course, if she breaks her waters then I’ll up it to eighty percent.’

He tried to keep his voice level. ‘You seem pretty calm about it.’

‘Not a lot we can do about it now.’ Kate smiled at him. ‘Who’s the person who says everything’s going to be fine? I can see you’re not comfortable.’

Rory rubbed the back of his neck uneasily. ‘Women should have babies in hospitals, where it’s safe.’ Not in the back of rough old ambulance trucks in tropical storms on a dirt road miles from civilisation.

‘There’s many that would disagree with you, including most of the Aboriginal women around here, but we’ll save that argument for another day.’ She ob
viously didn’t think they were totally out of their depth so he’d just have to trust her.

He thought about her word choice. So she’d argue with him another day? Suddenly it wasn’t so bad and he smiled at her. ‘I’ll hold you to that discussion at a later date.’ And Kate would be there to do the baby stuff.

When Rory bundled them back into the truck for the next stage of the journey the rain had eased but still fell in soaking sheets.

‘How do you feel after that walk around, Lucy?’ Kate put away the BP machine. ‘Your blood pressure’s good.’ Kate thought Lucy looked less sleepy, but she wasn’t sure that was a good thing.

‘Okay—’ Lucy’s voice dropped to a whisper ‘—but maybe I didn’t go to the toilet enough ‘cause I think I’ve just wet myself.’

O-oh. Ruptured membranes, Kate thought as she lowered her voice. ‘Little wet or big wet?’

Lucy blushed and hung her head. ‘Medium.’

Kate chewed her lip. Okay, then. ‘You could have a little tear in your bag of waters around baby, Luce.’ Kate dug into one of the emergency bags she’d brought. ‘See if you can slide this feminine pad into your underwear. I know it looks like a big white surfboard but it’ll make you feel more comfortable. As a bonus, we’ll be able to tell if the dampness is from the water from around the baby and how much is coming away.’

When Lucy had accomplished that feat, not easy in a swaying vehicle, Kate pulled out the tiny Doppler to listen to Lucy’s baby. The steady clop, clop, clop of Lucy’s baby’s heartbeat could be just heard over the rain on the roof.

So baby didn’t mind someone pulling the plug out of the bath, she thought. They were all silent for a minute as they listened, that just discernible galloping heartbeat a reminder of why they were driving through the ridiculous weather to Derby.

‘Should be about two hours to the next diesel stop,’ Rory said when Kate put the Doppler away. ‘Then, not long after that, the road will improve as we hit the main highway.’

‘So we’ll get through all right?’ Lucy’s voice was hard to distinguish over the rain and Kate repeated the question to Rory in case he hadn’t heard.

‘They said at the shop the next causeway hasn’t risen too much with the downpour yet,’ he said.

Kate hoped he was right but she wasn’t so sure about the return trip for her and Rory. Not much they could do about that except worry later and see.

When they reached the next crossing the water had risen to a little over eighteen inches but the causeway was concreted and the vehicle high. The truck drove through smoothly without any water coming in the doors.

Kate was glad now they’d stayed only briefly at the last stop.

The rain eased more as they drove towards the next mountain range they couldn’t see, she knew it was there, but today it was well and truly hidden in cloud. She mentally shrugged. If they kept going they’d find it eventually.

‘T
HE
pains are getting stronger.’ Lucy’s forehead was wrinkled with the effort to breathe slowly and calmly and Kate smoothed out her own frown as she watched.

‘I know, sweetheart.’ Kate glanced up and caught Rory’s eyes in the mirror again for a fleeting second, just for her own comfort, before she looked back at Lucy. ‘Keep your breathing going, you’re doing beautifully. It looks like this baby of yours is pretty keen on seeing what the world looks like on the outside of your tummy.’

Lucy grimaced. ‘I think I just wet myself again. This time it’s a flood.’ She shuddered in disgust.

Kate smiled. ‘Okay. We might get Rory to pull over for a minute while we sort out what’s happening down there.’ She looked to the front of the vehicle as they slowed. There was no doubt Rory was on antenna duty and could hear most of what they were saying, which saved her having to repeat everything.

There was nowhere sheltered to pull in so Rory
edged to the side of the road as much as he could without sinking into the soft mud. The last thing they needed was to be run over by a road train or bogged in wet bull dust mire and have to dig themselves out. Neither was a great option.

Rory had caught snatches of conversation for the last half hour and had an idea things had progressed in Lucy’s labour. They were still an hour out from the next stop but he’d been thinking along the lines of pulling off the track and down one of the side roads because they were ‘near’ one of the larger cattle stations.

A detour of maybe fifty kilometres would see them at a place that had facilities and an airstrip for when the sky cleared.

Kate pulled the privacy curtain while she attended to Lucy and Rory reached for a map from the seat beside him to see exactly where they were. The last crossing had been about sixty kilometres back so that made them near the turn off to Rainbow’s End Station.

It wasn’t a tourist facility like the high-end Xanadu they’d passed two hours ago, but he remembered the McRoberts family from the camel races when he was a kid. They’d certainly have no problem in an emergency like this.

But maybe it was quicker to keep rolling towards Derby and meet up with the ambulance coming the other way. He’d see what Kate wanted as soon as she was ready to tell him what was going on.

‘Rory! I need you.’ A calm voice but with that hint
of urgency that had him jerk aside the curtain and heave himself in beside Kate without any hesitation.

He glanced at Lucy and blinked. The girl’s whole body shuddered as the seizure took control and her half closed eyes stared vacantly at some point over Kate’s left shoulder as her body shook the stretcher in jerking movements.

Rory slipped the oxygen mask over her face as Lucy’s skin paled to alabaster. During the fit her body would use up the oxygen faster than she breathed it in and the tinge of blue around her lips deepened. Rory could feel his own heart gallop like the baby’s heart rate had through the Doppler earlier.

Kate was focused and in control, which boded well for Lucy. Rory glanced at Lucy’s stomach, which seemed to be heaving with a life of its own, and his fear for her baby mounted. He was so glad he wasn’t the only person here.

‘It’s okay, Lucy,’ Kate repeated. ‘It’s nearly over. We’re here with you. It’s okay.’ Kate’s soft voice repeated the litany until, after what seemed an hour but was probably less than two minutes, Lucy’s body slowly settled and then lay still.

A deep dragging breath from Lucy was echoed by the one Rory pulled in for himself as he glanced at Kate before he wiped Lucy’s face. He knew about fits. He’d dealt with epilepsy often but not with a pregnant woman and all he could think about was the lack of oxygen for Lucy’s baby.

‘The first eclamptic fit,’ Kate said as she reached for the medication roll. He didn’t like the sound of that.

‘You expecting more?’ He hoped she’d say no but of course it was likely. She handed him an ampoule and syringe and Rory busied himself with drawing up the medication while Kate checked Lucy’s blood pressure.

‘Her blood pressure’s shot up. And we’ll probably have to put some Magnesium Sulphate up in a drip to lower her cerebral irritability as well.’ Kate reached into another side pocket and removed an intravenous fluid flask to add drugs for slow infusion. ‘But we’ll start with more hydralazine for her blood pressure. After you draw up I’ll grab that satellite phone of yours, please.’

They worked seamlessly. Rory prepared the drugs, Kate checked and then injected them. Rory loaded the flask. He’d work with her on the road ambulance any day. No fluster or indecision—just how he liked it, his partner calm and the patient prioritised efficiently. She made everything easy, which was usually his job.

It was strange to remember that this was his Kate. The young woman he’d known years ago would have looked to him to save her. That time had certainly passed. He didn’t know how he felt about that but there’d be time to think about it later.

‘I thought her blood pressure was down.’ Rory looked at Lucy who, while still pale, breathed normally now.

Kate sighed and nodded as she rechecked the blood pressure on Lucy’s arm. ‘So did I. Obviously not enough for Lucy’s seizure threshold. Some people seize with an almost normal blood pressure, just like some babies can have febrile convulsions with only low temperatures.’ She shrugged. ‘If that’s how their make-up is. Lucy’s mother fitted. Either way, we need help.’

But what collateral damage? Rory thought. ‘And her baby?’

Kate spared him an understanding glance. ‘Will be fine. So far. The oxygen supply to the uterus was only decreased for a minute or two. As long as Lucy doesn’t have long fits or do something nasty like separate her placenta with a haemorrhage, the baby will rest like Lucy and then recover. Babies are designed to take some stress.’

He knew he looked unconvinced as Kate elaborated. ‘Lucy’s out for the count but her labour will probably progress more rapidly now.’

Rory winced down at his chart, where he recorded the drugs and time given. ‘More excitement to come, then.’

Kate flashed a smile back at him. ‘After this, I’ll be much happier when this baby is out.’

Happy? He was far from that. ‘As long as one of us is happy.’

Lucy moaned and shifted her head from side to side but still didn’t open her eyes.

Kate frowned and ran her hand over Lucy’s
abdomen. ‘I’m not
that
happy.’ She bent closer to Lucy’s ear. ‘Your uterus is contracting strongly now, Lucy. That’s what the pain is. Soon.’

‘Do you want me to head to Rainbow’s End Station? It’s less than an hour away. At least we’d have facilities and an airstrip.’

Kate had the Doppler out to check the baby’s heartbeat. The clop, clop was marginally slower and very regular but Kate couldn’t hear any slowing after the contractions. She stared at him for a moment and then nodded. ‘I’ll check with Derby but that sounds great. Let’s do it.’

Rory nodded and he could hear the baby’s heartbeat follow him as he climbed back through to the front, where he grabbed the satellite phone and passed it back before he started the engine.

Kate’s voice echoed around his head. This Kate was a new woman, so much more independent and bolshy than the one he’d loved with every ounce of his adolescent heart and she seemed quite capable of handling any situation. She certainly didn’t need him.

Kate, the person who had given his life meaning all those years ago, then had taken it away on a whim, leaving him a driven man. It amazed him to see her so gentle and calm as she talked to the semi-conscious girl and he was just as affected. Even though she was not part of his future, he could still feel proud of the woman she’d become.

Kate loosened her shoulders and took her own deep breath. Well, that was the first fit out of the way. Thank goodness Rory had been here. She’d have hated to try and cope with Charlie or Bob at the wheel.

Hopefully, Lucy wouldn’t have any more fits before the drugs kicked in. ‘It’s okay, Lucy.’ Kate stroked the girl’s arm. ‘You’ll start to feel better when baby’s born and the placenta that’s causing all this trouble has gone.’

She checked Lucy’s BP again and then picked up the phone. Lucy moaned and Kate slipped her other hand down to feel the contraction at the top of Lucy’s uterus. ‘Your baby’s fine and looks like he or she is determined to come soon.’

Kate dialled the number for Derby that she’d kept since the last stop. As she waited to be transferred through to the obstetrician on call she peered out of the window. ‘Is it my imagination or is the sky becoming lighter?’

Rory started to answer but Kate said, ‘I hope so,’ before he could. He remembered she’d had a habit of that. The memory drew an unwilling smile.

‘The storm seems to be concentrated more over the way we’ve come,’ he said quietly, then stopped as she lifted her head when they answered.

‘Hello? Yes, Doctor, it’s Kate Onslow again.’ She waited. Then, ‘Lucy’s just had one eclamptic episode lasting two minutes and her BP’s now one sixty over a hundred.’

She listened. ‘Foetal heart rate one hundred and
fifteen,’ and then nodded her head. ‘We’ve given the Hydralazine. Start the Magnesium Sulphate? Sure. I’ve got the protocol. No problem.’ She looked across at Rory and he waved the prepared flask.

‘She’s in established labour and we’d like to divert to Rainbow’s End Station for the birth.’ She paused, then, ‘About an hour. We’d wait there until RFDS can come and get them both. How’s the weather at your end?’

She smiled and Rory smiled too. It lifted his spirits to see that Kate again. So, good weather report, he gathered.

‘Our weather isn’t quite that here yet, but good news. So you’ll ring Rainbow’s End and tell them we’re coming. Great. We’ll see the plane there, then. Thanks.’

Kate put the phone down on the ledge and took the loaded flask from Rory and this time she gave him the full-blown grin that he’d give his brand new, fully equipped, supercharged Range Rover for. ‘We work pretty well together, don’t we?’

‘Funny, that,’ he said dryly. Maybe that’s because we should have been together ten years ago, he thought with a tinge of bitterness. ‘The weather’s clearing and I’m guessing they’ll get back to us with an arrival time?’

She nodded and turned to speak softly into Lucy’s ear. ‘Rory’s going to take us to Rainbow’s End Station and we’ll wait for the plane. Just rest as much as you can, Lucy.’

The track to Rainbow’s End seemed to take forever but he doubted Kate would have noticed. Things were hotting up in the back.

Lucy began to moan every few minutes and Rory realised his own shoulders had begun to tense just before the next contraction was due.

‘You okay, Rory?’ Kate moved up near his seat for a moment and he had the almost irresistible urge to reach back for her hand. A bit of personal comfort wouldn’t have gone astray.

Instead, he said, ‘I think you have enough to worry about apart from me, Kate.’

‘Just to let you know, when Lucy moans it’s because she’s listening to her body, not because she wants us to do anything.’

He could feel himself frown. ‘You’re telling me she’s not in pain?’

To his surprise, there was even a smile in her voice. ‘Oh, it hurts all right. I’m telling you she’s not scared of the pain. So don’t feel you’re failing her by not taking it away. Her own body is dealing with the pain by releasing endorphins. If it was overwhelming her it would be different. Okay?’

‘Okay.’ He didn’t understand but he had to believe Kate. And, now he thought about it, Lucy didn’t sound frantic or in a panic. She sounded almost drugged already. ‘Thanks, Kate. It was bothering me she was upset.’

He felt her hand lightly on his shoulder and then
she was gone. He only just heard her quiet, ‘Thought so,’ as she sat back down again next to Lucy.

The rest of the drive didn’t seem as bad. Rory sighed once to relieve the tension in his shoulders and focused his concentration on the conditions.

Soon he barely heard Lucy because the road was half covered by water in places and it was his job to get them to the station without mishap.

Finally the lights of the homestead could be seen on the hill ahead. Lucy had become more agitated in the last five minutes and Rory had begun to doubt Kate’s pain theory.

‘Stop here, Rory!’ That quiet yet immediate voice again from Kate.

Rory pulled over and by the time he stopped he could hear the sound he’d heard twice before in the back of an ambulance—the sound of a mother easing her child out into the world. And he could hear Kate’s voice as he climbed through.

‘Beautiful, Lucy. Nice and slow. Just breathe your baby out with the pains and relax between.’

‘What do you need?’ Rory whispered as he looked around, but it seemed Kate had everything ready.

‘Just that towel when I ask for it. We’ll dry baby before laying him or her on Lucy’s skin, and if you check Lucy’s BP as soon as it’s over that would be great.’

‘Baby on her skin?’

Kate’s voice was barely audible and he had the
feeling she didn’t want to distract Lucy from her thoughts. ‘Lucy’s a natural born heater. Best place for a newborn is on mother’s chest.’

He’d been thinking airways and resuscitation. Wrapping in space blankets. Apparently, that was out too for newborns. He leant over and spoke into Kate’s ear. ‘Breathing-wise?’

Kate shook her head and frowned but she glanced at the neonatal bag and mask she had ready. ‘The heart rate is great. There’s no reason to think baby won’t be fine. You always give them thirty seconds if the heart rate’s good before you interfere. If smaller than I expect, I’ll wrap his or her body up without drying in that roll of cling wrap there, and then onto Lucy’s skin to keep warm. Just dry the head and pop that little cap on.’

‘Cling wrap? Plastic sandwich wrap?’

He saw the flash of her teeth. ‘Neat, eh? Little babies get really cold from draughts and thin plastic wrap keeps air off wet skin. When the team arrives, if they want to access an arm or leg they just make a hole in the wrap for that part of the body. Keeps baby insulated.’

‘We have all the mod cons in this ambulance.’

‘Actually, I brought it with me but feel free to add it to your list when you go back.’