The Surgeon's One-Night Baby

‘So there are risks?’

For the first time, Archie’s head snapped up, as though she was hauling herself back to reality by her very fingernails.

Kaspar felt a sliver of pride slip through him, and he clasped her hand tighter as if that could somehow lend her strength.

‘There are risks with any procedure,’ his colleague answered, ‘but particularly in an emergency procedure where the cervix has already shortened and is partly dilated. There’s a risk of waters breaking and of infection developing. In your case, there’s only faint evidence of effacement and no dilation.’

‘But if I’m going to have it, it has to be now?’ Archie asked tightly.

‘As I said, I’d like a baseline measurement first, and we’ll go from there.’

‘Why didn’t my doctor pick up on it?’

Her pained expression tugged and twisted at something inside him. He wasn’t prepared for it. It was a strange, inner tussle not to jump in and grill Catherine on a much more detailed, medical level. Instead, he forced himself to continue sitting quietly, allowing Archie to go at her pace. The kind of questions he wanted to ask would only frighten her unnecessarily. They would deal with any other issues if and when they had to. Still, he would be calling Catherine as soon as he got a moment alone.

‘As I said, it’s very faint. This is my area of expertise...’

‘They’re supposed to be experts too...’ Archie cut in, panicked, and, with an instinct he hadn’t known he possessed, Kaspar found himself drawing her to him, making her meet his gaze. His voice quiet, level, as one might use to a frightened, cornered animal.

‘Catherine is a highly specialised, world-class neonatal and maternal-foetal surgeon,’ he soothed. ‘We will deal with this. She will deal with it.’

‘But if we miss it. If I don’t have the...the...’

‘Cervical suture,’ he supplied evenly, wondering if this raging storm inside him was how every patient felt when they were sitting opposite him and he was the one delivering their diagnoses or prognoses.

‘Right. If I don’t have that then I lose this baby like I did before?’

‘There’s no way to know,’ continued Catherine. ‘You’re past the point at which the previous miscarriage occurred. However, there is some evidence that your cervix might be beginning to efface. It’s possible you could go to term like this, without any intervention. I can’t be sure. I need more information. In cases like yours, where it isn’t clear, the suture is usually only put in if there’s a history of two or more late miscarriages or premature births.’

‘Lose two babies?’ Archie gasped, horrified. ‘Before they will do anything? No. No, I can’t lose another baby. I can’t.’

‘I know it’s hard, I’m sorry. But sometimes we have to be sure,’ Catherine was saying, but he couldn’t sit quietly any longer.

‘If Archie doesn’t have the cervical suture and then after that twenty-four-week mark begins to go into labour, you’ll do what?’ he asked his colleague sharply. ‘Pessaries?’

‘Yes.’ She nodded, turning her focus back to Archie. ‘If that is the case, then we would probably offer you progesterone or pessaries instead. As you mentioned during the examination, they tried an Arabin pessary with your first baby.’

‘Which didn’t work,’ Archie choked out as Catherine bobbed her head, again softly.

‘And that’s why I’d like to request your medical records from your doctor to determine whether a cervical suture might be a sensible precaution.’

‘And it will stop me from losing my baby?’

‘There’s no guarantee. Research into how well cervical sutures stop preterm birth is always ongoing, but it is thought to reduce the risk of early delivery by significant percentages. Once I have more information, I’ll bring you back for a further examination and we’ll discuss things in greater depth if we feel we might go ahead.’

‘But...’

The pleading in her tone twisted at Kapar’s gut, but he couldn’t indulge it. He had to be the strong one.

‘Archie, give Catherine your doctors’ contact details. Once she has your full notes she can make a more informed decision and, I promise you, we’ll answer every single one of your questions then.’

‘Right.’ Catherine shot him a grateful look. ‘You have full insurance?’

‘No...’ She froze, as if she hadn’t really thought that far ahead.

‘The medical expenses will be covered,’ Kaspar cut in firmly.

He’d pay for it out of his own pocket if necessary.