‘There are always variations in heart rate,’ Gail said immediately, her gaze challenging. ‘At home they don’t monitor it constantly so you don’t know about it and you don’t worry. And the baby is still fine when it’s born.’
‘Sometimes that’s true.’ Jake’s voice was quiet. ‘But are you willing to take that chance? What I’d like to do, with your permission, is ask Miranda to monitor you for a while so that I can get a better look at what’s happening during each contraction.’
‘You’re just going to drag me into Theatre at the first opportunity and cut me open!’
Jake shook his head. ‘If you want to check my records, I have a very low Caesarean section rate compared to the national average,’ he said calmly, ‘but I’m not willing to sacrifice a baby to keep that rate low. I can’t promise you that I won’t perform a Caesarean section if I think it’s necessary, but I can promise you that we’ll make the decision together. If everything goes well, there’s no reason why you can’t just quietly deliver your baby here. It’s not home, that’s true, but it’s a comfortable room and we do our best to make it as relaxing as possible.’
Gail stared at him and then at her husband, who looked exhausted, stressed and totally out of his depth.
‘Oh, hell, I don’t know,’ she muttered under her breath, and then her eyes slid to the trace again and she put a protective hand on her abdomen. ‘You really think that the baby might be in trouble?’
‘I don’t know. We need to do some more tests.’
Gail hesitated and then gave a reluctant nod. ‘All right. I suppose I’ll stay. For now. But I don’t want a stream of staff through here, staring at me or practising on me.’
‘There won’t be a stream of staff. Just me. I’m going to be staying with you,’ Miranda assured her, and Gail gave a wan smile.
‘I’ve heard that before. We both know that if my labour happens to run past the end of your shift I’ll get someone else,’ she said bitterly. ‘I had three midwives in total last time I had the misfortune to deliver in hospital.’
‘Well, that isn’t going to happen this time,’ Miranda said softly, putting a hand on her shoulder. ‘I can promise you that, whatever happens, I will stay until you’ve had this baby.’
Gail looked at her and gave a disbelieving laugh. ‘It’s Boxing Day. You’re pregnant yourself and you’ve got a family waiting for you. I should think it’s bad enough working, let alone running into overtime.’
Miranda’s gaze didn’t flicker. ‘I’m staying until you’ve had the baby. Now, if it’s all right with you, I want to put you on the monitor and see what’s happening.’
Something in the stiff set of her slim shoulders drew Jake’s gaze but there was nothing in her face to reveal what she was thinking. Who was her family? Where was the father of her baby? Suddenly he wished Gail had chosen to be more direct in her questioning. He might have received answers to some of the questions buzzing around his head.
‘I’ll be on the unit if you need me.’ He stood up and went back to his office to catch up on some paperwork, but every time he thought he was making headway he was interrupted.
He saw another patient for Ruth and then called the ward to check on Lucy.
When he looked up Miranda was standing in the doorway. Her gaze was wary and it was obvious that she would have preferred not to seek his help. ‘Gail’s progressing slowly. I presume you don’t want to accelerate labour with oxytocin?’
Jake shook his head. ‘There’s some evidence that it increases the risk of rupture. How’s the foetal heart?’
‘Showing variable decelerations.’ Miranda handed him a trace. ‘Gail’s complaining of pains, which might just be normal labour pain, of course, but I have a bad feeling about her.’
Never one to dismiss the instincts of a midwife, Jake looked at her. ‘She had a lower transverse incision, which makes a uterine rupture less likely. And she’s only had one previous Caesarean section.’
Miranda nodded. ‘That’s all true, I know, but her labour is slowing down and the baby’s heart rate isn’t as I would like it to be. And there’s something about this pain she’s complaining of that worries me. It just doesn’t sound like labour pain.’
Jake dragged his eyes away from the smooth skin of her cheeks and concentrated his attention on the trace. Instantly he saw the problem. ‘I’ll take another look at her but it certainly isn’t going to be easy to persuade her to allow us to intervene in any shape or form. Is she still as defensive as ever?’
‘I don’t think she means to be defensive. She’s just very frightened.’
‘There’s often more to a person than meets the eye, isn’t that right, Miranda?’
She had the grace to blush. ‘Perhaps.’
‘You and I are going to talk,’ he said softly, and she straightened her shoulders.
‘There’s nothing to talk about.’
‘There’s plenty to talk about, but it will keep for now. We need to see to Gail.’
CHAPTER FOUR
WHY was it, Miranda wondered as they walked through the labour ward towards Gail’s room, that every time she lowered her guard, it backfired?