Fiona McArthur - Midwife in a Million

Last month it had been hard enough to come back and face her belligerent father and the reality of his illness but that paled in comparison with Rory’s unexpected visit.

She’d been able to face the idea of coming home because she’d known her father would never change her mind about anything again. But Rory? Once he’d been the world to her.

She would just have to survive this too. Her independence would help her survive it. The sudden sting of threatening tears she ignored—they never came to anything. She hadn’t cried since all that had happened ten years ago and the lies. But the emotional turbulence had started and she hadn’t even seen him. She was a big girl now and not some needy teenager with an adolescent crush on the manager’s son.

Kate took a deep breath and straightened her shoulders. Too many years she’d spent telling herself she needed to stand on her own, rely on herself, be strong, and that determination would not be undermined by a man who had been out of her life for a long time. What did he want to see her for now, anyway?

Kate stripped Rory’s intrusion from her mind and concentrated on her descent because that was her strength. Single-minded concentration on what needed to be done. But, as soon as the plane grounded, as soon as room for distraction arrived, the thoughts returned to stick like the plane’s wheels to the ruts on the strip.

She gritted her teeth and secured her aircraft but the worry nagged at her all the way to town in her vehicle. Nagged her through the first half hour at work, right up until sixteen-year-old Lucy Bolton presented with the worst case of indigestion she’d had in her life.

Jabiru Township Clinic serviced the small town set in the baked earth at the edge of the station’s southern mountain ranges, a place that hid lush waterholes and settlements, plus far-flung aboriginal communities and out camps for the station. If the situation was dire, the doctor might be able to fly in once a week—unfortunately he’d been in yesterday.

Kate took one look at Lucy and put her to bed in the four bed ward. ‘Under those covers, young lady. No arguments. Where’s your mother?’

Lucy was a big-boned, hardworking girl whose mother leased one of the four pubs in town from Kate’s father. Usually happy-go-lucky and fun, Kate knew Lucy wasn’t one to complain. They bred them tough out here—had to—it was a long way to twentieth century medicine.

‘Mum’s tired.’ Lucy sat gingerly on the edge of the bed and kicked off her shoes. ‘There was a big outfit in town yesterday and I didn’t want to wake her.’ Lucy sighed as she rested her head back on the pillow and closed her eyes. ‘The queer thing is, Kate,’ she whispered, ‘I haven’t eaten a thing ‘cause I feel so rotten, so how can I have indigestion?’

‘That’s not good.’ Kate stared down at the young girl and in a swirl of memories saw herself. ‘Poor you.’ She stroked her hair. She saw the slight puffiness around the eyes, the tiredness, that protective maternal hand that crept over her stomach. Her voice dropped. ‘Any chance you’re pregnant, Luce?’

Lucy’s eyes flew open and the sudden fear in the young girl’s face was enough confirmation. Kate sighed under her breath for the loss of youth coming Lucy’s way and a smidgen for the prick of envy. She wished she’d had the sense to ask for help like Lucy had.

Though in Kate’s day Mrs Schulz mightn’t have been as easy to approach as Kate or Sophie would be, even if Kate had been able to get all the way to the township from the home station.

She stroked Lucy’s shoulder. ‘Everything will be fine. I’ll just take your blood pressure, poppet. You don’t look well to me either.’

By the time Kate had done a full physical assessment the window shutters were banging against the walls outside and the howl of the wind was clearly audible. Kate barely noticed it as her concern grew for the young woman in front of her.

The flying doctor would have to come back and pick her up because there was no way she could manage Lucy here. And there was no way she wanted to because she knew what it could cost.

The pregnancy test proved positive but Kate hadn’t needed that; she could clearly hear the heartbeat from Lucy’s little passenger inside and she was more worried about the dangerously high levels of protein she found in the specimen of Lucy’s urine.

Lucy’s uterus could be felt midway between her belly button and the bottom of her sternum, which meant she’d been hiding her secret for about seven months. Around eight weeks too early to birth, if the baby was growing well. Eight weeks to go!

Kate closed her eyes against the memories that wanted to surface. Right when the trouble had hit her all those years ago. She shook the unwanted thoughts away, not least because she didn’t want to jinx Lucy.

Unless Kate was mistaken, Lucy’s blood pressure would ensure labour happened soon anyway, and Kate knew how fragile premmie babies were. Not standard procedure around here, three thousand kilometres from Perth.

That was, of course, if Lucy wasn’t in labour already and didn’t know it. ‘You’re not having any tummy pains are you, Luce?’

Lucy shook her head carefully. ‘Just this headache and rotten indigestion that’s killing me.’

It isn’t indigestion, Kate thought—it’s your body telling you something is very wrong. At least Lucy had listened. Kate poured a small tumbler of antacid, more for comfort, and gave it to her. ‘Sip on this, Luce. I need to talk to the doctor on the radio.’

Five minutes later Kate lifted the headphones from her ears and looked at them. No way could they do that. She settled the pads on her ears again and, strangely, the action had calmed her nerves. ‘Say again,’ she said, but there was little hope it would sound different this time.

‘Medication and transfer. If I were you I’d transfer her today. The storm’s a big one. The only way to transport is on the ground. If you decide to go you’ll have to take her out by road before it rains again and we’ll fly her from Derby. Or you could sit on her for another twenty-four hours with those symptoms and pray.’

Kate closed her eyes. ‘It’s six hundred kilometres of corrugations. What if she gets worse on the trip?’ Kate had another, more practical thought and her eyes widened. ‘What if she goes into labour?’

‘You could hope she doesn’t deliver.’ Mac Dawson had been obstetric registrar when Kate had been a newly graduated midwife at Perth General. Now an obstetrician in Perth, Mac respected her knowledge and she knew he cared about her predicament. But he couldn’t do anything about their options. There was nothing else he could suggest. ‘You should have stayed with me in Perth.’

Kate rolled her eyes, glad he couldn’t see her. He’d asked her out a couple of times and Kate knew he’d have liked to have pursued their relationship if she’d been interested. She should have been but wasn’t. Mac’s pursuit had been a factor in her choice to work at one of the smaller hospitals in the suburbs of Perth after graduation.

Mac went on. ‘Her first baby, Kate. It’s your call but I’m sure you’d prefer early labour to an eclampsia out there while you wait for the storm to pass. The weather could set in for days and your strip will wash out. It’ll get tricky if she’s as unstable as you think and the roads are cut.’

Mac was right. She’d just needed to hear it twice. Road it was then. ‘Thanks for that, Mac. I’ll get back to you when I talk to her parents.’

‘Hear from you soon, then. Don’t forget to give me a ring when you get in so I can be sure you made it.’

Kate pulled the earphones from her head slowly and walked back to her patient via the drug cupboard. She reached for what she needed, along with the tray of intravenous cannulas, and set it down on the table beside the bed.

Lucy had fallen into an uneasy doze and every now and then her arm twitched in her sleep. Kate rechecked her blood pressure and the figures made her wince.

‘Lucy.’ Kate held the girl’s wrist as she counted her pulse. Lucy’s eyes flickered open. ‘I have to put a drip in your arm, poppet, and give you some drugs to bring your blood pressure down. Then I’ll ring your mum. The doctor says you have to go to Derby at least. Probably Perth.’

Lucy’s eyes opened wide and the apprehension in them made Kate squeeze her hand again. She looked so frightened. Kate had been frightened too.

‘It’s okay, I’ll come with you most of the way but you’ll have to stay there until after your baby is born.’

‘Mum doesn’t know I’m having a baby.’ They both looked down at Lucy’s difficult to distinguish stomach.

Kate remembered this all too well except she hadn’t had a mother. Just a ranting, wild-eyed father who’d bundled her off to strangers before anyone else found out.

‘We’ll have to tell her, but no one else needs to know just yet. This is serious, Luce. You could get really sick and so could your baby. I’m worried about you so we have no choice.’

Lucy slumped back in the bed and closed her eyes and two big silver tears slid down her cheeks. ‘I understand. Will you tell Mum?’

Kate looked down at Lucy’s soft round cheeks and her hand lifted and smoothed the limp hair back off her forehead. Poor Lucy. ‘If you want me to. Of course I will.’

The next half an hour made Kate wonder how some people could be so lucky. Lucy’s mother sagged at the news but straightened with a determined glint in her eye. ‘My poor baby. To think she’d been worrying about upsetting me when I’d be more worried about her. Here was me thinking all sorts of terrible things when now I can see why she’s been so quiet lately. And you say she’s sick?’ Mary Bolton stared at Kate hard. ‘How sick?’

‘It used to be called toxemia of pregnancy. Her blood pressure’s high and dangerous, for both her and her baby. I’m worried she could have a fit if it gets too high. They want her flown to Perth.’

Mary stared out of the window and then back at Kate. ‘I had that ‘clampsia thing. Scared the pants off the old man when he woke up and the bed was shaking, with me staring at him like a stunned rabbit unable to speak.’ Mary shrugged. ‘Or so he said—that was just before Lucy was born,’ Mary said matter-of-factly and Kate’s stomach dropped. Maternal history of eclampsia as well? So her mother had progressed to fitting. Kate closed her eyes. More risk for Lucy.

Mary glanced out of the window and frowned. ‘But the Flying Doctor won’t be able to fly in this weather.’

Kate looked out of the window to see what she already knew. The sky was heavy and purpling now. ‘I know. We’ll have to take her by road to Derby. Unless the weather clears further west and they can fly in and meet us at one of the stations along the way.’

Mary looked down at her daughter, then at Kate. ‘You must be worried, Kate, if you can’t wait here a day or two.’

‘I am.’

Mary grimaced. ‘We’re lucky you’re here. I’ll have to arrange for someone to take over the pub and mind the other kids, then I’ll follow. My sister lives in Derby. When does Lucy have to go?’

‘Today. Now. As soon as I can arrange it.’And that was when Kate realised the implications. By ambulance. The usual driver, Charlie, had retired and just left on his lifetime dream holiday. There was no one else with any training to come with her, and she really needed some bac-kup for this trip…

Sophie would be needed here and there was no one with any medical knowledge except—the second highest qualified paramedic in the state—she’d heard he’d got the Deputy job. The man from her past who’d flown in this morning to see her.