A Taste Of Italy: Midwife, Mother...Italian's Wife

CHAPTER FOUR

SO TAMMY wasn’t surprised when the doorbell rang at nine-thirty that night. Nor was she surprised at the identity of the caller. ‘Come in. I’m guessing Paulo’s asleep.’

‘And Louisa is watching over him. I am learning to trust he is safe again.’ Leon’s strong white teeth flashed in the low light. ‘I would like to take Louisa home to Italy. Perhaps a change of scenery would be good for her. Do you think she’d come?’

‘No.’ Louisa had been housekeeper at the old doctor’s residence, a short-term accommodation house for visiting doctors and nurses for a lot of years. Her husband had established Lyrebird Lake hospital and recently passed away.

‘I’m sure my brother has suggested I stay at the residence and not at the resort because he wants me to fall in love with Louisa’s cooking. And her stories. Has she told you about the myth of the lyrebird?’

Tammy had never been a fan of fairytales. ‘I’ve heard of it. In all my years at the lake I’ve never seen one. Emma has, twice, once with your brother.’ She smiled at how that ended. ‘You’d better watch out.’

He, too, smiled. ‘I think to see a bird will not change my life.’

‘Louisa’s husband used to say the lyrebird heals those in pain.’ She had the feeling Leon could do with a spot of healing but it was none of her business.

She returned to the notion of Leon worrying about Louisa. ‘Louisa spends time with her stepson’s family.’ She couldn’t help but think it strangely endearing that this big, quiet man was concerned for an elderly widow he barely knew. She’d made a mental note to visit Louisa herself in case she needed more company. ‘We won’t let you steal her. We’d all miss her too much.’

She glanced at the clock. ‘If you want a coffee, I’ll offer you one now. I’m on call and I know one of the girls has come in to birth with Misty and there’s another woman due out there.’

‘Please, to the coffee.’ He followed her when she stood and moved into the kitchen and she put her hand up to halt him at the door. He kept coming until his chest touched her fingers, a wicked glint in his eye that warned he didn’t take orders easily either, but then he stopped.

She shifted her fingers quick-smart and tried not to recognise how good the warmth of his solid chest had felt beneath her palm. She needed at least three feet between them for her to breathe. ‘If you can make my den feel small you’ll crowd my kitchen. Just stay there and let me work.’

He lifted one brow but obediently leaned against the doorframe, relaxed but alert, and they were both aware he was capable of swift movement, if he wished.

She breathed out forcefully as she turned away. Thank goodness he’d stopped. The guy was too much of a man to ignore when he was this close and a powerful incentive to get her chore done quickly and move out of here.

Then he said quietly, as if the thought had just occurred to him, ‘If you are called in to work, who is here for your Jack?’ Was that censure in his voice? Disapproval?

It had better not be. Nobody disapproved of her mothering. She flicked him a glance and his face was serious. ‘We have an intercom between the houses and I switch it on for my father to listen in. Jack knows he can call for his grandfather if I’m not around and Dad takes him next door.’ She glared at him and pressed the button on the machine for espresso and the beans began to grind—like her teeth.

‘And what if Ben is called out?’ Still the frown when it was none of his business but then, suddenly, she remembered he’d had a recent fright himself. One she’d put her foot in at the wedding. She eased the tension that had crept into her neck.

Of course he’d be security conscious. She didn’t need to be so quick to take offence. ‘We don’t do the same nights on call,’ she explained. ‘That’s the beauty of a small town and friends who organise rosters between families.’

The aroma of fresh beans made her nose twitch with calmer thoughts and she forced herself to stay relaxed. The guy could make her nerves stretch taut like a rubber band ready to snap back and sting her.

He nodded and looked at her almost apologetically, as if aware he may have overstepped a boundary. ‘I begin to see the sense of this place.’

To her further astonishment he smiled and added, ‘Perhaps I am less surprised at my brother’s decision to spend half his time here.’

She had the feeling that could’ve been a huge admission for him but she didn’t pursue it. She didn’t want him to think it mattered to her. It didn’t. Really. Time for a subject change. The coffee spurted from the twin spouts and filled their cups and she turned with them in her hands to face him.

He didn’t move initially and she realised her hands were full. He could touch her if he wished. She was defenceless. Something told her he realised it too. She lifted her brows at him and waited.

He grinned and heaved himself off the doorframe and stepped back to allow her past him into the den.

‘See how I understand your look?’

She bit back her smile as she sat his coffee on the low table almost on top of another of those fundraising pamphlets. She shifted it and her eye was caught by the title.

“Wanted! Man Willing To Wax Chest For Fundraising.”

She had a sudden image of Leon and the gurgle of laughter floated up like the brown bean froth in the cup.

‘You find that funny?’

She shook her head and bit her lip. She handed him the flyer. ‘Lucky you’re not here for long.’

He looked down at the paper and grimaced. ‘And a man would do this?’

She couldn’t help her glance at his broad chest, a few dark hairs gathered at the neck. ‘They haven’t found a volunteer yet. Want to offer?’

‘No.’ He shook his head with a smile. ‘Though—’ he paused and eyed her ‘—it would depend on who is doing the waxing.’ The look he sent her left no doubt there’d be a price paid for the privilege.

Tammy felt the heat start low down, potent and ready to flame, like a hot coal resting on tissue paper. Yikes. She snatched the flyer from him and stuffed it behind a cushion on the sofa. ‘Do you have much to do with young babies in your hospital?’

He settled back with a hint of smile and left the topic, clearly amused by her pink cheeks. ‘No. Neonatal surgery is too specialised and we don’t have a neonatal intensive care. But perhaps we would need a special care nursery if the maternity wing went ahead.’

He leaned forward and she could tell he was weighing possibilities and scenarios. She could see the big businessman she’d mentally accused him of being before she’d known him better, before she’d been kissed by him perhaps. But she had no doubt that if such a venture could be successful, then Leon would be the man to do it.

‘These are all things to be taken into consideration if we opened a midwifery service. I’m sure a lot has changed since my obstetric rotation a decade ago. At the moment of birth, I mean.’

She could talk about that all day—and night. ‘You’re right. Things have changed a lot.’ She tried to imagine Leon as a young medical student, diffident and overawed like those she’d seen in her training, but he was too strong a personality for her to imagine him ever being daunted by setting. ‘I think the biggest change here is to keep the baby with the mother at all times from the moment of birth. Not separate in a cot. With emphasis on skin-to-skin contact for the first hour at least. At birth, we try not to clamp the umbilical cord for a few minutes either, unless we really have to.’

He nodded with a little scepticism. ‘If the baby requires resuscitation?’

‘Sure.’ She brushed the hair out of her eyes. ‘Though not always. It’s a little trickier but the latest studies have shown that not cutting the umbilical cord for at least three minutes after birth is beneficial, though perhaps not that long in resuscitation.’

His face said he couldn’t see how that would work so she explained more. ‘We can give oxygen and even cardiac massage on the bed with the mother and that allows us to keep the blood flow from the cord as well. We’ve had great success with it. But then all our babies that come through the centre are low risk so any problems they have at birth are usually transient and should be resolved fairly quickly.’

He looked unconvinced and she couldn’t help teasing him. ‘Or is this a little too radical for your maternity hospital idea?’

‘I’m always willing to see and hear of new ideas.’ He raised his eyebrows at her comment, so quick to respond to any negative feedback she gave him, but she had no time to go on before the phone rang.

She dug her mobile out of her pocket. It was Misty and she had to leave.

‘Sorry. I’m needed in birthing. You’ll have to go.’ Leon’s eyebrows rose haughtily and Tammy almost smiled. She could tell he wasn’t used to that. A woman had to go and he would be left cooling his heels.

He stood, though to say he did it obediently didn’t suit the way he complied. ‘You are not in awe of me at all, are you, Tamara?’

She didn’t have time for this, unfortunately. ‘Should I be?’ She switched on the intercom between the two houses. ‘I hope I haven’t jinxed us talking about resuscitation and healthy babies.’

She saw his mind switch to the medical urgency. ‘What was said?’

She gave him half an ear as she scooped up her keys. ‘On the phone? Misty’s concerned at the delay in second stage, and there’s some unease with the baby’s heart rate,’ she murmured as she closed the front door behind them both. ‘If it was bad she’d ship them out to the base hospital, but backup is always good when the back of your neck prickles. Do you want to come?’

He shrugged. ‘I’m not registered in this country but happy to advise you if needed. Please.’

‘Fine. People know Gianni so they’ll have no problem accepting your presence.’

He hesitated at the two cars. ‘I’ll meet you there. No sense leaving your car or mine here because we don’t know how long you’ll be.’

They met outside the hospital and she let them in through the side entrance. Trying to remain unobtrusive they drifted into the birthing room and over to Misty. The lighting was still dim but Tammy saw the heater on for the infant resuscitation trolley and the preparations Misty had made. And the birthing mother, Trina, was beside the bed and not in the bath.

There was even a flicker of relief in her stepmother’s eyes when she saw Leon. Tammy’s stomach tightened. With uncomplicated births the midwife called a staff member from another part of the hospital as an extra pair of hands. If the midwife was uneasy she called the on-call midwife or doctor as a more experienced backup.

Misty spoke quietly so as not to disturb the couple who were leaning over the bed together. ‘Trina’s been pushing for an hour and a half now and everyone’s getting tired. There’s good descent of the head but there’s still a heck of a lot of baby to come.’

Tammy nodded. ‘Do you want to transfer?’

Misty shook her head. ‘Maybe earlier would have been better but Trina didn’t want to go. We’re just getting a head-on view now and we don’t want a difficult birth lying down in an ambulance. Trina’s done an amazing job.’ She eased her neck stiffness. ‘Thanks for coming. I wanted some backup for the end. We’ll move to all fours when the head’s almost here.’

‘Sure. Good call.’ Tammy was peripherally aware that Leon had moved to the resuscitation trolley and was checking the drawers. Excellent. It would be much easier if he knew what they had and where it was. He shut the bottom drawer, glanced up and nodded.

She hoped they wouldn’t need him.

The next pain came and the expulsive efforts from Trina were huge. Tammy could see why Misty was impressed with Trina’s progress. Slowly a thatch of baby’s hair could be seen and Misty helped Trina down onto her hands and knees, the position least likely to result in a baby’s shoulder becoming lodged behind the pubic bone of the mother.

During the next contraction the baby’s head was born. Tammy raised her eyebrows at Misty. Not a small head and the fact didn’t auger well for small shoulders. Tammy glanced at the clock.

‘If your baby’s shoulders feel tight remember you can help by bringing your chest in close. Nipples to knees. That flattens the curve of your coccyx and allows baby an extra centimetre or two.’ All calm and quiet instructions that Tammy knew Misty would have given before this stage as well.

As the seconds passed and they waited for the next contraction, the skin of the baby’s scalp faded from pink to pale blue, and Tammy could feel her own heart rate begin to gallop as the handheld Doppler amplified the way Trina’s baby’s heart rate slowed. The contraction finally began again and baby’s head seemed to try to extend but didn’t move and Tammy crouched down beside Trina’s ear. ‘Bring your knees together as close as you can and flatten your breasts down towards your knees. You’re doing awesome.’

Trina squashed down as much as she could and Misty supported the baby’s head. The contraction built. ‘Okay, Trina, push now.’

Trina pushed and suddenly her baby eased under the arch of her mother’s pelvis and tumbled limply into Misty’s hands. ‘Flip around, Trina, so we can lay baby on your warm stomach and have a look at this little bruiser.’

Misty wiped the baby briskly with a warm towel and passed her baby, all cord and limbs and damp skin, back to Trina between her legs, and the new mother shifted around until she was lying on her back with her stunned baby flaccid on her stomach.

Misty used the little handheld Doppler directly against the baby’s chest and the comparatively slow thump-thump-thump of the baby’s heart rate made them all look at the clock.

‘Over a hundred,’ Leon said, ‘and some respiratory effort.’ He leaned down and held the green oxygen tubing near baby’s face until the little body became gradually more pink.

‘Thirty seconds since birth,’ Tammy said, and as if on cue Trina’s baby screwed her face up and began to cry in a gradually increasing volume. Except for the slight blueness in her face from the tight fit, Trina’s baby was vigorous and pink all over now as she roared her disapproval of the cool air Leon was holding near her nose.

He took it away and watched Tammy and Misty exchange smiles, and Misty’s shoulders dropped with relief. She slid the baby up Trina’s body to her breasts and put a warm blanket over both of them.

‘What do you think she weighs?’ Trina’s husband seemed to have missed the tenseness the attendants had felt and Misty wiped her forehead with the back of her wrist.

‘I’d say at least eleven pounds.’ She looked at Trina. ‘What do you think, Trina?’

Trina looked away from her baby and grinned widely up at Misty. ‘She’s as big as a watermelon. And I’m stiff and sore but glad it’s over. She’s definitely my biggest—’ she glanced at her husband ‘—and my last.’

‘I’m glad you mentioned you don’t cut the cord immediately,’ Leon said quietly into Tammy’s ear. ‘Or I would have been expecting a different sequence of events.’

They’d moved back away from the birthing couple to the sink to strip off their gloves and wash their hands. Tammy nodded. ‘Do you think it would have made much difference if we’d clamped and cut and moved the baby to the resuscitation trolley?’

‘Not with an adequate heart rate like that.’ He paused and she wondered if he was comparing this with other occasions he’d known. ‘Actually, no, and I can see advantages. It is always good to see differences in the way things are managed in other hospitals, let alone other countries.’

They waved to Misty and let themselves out. The parents were absorbed in their new daughter and waved absently.

Tammy smiled at the man walking beside her. ‘It was good to know you were there. If those shoulders had been more stubborn we would have had a baby in much poorer condition, and in resuscitation the more hands the better.’

‘The maternal positioning worked very well. My memories of shoulder dystocia were always fraught with a dread that was missing tonight.’ He smiled.

‘You were both remarkably calm.’

‘There’s some anxiety when you see a very large baby like Trina’s. But we do drills for that scenario at least once a week so if there’s a delay we can move straight into the positions. Because we knew Trina’s baby was larger, Misty would have spoken to her about what to do if needed and good positions to try. But it can happen with small babies too.’

He dropped his arm around her shoulders, and it was companionable, not sexual. Not something she would have believed possible earlier. ‘You must be very proud of your team here.’

‘We are.’ His arm felt warm and heavy but not a heaviness she wanted to shrug off. A heaviness of wanting to snuggle in and encourage more snuggling. She shifted away from that concept quick-smart and he picked up the tiny movement and slid his arm away. She pretended she didn’t miss it. ‘And the women and their families love the centre and the choice it gives them. We’ve quite a clientele from the larger centres coming here to birth and then going home from here.’