Page 11 of The Midwife By the Sea

It had been a week since the infertility support group meeting and Danni had finally announced her pregnancy to the rest of the department, which had lifted a bit more of the guilt from Esther’s shoulders. Things were moving forward, as they always did, and Esther decided to focus on the future too. She and Joe would get their family, one way or another. Somehow, she felt far more certain of that now, they just had to keep moving forward too, and she shouldn’t allow it to consume her the way she had. Work was always a good way of avoiding that and life in the A&E department ensured there was never a dull moment. By 4p.m. she’d already worked alongside her colleagues to deal with a broken arm, a pitchfork embedded in the foot of a sixty-three-year-old man, a suspected case of pneumonia, a third degree burn from a pan of water slipping out of a patient’s hand, a case of appendicitis and two minor head wounds. She was on her way back from a coffee run in her break, feeling dead on her feet and looking forward to the end of her shift, when a man charged into the department, carrying a woman in his arms.

‘Help me, please. It’s my wife, she’s been refusing to drink anything for the last couple of days. I’ve been trying to persuade her, but she thinks the water is poisoned. I was going to try to take her to see her midwife, but she fainted and I just panicked and brought her straight here.’

‘You’ve done the right thing.’ Grabbing a wheelchair, Esther helped the man manoeuvre his wife into it and tried not to gasp when she spotted an undeniable truth. The woman was almost due to give birth, by the looks of her. She was also conscious but incoherent, mumbling something unintelligible, apart from the word ‘no’, which she repeated several times.

‘What’s your wife’s name?’

‘Elena, and I’m Tomáš.’

‘Okay Tomáš, I’m Esther, one of the nurses. We’ll get you through to a cubicle and have Elena assessed. How many weeks pregnant is she?’

‘Thirty-six and she’s been doing so well until now.’ Tomáš wiped at his eyes with the back of his hand, not quite managing to sweep away evidence of the tears that had formed there, and Esther wanted to tell him that he didn’t need to try and suppress his emotions, but there was no time for that now. The next bit of information he revealed made the situation even more pressing. ‘She came off her bipolar medication. She was switched to one she was told was safe during pregnancy, but then she came in at thirty-four weeks because she was worried she couldn’t feel the baby moving. Everything was okay, it was just the position the baby was in, they said, but Elena wouldn’t take her medication after that and these last few days…’ Tomáš seemed to trail off, the toll that recent events had taken on both of them written all over his face.

‘That’s really useful to know,’ Esther tried to reassure him. ‘Once Elena is stable, we’ll ask for teams from the maternity and mental health departments to come down, so we can make a plan, but the most important thing for now is to make sure Elena is rehydrated and that everything is okay with the baby.’

As Esther took hold of the handles of the wheelchair, her heart hammered in her chest at the thought of running the scanner over Elena’s bump and revealing something terrible. Please let the baby be okay. The silent prayer she offered up pushed aside her usual prayer for a baby of her own. There was only one child that mattered right now and all she could do was hope it wasn’t already too late.

It had been a busy night with a tricky delivery to end the shift, and Hope was already an hour late finishing when she took the call from the emergency department to ask if one of the team could go down to talk about a patient. A consultant obstetrician had been requested too, as well as someone from the mental health team, for what sounded like a complex case. Hope had recognised Esther’s voice immediately, but she’d decided not to say so. The other woman would probably have thought it really odd that she had known it was her so easily after just one infertility support group meeting, but then she didn’t know that Hope had sat in a toilet cubicle, listening to Esther share her deepest pain, and that she’d have recognised her voice from that encounter alone because the words were so imprinted on her brain.

Instead, she made an offer she wasn’t sure was wise. ‘I’ll come straight down.’

She reasoned with herself that she’d done it because her colleagues were already very busy and all she’d been planning to do was go home and binge watch the latest Harlen Coben series on Netflix. She did want to ease her colleagues’ burden, that much was true, but she wanted to spend more time with Esther too, and she wasn’t sure she could have explained why, even to herself. She couldn’t imagine anything changing her decision not to tell Joe that he was her biological father, but she had wanted to go down to A&E all the same, even before Esther had mentioned asking someone from the mental health team to attend as well. There was a very slim chance that that someone might be Joe, and Hope couldn’t miss the opportunity to meet him, even if he was never going to know why that encounter would be so momentous to her.

By the time Hope got down to the emergency department, she’d already given herself a good talking to. She had to keep her expectations in check and not hope for too much. There was every possibility it wouldn’t even be Joe who turned up to see the patient and, even if he did, it could easily turn out to be a let-down in other ways. He could be obnoxious, with a far too high opinion of himself, for a start. Even if he was every bit as lovely as she hoped he’d be, her presence would mean nothing to him. She could be any midwife and it wouldn’t make a jot of difference to Joe, as long as she did her job.

‘Oh hi, Hope, it’s good to see you again. Thanks so much for coming.’ Esther greeted her with a smile, and she felt absurdly pleased that the older woman had remembered her name. Her biological father’s wife knew who she was and seemed pleased to see her. It felt hugely significant somehow, and for a moment the urge to tell Esther so much more rose up inside of Hope, but she couldn’t do it. Even if she eventually decided to share her secret, now definitely wasn’t the time.

‘Good to see you too, and I’m always happy to do whatever I can to help.’

‘Thank goodness, because the obstetrician is going to be at least half an hour, apparently. All the consultants are already busy with urgent stuff.’ Esther frowned and shook her head. ‘The patient, Elena Novak, is thirty-six weeks pregnant and made the decision to stop taking medication for bipolar disorder around two weeks ago, against medical advice, due to what she perceived were low foetal movements, even though monitoring didn’t highlight any concerns. Elena’s husband, Tomáš, brought her in, after she fainted. She’s been refusing to eat or drink anything, because she’s convinced herself that someone is trying to poison her, and she’s showing all the signs of being dehydrated. We need to get some fluids in to rehydrate her, but when I mentioned the IV, she became hysterical. She’s clearly terrified.’

‘I’m not surprised, poor woman, that must be incredibly tough. Are the mental health team here yet?’ Hope tried to keep her tone light, as though it wouldn’t matter to her either way if someone was coming or not, let alone who that someone was.

‘We’ve put a call in and they’re going to send someone as soon as they can, but it seems to be one of those days today, everyone is stretched to the limit.’ Esther frowned again. ‘If it takes too long, I might have to pull in a favour and get my husband to come down.’

‘Sounds like a good plan; there has to be a benefit to having friends in high places.’ Hope was still fighting to sound casual, even though there was nothing she wanted more right now than for Esther to put in that call, but in the meantime, she had a patient who needed her help and that had to be the priority. ‘Do you think she’ll let me examine her?’

‘I’m not sure, she wouldn’t let me anywhere close. Although she did ask to see a midwife, so that’s something. Apparently, her mother’s a midwife, but she lives in Slovakia, so that doesn’t do us or Elena a lot of good.’ Esther’s sigh was even deeper this time around. ‘It might help her to trust you, though.’

‘Let’s hope so, I’d better give it a try. It doesn’t sound like there’s any time to waste.’ Hope swallowed against the frisson of nerves that were bubbling up inside her. There were times in her job when she felt so powerless, as though nothing she did could help, and all she could so was hope that this wouldn’t be one of them.

‘I’ll take you through.’ Esther was already leading the way. ‘Her husband Tomáš has been doing his best to help persuade Elena to let me examine her, but she just kept repeating that she doesn’t want a nurse, she wants a midwife.’

‘Fingers crossed I pass the test.’ Hope followed Esther through to the side room where Elena was waiting, still on her feet, rather than resting on the bed. The patient clearly needed calm and privacy if there was going to be any chance of reducing the distress she was under. That meant she needed to be away from the busy cubicle area, which Hope suspected could have given Waterloo station a run for its money, with the number of people passing through.

‘How are you doing, Elena?’ Esther asked as they entered the room. ‘This is Hope, one of the midwives, she’s come to see how you and the baby are.’

‘You’re not touching me. Don’t let them touch me, Tomáš. They want to give me poison. Promise me you won’t let them.’ Elena turned away, pressing herself into her husband’s arms. ‘Don’t let them do it, please. I couldn’t bear it if we lost her.’

‘No one is trying to hurt you, Elena.’ Tomáš tried to stroke her hair, but she shrank back from him as though he’d burnt her with a cigarette.

‘They are, that’s what they always do when they think something is going to be wrong with babies like ours, because they don’t want them to live. Why don’t you believe me? I need you to believe me, Tomáš, or it will happen to our baby too.’ Elena’s distress was so obvious it tugged at Hope’s heart.

‘What do you mean when you say “babies like ours”?’ Hope kept her voice low, sensing that Elena needed to feel listened to, rather than being given empty platitudes that she couldn’t believe.

‘We weren’t born here, I am from Slovakia and Tomáš is from Poland, and there are so many people who don’t make us feel welcome. They won’t want our baby here either, especially if there is something wrong with her. They’d rather she died.’

The breath caught in Hope’s throat for a moment, the ache she’d felt in her heart deepening even further as she realised the cause of Elena’s distress. The mental health challenges she was facing were significant, especially as she’d stopped taking her medication, but the distress she’d been experiencing clearly wasn’t ‘all in her head’, and Hope had a horrible feeling that Elena had experienced some form of racism that played into the anxiety she already felt.