Midwives On-Call. Alison Roberts

she loved him still.

      Concentrate on medicine, on your patient, on anything other than Oliver, she told herself fiercely. Concentrating on Oliver was just too scary.

      What had Ruby asked? Why she needed a Caesarean?

      ‘You see the incision we just cut in Rufus’s mum’s uterus?’ Oliver was saying, flicking back to the screen, where they could see the now closed incision in the abdomen. ‘I’ve stitched it with care, as I’ll stitch you with care, but when your bub comes out, she’ll push. You have no idea how hard a baby can push. She wants to get out to meet you, and nothing’s going to stop her. So maybe she’ll push against that scar, and if she pushes hard enough on very new scar tissue she might cause you to bleed. I have two people I care about, Ruby. I care about your daughter but my absolute priority is to keep you safe. That means a Caesarean birth, because, much as I want to meet your baby, we’ll need to deliver her before she even thinks about pushing.’

      ‘But if you wanted to keep me really safe you wouldn’t operate in the first place,’ Ruby muttered, a trace of the old resentment resurfacing. But it didn’t mess with Oliver’s composure.

      ‘That’s right,’ he agreed, his tone not changing. ‘I believe we will keep you safe but there are risks. They’re minor but they’re real. That’s why it’s your choice. You can still pull out. Right up to the time we give you the anaesthetic, you can pull out, and no one will think the worse of you. That’s your right.’

      The room fell silent. It was such a hard decision to make, Em thought, and once again she thought, Where was this kid’s mum?

      But, surprisingly, when Ruby spoke again it seemed that worry about the operation was being supplanted by something deeper.

      ‘If I had her …’ Ruby said, and then amended her statement. ‘When I have her … after she’s born, she’ll have a scar, too.’

      ‘She will,’ Oliver told her, as watchful as Em, waiting to know where Ruby was going with this.

      ‘And she’ll have it for ever?

      ‘Yes.’

      ‘She might hate it—as a teenager,’ Ruby whispered. ‘I know I would.’

      ‘I’ll do my best to make it as inconspicuous as possible—and cosmetic touch-ups when she’s older might help even more. It shouldn’t be obvious.’

      ‘But teenagers freak out about stuff like that. I know I would,’ Ruby whispered. ‘And she won’t have a mum to tell her it’s okay.’

      ‘If she’s adopted, she’ll have a mum,’ Em ventured. ‘Ruby, we’ve gone through what happens. Adoption is your choice all the way. You’ll get to meet the adoptive parents. You’ll know she goes to parents who’ll love her.’

      ‘But … Fil love her more. She’s my baby.’

      And suddenly Ruby was crying, great fat tears slipping down her face, and Em shifted so she could take her into her arms. And as she did so, Oliver’s laptop slid off the bed and landed with a crash on the floor.

      Uh-oh. But Em didn’t move. For now she couldn’t afford to think of computers. For now holding this girl was the most important thing in the world.

      But still … A car and then a laptop …

      She was starting to be an expensive ex-wife, she thought ruefully, and she almost smiled—but, of course, she didn’t. She simply held Ruby until the sobs receded, until Ruby tugged away and grabbed a handful of tissues. That was a bit late. Em’s shoulder was soaked, but who cared? How many times had Em ever finished a shift clean? She could count them on one hand. She always got her hands dirty, one way or another.

      And it seemed, so did Oliver, for he was still there. Most consultants would have fled at the first sign of tears, Em thought. As a breed, surgeons weren’t known for their empathy.

      He’d risen, but he was standing by the door, watching, and there was definitely sympathy. Definitely caring.

      He was holding the two halves of his laptop. The screen had completely split from the keyboard. And the screen itself … smashed.

      ‘Whoops,’ she said, as Ruby blew her nose.

      He glanced down at the ruined machine. ‘As you say, whoops.’

      And as Ruby realised what he was holding, the teenager choked on something that was almost a laugh. ‘Em’s smashed your computer,’ she said, awed. ‘Do you mind?’

      ‘I can’t afford to mind.’

      ‘Why not?’ She was caught, pulled out of her misery by a smashed computer.

      ‘Priorities,’ he said. ‘You. Baby. Computer. In that order.’

      ‘What about Em?’ she asked, a touch of cheekiness emerging. ‘Is she a priority?’

      ‘Don’t you dare answer,’ Em told him. ‘Not until you’ve checked that your computer is covered by insurance. Ruby, if you’re rethinking your plans to adopt …’

      ‘I think … I might be.’

      ‘Then let’s not make any decisions yet,’ she said, hurriedly. Surely now wasn’t the time to make such an emotional decision? ‘Let’s get this operation over with first.’

      Ruby took a deep breath and looked from Oliver to Emily and back again. ‘Maybe I do need a bit of time,’ she conceded. ‘Maybe a sleep … time to think.’

      ‘Of course you do.’ She pulled up her covers and tucked her in. ‘Ruby, nothing’s urgent. No decisions need to be made now. Just sleep.’

      ‘Thank you. And, Dr Evans …’

      ‘Mmm?’ Oliver was about to leave but turned back.

      ‘I hope your computer’s all right.’

      ‘It will be,’ he said. But it wouldn’t. Em could see the smashed screen from where she stood. ‘But even if it’s not, it’s not your problem,’ he said, gently now, almost as a blessing. ‘From here on, Ruby, we don’t want you to worry about a thing. You’ve put yourself in our hands and we’ll keep you safe. Em and I are a great team. You and your baby are safe with us.’

      His lovely, gentle bedside manner lasted until they were ten feet from Ruby’s door. Em closed the door behind her, looked ahead—and Oliver was staring straight at her. Vibrating with anger.

      ‘You’re planning on talking her out of keeping her baby?’

      The turnabout from empathy to anger was shocking. The gentleness had completely gone from his voice. What she saw now was fury.

      She faced him directly, puzzled. ‘What are you saying? I didn’t. I’m not.’

      ‘You are. She’d decided on adoption but now she’s changing her mind. But you stopped her.’

      ‘I didn’t stop her. I’d never do that.’ She thought back to the scene she’d just left, trying to replay her words. ‘I just said she had time …’

      ‘You told her not to make a decision now. Why not? Right now she’s thinking of keeping her baby. You don’t think it’s important to encourage her?’

      ‘I don’t think it’s my right to direct her one way or another.’ She felt herself getting angry in response. ‘All I saw in there was a frightened, tired kid who’s facing major surgery tomorrow. Who needs to stay calm and focused. Who doesn’t need to be making life-changing decisions right now. She’s already decided enough.’

      ‘But maybe when you’re emotional, that’s the time to make the decision. When she knows she loves her baby.’

      ‘She’ll always love her baby.’ Em was struggling to stay calm in the face of his anger—in the face of his accusation? ‘Ruby is a seventeen-year-old,