‘ANY ROOM AT the inn?’ Johnny, one of the paramedics, breezed into the labour suite, stomping snow from his boots while pushing a young woman on a trolley. For five o’clock in the morning, Christmas Day, the man looked remarkably chipper. The girl, not so.
‘Yeah, yeah, very funny. I’ve never heard that one before. Happy Christmas to you, too.’ Sean shook his head and laughed, giving an extra-special smile to the girl on the gurney. She looked so young, pale and frightened. And on her own. Who the hell wanted to be here instead of unwrapping presents? Which was where she should have been right now, with her family looking after her—she barely looked old enough to be out on her own. ‘Hello there. Who do we have here?’
The girl gave him a grimace and curled up around her distended belly. Tears streaked her face as she sucked on portable gas and air. Sean took her in—straggly hair, clothes that were scruffy, long thin bones, skin stretched tight over her cheekbones. Man, she was way too thin.
Johnny handed over a copy of his observation chart. ‘This is Phoenix Harding. She’s eighteen years old and, we think, about thirty-two weeks pregnant. She’s had lower abdominal pain for the past week increasing over time. Lower back pain too. Using gas and air to good effect. Contractions started at around midnight, getting closer together and stronger, every two to three minutes.’
‘Okay, thanks, Johnny. We’ll take it from here. Hi there, Phoenix, my name’s Sean and I’m one of the doctors here. Can you manage to tell me what’s been happening?’
She shook her head. Terrified.
‘Are you okay if I do some prodding and poking around? I need to have a listen to baby—that will help us work out what to do next.’
She nodded, but hid her face in her hands.
Sean began his assessment, had Hope attach the heart monitor across Phoenix’s belly, and heard a strong quick heartbeat. ‘That’s sounding good. Baby seems to be quite happy.’ But the girl doubled up in pain. He tried to get her to look at him. ‘Phoenix, he’s not as cooked as we’d like, so we’d prefer to keep him in a little longer. But it looks like he’s keen to meet you.’
Phoenix shook her head. Still no words. She looked so young. So frightened. And, as he watched Hope leave the cubicle with an apologetic raise of her eyebrows, in need of a friend and a chaperone.
‘Have you got anyone we can call to come and be with you? Friends? Family? Baby’s dad?’
Again she shook her head. It was going to be difficult if he had to conduct the assessment by telepathy. ‘Hey, missy, just a quick question: can you recall whether your waters broke? It’d have been like a gush of water … an unexpected trickle?’
There was a knock on the door. Isabel stepped into the cubicle and Sean’s heart felt as if it were tumbling, mixed with a sharp sense of relief. He never could get used to seeing her without having some kind of reaction. ‘Hope’s just had to pop out—she thought you’d need a chaperone, everyone else is busy so she asked me to come in.’
After he brought her up to speed with Phoenix’s case he added, ‘But Phoenix isn’t feeling like talking at the moment, so we’re taking things slow.’
Isabel nodded, as if she understood exactly what he meant. Thirty-two weeks meant a risk to baby—it was too immature to be born yet. But if it was, they’d need extra care—usually a stint in the SCBU to monitor progress and for special feeding; babies that young often didn’t quite get the hang of sucking at a nipple or a teat. Never mind the dangers of immature lungs trying to suck in hospital air.
Isabel smiled at the girl. ‘Oh, that’s okay, we can take all the time you like, Phoenix.’ She paused and stroked the girl’s back as she curled into another contraction. ‘Although we can’t do anything to help if we don’t know what’s happening. That baby is a bit young to be born yet—so we need to try to keep it in there a bit longer. Phoenix, do you mind if I examine you?’ Time was running out if they wanted to stall the labour; obviously Isabel was fully aware of this.
The girl shook her head and turned onto her back. She looked grateful to have Isabel there at least and when Isabel had done her examination she breathed out a big breath. ‘Eight centimetres—wow, you’re doing well. And your waters must have broken some time? You don’t remember? Can you try to think?’
‘No.’ Finally a voice.
‘Never mind, honey. The main thing is, your cervix is dilating quickly, your baby’s on the way. We’ll have to give you an injection of steroids to make his lungs good and strong for when he’s born. He’s going to be a bit small as yet, so we have to give him all the help we can. Is that okay? And I’d like to work out why this is happening now … Have you had any problems or anything over the last few days? Taken any different medicines, drugs? Alcohol? Any accidents, bumps? Done anything really strenuous?’
‘No.’ As if grabbing onto a life raft Phoenix took hold of the hand Isabel offered to her. ‘I’ve been going to the toilet more. I thought it was just the pregnancy—I read somewhere that you pee more often. But looking back it was twice as many times for half as much wee.’
‘In which case we’ll need to test your urine as soon as we can. Any fever? Lower back pain?’ Isabel reached for a thermometer to continue her assessment.
‘Pain, yes.’ She pointed to her lumbar region. ‘And when I pee.’
‘It sounds as if you might have a kidney infection. We’ll set up some intravenous antibiotics to help you and to prevent baby getting an infection too.’ Isabel inhaled sharply as she helped Phoenix to sit, revealing her skeletal frame under her nightie. ‘Have you eaten recently?’
The girl clung to Isabel’s arm. ‘No, not really. I’m so stupid. I’m so stupid.’
‘No, you’re not.’
‘I should have been more careful. I should have looked after him instead of pretending it wasn’t happening.’ Then she began to cry thick tears. Isabel held Phoenix as her chest racked with deep sobs for a few minutes. When she’d finished the girl managed to force a few more words out. ‘I’m sorry. I’m sorry. I didn’t know what to do. I was scared so I didn’t tell anyone and I haven’t been doing the right things. Have I killed him? Hurt him? Will he be okay?’
‘Hey … hush now. We’ll sort you out. Don’t worry.’ Sean watched for Isabel’s reaction. It must have been like a rerun of her own life. Which she steadfastly would not allow to interfere here, that much he knew.
She pressed her lips together, took a long deep breath. ‘I understand. I do. I know you were scared and that you’re scared now. But it will be fine. It will. The main thing is that baby has been growing—clearly. Maybe you’d like a little walk around? Sometimes it’s easier if you move.’
Make yourself useful, Sean was telling himself. Find someone to help her. ‘It’s okay. Really, we’re here to help. Are you sure you don’t want me to phone anyone?’
The girl shook her head vehemently. ‘There isn’t anyone.’
‘There must be someone, surely, sweetheart?’
She was gripping onto Isabel’s hand now as pain ripped through her. ‘No.’
Damn. Whether there was or wasn’t anyone in her life to help her was clearly not up for discussion. ‘What are you doing in Cambridge? On your own? Working? Student?’
Phoenix took a deep breath. ‘It was supposed to be a fresh start for me and my ex—things hadn’t been going well between us in Manchester—he got a job down here so we came. But as soon as he found out about the baby he ran a mile. Or a hundred miles. I have no idea where he is.’ She cradled her belly as another contraction rippled through her. When she got through it she asked, her voice weak with fear, ‘Have I done something bad to him? Why is he coming so early? I’m not due until March. I can’t have him now. I can’t.’
Sitting down in the chair next to her, Isabel stroked the girl’s arm. ‘Sometimes infections can bring on an early labour. All sorts of things can—not eating properly …’
‘I was trying to lose weight to hide the bump when I went for job interviews.’ Looking defeated, Phoenix slumped forward. ‘It didn’t work—I never got any job, I’m starving, he’s coming now and I’ve made a mess of everything.’
‘Look, sweetheart, sometimes babies come early. We’ll do everything we can to make sure he’s okay. But what about you? Have you got any friends to come and help you?’
Their patient shook her head. ‘You don’t make many friends when you don’t go out.’
‘What about your midwife? Who did you register with?’
‘I didn’t. I didn’t think. I just wanted it all to go away.’ She blinked up at them both with frightened eyes. ‘Will you stay with me? And him.’
‘Of course we will. Whatever you need, Phoenix.’ After giving her the injections Sean stepped forward and took the girl’s other hand as another, stronger contraction ripped through her. They were coming thick and fast. No woman should have to face this on her own. ‘We’ll stay with you, and Hope—the midwife—she’ll be back soon and we’ll all help you get through this. You’ll see.’
Isabel looked across the bed and he felt the punch to his heart as she gave him a weak smile; gratitude shone from her eyes. It gave him some hope for their next conversation. Although there was that nagging sensation again, the one that said she would run as fast as she could, far away from him, all over again. And even though he knew that, the familiar warmth curled through his gut. What was it about her that held him captivated?
He dragged his eyes away from that mass of blonde hair that he loved to run his hands through and turned to listen to Phoenix. Her voice was starting to sound panicked. ‘What if I can’t do it? What if I’m not strong enough? I’m scared.’
‘Don’t worry, really. You’ll manage. You’re young …’ He was going to say and fit and healthy … but she’d neglected herself a little too much. He had only to hope that the little one had got what it needed from her.
Her body began to tense and she screwed her face up. ‘Owwww. I feel like it’s pressing down, like I need to push it out. But I don’t want to. He’s too little. It’s too soon. What if it’s … what if he …?’
Isabel gave her a warm smile. ‘You’re fully dilated now, sweetheart. Your body will work whether you think it’s the right time or not, honey. Whatever happens we’ll deal with it. You can do this. You can do this.’
But there was a catch in her throat that made Sean lift his head and look at her. She blinked and turned away, shaking her head. Then she turned back, in full control again. ‘It’s okay, Phoenix. You have me and Sean. We can do this together. Okay? So I need you to breathe like this.’
Isabel began to pant and count.
When Phoenix screamed and bore down, squeezing against Isabel, Sean took over. ‘Okay, so breathe with me, Phoenix. Breathe with me. That’s a good girl. Lift your legs a little. Well done. I can see the head. Not long to go now.
The girl began to cry. ‘Owwww. I don’t want to push.’
‘You have to push when I say so. Okay? Okay? Okay, Phoenix … you need to push now.’ Cradling the head with one hand, he caught the body as it slithered out. He laid it on Phoenix’s chest, but she turned away as he cut the cord. Closed her eyes tight shut as tears trickled anyway down her cheeks.
‘A girl, you have a daughter, Phoenix.’ But the little one wasn’t happy to be out in the big wide world. He rubbed her chest with a towel. And again. Come on. Come on. Breathe for me. Breathe, damn it.
His gut twisted as he carried her to the Resuscitaire, worked on her until she took a short breath and squawked. A river of relief ran through him. He would not have been able to look at Isabel if this little one hadn’t made it. God knew what she was feeling. Dealing with a young desperate teenager and a preemie baby. Although not as preemie as Joshua …
Isabel seemed to have overridden any emotion and was handling the situation with warmth and professionalism; she’d delivered the placenta and was clearing up with a sunny smile. But he could see the stretch in her shoulders, the clench of her jaw. It was costing her a lot to be here, he knew. She’d done that ever since he’d been back in her life again: borne every emotional insult with fastidious grace. She might have called it coping. He called it denial. She refused to be broken. No, she refused to allow anything to reach her emotionally.
‘She’s beautiful, Phoenix. Do you want to hold her just for a few moments?’ He carried the little one over. ‘Just hold her against your chest, skin to skin. They love that.’
‘No. I don’t know what to do. I don’t know what to do.’ The girl was shaking. ‘She’s so small. Her skin’s too big. She looks … she looks so tiny.’
‘Look, she’ll love being against your skin.’
She turned away. ‘No. I don’t … I can’t. I’m too scared.’
‘It’s okay to be scared, sweetheart. But you have the strength to do this. She needs you. She needs her mum.’ Isabel cast a worried flicker of her eyes to Sean. This teenager was experiencing the most traumatic experience possibly of her young life—having a premature baby with no emotional support. She needed someone she knew and loved to be with her. ‘Hey, are you sure you don’t have a friend, your mum, someone who you can at least talk to on the phone? You need someone here for you, Phoenix. You and … your daughter. Have you chosen a name yet?’
‘No. I don’t know … I thought it was going to be a boy … I thought she was going to die. I thought—’
‘Look, she’s doing okay. Your daughter is perfect.’
Clearly Phoenix was struggling and needed time to get to grips with all this. And baby needed to be looked after properly—she needed a full assessment, warmth and care. Sean bent to speak to her. ‘Okay, so she’s managing to breathe fine on her own, she’s a trooper, but she’s quite little and may not be able to feed properly as yet. I’d like to get her along to the Special Care Baby Unit as soon as we can—get her checked out and warm and looked after. How about I run her along there now and you come with Isabel or Hope when you’re a bit more settled?’
Phoenix looked up at Isabel, saw the quick nod of her head. ‘Okay. Yes. Okay. Thank you.’
‘I’ll stay here with Phoenix.’ Isabel caught his gaze. She looked as shaken as he felt. He didn’t miss the irony—that Isabel had been almost in the same situation, with no one experienced to help her. She’d been through months of worry and anxiety. She hadn’t told a soul about her pregnancy. And yet here she was dealing with this.
Her face was fixed in a mask, her emotions hidden so deep that it made his chest ache. Was this how she’d been? Had she shaken like this? Cried? Or had she internalised it all? Damn, he didn’t want to think about any of that. Like her, he didn’t want to meet those emotions head-on.
But they were there, glittering brightly within him. He wanted to comfort her. He wanted to stroke her worries away. Goddamn, he wanted her, body and soul, more than anything he’d wanted in his whole life.
So, yeah, he loved her. Which was hardly a surprise given that he’d probably been in love with her for most of his life.
Which was a dumb move on his part, because he knew that loving Isabel Delamere was the single most destructive thing he could do. Because she wouldn’t allow herself to love him back.
But still, all he wanted to do was take her in his arms and hold her, soothe her pain away. To make her believe how much she meant to him. But he couldn’t. He had a professional responsibility to Phoenix and the little scrap of new life in his hands. He also had a responsibility to himself. ‘Excellent, I’ll see you up there in a little while.’ And that would give him a few precious minutes to get his act together too.