“I’m so sorry I got you out in this bad weather,” she said.
“Better safe than sorry,” Ellen said, setting her bag on the coffee table. “Let’s see what’s going on.”
She knelt beside the couch, her tone gentle but firm. “Tell me everything. When did the cramping start?”
“Last night, around two in the morning, I woke up to pee—I swear I have to pee every hour on the hour.”
Ellen laughed. “I remember those days.”
“It wasn’t sharp or anything, just a little tight, maybe? I went back to sleep and a couple hours later got up to pee and the cramp came back.”
“Where specifically is the cramp?”
“Mostly my lower back, but then this morning it kind of radiated around my lower belly.” She rubbed her hands under her belly to illustrate. “And then after breakfast, that’s when I had the spotting. But it hasn’t come back.”
“Spotting is normal, but not continued bleeding. You know the difference?”
“Yes. The book you gave me explained it well. It was spotting.”
“Okay.” Ellen nodded, slipping on a blood pressure cuff. “Any headaches? Blurred vision?”
Margery shook her head. “No. Just tired.”
“Good.” She took Margery’s hand and gave it a light squeezebefore inflating the cuff. While the pressure dial climbed, Ellen spoke low, almost conversational. “Baby moving well?”
Margery smiled, her eyes lighting up. “More squirmy than usual. I can’t wait to meet Bump.”
Margery was the first woman Ellen had worked with in years who hadn’t wanted to peek at the baby’s gender. Ellen liked that. She hadn’t looked with her first, but the others? Yeah, she had wanted to know. Sometimes she wished she had just been surprised, because there were so few good surprises in the world anymore.
Ellen released the valve and watched the numbers drop—140 over 90. Higher than Ellen wanted, but not in the danger zone. She made a note in her logbook.
“Let’s check your other vitals. Then I’ll want to do a quick exam.”
Margery nodded. Susie hovered near the kitchen, arms crossed over her chest, trying to look calm but clearly fighting the urge to ask a hundred questions. Ellen caught her eye and offered a calm, practiced smile.
“Can you bring Margery a glass of water? Or something with electrolytes if you’ve got it?” she asked.
“Yeah—yes, of course.” Susie turned to the fridge like she was grateful for something to do.
Ellen checked Margery’s pulse, respiration, then used her Doppler to find the baby’s heartbeat. The galloping rhythm filled the living room, strong and steady.
“There’s our little one,” Ellen said, and Margery let out a happy sigh, a smile on her lips.
She moved methodically, palpating Margery’s belly, feeling the firmness of the uterus, checking for any signs of early labor. No contractions she could measure yet, but the tightness could be Braxton Hicks.
When Susie returned with a glass of Gatorade over ice, Ellenguided Margery to sip slowly, then helped her sit up so she could take her weight and temperature properly.
Ellen made notes in her small, leather-bound book, flipping pages back to compare earlier measurements. This was the third visit in two weeks where Margery’s blood pressure had edged upward. Not dangerous yet, but not trending in the right direction.
Still, the blood tests had been normal, and the urine test done two weeks ago at her last appointment showed no sign of protein that would be a clear indicator of preeclampsia.
“Okay,” she said gently, sitting on the ottoman across from Margery. “Your blood pressure’s a bit high. It’s not alarming, but I want to keep an eye on it. Baby sounds great, and there’s no immediate sign of labor, but I’m going to hang out for the next hour or so, just to watch.”
Margery nodded, eyes wide but calm. “You think it’s preeclampsia?”
“It might just be stress,” Ellen said carefully. “Or the weather. Or nothing at all. But we won’t guess. We’ll watch. And I’m going to leave a message for Dr. Patel, just as a precaution, so he can decide if he wants any labs drawn or a hospital check later. I’m pretty sure if your blood pressure doesn’t increase, he won’t want you out on the roads today.”
Margery looked half-panicked. “I don’t want to leave. There’s a flood watch in effect, and we have to cross Rock Creek to get to the highway. It floods all the time.”
