Page 12 of The Midwife By the Sea

‘No one here right now feels that way. I promise you that.’ Hope knew her words were never going to be enough to change how Elena felt, but she said them anyway.

‘It happened to my friend Kristina in the hospital. She trusted them and they let her baby die.’ Elena turned her tear-stained face towards Hope.

‘That’s not what happened.’ Tomáš reached for his wife, but she shrank away from his touch for a second time and he looked towards Hope, desperation etched on his face. ‘Kristina had an infection, I can’t remember the name, and that’s why the baby died.’

‘It’s not!’ There was a wild expression in Elena’s eyes now. ‘The doctors said they would give her the medicine the baby needed, so he wouldn’t get the infection too, but he still died, because it wasn’t medicine, it was poison. That’s what they’ll do to me, and they’ve put it in the water too, and my food, because I won’t take their medicine and make it easy for them. I’m not going to take anything until this baby is here!’

She was sobbing and shaking now, and Hope was worried that anything she said was just going to make the situation worse, but the fact that Elena had gone so long without any kind of fluid was terrifying. Whatever intervention they tried might already be too late for the baby.

‘Will you let me listen to the baby’s heartbeat? Just to put our minds at rest that everything is okay.’ Hope was amazed at how steady she’d managed to keep her tone, when so much hung on the response, and she could see that Elena was wavering. She had to seal the deal. ‘You can examine the doppler before I use it and make sure everything looks the way you think it should. I won’t hide anything from you, I promise.’

‘No, there could be radio waves you use to hurt my baby.’ Elena shook her head hard, taking a step backwards as she did, and Hope resisted the urge to take a step forward in response. Backing a terrified woman into a corner was hardly the way to go.

‘I can use my Pinard stethoscope; it doesn’t use any electrical or battery source. I take it out with me when I go on my rounds, because some women prefer it, and it’s very similar to any other kind of stethoscope. You can look at it before we use it and make sure you feel comfortable.’

‘I don’t know…’ Elena shook her head again, but she wasn’t saying a definite no this time and the signs of wavering were growing stronger. Hope wasn’t the only one who’d spotted it either.

‘Please, Elena.’ Tomáš grasped her hand and this time she didn’t pull away. ‘At least let the midwife show you the stethoscope before you decide.’

Elena paused for what felt like an eternity before she finally nodded, so slowly and with such a small movement that for a moment, Hope wondered if she’d imagined it altogether, until she realised everyone else in the room was looking at her and waiting.

‘I’ll go and get one.’ Hope left the room as quickly as she could, hurrying along the corridor outside. She didn’t realise that Esther was right behind her until she felt a hand on her back, making her jump.

‘Oh God!’ She clasped a hand to her chest and blew out a breath. ‘You scared the life out of me.’

‘Sorry, I just wanted to say how well you handled that.’

‘Thank you, but she hasn’t let me examine her yet.’ Hope shook her head. ‘And part of me is terrified that even if she does, I won’t be able to hear a heartbeat. I really hope I can, but we can’t force any treatment – not even IV fluids – not while she’s deemed to have mental capacity.’

‘Even with a psychological assessment the process isn’t quick, and we don’t have the time to waste, do we?’ Esther didn’t wait for an answer before she continued. ‘Do you know what might have happened to her friend’s baby?’

‘From what Tomáš said, it sounds to me like Elena’s friend had a Strep B infection. Usually, antibiotics are enough to prevent the infection being passed on to the baby during labour, but very occasionally it’s not enough. If I had to, I’d guess that’s what happened, but even if we knew for certain, I don’t think Elena would be willing to listen to any explanation we tried to offer. She’s convinced herself that the only way to keep the baby safe is not to ingest anything until she’s born.’

‘Will the obstetrician agree to deliver early?’

‘Even if they do, I doubt very much Elena will allow the kind of intervention that would require.’ Hope was trying to live up to the name she’d been given, but right now that felt almost impossible. When Elena was talking, she’d had the spark of an idea that might just help a tiny bit, and it meant getting the support of a Slovakian colleague. She wished things didn’t have to be this way and that Elena felt she could put her faith in any member of hospital staff, but they were at the stage where they needed to try whatever they could. ‘I’m going to grab the Pinard stethoscope, but I’m also going to see if there’s any chance they can send Adriana down to see Elena. She’s one of the consultant obstetricians and she told me that she moved here from Slovakia after she met her partner. It shouldn’t matter, but from the sound of the things that some people have said to Elena, it might just be enough to help her trust Adriana a bit more than she trusts us.’

‘It’s true, it shouldn’t matter.’ Esther’s mouth turned down at the corners. ‘But I think you’re right that it will. It makes me feel so sad, but it proves how insightful you are, and I’m so thankful you got down here as quickly as you did.’

‘You’re really kind to say so, but any of my colleagues would have done the same. I just hope we can find a way to help Elena.’

‘Me too. Thank God we’re in this together.’ Esther reached out and squeezed her hand, making Hope swallow hard. Joe’s wife was lovely and they were connected in a way that Esther couldn’t even begin to imagine, but Hope was almost certain the truth would break Esther’s heart. Even before she’d got to know her, Hope hadn’t been sure she could take that risk, but with every interaction they had, she became more and more certain she never would.

8

Hope put the call into the maternity department, requesting that Adriana was the one to see Elena if at all possible. When she’d returned to A&E with the Pinard stethoscope, Elena had examined it in forensic detail. Hope hadn’t even realised she’d crossed two of her fingers over one another until the other woman eventually nodded her head. There was still an air of reluctance and not the slightest trace of enthusiasm on Elena’s face, but it was an affirmative gesture, and Hope was seizing the moment.

‘Okay, that’s great, let’s check on baby then.’ Her voice sounded falsely bright, even to her own ears; she just hoped it was doing more to convince Elena than it was to convince herself. Even after Elena was on the bed and Hope had gently lifted her top, she couldn’t seem to stop her hand from shaking. These kinds of situations never got any easier, where there was a risk to the baby’s wellbeing. Sadly, she’d been with women when they discovered the baby they were carrying had died and she’d also been at the delivery of a baby who was stillborn, after the placenta had failed. She had no idea if she’d be able to hear this baby’s heartbeat, and all she could do was continue to silently pray that this time things would be okay.

Placing the stethoscope on Elena’s stomach, she couldn’t hear any trace of a foetal heartbeat and a wave of nausea welled up inside her. She wasn’t giving up, though, and she needed her patient to know that.

‘It’s okay, Elena. We often don’t find the baby’s heartbeat straight away.’ Attempting to keep the wobble out of her voice made Hope’s throat constrict so much that she could barely get the words out at all. Holding her breath as she moved the stethoscope to a different position, she was scared she might miss the sound she was longing to hear if she allowed herself to exhale. And that’s when she heard it, like a horse galloping somewhere far away, distant and out of sight, but unmistakeably there all the same.

‘I can hear it, Elena, I can hear the baby’s heartbeat.’ She beamed up at the woman, expecting to see her smile reflected on Elena’s face, but tears were streaming down her cheeks instead.

‘Are you sure? I thought… I thought I was too late, that I had already let them hurt her.’

‘I’m sure.’ Hope reached for her hand. ‘Do you want to listen?’