Page 14 of The Midwife By the Sea

‘Oh brilliant, you’re still here, we didn’t think you would be.’ Esther beamed at her and there was nothing in her tone to suggest she thought Hope was odd for hanging around so long. Joe’s face was open and friendly too, but Hope’s cheeks coloured all the same and she felt the need to explain her presence away.

‘I was just about to leave, but Gwen is far too good at plying me with coffee and cake, so I ended up staying longer than I planned.’

‘She’s very good at that, isn’t she? But I’m glad you’re still here. If not, I was going to see if Jess could give me your number, so I could make sure you got the update.’ Esther paused for a moment, and Hope tried to read her expression. She looked far too smiley for someone about to impart bad news and what she said next confirmed Hope’s tentative optimism. ‘Adriana persuaded Elena to have a scan and everything looks fine with the baby, thank God. She’s on an IV now to replace some of the fluids she’s lost and she’s being moved up to the maternity department.’

‘Oh, that’s great news! Did Adriana say whether they’re going to induce her?’

‘Probably, but they want to make sure the baby’s lungs are mature enough first, so Adriana said she might need to be given some kind of steroid, I think it was?’

‘That will be antenatal corticosteroids.’ Hope nodded. If the baby was ready to be delivered that would be the best option, given how fragile Elena’s mental health appeared to be, especially as there was no way of knowing when she might withdraw her consent to any type of treatment, or even start refusing fluids again.

Esther seemed to read her mind. ‘I didn’t think we’d persuade her to let us get anywhere near her when she first came in, let alone agree to all the things she consented to once Adriana arrived.’

‘She’s a brilliant doctor.’

‘Funnily enough, she said you were a brilliant midwife too,’ Joe interjected and Hope flushed a far deeper shade of red this time. These were the first words her biological father had spoken directly to her, and she couldn’t have asked for him to say anything better if she’d written the script herself. He was smiling at her so warmly and there was something about the way his mouth lifted, ever so slightly more on one side than it did on the other, which she recognised in herself. She was almost sure it would be imperceptible to anyone else, no one had ever mentioned to Hope that they’d noticed it in her, but she’d peered at her reflection in the mirror and looked at photographs with a critical eye often enough to have seen it in herself. She could see it in Joe too, and there wasn’t even a grain of doubt in her mind that Laura had been telling the truth when she said he was her father.

‘She couldn’t sing your praises highly enough,’ Esther added, smiling just as broadly as her husband. ‘I was telling her what a great call you’d made asking the maternity team to send her down and she said they all think you’ve been wonderful since you arrived.’

Hope attempted a casual shrug, part of her wanting to allow herself to just enjoy the praise from these people who had no knowledge of how much they meant to her, but the rest of her feeling unable to accept it. ‘All I did was suggest Adriana came down, she’s the one who got through to Elena.’

‘That’s not true at all. Somehow you managed to get Elena to trust you enough to listen to the baby’s heartbeat and, when you let her hear it too, that’s when she really started to open up. It’s what made her willing to accept Adriana’s help when she arrived.’

‘Maybe…’

‘There’s no “maybe” about it.’ Joe’s tone was resolute; the smile still firmly fixed on his face. ‘And if you ever fancy a change of direction, we can always use people with your kind of skills in the mental health team.’

‘Hey, we agreed!’ Esther gave Joe a playful dig in the ribs. ‘Emergency medicine gets first dibs, if Hope ever fancies a change.’

‘That’s very flattering.’ She couldn’t help smiling, despite the disquiet she still felt about having so much praise heaped upon her, never mind the huge secret she was keeping from Esther and Joe. It was impossible not to smile at the idea that she was wanted by these people who would never know the tie that bound them together. ‘But as exciting as emergency medicine must be, I’ve wanted to be a midwife for as long as I can remember and everything I’ve experienced in the job so far has convinced me of that even further. Although I have been talking to Anna, who heads up the midwifery unit in Port Agnes, about doing the perinatal mental health module at Plymouth University, once I’m a bit more established in my role. Today felt like all the more reason to consider it.’

‘You definitely should.’ Joe’s smile broadened even further, his mouth levelling up completely, so that the tiny trait they shared was no longer visible, even to her. ‘It would have been almost impossible to challenge Elena’s capacity to make her own decisions in time to ensure the baby was kept safe, and obviously it’s never ideal to have to go down that route. The approach and actions you took avoided us even having to try. You’ve got the kind of insight that can’t be taught, but becoming a specialist will allow you to help a lot more women and there’s a huge need for it in both perinatal and antenatal care. We’ve been able to put some plans in place to monitor and support Elena once the baby is here, because of how things were managed today. That’s a huge win in anyone’s book.’

‘I still don’t think I did anything special.’ Hope was doing her best to minimise the role she’d played, but there was a warm glow in her stomach that not even her own protestations could extinguish.

‘And that says it all really. The fact you see it as all in a day’s work shows just how lucky St Piran’s is to have you, in whatever capacity you choose to work here, especially as Adriana told us you’d already finished your shift before you volunteered to come down and see Elena.’ Joe was so kind and Hope had an almost overwhelming urge to stand up and hug him, just once, to know what it would feel like to be held in her biological father’s arms. She and Laura had embraced when they’d met and that had been enough for her. It hadn’t felt the same as being hugged by her mother. Alison had been the one who’d hugged Hope thousands of times across the course of her life, to comfort her in times of hurt, to celebrate moments of joy, or just to exchange affection. Hope was sure that if she hugged Joe it wouldn’t compare to hugging her father, Dave, either, but the difference was, she was never going to be able to find out. She was never going to get the kind of closure that meeting Laura had given her, knowing that each of their lives was a little bit richer for having had that experience, but also feeling satisfied it would be enough if they decided not to build on that. That was why she wanted to hug Joe, but unless she was willing to explain who she was, that would definitely be crossing a line.

‘Can we get you another drink as a thank you, or something to eat?’ Esther asked. ‘We’re grabbing a quick break before Joe’s clinic.’

‘Thank you, but I’ve already had a huge piece of cake courtesy of Gwen, and I’d really better get off home soon. Now that I know Elena is okay.’

‘Are you sure?’ Joe looked at her, the very slightly crooked smile back on his face and the recognition jolted her spine, almost like a physical pain.

‘Absolutely, but thank you so much.’

‘I’d better go and have a chat with Gwen then, before she abandons her post and comes over here. I can see her craning her neck.’ Joe laughed. ‘Her nephew, Louie, started work in my department last month and she grills me for an update on his progress every time I see her. Luckily, he’s doing brilliantly.’

‘HR are obviously doing a good job of recruiting the right people lately.’ Esther shot another smile in Hope’s direction. ‘Hopefully we’ll see you around the hospital and we certainly know who to consult if we need any advice about pregnant patients. And of course, I’ll see you at the infertility support group.’

For the first time Esther’s smile wobbled ever so slightly, which served to remind Hope exactly why she needed to push her own wobbles down, where she wouldn’t have to acknowledge them. She couldn’t waver on her decision not to tell Joe and Esther who she was, but she needed a hug from her parents more than she could ever remember needing one. So she knew exactly what she was going to do with the stretch of four days without a shift that she had coming up. She was going home.

9

Esther had undergone more scans than she ever expected to as a woman who was yet to conceive, all in an attempt to uncover why she hadn’t. She knew she was lucky that money wasn’t an issue for her and Joe when it came to fertility treatment, and they didn’t have to wait to reach the top of the NHS waiting list to start IVF. It was heartbreaking to read some of the messages in the forums she’d joined online, with some women having to wait almost three years before their treatment started and some being refused treatment altogether, because their partner already had a child from a previous relationship, or their age or weight was just beyond the limit for the NHS trust where they were living. The financial freedom she and Joe enjoyed undoubtedly took the pressure off in some ways, but it didn’t relieve the crushing weight of dread that nothing they tried might work.

They’d had some initial tests that had shown no concerns and yet there was still no baby. They’d been talking for a while about starting IVF, but it had been the meeting with the infertility support group that had convinced Esther she didn’t want to wait any longer and just ‘keep trying’ until they reached the two-year mark, as one doctor they’d seen had suggested. His reasoning had been that there were no medical issues identified preventing Esther from becoming pregnant, so a natural conception should still be ‘quite likely’.

The phrase had been nowhere near certain enough to persuade Esther. So today, she and Joe were at a private fertility clinic in Plymouth for an advanced ultrasound, which would provide 3D scans of her womb to check for structural anomalies, assess the blood flow to her ovaries and uterus, check the potential quality of her eggs and ovarian reserve, and the overall health of her reproductive system. After that they’d decide whether to try fertility drugs initially or go straight to IVF. Joe’s blood tests and semen analysis were also being repeated, at the clinic’s insistence, now that they were proceeding with private treatment, and he would also be undergoing an ultrasound to check for testicular blockages and abnormalities. It made it feel a bit more like they were both in this together, rather than everything hanging on her, which is how it had so often felt.