Page 4 of The Midwife By the Sea

When her contract in Haverfordwest had been coming to an end and she’d started to search for her next opportunity, she’d known she wanted to try and find a permanent position that would allow her to experience both the intensity of hospital midwifery and the sense of making a difference to the experience of the women she cared for, which was unique to community midwifery. Her breath had caught in her throat when she’d seen the job working between St Piran’s and the Port Agnes Midwifery Unit. She’d known there’d be a lot of competition and had told herself if she got the job that it would be a sign from the universe that maybe she should approach her biological father and let him know she existed. Except now that she was in Cornwall, living in the same area as him, and spending half her working week in the same hospital as not just Joe, but his wife and sister too, she still had no idea whether she should reveal the secret. Discovering that Joe and his wife were struggling to conceive a child of their own had muddied the waters even further. So, for now, all Hope could do was concentrate on her job and try to push the question of what to do about Joe to the back of her mind.

‘Have you got a minute for a quick chat?’ Anna, who headed up the midwifery unit, called out to Hope as she walked past the staffroom at the end of her shift and a frisson of nerves made her scalp prickle. She couldn’t think of anything she’d done wrong, but midwifery was a hugely responsible job and the idea that she might have done terrified her. She already loved her new job, but she was still on probation, which meant the pressure was on to make a good impression. If she had made a mistake, she’d just have to face the music.

‘Of course.’ Walking into the staffroom, she attempted to steady her breathing. Only Anna and Jess were there, so if she was going to get a telling off, at least it wouldn’t be witnessed by all of her colleagues. Although having both of her managers waiting for her might be a really bad sign. Jess worked mainly in the maternity department at the hospital and was Hope’s supervisor there, working shifts in the community about once or twice a week, whereas Anna worked exclusively at the unit. The two women led on overseeing continuity of care for maternity services in the Three Ports area, so it wasn’t unusual for them to meet at either the unit or the hospital, but that didn’t stop Hope worrying that this particular meeting might be about her.

‘Do you want a cuppa?’ Anna gave her a broad smile and Hope’s shoulders relaxed. Surely Anna wouldn’t be so friendly if she was in trouble?

‘Thanks, but I’m good.’

‘You certainly are.’ Jess, who was smiling too, exchanged a look with Anna before continuing. ‘When you sent Daniella Kennedy into St Piran’s this morning, the scan showed her placenta was failing and she had an emergency C-section.’

‘Oh my God.’ Hope sat down heavily on one of the chairs. ‘Is she okay? What about the baby?’

‘The baby is a bit on the small side, but thanks to you they’re both going to be fine, another few hours and it might have been a very different story.’ Anna’s tone was gentle despite the weight of what she was saying. ‘A lot of midwives might have dismissed the fact she hadn’t gained quite as much weight as expected, especially as it wasn’t massively below average. But if it had been left much longer, the placenta could have failed altogether before Daniella even knew there was a problem.’

‘She mentioned having a few twinges too and, even though we all know aches and pains can be perfectly normal in pregnancy, something just didn’t sit right with me, and I didn’t want to take any chances.’ Hope blew out a long breath. Thank God she’d gone with her gut, but it brought home just how high the stakes in her job could be and the thought of what might have happened made goosepimples break out all over her skin, despite the warmth of the room.

‘It was a great call, and we both think you’re going to be huge asset to the team, don’t we, Anna?’ Jess sounded like a proud mother and for the first time Hope allowed herself to smile. She’d only been in the job a couple of weeks, but it already felt like somewhere she could picture herself staying long-term.

‘We certainly do and we want to make sure that you’re as happy to be working across the hospital and the community as we are to have your skills in both areas. That’s why we wanted to talk to you about whether there are any particular areas of work you might want to get involved with?’

‘I love having the opportunity to work in both the community and the hospital.’ Hope returned Anna’s smile. ‘I enjoy all of it and I’ve run antenatal classes before too, as well as mentoring student midwives. So I’m happy to get involved in things like that, if you’d like me to?’

‘Absolutely.’ Anna nodded. ‘There is another initiative that’s a bit outside the scope of usual midwifery services, which some of us volunteer for, and we’re a bit shorthanded right now, but it might not be something you feel comfortable with.’

‘You’ve got me intrigued now.’ Hope couldn’t imagine what it could possibly be, but she definitely wanted to know.

‘Both Anna and I experienced fertility problems when we were trying for our own families.’ Jess’s tone was surprisingly matter-of-fact. ‘Anna went on to have successful fertility treatment, and I eventually fostered and then adopted, but we discovered through our own experiences how little support there was for women experiencing infertility in the Three Ports areas. So we set up our own group.’

‘It might sound unusual for midwives to run an infertility group.’ Anna continued where Jess had left off. ‘But we’ve had a wealth of experience dealing with all kinds of pregnancies and it felt like that, along with our personal experiences, made us ideally placed to support other women going through what we did. We still run the group once a fortnight, but I’ve been offered a place on a part-time master’s degree at Portsmouth University, and unfortunately the lectures are on the same night as the infertility support group. We did consider changing it, but it’s quite established and some of the members have arranged their own shift patterns around it. Usually, if one of us is on shift or on call on the night of the group, one of the other midwives on the team helps out. But we could do with someone who can stand in for me as a regular at the group until I finish the course.’

‘It sounds great, but I haven’t got any personal experience of infertility.’ For a moment Hope wondered if she should share the fact that she did have some personal insight into fostering and adoption, but she wasn’t ready to do that. If she was going to tell anyone at the hospital about her history, it should be Joe, but she still had no idea if she’d ever be ready to do that either.

‘That’s not a problem at all,’ Jess said. ‘The women in the group are generally very open, and I’ve found it really useful to gain so much insight into issues around infertility and how that affects women, if they do eventually become pregnant. It’s helped me understand how much anxiety this can result in, and how to support the women I’m looking after to make informed decisions. We just thought that getting involved might interest you on that basis, but there’s absolutely no pressure, especially as it’s an unpaid role.’

For a moment Hope didn’t say anything, and Anna must have taken it as reluctance. ‘Like Jess said, there’s no pressure at all. Just have a think about it for a few days and let us know if it’s something you might be interested in trying.’

‘I’d love to do it.’ The certainty in Hope’s voice took her by surprise, but she wasn’t just trying to please her new managers – she really did want to do this. She’d been so lucky to be fostered and then adopted by her wonderful parents and she knew better than anyone that families could be made in lots of different ways. If getting involved in the group allowed her to give one woman hope for a future she might not have been able to envisage, then she’d have lived up to the name Laura had given her and done a tiny bit to repay the love her parents had shown her. Suddenly it didn’t matter that other people at the hospital might hear her story before Joe did, because her history had the potential to help people. When it came to Joe, it still felt as though there was a distinct possibility that the knowledge could ruin his life. Until she was absolutely certain that wasn’t the case, she wouldn’t be going anywhere near him, let alone telling him he had a daughter he didn’t even know existed.

3

Esther was glad to be at work, with her mobile phone stashed safely in her locker, so that she wouldn’t be tempted to fall back down the rabbit hole of googling, the way she seemed to spend all her spare time doing lately. Unexplained infertility. That’s what she and Joe had been labelled with. They’d waited through a long and painful year of disappointment, before going to see their GP, who’d referred Esther and Joe for some initial tests.

The tests couldn’t identify any reason why they weren’t getting pregnant and the advice had been to just relax and keep trying. There’d been some guidance about possible lifestyle changes that might help too, around diet and reducing stress. Esther had given a hollow laugh at the thought of trying to do that in the kind of jobs she and Joe had. Trauma and mental health units weren’t exactly known for being restful, never mind the impossibility of relaxing when she was gripped by the fear that she might never become a mother. Rationally, she knew she shouldn’t allow the desire to become her everything; she had a wonderful relationship with a man she adored, a great career, a loving family and the very best friends. Yet, despite all of that, she still felt so empty it was as though someone had scooped her insides out and filled the void with an ache nothing could soothe. She didn’t want to feel that way. She wanted to have faith that she’d somehow be okay, even if there was never a baby, but she couldn’t make herself believe that, no matter how many times Joe told her that all that mattered was that they had each other. It was lovely to hear, but it scared her too; the possibility that Joe might be able to accept a life that didn’t include a family of their own, because Esther was nowhere near ready to do that. Hope was all she had right now and she wasn’t sure she’d ever be able to let it go.

It was why, when she’d run out of the toilets just over a fortnight ago, after yet another negative pregnancy test, she hadn’t gone to see her husband, despite telling Danni that she was. She’d got halfway to Joe’s office and changed her mind. She hadn’t wanted him to comfort her with talk of all the things they could do together instead, if they were faced with a childfree life, not when the ache inside her was still so all-consuming. Instead, she’d locked herself in another toilet on the opposite side of the hospital and started googling ways to overcome unexplained infertility for what felt like the millionth time. She wanted solutions, not platitudes, and more than anything, she wanted a baby. Sometimes it felt like coming to work was her only break from it. The emergency department was unfailingly busy, and her job involved helping people who were often facing the worst moments of their lives, sometimes even the final moments. It was the only thing capable of putting her own problems into perspective and giving her a bit of respite, but she felt terrible that it came at the expense of someone else’s pain.

‘We’ve got an RTA on the way in.’ Danni’s pronouncement made Esther’s head jolt up in response and she grimaced.

‘Do we have any more details?’ It was a relief to be able to meet Danni’s gaze as she asked the question, because she’d barely been able to look at her best friend since she’d run out of the toilets after that negative test. She ought to be able to tell Danni anything, but it was as if a barrier had started to grow between them with every month that passed and Esther still wasn’t pregnant. She’d envisaged the two of them raising their children together, sharing the highs and lows of motherhood, but Danni’s little boy, Caleb, was a toddler now. Her husband, Charlie, had made a joke the last time the four of them were together, about having to start thinking about schools, and whether they might need to move to make sure they were in the right catchment area for a good one. It had hit Esther again, in that moment, just how fast time was moving and how far apart Danni and Charlie’s lives were already getting from hers and Joe’s.

Esther loved Caleb more than words could describe, but she was even starting to find it hard to be around her nephew. Sometimes he’d pull a certain face that made him look so much like a little version of Joe that it hurt her heart. Was that the closest she was going to get to seeing what the children she ached to have might have looked like? The last thing she wanted to do was for any of those feelings to come between her and Danni, but it seemed to be happening anyway. Her best friend was never going to be able to understand how Esther felt if she didn’t ever get to have a baby, and the truth was she’d never understand how it felt to be a mother either, until it happened. She couldn’t keep leaning on Danni and expecting her to somehow fix the situation, because she couldn’t. No one could. The only thing Esther felt as though she could do was to back off from their friendship, even though it meant the world to her, and for the past couple of weeks that’s exactly what she’d been doing. Usually, they tried to align their shifts as much as possible, and spent time together outside of work whenever they could, but Esther had swapped shifts and pushed back on arranging to meet up. Yet despite how tense things had felt lately, there was no one she’d rather have by her side going into an emergency situation, as Danni outlined what she knew.

‘It’s an adult male with a GCS score of fifteen, but with an open fracture on the right tibia and a suspected broken pelvis, as well as possible internal bleeding.’

‘Do you want to me to check whether one of the orthopaedic surgeons can be here when the patient arrives?’ Esther didn’t like the sound of this. A broken pelvis and an open fracture were both extremely serious injuries, and the surgical teams would need to be involved, but the prospect of internal bleeding was always a major concern.

‘There’s no harm putting in a call to give them the heads-up, but the most important thing is to make sure he’s stable and we’ll be taking him straight into resus. After that he’s going to need a CT, so if you can do anything to clear the path for the scan, that would be brilliant.’