Page 75 of Heartbreak for the Irish Midwife

They walked together, following their usual route through the hospital grounds, and Alex told her what he and Russell suspected: polyhydramnios. There was too much fluid around the baby, and it was concerning because it could cause serious complications.

‘What sort of complications?’

‘Depends on the cause, and what happens as the pregnancy progresses, but pre-PROM, haemorrhage, stillbirth . . . The woman we saw this morning has quite a severe case, so Russell is right to be concerned.’

‘I see.’ She fell silent.

‘Are you all right?’ His expression showed concern. ‘This is a tough one.’

‘Aye. How about you?’

‘I’ll be grand. We need to find a way through for that poor girl.’

‘Given the history, both the woman and her mother suggested . . .’ Maisie’s voice tailed away. She couldn’t say it out loud, especially in a semi-public place. No one was near, but still . . .

He made a face. ‘Poor girl. But we might not have to go there. One of the things we have to think about here is major foetal anomaly.’

‘Ah.’ Major foetal anomaly. A significant pre-birth defect in a baby’s development, often meaning the baby had no chance of surviving. ‘Hence the X-ray.’ And maybe no need for an abortion, if the baby was unlikely to live anyway.

‘Exactly.’

They shared a look, and it occurred to Maisie that in the middle of such a complex, emotional case, it was good to have Alex to lean on. He was using his brain and his heart and all his attention to support Maggie-Ann and her mother, and still he was looking after her too. He was quite simply the best man she had ever met.

* * *

Alex peered at the tiny image, trying to work out what he was seeing. The mother’s anatomy and that of the foetus was all there, in black, white, and grey, making it challenging to decipher. The X-ray technician had managed to take a number of photographs, and he and Russell were now reviewing them, Maisie having accompanied Maggie-Ann and her mother back to the maternity hospital to await results.

‘There!’ Russell pointed his pen, touching different parts of the foetus’s face, outlined in ghostly white. ‘Mandible, maxilla, supra-orbital ridge, and then—’

‘Nothing!’

‘Correct, Lowe. Anencephaly.’ The baby’s brain hadn’t developed at all, the head flat and misshapen.

Lord! Alex had known of anencephaly from textbooks and lectures, but to actually see it was upsetting. ‘Right.’ He was thinking it through. ‘Which means . . .’

‘The baby has no chance of survival. Yes.’ Russell stood. ‘Right. Let’s go and break the news.’

As they walked out of the main Royal Victoria Hospital towards the smaller maternity hospital, Alex’s mind was racing. While it was dreadful to see a baby so malformed, in this case it removed the necessity for young Maggie-Ann to have to consider termination. Nature itself would cruelly resolve the situation, and Maggie-Ann would have a better chance to heal and recover from her ordeal.

Feeling a hundred things at once, Alex listened carefully as Russell spoke in more detail about the risks faced by the young mother. The excess fluid around the baby was due to the anencephaly, and it was likely that the sac of fluid would give way before long, triggering early labour and potentially a dangerous bleed if the placenta came away abruptly during the process. Maggie-Ann was still at risk of physical harm, if things went badly.

‘That’s all she would need,’ Alex commented soberly. ‘I presume she’ll be admitted?’

‘She will. We might need to rush her to theatre if it happens, so she’ll be safer here, in the building.’ He sighed. ‘A bad business.’

The sailor. ‘It is indeed.’ They continued in silence for a while. ‘According to the radio, it’s looking likely the Nazis will take Paris today,’ Russell announced in a clear change of topic. ‘They’ll likely surrender within days.’

‘God help them,’ Alex replied. ‘The French, I mean.’

Russell nodded. ‘Indeed. Between war, and complex cases, and evil men attacking innocent girls, the world feels very dark right now.’ He straightened. ‘We do what we must though – it’s all we can do!’

‘Agreed. Our work here means something.’

Russell nodded. ‘It does. But you make sure you keep going to those Orpheus dances and enjoy yourself.’ He sent him a sly look. ‘Was that Midwife Canavan I saw you dancing with last month?’

Alex could feel heat on his face. ‘Er – yes. I’ll get there late tonight as I’m on until seven.’

‘Ah, that’s right. Make sure you go, though. Dances and enjoyment are most definitely needed these days, and especially on a day like this.’