Mel knew John and June were right. It was important to face this head-on and tell Jack as soon as possible. Let him have time to react. Respond. When she got back to Virgin River, she intended to go straight to the bar. But there, in front of Doc’s, was a car she recognized. Anne and Jeremy Givens. It was her time. When she got inside she found the Givenses with Doc, waiting in the kitchen with a cup of tea. “So this is it?” Mel asked.
“I think so,” Anne said. “I’ve been in labor all day, and now I’m having contractions less than five minutes apart and some spotting. That’s when you said to call, right?”
“That’s what we decided. Would you like to come upstairs, settle in and let me check you?”
“I’m scared,” Anne said. “I didn’t think I would be.”
“Darling, there is nothing in the world to be afraid of. You’re going to sail through this. Jeremy, why don’t you let me get Anne comfortable and then you can come upstairs.”
“But I want to be there for everything!” he said.
Mel laughed in amusement. “She’s just going to get undressed, Jeremy. I bet you’ve been there for that about a million times.” She took Anne’s suitcase and her arm.
“Come on, sweetheart. Let’s go have a baby.”
Once settled in, Anne proved to be only four centimeters dilated. Back at the hospital in L.A. they would call that the price of admission—anything less than four centimeters and you were sent home to labor a little longer. Mel observed a couple of contractions and they were coming strong and long. That business about sailing through was perhaps overly optimistic.
Jeremy was at his wife’s side as soon as he was invited and, unlike Darryl, he was completely prepared for the rigors of labor. This couple actually had had some birthing training. Mel told Jeremy to walk his wife up and down the upstairs hallway and left Anne in his able hands to go downstairs to use the phone to call Jack.
“Hi,” she said. “I have a delivery, so I’m not coming to the bar.”
“You think it’ll be long?” he asked.
“There’s no telling. She hasn’t progressed very far yet.”
“Can I bring you anything? Something to eat?”
“No, Jack, not for me. Doc can walk across the street if he wants to. But listen—my instinct tells me maybe he shouldn’t have a whiskey tonight.”
“Don’t worry about Doc—his instincts are pretty good, too. Mel? My door will be unlocked.”
“Thank you,” she said. “If we finish up before morning, I’ll sneak into your room. Would that be all right?”
He laughed his low, sexy laugh. “It’s always all right, Melinda. I might not be able to sleep for hoping.”
“I’ll hope, too—but for Anne’s sake, not yours or mine.”
Anne’s blood pressure was stable and her labor was difficult. Three hours later, in spite of walking, squatting and laboring, she was still only at four centimeters. At midnight she was at a possible five. Doc suggested a Pitocin drip and breaking her water, which Mel had just been considering. Her contractions were coming every two minutes. Near midnight Mel checked her and with great relief, found that she had progressed to eight centimeters. But then, just thirty minutes later, she was back at five. Mel had been down this road before—the cervix had swollen and appeared as though it was shrinking. That indicated they might not be able to have a vaginal birth. She examined Anne during a contraction when her cervix widened and literally tried to hold her cervix open to the great discomfort of the patient, but it just wasn’t working. Anne was wet with sweat and growing more exhausted by the minute. It was three-thirty in the morning when Mel made the call to John Stone. “God, I’m sorry to do this to you,” she said. “I have a delivery that might be going south. I’ve got a patient who’s been laboring for hours, stuck at five. Her cervix advanced to eight and swelled back to five. She’s not progressing. We could ride this out, but mother is wilting and I have no indication that…I think it’s very possible the baby’s not going to fit. I suspect I’m going to need a caesarian.”
“Did you pit her?”
“Yeah. Pitocin running and I broke her water.”
“Okay, stop the pit, turn her on her left side. How long has she been laboring, stuck at four or five?”
“Ten hours with me. She labored at home for about eight.”
“Have you tried stretching the cervix?”
“Unsuccessfully,” she said. “Our ultrasound at your clinic showed a competent pelvis and average-size baby.”
“Things change,” he said. “Any fetal distress?”
“Not yet. The doptone shows a strong, regular, even heart rate, but mother’s pressure is up a bit.”
“You could ride this out awhile, but if she’s exhausted, I vote for not waiting. I’ll meet you at Valley. Can you make the drive or do you need helicopter transport?”
“We’ve got some real good shocks on that Hummer,” she said. “Either way, she’s an hour or more from the hospital. I’ll wake Jack. Get his help.”
Mel checked Anne once more; she had finally made six centimeters, but she was weakening. Anne’s heart rate was increasing and the baby’s had dropped just slightly. Jeremy was growing nervous and pale despite the number of times Mel reassured him that this wasn’t unusual. It was starting to look like even if the baby was going to fit, Anne might not have the energy to push him out.
It was 4:00 a.m. when Mel called Jack. He didn’t sound as though he’d been asleep.
“Jack, I’m going to have to transport my patient to Valley Hospital for a caesarian. John’s going to meet us there. I could use some help.”
“Be right there,” he said.
“I’ll try to get her downstairs and then if you’ll—”
“No, Mel,” Jack said. “Leave her where she is. I’ll get her downstairs. I wouldn’t want both of you to fall.”
“Okay, sure. Thanks.”
Then she went back to her patient. Although Doc was standing by, this was Mel’s case and a decision like this was entirely hers. “Anne,” she said, gently brushing the hair away from her soaking brow. “We’re going to transport you to Valley Hospital for a C-section….”
“Nooo,” she cried. “I want to have the baby normally.”
“Nothing abnormal about a C-section,” she said. “It’s a good operation, and it keeps you and the baby out of distress. Fortunately, we have the time so you’re not at major risk. But with the distance to the hospital, we shouldn’t wait until you are. It’s going to be fine, Anne.”
“Oh, God,” she cried.
Then she was gripped by another hard contraction and fear gave way to pain. Her husband tried the breathing with her, but after all these hours of hard labor, it was futile. She had very little space between contractions and some residual pain that made it feel, to her, as if her contractions were continual, back to back. Mel had had tough deliveries before, but it was different in the hospital, when you could just wheel your patient down the hall to surgery and let the surgeons and anesthesiologist take over; in a hospital she would give the mother every chance to make it through, if she wanted to try. It was different for her here, when the hospital was so far away, staffed and equipped for only routine procedures and surgeries. She couldn’t help but feel very disappointed for Anne, who had so looked forward to a natural childbirth with her husband.
“Anne, it’s just one of those things. Sometimes a C-section is the best answer,” Mel said. “You’re not going to have this baby here, but we want you to have as many healthy births as you desire.”
“Of course you’re right,” she answered breathlessly.
Mel heard the front door open, Jack’s feet on the stairs and then his voice outside the door. “Mel?”
She pushed the door open.
“Let me take her down for you. I’ll drive you to the hospital in the Hummer.”
“Thanks. Come in. Just let her get through this next contraction.”
Jack stepped into the room and nodded at Jeremy. “How you doing, man?” he asked.
“I’m going to carry your wife downstairs for you—you look pretty exhausted. You and Mel can ride in back with her and I’ll drive.” As soon as Anne seemed to relax a bit, Jack bent over the bed and lifted her easily into his arms. “Hang on, kiddo,” he said. “I’ll get you down before the next one hits, how’s that?”
Mel grabbed her bag and said, “Jeremy, please get Anne’s suitcase.” She followed Jack downstairs, grabbed her coat and while Jack held Anne, she opened up the back of the Hummer and slid out the gurney. “Anne, I want you on your left side, please.”
Once she was situated, Mel and Jeremy climbed in on either side of her, kneeling, while Jack got behind the wheel and took off in the direction of Valley Hospital. Mel kept the fetoscope handy and blood pressure cuff on Anne’s upper arm. She checked her pressure and the fetal heartbeat every few minutes. They were nearly halfway when she reached forward and put a thankful hand on Jack’s shoulder. His hand automatically came up to cover hers. “You were still awake,” she said softly.
“In case you needed anything,” he answered.
She gently squeezed his shoulder, but what she really wanted to do was throw her arms around him. She so appreciated the way he instinctively supported her in her work.
When they got to the hospital they entered the emergency room and, once inside, Mel handed Jack her coat and said, “You should move the SUV. Jeremy and I will take her up to labor and delivery. John’s meeting us. I hate to ask you, but…”
“Of course I’ll wait. I’ll be right here. Don’t worry about me.”
“Am I going to be allowed in?” Jeremy asked while they were in the elevator.
“That’s going to be up to Dr. Stone,” she said. “If it were up to me, I wouldn’t have a problem with it.”
Mel pushed the gurney through the swinging doors and was very happy to see John standing at the sink, finishing his scrub. Hands held up, he turned toward her and gave a nod and a smile. “Number two is set up, Mel. The anesthesiologist is here.”
Beside him at the adjoining sink, pumping the faucet pedal with her foot, was a nurse in scrubs, her mask tied around her neck. She looked over at Mel and with a sarcastic twist of her lips, said, “Another botched home birth?”
Mel’s mouth dropped open and her eyes widened as if slapped. John whirled on the nurse, glaring at her. Then John turned back to Mel and said, “Can you scrub in with me, Mel?”
“I’m prepared to assist, Dr. Stone,” the nurse said from behind him.
“Thank you, Juliette, but I’m leaning toward someone more professional. You and I will talk later.” And to Mel, “You have less than fifteen minutes.”
“Certainly. Jeremy wants to be there,” she said.
“Of course. Juliette, find the father some scrubs. Mel, you’ll find some in the locker room. Shake a leg.”
Mel pushed the gurney to operating room number two and let the circulating nurse pull Anne into the room. She donned green scrubs in the locker room and joined Jeremy at the sink, saying, “If you scrub in, the doctor might be inclined to let you hold your son when he’s born. Just like this,” she said, demonstrating the scrubbing technique. “No guarantees on that, so no pouting. And you’ll have to stay at Anne’s head.”
“Have you done this before?” he asked her. “Assisted in a C-section?”
“Many times,” she said.