Author's Note: Once again, blame Taylor Swift. The first time I heard that song, my brain created the crux of this story. I've been waiting almost two years to reach this point in Bartlet History. And since then, I've added more and more and more to the idea until I started writing and had to break it into multiple chapters. I didn't want to inundate everyone with a monster of a fic; this is much more easily consumed. Please review, and there will be more soon.
Are We Out of the Woods
It was very lucky that Jed and Abbey were both such intelligent and mindful individuals. It was also quite stressful in times like this, when they were both keenly aware of everything that could possibly go wrong. It was always useful, however, that they each knew when the other was being too cautious; the other would always buoy and encourage the trepidatious spouse.
And so for months, the Bartlets took turns being terrified and thrilled at the arrival of their third child. After a miscarriage nearly two years earlier, they were both afraid of losing another baby. But neither could resist the excitement of becoming parents again. Whenever Jed treated Abbey a little too fragilely—"Just in case!"—Abbey would tell him to calm down and put his hand on her growing belly to feel the life inside. And when Abbey fell into the paralyzing fear, Jed was there to remind her of the joys of a baby in the house and that everything would be alright.
Everyone around them noticed this strange behavior; they hadn't done this before with Ellie or Liz. But no one questioned anything. The Bartlets were getting a little older, they both had careers and two children already, that must be the cause of the over-attentiveness at Abbey's pregnancy.
For five months, everything went just fine. Until it wasn't.
Abbey felt a sharp pain in her abdomen that reached all the way to her lower back. It wasn't like the constant stabbing ache from last time. No, this was different. "Jed, something's wrong."
A cold chill gripped his insides at her tone. "What's the matter?" he asked, trying to remain calm for both their sakes.
"I don't know. But it hurts."
"Could it just be a cramp or something? False labor?" He clung to any rational answer, hoping that her doctor's knowledge would overtake her maternal panic. Surely this wasn't serious. It couldn't be. Not again.
Abbey just shook her head. "No, Jed, something is really wrong." She reached her hand out to him and squeezed him in a death grip. Her eyes filled with tears as panic threatened to consume her. "We made it to twenty weeks and now something is wrong. I can't lose this baby, Jed," she said, her voice quiet but wavering with emotion.
Jed pulled her into his arms and held her tight. "I know. I know. Shh. We're going to go to the hospital right now."
"Should we call Dr. Hardy?"
"The emergency room can call him. You get your purse, I'll go talk to the girls."
Abbey sniffed back tears and walked quickly but carefully to collect her things as Jed ran upstairs.
"Elizabeth, Eleanor, come here please!" he called to his children.
Ellie came running out of her room. She'd been reading quietly on that Saturday afternoon, having finished her homework earlier that morning. Liz took a little longer to respond. She had been drawing instead of doing her algebra assignment.
"Lizzie, I need you to do me a very big favor."
"Okay…" the eldest Bartlet girl replied skeptically.
"Mom and I have to go to the hospital. She doesn't feel good and we're worried about the baby. We don't have time to wait, so could you please call Mrs. Landingham to come stay with you? Tell her it's an emergency, and I'm sure she'll be over as soon as possible," Jed instructed.
Liz nodded, responding to the stress and gravity evident in her father's expression.
"Ell, you be good and listen to Liz."
Ellie gave Jed a big hug. He kissed the top of her head and let her go, then doing the same thing for Liz.
"Tell Mom we love her," Liz said as Jed went back down the stairs. He just nodded back at her.
In the car, Abbey couldn't stay still. She kept shifting in the passenger seat, hoping that a different position or a little stretch or something would alleviate the discomfort. For the life of her, she couldn't imagine what this could be. As Jed drove, breaking every speed limit, she tried to perform some preliminary examinations on herself. No rigidity in the abdomen. The pain was almost certainly coming from her uterus. She briefly hoped it was her liver or maybe her appendix, but now having almost a full year of internal medicine residency under her belt, she knew better. The source of the pain was much too low to be the appendix, and liver problems would present differently than this. This was a pregnancy complication, she was sure of it. But the exact kind of complication and the severity of it was unknown to her. And the lack of information was something she wasn't used to.
As they pulled up to the hospital, Jed told her, "You know how this works better than I do. I can shout at people to come help you but I don't know who to shout at. So you just point out whoever is in charge so I can shout at them."
Abbey gave a small involuntary smile. "No shouting. I know who to talk to. You just hold my hand, okay?"
"Always."
They made their way into the emergency room and Abbey led them directly to the admitting nurse. "Excuse me, my name is Abigail Bartlet. I'm twenty weeks pregnant and experiencing severe pain. I am a doctor and I know it's not Braxton-Hicks contractions and it's not gas and it's not my appendix. I need an ultrasound and a fetal heart monitor as soon as possible. My regular obstetrician is Dr. Hardy. Someone needs to call him as soon as I'm admitted."
Jed stood by, holding her hand, watching her in amazement. Despite the fear he knew she was feeling, she was calm and collected and completely in control. He was never that cool under pressure. He had such trouble functioning with any sort of clarity when his emotions got in the way. Abbey never had that problem. Probably why she was such a great doctor and he stuck to economics and local elections.
The admitting nurse absorbed everything Abbey told her and immediately spurred those nearby into action. "I need a gurney and an ultrasound machine for Dr. Bartlet." She then picked up the phone and paged Dr. Hardy.
Within ten minutes, Abbey was admitted to the ER and a nurse was prepping her for the ultrasound. Jed just kept holding her hand.
Abbey found all the activity around her to be strangely soothing, and lying on the gurney in the exam room was actually easing the pain. Knowing that people were working on finding out what was wrong made her feel less helpless. She would have answers soon. And if she knew what was happening, she could prepare for what would come next. Even if the worst was to come, she would know. And they'd cross that bridge when they got to it.
"Mr. and Mrs. Bartlet, it's nice to see you again." Dr. Hardy entered the exam room. "I hear you're having some pain, Mrs. Bartlet. Can you describe it, please?"
Abbey told him what she was feeling, where it was, and what she'd already ruled out and why. "And that's as far as I know. Obstetrics has never been my forte, though on my fourth pregnancy, you'd think I'd know better," she joked, a desperate attempt for levity.
"Well you were right to come in and ask for an ultrasound. Let's take a look and see what your baby is up too, okay?"
The first ultrasound of this pregnancy had been a traumatic flashback to the ultrasound that had told her that her baby had died. But after a few very successful checkups, the process had become much easier for her. She was very used to this now. And she'd gotten rather proficient at reading the images as well.
Dr. Hardy moved the imaging wand around Abbey's abdomen, looking for the fetus. "Ah, there we go."
A gurgling thump sounded from the machine. The baby's heartbeat. Abbey let her head roll back as she sighed in relief.
"Mrs. Bartlet, your baby is moving and the heart is beating. But it is a little slower than what we'd like to see at this stage. I'm sure it's connected to the pain you've been feeling. I'm going to conduct a full examination now. Mr. Bartlet, if you'd like to wait outside."
"Oh…I…" Jed stammered.
"No, he stays," Abbey insisted, tightening her grip on her husband's hand.
Dr. Hardy nodded. "Very well." He then went about the examination. The cause of Abbey's problems became abundantly clear. "Mrs. Bartlet, you have an incompetent cervix."
Abbey blinked at him. "Excuse me?"
"I don't think I like that characterization of my wife," Jed quipped, unable to resist commenting on the strange phrasing. "I'm sure her cervix is perfectly competent."
"Jed, shut up," she scolded. "What risks does that present?"
"Essentially, your cervix has dilated too soon. It leads to premature labor, which often leads to miscarriage. The pain you felt was your cervix dilating and contractions beginning. But because the rest of your body knows it isn't time for labor yet, the contractions were more concentrated. It's very good you came in, Mrs. Bartlet. If you'd let this go on too long, it might have been too late," Dr. Hardy explained.
"So what do you do now, give her a pill? A shot? Tell her to cross her legs?" Jed asked, choosing to ignore the thought of how close they might have come to losing this baby.
"Bed rest. Limiting your activity will go a long way to preventing any further dilation. You're too far along in your pregnancy for surgery. I can prescribe weekly progesterone injections, but that could be tricky on bed rest."
Abbey was quiet for a moment, weighing her options. A thought popped into her head. "Doctor, what caused this? Do I have other risk factors for this condition?"
"Most often, an incompetent cervix is caused by some kind of trauma to the cervix. My best guess is that the procedure we did to terminate your last pregnancy contributed to it."
"Oh so you did this," she blurted. Dr. Hardy's eyes grew wide with fear. She gave him a kind smile. "I'm not going to sue for malpractice. I know how things go in surgery. Sometimes these things happen." She gently tugged on Jed's hand. "Honey, why don't you call the house and make sure Mrs. Landingham got there and the girls are okay. I'm going to talk to Dr. Hardy for a minute."
Jed kissed her cheek and left. He knew she and the doctor were going to speak some technical jargon that Abbey would explain later. All he knew was that she had relaxed considerably, so things must be fine.
"Mrs. Bartlet, your instincts and medical knowledge saved your baby's life today. I'm sure you know that," Dr. Hardy said.
"I do know. And I'm glad for it. Now, tell me if this would work: can we get the progesterone delivered to me so I can give myself the injections? That way I can stay on bed rest and receive that treatment. Unless you want to make house calls," she suggested. Abbey relaxed a little more, now that she knew what was going on and the pain had mostly dissipated. Evidently, bed rest would be the best thing for her.
Dr. Hardy regarded her curiously. "You don't like me much, do you?"
Abbey was taken aback. "What on earth gave you that impression?"
"I've had other patients who were also doctors, but none of them ever spoke down to me the way you do."
"Well, you don't take me seriously, so I'm just responding in kind," she fired back.
"You are brilliant and I will admit that I underestimated you at first. But I do respect you, Mrs. Bartlet. I'm just not used to collaborating with my patients on their treatments."
"For the record, Dr. Hardy, if I didn't like you and I didn't think you were a good doctor, I'd find someone else. But you took care of me with my last pregnancy with honesty and kindness. And despite your tone when you speak to me sometimes, you have always made me feel safe and well taken care of. You can take that however you want."
"I'll come to your home every Sunday evening to check on you and administer the progesterone. That's my day off, so you'll only be charged for the medication," he offered. "But you are going to have to be on strict bed rest. When you get home and into bed, you won't be getting up for anything more than going to the bathroom for the next four months."
Abbey interrupted him. "Can you wait till my husband gets back? If he doesn't hear you say all this, he won't believe that it's real."
With nearly perfect timing, Jed walked back into the room a minute later. "Mrs. Landingham is there, worried sick about you. Apparently Liz told her that we had to go to the hospital because something was wrong with the baby, which upset everyone much more than necessary," he informed Abbey.
"Jed, listen to Dr. Hardy. I have rules for bed rest."
"For the next four months, Mrs. Bartlet, you are only allowed to get up to go to the bathroom. No showering or bathing. That's too much time out of bed. Sponge baths only. No heavy jostling, so that means making sure your kids are extremely gentle when they climb all over the bed. I don't think you'll need any special dietary restrictions. But we'll readjust the rules as the weeks go by. As we discussed, I'll be over every Sunday to give you progesterone shots and give you an examination. Depending on how the hormones work, we might be able to ease up on the restrictions," Dr. Hardy directed. "And unless you have any questions, I can discharge you and let you get home. I'll be over tomorrow for the first injection."
"I do have a question," Abbey interjected. "What about sex?"
Jed choked on the air.
"No sexual activity at all."
"No sex of any kind?" Abbey asked with disappointment.
"No sex of any kind," Dr. Hardy confirmed.
Abbey briefly wondered how she was going to survive four months without sex, but she held on to the possibility of more relaxed restrictions following the progesterone.
Dr. Hardy wanted Abbey to stay and be monitored for a few hours; it was still early enough in the day that she would be able to go home and sleep in her own bed later that night, as long as no other complications presented themselves. And sure enough, after about three hours of lying in a hospital bed, Jed was allowed to drive his wife back home. She was no longer in pain, and she had all the instructions on how to take care of herself and their unborn baby. They weren't out of the woods yet, but she knew what to do to keep them safe.