A/N: I'm back hi! This fic seems to be taking on a life of its own in my head! I've got lots of ideas for coming chapters but happy to hear more in your reviews :) This chapter kind of ran away with itself even though i guess its a bit of a filler chapter really. Hopefully it's still enjoyable, I'm quite liking writing a bit more of the medical drama type stuff but it might not be to everyone's taste. I'm no medical expert so please don't scrutinise the detail too carefully :D
"You delivered many babies Reet?" Iain turned his attention away from the letterbox to address his colleague again "I mean, I'm not an expert but I don't think this one wants to wait much longer…" His voice tailed off as Rita looked up from the device on her wrist.
"Yep I timed those last contractions at just over two minutes apart" Rita grimaced "I'm no Sister Evangelina but I've brought one or two into the world in my time"
"Sister Avengers-what?" Iain asked, his nose wrinkled in confusion before he was distracted by another cry from inside the house "Shit we can't even get the entonox to her as it stands..." he straightened up and raked his hands through his hair again.
"Right, I'm going to see if I can get in round the back. I'll be as fast as I can, anything you can do to keep her calm in the meantime…sorry that's like teaching granny to suck eggs right?" Iain corrected himself quickly knowing that a nurse of Rita's calibre was going to prove a much better partner in this situation than the over enthusiastic rookie paramedic he was usually stuck with.
"Err… Less of the granny thanks!" Rita pursed her lips in mock-annoyance as Iain laughed.
"Katie" Iain leant down to the letterbox once more "I'm going to leave you with Rita while I go find a way in. She's the best nurse in Holby so you're going to be just fine" the paramedic flashed his colleague a smile before sprinting off down the side of the house.
"Right" Rita mumbled to herself while she rummaged in Iain's kit bag "For starters Katie, who said we can't get entonox to you. Where there's a woman with a will there a way..."
By the time Iain jogged back around the front of the house, Rita had taped two tubes together giving the length she needed to pass a mouth piece to much-needed analgesic through to the stricken patient. Iain stopped in his tracks at the sight.
"Not just a pretty face eh Freeman?" he observed, Rita shaking her head at the half compliment.
"You don't know how good it is to see you've rigged that up because I'm going to need you round the back with me. There's a window open but there's no way I'll fit through it..."
Once they'd given Katie an update, the pair raced around the back together. The window in question was certainly too small for Iain to get his broad shoulders through though Rita saw to her dismay that it was halfway up the house.
"And how am I supposed to get up there?" Rita gasped looking round her desperately.
"I've already checked for a ladder..." Iain responded "everything's locked. Wrap your thighs around my head."
"Excuse me? Aargh!...Iain!" Rita squealed as, unaware that Iain had crouched down behind her, she suddenly found a head of tousled dark hair appear between her legs.
"Hold tight!" he ordered as he straightened up, firmly holding onto the top of her legs as he lifted her up in the air. She grabbed at his hair to steady herself and Iain yelped in pain.
"Well a bit of warning would have been nice" she muttered apologetically as she took the hands that he was now offering up to her. Rita suddenly found herself noticing the warmth of him between her thighs, the unexpected softness of the hands that now gripped hers and the fact that her skin was still tingling from where he'd gripped her legs.
"Sorry what?" She cursed herself silently at the distraction as she became aware that Iain was waiting for her.
"I said what is that thing on your wrist anyway? One of those heart rate activity tracker thingies? How is your pulse with me between your legs anyway? Ouch!" he was rewarded for his cheeky question with a sharp tweak of his ear.
"Right, come on you can do it. You trust me right? Three points of contact... Just take it slowly... I've got you" Iain voice regained its serious tone as he fixed his focus back on the job in hand.
Rita transferred more weight to Iain's hands as she gingerly got her feet up onto his shoulders.
"Ok now use that drainpipe to pull yourself up. Test it first!" he instructed, spreading his legs slightly to give them more stability and transferring his hands one by one to her ankles as she found a new grip on the house "y'ok?"
"M'fine… I think I can get up from here" Rita's feet found various footholds and she scrambled up to the sill and hauled herself in through the window. Iain stood back as he watched her disappearing.
"Careful getting down Reet" he shouted, then held his breath as he waited for confirmation that she'd landed safely inside. Within seconds the back door swung open and Rita's relieved face greeted him.
Minutes later the pair were crouched next to the frightened woman, now reunited with her pain relief, Iain having collected all his kit from the front before joining Rita with their patient.
They'd established that Katie had fallen down around seven stairs, landing awkwardly in order to protect her bump, her leg and side of face taking the brunt of the impact. Needing to assess the leg injury and progression of labour Rita was carefully cutting away the clothes on Katie's lower half while Iain treated the cut to her face. They paused and exchanged nervous glances while the woman coped with another contraction.
"Okay I'm just going to examine you Katie, then Iain can have a look at that leg…let's find out what we're dealing with here…" Rita shuffled herself into a better position on the floor between the woman's splayed legs only to aware that the damp puddle around them were her broken waters. She eventually pushed herself back onto her heels and shook her fringe away from her face.
"So the good news is that I can see baby's head!" Rita announced.
"That's the good news?!" Iain queried tentatively.
"Well yes…" Rita stated, smiling up at their patient "it means all the hard - and painful - work Katie's been doing has been taking us in the right direction. The tricky part with this injured leg is going to be making her comfortable while we get baby out. We have to do it here, a stretcher in the back of your ambulance is going to be even more awkward and this is one little person in a bit of a rush to see the world if you ask me"
"Right you are…" exhaled Iain. He'd finished the temporary dressing on Katie's face so moved round to her other side, a reassuring hand on Rita's shoulder as he clambered over to squat alongside her. They were all aware of the misshapen appearance of Katie's lower leg, a bony lump protruding from her shin. "Pretty safe to say there's a fracture there, we won't know the extent until it's been xrayed but if I just stabilise it in a splint and rest it as far out to the side as is comfortable for you, we can give you ladies as much room to work as possible okay?" he looked up at Rita for confirmation and proceeded to prep the splint when she smiled gratefully and nodded.
Rita moved to Katie's side and took hold of her free hand.
"You just squeeze that if it gets too much, as hard as you like alright? And keep going on the gas and air as much as you need. If you feel another contraction coming just say and Iain can stop, there's only so much we want you dealing with at once, okay?"
Katie managed a weak smile and nodded then suddenly the expression in her face changed.
"Do you know what? I'm fine actually, I don't think we'll do this now. I've got a midwife appointment in the morning, you've been very kind but I think i'll just wait for that" she breathed. Rita bit back a half smile and raised her eyebrows at Iain whose face had a look of pure confusion.
"Transition" the nurse mouthed at him before turning back to the woman, stroking her hand reassuringly, Iain finishing up with the splint.
"Katie, even if baby wasn't on its way, we're not going anywhere with your leg like that" Rita spoke softly "But believe me, your little one is coming now. Denial is a pretty common thing at this stage…"
As if on cue, the noise she made during her next contraction took them all by surprise: much louder, lower and longer than previously.
"Okay Katie it sounds like you're wanting to push, just go with it sweetheart" Rita instructed gently as Iain pushed himself up to his knees and deliberately out of the line of sight of the action.
"What can I do?" he asked Rita awkwardly as the latest contraction eased off.
"Towels and pillows?" Rita replied and Iain sprang into action. "Let's get her comfy and something clean to deliver onto. And is there anyone we can call for you Katie?"
"There's just my husband but he's with one of his suppliers all afternoon at some farm. There's no reception I already tried. I bloody told him I didn't think it was a good idea today but his restaurant opens next week. We were hoping to be up and running in time for the baby arriving…"
As Iain returned from upstairs, his arms full of linen, he could hear Rita congratulating Katie that her baby's head was out. One, two, three contractions later and Rita's euphoria was being replaced by increasing concern. She flashed a warning look at Iain as she shifted on her knees to try and find a more comfortable position. They could both see the colour was starting to drain from the baby's face and, equally worryingly, the spots of bright red blood that were starting to stain the white towel laid beneath Katie.
"I don't understand why we can't get the shoulders out…" Iain was close enough to pick up on Rita's panicked low whisper even if their patient couldn't "... Oh for gods sake!" She exclaimed much more loudly as she blew her fringe away from her vision for what felt like the hundredth time.
"Here, let me help..." Iain said calmly, removing a glove. Crouching next to her he scooped up the offending locks, twisting them between his fingers before gently tucking the hair behind her ear.
Rita looked up at him, a slightly bemused expression on her face "umm… thanks" she mumbled before turning her full focus back to the serious problem they were facing. "Katie I need you to try really hard not to push through the next contraction. Lots of really quick short breaths instead okay, like this…" Rita demonstrated the panting action that was required. "I need to try and see what's holding baby up"
The examination Rita managed to conduct during the next contraction confirmed her fears. She inhaled a shaky breath and looked up at Iain trying to stay calm.
"Talk to me Rita" Iain's voice was low.
Rita blew her breath out in a hurry "Nuchal chord" she grimaced.
"Nuchal chord? Umbilical chord round baby's neck?" Iain questioned slowly as he struggled to recall the term. Rita nodded and rubbed her forehead before gently explaining to Katie what was causing the delay.
"We covered it in my refresher course last year… From what I remember it's pretty common… It...it usually resolves itself but getting the mother to stand was the best advice I think and well… " Rita glanced across at Katie's splint in frustration.
"Okay…" Iain began slowly "well we know we've no chance of getting a midwife here in a hurry… Common sense would say we might be able to manipulate things ourselves? Maybe? Well... someone with small hands might be able to…?" he flashed Rita an apologetic smile aware that he was indirectly putting her forward for the task, "but how about I get control on the radio, see if anyone can talk us through it?" Rita visibly relaxed at the thought of them having some sort of plan and she wiped her brow with her sleeve as she nodded.
"Okay I'm on it" the paramedic announced lifting his radio "but while I get hold of them, you ladies look like you need a drink. You're both looking a bit hot"
"Two of your finest chat up lines eh Mr Dean?" Rita attempted a smile up at him, the pair of them trying to keep the mood as light as possible for their patient's sake as much as anything. As Iain hurried his way to the kitchen both medics tried to banish their own thoughts of how serious the situation was fast becoming. It was 2016 yes, but this labour had the potential to go very wrong indeed. With no chance of back up or specialist help for at least an hour, they knew that the lives of both the mother and baby were now very firmly in their own hands.